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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

HLA-typing was performed in 149 patients with essential hypertension, 86 males and 63 females. In 66 patients with significantly elevated serum levels of immunoglobulins, HLA-B27 was increased to 18%, from 8% in the controls (P less than 0.007). This was not significant when correcting the P-value for the number of antigens analyzed, but confirms reports of an association of this antigen with serum levels of immunoglobulins. HLA-Bw15 was found to be increased two-fold in patients with a family history of hypertension (P corrected less than 0.05) and in patients with autoantibodies (not significant). This is discussed in relation to the increase of Bw15 in juvenile diabetes and in Systemic Lupus Erythematosus, diseases in which vascular damage also occurs.
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PMID:HLA antigens in essential hypertension. Relation to familiar disposition and serum immunoglobulins. 7 Aug 61

Dehydroepiandrosterone sulphate (DHAS) was administered intravenously to 70 women in the third trimester of pregnancy. By measuring the increase in the concentrations of estrogens in maternal plasma, it was hoped to assess the reserve capacity of the placenta. In normal pregnancies, unconjugated estradiol invariably showed a marked increase within 60 minutes of the injection of DHAS, reaching 174 to 478% above basal levels. Changes in unconjugated estrone were more variable, but significant increases usually occurred 2 to 3 hours after the peak concentration of estradiol. The concentrations of unconjugated estriol showed no significant change. Patients with preeclampsia, essential hypertension, retarded intrauterine growth, diabetes, and twin pregnancies did not show any major differences in response compared to the normal pregnancies. Two patients with intrauterine deaths had low basal concentrations of estrogens but responded to the DHAS injection by having significantly increased concentrations of unconjugated estradiol after 60 minutes. The only patient who did not show any increase in unconjugated estradiol levels after DHAS was thought to have a placental sulphatase deficiency. This test does not appear to have any advantage over existing methods of assessing the endocrine function of the placenta except in confirmation of placental sulphatase deficiency.
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PMID:Plasma estrogen response to dehydroepiandrosterone sulphate injection in normal and complicated late pregnancy. 12 14

1. The presence of autoantibodies and the histocompatibility leucocyte antigen (HLA) antigen B15 was studied in relation to vascular complications (WHO III) in 148 patients with essential hypertension. 2. Nine of 36 patients with WHO stage III hypertension had autoantibodies, compared with seven out of 78 normotensive controls. 3. The frequency of B15 was 36.1% in hypertensive patients with stage III hypertension and 14.8% in controls. Nine of 18 patients with cerebral complications had B15 and four out of 18 with cardiac complications had B15. 4. The relative risk of vascular complications was 3.4 times higher in B15-positive patients with essential hypertension compared with B15-negative patients. 5. This study suggests that B15-positive patients with essential hypertension represent a subgroup with a higher risk of vascular complications. Long-term studies are needed to determine whether B15 might serve as predictor for vascular complications. 6. The study adds further support to suggestions of a genetic and possibly HLA-linked connection between essential hypertension, diabetes and autoimmunity.
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PMID:Autoantibodies in untreated and treated essential hypertension: relationship to histocompatability leucocyte antigen-B15 and vascular complications. 54 Apr 44

Weight reduction is almost always successful in cases of essential hypertension if and when the weight loss is accompanied by a drastic sodium reduction. (2) Weight normalization is of remarkable help in complete reversal of abnormal glucose tolerance, decrease in insulin requirement in manifest diabetes mellitus, and - in many patients with mild diabetes - discontinuation of oral hypoglycemic agents. (3) Weight loss will occasionally relieve gout patients of their symptoms. The majority of hyperuricemic patients will benefit with a lowering of serum uric acid levels. (4) An unresolved issue is the influence of weight reduction on the cholesterol metabolism - short- and long-term results are by no means predictable. Whereas the triglycerides in obese patients almost always return to lower serum concentrations, and with them the hyperlipoproteinemias of type IIB, III and IV, the type IIA is only rarely seen in association with obesity. Therefore, information on this lipid abnormality is very limited regarding the effect of weight loss.
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PMID:The workinghman's diet. II. Effect of weight reduction in obese patients with hypertension, diabetes, hyperuricemia and hyperlipidemia. 63 8

Twenty-eight patients with total occlusion of the infrarenal aorta have been seen at the UCLA Hospitals in the past 11 years. Claudication was the presenting complaint in all but one patient, with one-third having ischemic rest pain. The average age of these patients was 54 years, and their histories revealed a surprising absence of myocardial infarction, stroke, or diabetes, although 40% had essential hypertension. Heavy tobacco use, however, was characteristic of the entire group. Arteriography proved valuable in identifying and characterizing the vascular abnormalities, but posed problems in technique and interpretation. Significant distal arterial disease was detected radiographically in only 21% of these patients. Operative correction of the aortic occlusion was performed on 26 patients, 18 by aortic bypass grafts and eight by aorto-iliac endarterectomy, with one early postoperative death. Although the thrombus extended to the renal artery origins in 77% of the cases, a well-designed technical approach did not require renal artery occlusion. Using serial creatinine determinations, one case of renal insufficiency was detected which was associated with prolonged postoperative hypotension. Although the extent of distal disease was more severe in those who underwent bypass, symptoms of claudication returned earlier and were more prominent in the endarterectomy group. This recurrence of systems was not favorably altered by sympathectomy performed concomitantly with the initial procedure. Even though this condition seems to pose difficult technical obstacles and has a poor prognosis, infrarenal aortic occlusion can be successfully treated by aortic bypass, with favorable long-term results, if particular attention is paid to elements of the preoperative evaluation and the intraoperative technical requirements peculiar to this relatively uncommon disease entity.
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PMID:Infrarenal aortic occlusion. 64 79

