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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient with Shy-Drager syndrome who presented with severe angina pectoris is described. Special investigations of his autonomic nervous system showed sympathetic and parasympathetic dysfunction with supersensitive end-organ response. Sympathetic dysfunction manifested as labile hypertension, severe postural hypotension, and inadequate heart rate response to atropine and the Valsalva manoeuvre. These changes in blood pressure were accompanied by severe disabling angina pectoris. Selective coronary angiography showed normal coronary arteries. It is suggested that angina pectoris resulted from the inadequate circulatory response and is another clinical manifestation of the Shy-Drager syndrome.
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PMID:Angina pectoris with normal coronary arteries in Shy-Drager syndrome. 51 66

Carotid baroreceptors were stimulated with graded neck suction in supine and standing volunteers, before and after autonomic blockade, to determine the influence of posture on baroreflex responsiveness. Propranolol significantly augmented baroreflex pulse interval prolongation in the supine position. Upright posture did not modify baroreflex pulse interval responses prior to propranolol, but significantly augmented responses after propranolol. The results suggest that standing enhances baroreflex sensitivity, but that under normal circumstances, this effect is masked by beta-adrenergic stimulation. Augmentation of baroreflex pulse interval prolongation in the supine and standing positions by propranolol may contribute to the effectiveness of this drug in angina pectoris and labile hypertension.
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PMID:Modulation of carotid baroreflex responsiveness in man: effects of posture and propranolol. 96 7

The authors showed, in a spin-off study of SYST-EUR, that 24% of subjects with isolated systolic hypertension on conventional measurement were not hypertensive during ambulatory blood pressure monitoring. Moreover, in white coat hypertension, treatment had no effect either on the electrical signs of left ventricular hypertrophy or on the incidence of clinical events (cerebrovascular accident and global cardiovascular complications), contrary to what is observed in permanent systolic hypertension. These results raise question as to the diagnosis and treatment of isolated systolic hypertension in the elderly and prompt to a larger usage (if not systematic) of ambulatory blood pressure monitoring in this context. The importance of systolic blood pressure and pulsed pressure For different reasons, diastolic blood pressure was thought to be of greater prognostic significance, as the very large majority of clinical trials recruited on the basis of the value of their diastolic blood pressure alone demonstrate. In recent years, the importance of systolic blood pressure has been underlined in many studies and 3 trials have shown the unquestionable benefits of treatment of isolated hypertension. It would also appear that the pulse pressure, which reflects arterial compliance, has considerable prognostic value. In the absence of established manometric criteria and mostly of therapeutic trials, the practical use of the pulse pressure remains questionable. The interruption of the doxazosin arm of the ALLHAT trial The ALLHAT (Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial) study showed a doubling of the morbidity from cardiac failure, a 19% excess of cerebrovascular events and 16% of angina pectoris in subjects treated with doxazosin compared with those treated with chlorthalidone. The differences in blood pressure with treatment were minimal and, a priori, unable to explain these results. Beyond the fact that alphablockers cannot be considered as first-line antihypertensive therapy, without doubt, the affirmation that lowering the blood pressure provides the same benefit irrespective of the antihypertensive agent used, probably needs to be reviewed.
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PMID:[The best in 2000 on arterial hypertension]. 1126 Aug 42

Currently, the main circulatory function-testing tools for home use are blood pressure monitors and elec- trocardiography devices. Just like blood pressure monitors that are already widespread for home use, some devices with an electrocardiographic function have recently become available for purchase for personal use by the general public. On the other hand, clinic equipment on loan from doctors to patients in need can perform circulatory function tests like 24-hour ambulatory blood pressure monitoring (ABPM), Holter monitoring, and real-time electrocardiography. We introduce the actual clinical usage of ABPM and real-time electro- cardiography, and discuss the usefulness of these procedures. ABPM uses a blood pressure measurement device worn on the body for 24 hours a day to measure blood pressure at regular intervals. This makes it possible to check blood pressure changes throughout the day in a way in which conventional home-use blood pressure monitors cannot, like during sleep. This method al- lows the identification of masked hypertension like early-morning and nocturnal hypertension, stress hyper- tension including workplace hypertension, and white coat hypertension that only occurs in the doctor's office. Under routine care, there are few opportunities to perform electrocardiography at the time a patient is experiencing symptoms. Now, real-time electrocardiography has begun to be used in routine care, and pa- tients can record an electrocardiogram by themselves anytime, anywhere, and send the data by telephone or the Internet for analysis and diagnosis. Transmission-capable electrocardiography devices can play an im- portant role in the event of dangerous symptoms like arrhythmia, angina, or acute myocardial infarction. The spread of ABPM and event heart monitors is likely to make the early treatment and prevention of stroke and heart disease possible. We are expecting rapid development in this field in the future.
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PMID:[Circulatory Function Tests for Home & Community Use.] 2918 13