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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of the study was to investigate alterations in the content of the basic lipid fractions, and of the low density lipoproteins (LDL) in the liver, the blood serum and aorta, as well as to determine by acrylamide disc electrophoresis the hyperlipoproteinaemic type of spontaneously hypertensive rats (SHR) which are considered as the most suitable model of essential hypertension. The experiments were carried out on 25 normotensive control Wistar rats and 30 SHR (Okamoto-Aoki strain). An augmentation of lipid metabolism in the liver and a moderate hyperlipidaemia mainly due to an increase in triglycerides was found. The quantitative alterations of the lipid fractions corresponded with the qualitative alterations of the lipoproteins, an intensive and permanent pre-beta-LP fraction being established. In all the SHR a peculiar pattern of hyperlipoproteinaemia differing from the basic Fredickson-Lees patterns by a LP-fraction located between tha alpha- and beta-LP fractions was also established. The alterations in the lipid and lipoprotein metabolism in SHR are considered as connected with the hypertensive state itself since no accompanying atherosclerosis was observed.
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PMID:The action of arterial hypertension on lipid and lipoprotein metabolism. II. Qualitative and quantitative alterations of blood serum, liver and aortic lipids and lipoproteins in Okamoto-Aoki rats with spontaneous hypertension. 18 75

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

Available clinical evidence indicates a high prevalence of hyperuricemia in patients with essential hypertension; this becomes accentuated with diuretic therapy. Since there is an association of hyperlipidemia with hyperuricuria and hypertension and since hyperuricemia is a feature of diuretic therapy, we explored whether these relationships might be provoked by prolonged diuretic therapy. Eighteen male patients with uncomplicated essential hypertension of mild severity were treated for 9 months with hydrochlorothiazide and supplemental potassium chloride, 100 mg and 45 mEq/day, respectively. Arterial pressure, renal function, and serum electrolyte, uric acid, blood glucose, and lipid concentrations were measured several times before and during therapy. Arterial pressure remained significantly reduced during therapy (P less than 0.001); this was associated with reduced serum potassium (P less than 0.01) and increased blood glucose and serum uric acid concentrations (P less than 0.005, P less than .025, respectively). Blood urea nitrogen, serum creatinine, sodium, cholesterol and triglyceride levels did not significantly change with treatment. Thus, although diuretics increase serum uric acid and blood glucose, their effect on serum lipid concentration is negligible.
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PMID:Effects of diuretics on lipid metabolism in patients with essential hypertension. 107 5

Copper IUDs, oral contraceptives, "morning-after' pills and injectables are discussed in general in this review. Small IUDs are less effective, but better tolerated. An exception is the Dalkon shield, which is no longer manufactured because several women died from latent infections when they became pregnant. The Copper T IUD is tolerated much better than the Copper 7, and has only a 3% failure rate. Copper Ts must be replaced every 2 years, however, and are difficult to remove. A beneficial effect of IUDs is cure of uterine adhesions; a subjective side effect if discomfort reported by husbands. Strict contraindications or oral contraceptives are history of cholostatic jaundice of pregnancy, thromboembolism, essential hypertension, tension, diabetes, gynecologic cancer and pregnancy. Relative contraindications are hyperthyroidism, hyperlipidemia, and depression. Depressions occuring soon after starting pills may be due to unconscious rejection; those appearing later may be due to the progestagen itself. The subjective sequelae of pills are more likely in maternal women, women raised to feel guilty for using contraception, women susceptible to believing sensational media reports about pills, and women dominated by their husband's views. Pills are beneficial for essential dysmenorrhea, menstrual irregularity, premenstrual syndrome, depression, frigidity due to fear of pregnancy, uterine hypotrophy, ovarian cyst, certain ovarian dystrophies such as Stein Levinthan syndrome, menopausal symptoms, acne and hirsutism. The morning after pill, 5 mg ethinyl estradiol for 3 consecutive days, is indicated only in exceptional cases such as rape. Injectables are more suitable for those who desire long-term contraception and whose who want no more children. A lower cancer rate has been reported for users of depot progestagens than for women notu sing contraception.
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PMID:[Subjective and objective aspects of modern methods of contraception]. 114 75

