Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011881 (diabetic nephropathy)
 10,836 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This review describes current management of acute hypertension in the University of Cincinnati Hospitals and emphasizes prevention of recurrent vascular incidents. Careful management of hypertension involves: 1) accurate measurement of recumbent and standing blood pressure to document definite abnormality, severity of disease, and need for antihypertensive medication; 2) concise history and physical examination to identify the possible role of medication in blood pressure elevation; 3) compilation of a laboratory database for evaluating target organ function; and 4) discussion with the patient concerning the physician's findings, treatment plan, and risks of untreated hypertension. In the patient with antecedent hypertension cerebral crisis usually results from ruptured berry aneurysm, massive intracerebral hemorrhage, lacunar hemorrhage in critical areas, large artery occlusion, or hypertensive encephalopathy. Principal elements in managing accelerated or malignant hypertension include a careful history to determine duration of disease, symptoms, and current drug therapy. Oral contraceptives (OCs) and other drugs may sharply escalate otherwise stable hypertension. Cerebral hemorrhage dissecting and ruptured or aortic aneurysms account for the majority of sudden hypertension-related deaths, and hypertension is the leading cause of left ventricular failure causing pulmonary edema. Hypertension complicates pregnancy in several settings including the primigravida without antecedent hypertension. It can also be a complicating factor in the primigravida with known antecedent hypertension. Initial management of most hypertensive pregnancies requires observation, usually in a hospital. Most patients exhibit a fall in blood pressure during the 1st 2 trimesters, but antihypertensive medication (diuretics, reserpine, hydralazine, and methyldopa) have been administered without complications. OC medication is the most prevalent cause of hypertension in young women. Revision of estrogen-gestagen dosage formulas, shortened periods of administration, and periodic blood pressure measurement have diminished the incidence of OC associated hypertension. Emergency surgery situations, renal transplantation, diabetic nephropathy, and coronary disease are also discussed.
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PMID:Systemic hypertension: prevention and treatment of target organ catastrophe. 634 Sep 42