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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Atherosclerosis is an important cause of cardiovascular morbidity and mortality. A good arterial compliance has been suggested to protect large vessels from atherosclerosis. Arterial compliance is diminished in patients with essential hypertension. The influence of verapamil (calcium-antagonist) and nebivolol (beta-adrenoceptor antagonist) on the vessel-wall properties of the common carotid artery were investigated. The two drugs improved compliance of the common carotid artery. Results from other studies on arterial compliance and antihypertensive drugs are also discussed.
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PMID:Antihypertensive treatment and vessel wall properties of large arteries. 203 97

Even if glucose tolerance is normal, a glucose-stimulated or postprandial hyperinsulinemia can frequently be observed in patients with early stages and mild forms of essential hypertension. Numerous epidemiological, clinical and experimental data suggest that hyperinsulinemia might be an independent risk factor for atherosclerosis which should be paid more attention. It could be hypothesized that, apart from the haemodynamic phenomenon of high blood pressure, the postprandial hyperinsulinemia of patients with mild essential hypertension might be relevant to their cardiovascular risk.
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PMID:Glucose-induced or postprandial hyperinsulinemia in mild essential hypertension--an underestimated biochemical risk indicator? 204 91

Resistance to the action of insulin on glucose metabolism, with the ensuing compensatory hyperinsulinaemia, is closely linked to essential hypertension. The decreased insulin sensitivity observed in hypertensive patients is independent of obesity. Hyperinsulinaemia is likely to promote the dyslipidaemia that frequently accompanies the hypertensive state, and often presents as increased total and very low density lipoprotein (VLDL)-triglycerides, low high density lipoprotein (HDL)-cholesterol and, in some studies, elevated levels of low density lipoprotein (LDL)-cholesterol. Lipid abnormalities, hypertension and possibly hyperinsulinaemia act together to increase the risk of atherosclerotic disease manifestations in hypertensive patients. Acutely, insulin has been shown to stimulate sympathetic nervous system activity and transmembrane electrolyte transport, to promote sodium retention and to cause vascular wall changes, including increased cholesterol biosynthesis and smooth muscle proliferation. If these mechanisms operate on a chronic basis, the continuous exposure to elevated plasma insulin levels may play a pathogenetic role in the development of high blood pressure, and also of a predisposition toward atherosclerosis in patients with hypertension. Further studies are necessary to establish these hypothetical cause-effect relationship which, if shown to be true, will contribute to a more wide-ranging view of essential hypertension and the optimum strategy for antihypertensive treatment.
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PMID:Insulin resistance in hypertension--a relationship with consequences? 204 24

The frequent concurrence of other cardiovascular risk factors in hypertensive patients, such as obesity and diabetes mellitus, suggests that overlapping genetic and environmental factors may contribute to the common metabolic and cardiovascular derangements observed in these populations. Hypertension and hyperglycemia accelerate atherosclerosis in diabetics, and play an important role in associated morbidity and mortality. Several abnormalities in blood pressure regulatory systems such as the renin-angiotensin system, the sympathetic nervous system, and sodium/volume control have been described in diabetes mellitus. Sodium retention and cardiovascular hyperreactivity appear to occur early in the course of diabetes mellitus, even at normal blood pressure levels and before onset of renal failure, and could set the stage for the development of hypertension. The relationship between obesity and hypertension is also well-established, and may reflect metabolic and cardiovascular adaptations in obese subjects which predispose to blood pressure elevations. Obese subjects display changes in sympathetic nervous system activity, sodium metabolism, and vascular hemodynamics. Sodium-sensitive blood pressure responses in the obese may be secondary to increased cardiac output or fluid volume, and are directly related to circulating insulin levels. Certain metabolic and vascular characteristics of obesity and diabetes mellitus are found in patients with essential hypertension. It has been suggested that insulin and insulin resistance may be the common link between these risk factors. Improved understanding of metabolic considerations in the treatment of obese and diabetic hypertensives should lead to more careful selection of medications that avoid metabolic complications. Although diuretics and beta-blockers may be useful in some patients, there are several reasons not to recommend their use as initial therapy in obese and diabetic hypertensives. On the other hand, calcium channel blockers and angiotensin converting enzyme inhibitors are highly effective, with minimal effects on metabolic parameters, and are well-suited as first-line therapy in the treatment of obese and diabetic hypertensives.
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PMID:Metabolic considerations in hypertension. 207 23

The increased potential for growth of vascular smooth muscle cells in one of the key abnormalities in the development of essential hypertension, diabetic microangiopathy and atherosclerosis. The underlying mechanisms seem to be extrinsic (increased platelet-derived growth factor-like activity) and intrinsic (increased rate of growth, greater maximal response to growth factors and less contact inhibition). In this article, the authors discuss the primary role of an alteration in vascular smooth muscle cellular proliferation in hypertension, the extrinsic growth factors contained in platelet extracts of diabetic and hypertensive subjects and the specific effects of insulin and antihypertensive therapy on this pro-mitotic platelet activity. The result of experimental studies in our laboratory and in other studies suggest that genetic factors and therapeutic intervention could control the growth of vascular smooth muscle cells and that further evaluation of anti-hypertensive therapy may be necessary.
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PMID:[Intrinsic and extrinsic factors implicated in cell proliferation of vascular smooth muscle in hypertension and diabetes]. 208 Aug 91