Mild-to-moderate essential hypertension is the most common medical problem seen by physicians in Western populations, and pharmacologic antihypertensive therapy is now usually undertaken. Clinical trials have shown that lowering of elevated blood pressure using diuretics and beta-blockers reduces cardiovascular morbidity and mortality. Despite these benefits, the trials have provided no convincing evidence that the incidence of coronary artery disease or its complications is reduced: Treated hypertensive patients remain at increased cardiovascular risk compared with untreated normotensive subjects. Possible explanations for this disappointing outcome are that the drugs used may themselves have negative effects on serum lipids, glucose, and insulin resistance, thereby outweighing their antihypertensive benefits. An equally important role in this respect may be played by the diseases and therapies most commonly found in association with mild-to-moderate hypertension: hyperlipidemia, type II diabetes, coronary artery disease, left ventricular hypertrophy, cardiac arrhythmias, peripheral arterial disease, and nephropathy. Such conditions may be potent determinants of what constitutes the optimal first-line choice of antihypertensive therapy. Furthermore, the negative effects that antihypertensive drugs can have on quality-of-life factors may result in noncompliance and ineffective long-term treatment. Therefore, in a new therapeutic approach to the treatment of high blood pressure, it would be logical to base antihypertensive therapy on strategies that not only lower the blood pressure but that have beneficial impacts on hemodynamics, vascular and cardiac structure, metabolism, and quality-of-life issues.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Antihypertensive therapy: new strategies beyond blood pressure control. 128 82

1. Increased erythrocyte sodium-lithium countertransport activity has been reported to be associated with nephropathy in type 1 diabetes and linked to a family history of essential hypertension. 2. This study aimed to determine the mechanism of increased sodium-lithium countertransport activity. Sodium-lithium countertransport kinetics were measured in uncomplicated and hyperlipidaemic type 1 diabetic patients. 3. In the nine out of 31 uncomplicated type 1 diabetic patients who had high sodium-lithium countertransport activity, the sodium affinity (Km) was normal but the maximum velocity (Vmax) was increased. 4. Hyperlipidaemia, when present in diabetic patients, was associated with increased sodium-lithium countertransport activity, but could not explain the high activity in uncomplicated type 1 diabetic patients in whom plasma lipid concentrations were normal. 5. Sodium-lithium countertransport activity is increased in type 1 diabetes by a mechanism different to that in essential hypertension, where the mechanism is a low Km (increased sodium affinity). Hence familial hypertension cannot explain the raised sodium-lithium countertransport activity in type 1 diabetes.
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PMID:Kinetics of sodium-lithium countertransport activity in patients with uncomplicated type 1 diabetes. 131 14

Inheritance is a major determinant of increased sodium-lithium countertransport (SLC) activity in hypertension. However, hyperlipidaemia can also cause increased SLC activity in some individuals and it is difficult to distinguish this effect from the effect of hypertension. Erythrocyte SLC activity and its kinetic determinants sodium affinity (km) and maximum velocity (Vmax) were measured in 25 hyperlipidaemic patients and 15 normal controls (NC). Increased SLC activity (0.31 +/- SEM 0.03 mmol Li/(h x 1 cells) vs. NC 0.20 +/- 0.01, P < 0.01) in the hyperlipidaemic patients was associated with increased Vmax (0.59 +/- 0.07 vs. NC 0.41 +/- 0.03, P < 0.01) but normal km (median 120 range [40-324] mmol l-1 vs. 140 [108-260]. Lipid-lowering therapy resulted in decreased SLC activity secondary to a fall in Vmax. Km remained constant despite the changes in lipids and Vmax. The mechanism of increased SLC activity in hyperlipidaemia is different from that in essential hypertension where increased sodium affinity is found. Measurement of the kinetic characteristics of SLC may discriminate between the independent influences of hypertension and hyperlipidaemia on the sodium-lithium countertransporter.
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PMID:Plasma lipids affect maximum velocity not sodium affinity of human sodium-lithium countertransport: distinction from essential hypertension. 147 40