In a random house-to-house study of 1 000 Indians the prevalence of essential hypertension according to the World Health Organization (WHO) criteria was 19% (females 22%; males 15%). The study revealed that the prevalence of hypertension was higher than in published data from India. Ethnicity in our study caused a significant variation in prevalence. Prevalence was lower than in our urban Zulu study. Blood pressure rose with age, but there was a greater rise in systolic than in diastolic blood pressure. Prevalence in males and females under 40 years were equal. There was an association between hypertension and diabetes mellitus. More effective screening and therapeutic programmes should be initiated in the Indian population because of the high prevalence of hypertension which may lead to complications if untreated, and because 58% of the hypertensive subjects were untreated or had discontinued therapy.
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PMID:The prevalence of hypertension in the Indian population of Durban. 69 88

This paper presents an analysis of publications, mostly by Soviet authores, on clinical studies and morphological examinations of the microcirculatory bed in different pathology. It is concluded that the microcirculatory bed should be regarded as an integral system responding to the pathological effects by a local and general reaction of its structural components and by changing the rheological properties of blood. Two types of changes develop in the microcirculatory system -- sterotyped ones, typical for extreme states (various kinds of shock, hypertensive crisis, stress situations), and those specific for certain diseases (diabetes melitus, essential hypertension, athersclerosis, collagenoses, etc.). In all the above diseases the pathological process affects the functional structures of microcirculation that undergo a rearrangement in accordance with the requirements of the body. In the initial period of the disease this re-arrangement is of a compensatory nature and passes ahead of the clinical manifestations. A comparison of the pictutrs obtained by biomicroscopy of the bulbconjunctiva of the eye and of other mucosae with film preparations of the serosae demonstrates their complete similarity. Therefore, the method of biomicroscopy of the eyeball and of the mucosae as a method reflecting the state of microcirculation in the body as a whole should become an integral part of the clinical examination of patients.
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PMID:[Comparative pathology of the microcirculatory bed]. 79 35

This article presents a theory concerning the pathogenetic background for three diseases of civilization: essential hypertension, stable diabetes and atherosclerosis. Man and many other animals have mobilizing mechanisms for preparation for physical activity, expressed inter alia by an increase in blood pressure, hyperglycaemia and hyperlipidaemia. During physical activity, blood pressure falls almost to the resting level and hyperglycaemia and hyperlipidaemia are reduced parallel with the metabolism of glucose and fats in working muscles. In wealthy countries, this preparation for physical activity, which is dominated by the sympathetic-adrenergic system, comes into action just as frequently as in less wealthy countries -- or possibly even more frequently -- but this is rarely followed by muscular activity. How long is this sympathetic dominance maintained? How high are the blood pressure, hyperglycaemia and hyperlipidaemia? How slowly do these return to normal levels? It appears probable that this may be of fundamental pathogenetic significance in the three abovementioned diseases, the causes of which we have difficulty in finding or agreeing upon. Various prophylactic possibilities are mentioned briefly.
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PMID:[An hypothesis concerning the pathogenetic background of 3 diseases of civilization]. 90 6

Plasma renin activity (PRA) was determined in 48 patients with diabetes mellitus in sodium balance on a 10-20 mEq. Na diet. Nine were normotensive (group I), 11 11 were hypertensive without diabetic nephropathy (group III). Results were compared with those in 16 normal subjects and 49 nondiabetic patients with essential hypertension in similar Na balance. Mean supine PRA did not differ significantly among groups I and II, normal subjects, and patients with essential hypertension. Group III diabetics had a supine PRA of 2.4 +/- 0.4 ng./ml./hr. (x +/- S.E.M.), significantly lower than the other diabetic groups (P less than 0.005) and normal subjects (P less than 0.05). Upright PRA was 12.8 +/- 2.2 in group I diabetics, similar to that in normal subjects (13.3 +/- 2.3), and 8.1 +/- 1.4 in group II diabetics, similar to that in essential hypertensives (6.8 +/- 0.8). In group III diabetics, upright PRA was 4.0 +/- 0.5, significantly lower than that in any other group. These results suggest that (1) PRA is normal in normotensive diabetics, (2) upright PRA in diabetics with hypertension but no nephropathy is similar to that in essential hypertension, and (3) patients with diabetes, hypertension, and nephropathy have "low renin hypertension," explaining the virtual absence of malignant hypertension in this group. Although the major mechanism for this low PRA may be volume expansion, indicating the need for potent diuretics, other mechanisms include hyalinization of the afferent arteriole, decreased cathecholamine stimulation of renin release, and inadequate conversion of prorenin to renin.
Diabetes 1976 Oct
PMID:Plasma renin activity and hypertension in diabetes mellitus. 97 6

Of 270 women who survived eclampsia in the period 1931 through 1951, all but three were traced in 1974. In white women having eclampsia as primiparas, neither the remote mortality nor the prevalence of hypertension is increased over that in unselected women matched for age. Both are increased significantly in white women having eclampsia as multiparas and in the 24 black women in the study. The excess of remote deaths among the multiparous eclamptic women is accounted for by the lethal consequences of hypertensive disease. Repeated hypertensive pregnancies after eclampsia are often a sign of latent essential hypertension and may precipitate prematurely a chronic hypertension that is in the making. The prevalence of diabetes of late onset is increased over the expected rate in both primiparous and multiparous eclamptic women. It is concluded that eclampsia is neither a sign of latent hypertensive nor of renal disease, and it does not cause chronic hypertension, whatever the duration of the acute hypertensive phase.
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PMID:Remote prognosis after eclampsia. 100 44


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