To examine the efficacy and usefulness of captopril-enhanced renal vein renin (RVR) measurements in detecting the functional significance of renal artery stenosis found in hypertensives, we compared these values in 22 patients with arteriographically documented renovascular hypertension due to unilateral (URVH: 14 patients) or bilateral renal artery stenosis (BRVH: 8 patients) and 12 patients with high renin essential hypertension (EHT). Before captopril administration, RVR ratio was less than 1.5 in 8 patients (36.4%) with renovascular hypertension and all patients (100%) with EHT. Captopril enhanced the lateralization of renal vein renin in renovascular hypertension; the postcaptopril RVR ratio was greater than 2.0 in 18 patients (81.8%) and greater than 1.5 in all the patients (100%). On the other hand, RVR ratio remained unchanged in most patients with EHT. There was no significant difference in the postcaptopril RVR ratios between URVH and BRVH. However, the postcaptopril RVR ratio was higher in atherosclerosis (10 patients) than in fibromuscular dysplasia (11 patients) (P less than .05). Captopril also elucidated contralateral renin suppression as expressed by a contralateral/peripheral renin ratio of less than 1.0, which was associated with a favorable outcome of unilateral surgical intervention. Captopril-stimulated RVR indices were valuable in detecting the functionally significant renal artery stenosis and predicting surgical curability in renovascular hypertension.
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PMID:Captopril-stimulated renal vein renin in hypertensive patients with or without renal artery stenosis. 208 Oct 13

The elusiveness of the agent responsible for primary hypertension and the diversity of its impact upon the body, as reflected by the widely differing and almost independent avenues of research in this field, indicate that the answer could lie with a particularly common substance in the body acting at various levels of fundamental physiological function. This hypothesis pursues some basic physics of phospholipid whereby a change in quantity or quality can affect the capability to generate extreme surface activity manifest as the numerous properties which this agent can impart to blood and to adjacent surfaces by adsorption. Nine possible roles are traced by which surface-active phospholipid could impinge upon neurogenic control of blood pressure, the effects of circulating relaxing factors, blood rheology, atherosclerosis, and the major renal aspects of control by diuresis and association with the antihypertensive neutral renomedullary lipid. This multi-faceted approach offers mechanisms by which diet can affect blood pressure in addition to the traditional emphasis upon the deposition of atheroma.
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PMID:Multiple roles for surface-active phospholipid in hypertension. 209 Sep 31

Complement component 3 (C3) phenotype and allele frequencies were defined in 312 patients with type-1 diabetes (insulin-dependent diabetes mellitus), 256 patients with type-2 diabetes (non-insulin-dependent diabetes mellitus), 114 apparently non-diabetic first-degree relatives of type-1 diabetics, in 10 families (29 members) with a familial history of type-1 or type-2 diabetes, in 181 patients with coronary heart disease and 255 subjects with arterial hypertension. 512 blood donors served as controls. All persons investigated were Europeans. There is no evidence that genes linked to C3 influence susceptibility to type-1 and type-2 diabetes and to their late complications as well as to atherosclerosis and essential hypertension. The distribution of apolipoprotein E phenotypes in patients and controls was likewise not significantly different. The combined evaluation of data from linked genes (C3 and apo E) could not improve the results. Deductions of C3 as a genetic disease marker have to be interpreted with caution.
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PMID:Complement component 3 (C3) genetics and diabetes mellitus. 209 95

A survey shall be given on the physiological, pathophysiological and pharmacotherapeutic backgrounds of the biogenic amine 5-hydroxytryptamine (serotonin; 5HT), to be preceded by a few historical remarks. 5HT is biosynthesized from L-tryptophan via hydroxylation and subsequent decarboxylation. 5HT is predominantly found in enterochromaffin cells, platelets and in various structures of the central nervous system. Its concentration in circulating blood is low and probably subthreshold. Whereas the physiological role of 5HT is rather unclear, 5HT appears to play a relevant role in certain psychiatric disorders, in migraine and the carcinoid syndrome. Its role in essential hypertension remains uncertain. However, 5HT appears to contribute to and to exacerbate the damage to blood vessels which were already predamaged by atherosclerosis, diabetes mellitus or possibly old age as such. A major breakthrough in the pharmacology of the serotonergic system was achieved by the discovery of several subtypes of 5HT receptors, with a corresponding collection of selective agonists and antagonists towards these receptor subtypes. This development is the basis of various drugs which interact with the serotonergic system and its receptors, like the various 5HT2 receptor antagonists (of which ketanserin is the prototype), methysergide, pizotifen, urapidil, flesinoxan and a variety of psychoactive drugs. The most important of these drugs and their potential application will be discussed with an emphasis on cardiovascular disorders.
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PMID:Pathophysiological and pharmacotherapeutic aspects of serotonin and serotonergic drugs. 213 70

Since the pathogenesis of essential hypertension has not yet been clarified, laboratory examinations are needed to identify secondary hypertension and to classify the patients with essential hypertension into subclasses. We reviewed the recent topics on hypertension-research related to laboratory examinations such as 1) recording of arterial pressure, 2) plasma renin activity and digitalis-like substances as the cause of essential hypertension, and 3) atrial natriuretic polypeptides and endothelin, as possible indices of atherosclerosis, one of major complications of hypertension.
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PMID:[Pathophysiology and laboratory examinations of essential hypertension--a review of recent topics]. 214 38


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