A risk factor is a characteristic which is associated with a greater than average probability of developing coronary disease. Raised serum cholesterol and hypertension are two such factors. Intervention studies conducted to confirm the risk factor hypothesis have shown that reduction of serum cholesterol and essential hypertension may be associated with a small decreased CHD incidence, however there were almost as many deaths due to coronary disease in the intervention groups as in the control groups. These findings suggest that our approach to risk factor intervention may be a misguided attempt which needs modification. It is possible that the major risk factors develop in an attempt of our body to adapt to environmental factors such as increased intake of salt, saturated fat and cholesterol, physical inactivity, increased intake of calories and obesity and stress. Smoking may be the result of social changes. Since the body has to modify its metabolic mechanism depending upon the factor to which it adapts, development of hyperlipidemia and hypertension may be protective mechanisms of the body which it has developed while fighting against environmental factors. Reduction of major risk factors by drug therapy may mean that we are trying to prevent the body, fighting environmental factors. Thus our approach to control of the major risk factors should be to treat the causative environmental factors or alter the lifestyle.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Risk factors for coronary heart disease: synthesis of a new hypothesis through adaptation. 149 21

The correlations between the cardiovascular risk factors hypertension, overweight, hyperlipidemia and fibrinolysis parameters were studied in a group of 54 otherwise healthy patients (age 19 to 70 years) with essential hypertension of moderate severity. Of the 54 patients 43 were treated with antihypertensive drugs and eleven were not. The patients included in this study who were treated with antihypertensive drugs were, in spite of their treatment, still hypertensive. Lipoprotein levels and fibrinolysis parameters did not differ between the untreated and treated patients. In the patient group we found significant incidence of hypertriglyceridemia (46%) elevated LDL-cholesterol (28%) and elevated lipoprotein (a) levels (43%). In comparison with a healthy control group the hypertensive patient group showed a decreased median tissue plasminogen activator activity (interquartile range): 0.23 (0.79) IU.10(3)/l vs 1.5 (0.47) IU.10(3)/l in the controls (p less than 0.0001), an increased tissue plasminogen activator antigen concentration: 8.2 (4.5) micrograms/l vs 5.1 (3.9) micrograms/l in the controls (p less than 0.0001), an elevated plasminogen activator inhibitor-1 level: 2.8 (2.5) AU.10(3)/l vs 1.1 (2.0) AU.10(3)/l in the controls (p less than 0.01) and a slightly increased alpha 2-antiplasmin concentration: 110 (8)% vs 98 (16)% in the controls (p less than 0.0001). Median D-dimer concentration levels were substantially increased in the hypertensive patients: 315 (263) micrograms/l vs 199 (146) micrograms/l in the controls (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fibrinolysis factors and lipid composition of the blood in treated and untreated hypertensive patients. 162 20

Early screening for hypertension in diabetic patients and for glycoregulation abnormalities in hypertensives is justified by the additive cardiovascular risks when hypertension and diabetes co-exist and by the accelerated development of diabetic nephropathy and retinopathy if hypertension co-exists. In insulin-dependent diabetes, hypertension is generally preceded by microalbuminuria, known to be reduced by angiotensin converting enzyme inhibitors. The requirement for nephropathy prevention and the hemodynamic and/or tissular effects of this therapeutic class could justify their use at a blood pressure level less than that conventionally considered hypertensive. This strategy must be confirmed by prospective trials, already underway, evaluating the nephroprotective efficacy of this therapy. In non-insulin-dependent diabetes, hypertension is often present before the diabetes is diagnosed and antihypertensive therapy, especially thiazide diuretics, could play a demasking or favorizing role. The optimal blood pressure level to which these patients at high renal and coronary risk should be lowered still has to be determined. A prospective study, comparing the effects of strict (treated diastolic blood pressure less than 80 mmHg) and less strict (treated diastolic blood pressure between 90 and 100 mmHg) hypertensive control on coronary event prevention in essential hypertension, is in progress and will have important implications for hypertension treatment in diabetics. Appropriate treatment of other risk factors, such as hyperlipidaemia and smoking, contributes to coronary and renal prevention in all diabetic hypertensives.
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PMID:[Treatment of hypertension in diabetes: threshold of intervention and therapeutic options]. 163 6


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