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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case-control study of sudden unexpected death (SUD) as the initial manifestation of coronary heart disease in women younger than 60 years of age was conducted in Rochester, Minnesota. Risk factors among the 15 SUD cases identified during the years 1960 through 1974 were compared with those in two control groups--a population group of 60 (4 age-matched controls per case) and the 59 cases of myocardial infarction diagnosed in women younger than 60 years of age in Rochester during the same period. By using Miettinen's matched analysis for comparison of SUD cases and matched controls, the relative risks for the accepted coronary heart disease risk factors of ever smoking and hypertension were 8.6 (95% confidence interval [CI], 1.3 to 57.3) and 5.7 (95% CI, 1.2 to 26.9), respectively. In a comparison of SUD cases and myocardial infarction cases by using the Mantel-Haenszel procedure and stratifying by five age groups, the odds ratios were 1.2 for ever smoking and 0.8 for hypertension. Six of the 15 SUD cases had a diagnosis of alcoholism compared with 2 of the 60 controls and 4 of the 59 myocardial infarction cases; thus, the relative risks were 12.0 (95% CI, 3.4 to 41.9) and 4.8 (95% CI, 1.3 to 18.2), respectively. Ever married SUD cases were nulliparous or had fewer children more often than the controls or the myocardial infarction cases. The combination of major psychiatric diagnosis and major tranquilizer use occurred with greater frequency among SUD cases than among controls (relative risk, 2.9; 95% CI, 0.6 to 14.1), whereas comparison of SUD cases and myocardial infarction cases for this variable resulted in a relative risk of 0.7 (95% CI, 0.3 to 1.9).
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PMID:Risk factors for sudden unexpected cardiac death in young women in Rochester, Minnesota, 1960 through 1974. 394 19

In 109 patients who underwent abdominal aortic reconstruction, the importance of preoperative complicating factors was retrospectively studied. High age at operation, presence of coronary heart disease, heart failure, hypertension, chronic pulmonary disease and renal failure, heavy smoking and alcoholism were among the investigated factors. A simple preoperative risk score was defined, based on the number of such complicating factors present in each case. Although the operation was technically uncomplicated in all 109 patients, 15 required intensive care for more than 4 days and seven died. Morbidity and mortality were heightened in cases with more than three risk factors. Coronary heart disease and renal failure were the most important risk factors.
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PMID:Abdominal aortic reconstruction. Prognostic importance of coexistent diseases. 395 5

Previous studies have shown good clinical results after anterior transposition of the ulnar nerve for compression neuropathy. However, it has been suggested that younger patients with a shorter duration of preoperative symptoms benefit most from surgical therapy. To determine what factors adversely affect the prognosis in patients with advanced disease, 23 of 24 anterior transpositions performed consecutively over 6 years were observed at a mean of 33.2 months. The mean age was 52.1 years. Symptoms were present for a mean of 11.3 months. Before the operation, 30% were graded moderate and 70% severe. After the operation, 70% of the patients improved, with 40% having a good result and 30% fair. Advanced age, duration of preoperative symptoms, diabetes, hypertension, alcoholism, etiology, type of transposition, tourniquet time, or atrophy did not predict a poor outcome. Severe clinical findings confirmed by electrophysiologic studies did not contraindicate surgery or preclude a reasonable rate of success in this small but relatively homogeneous group of patients.
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PMID:Anterior transposition for advanced ulnar neuropathy at the elbow. 396 61

We reviewed the clinical and laboratory characteristics of 34 patients who had classical heatstroke during the Kansas City heat wave of 1980. The patients were elderly, predominantly black, and of low socioeconomic class. Overall mortality was 18%, with 9% of patients exhibiting severe residual neurologic deficit; 73% had full recovery. Patients with coma, temperature greater than or equal to 108 F (42.2 C), severe hypotension, coagulopathy, and need for respiratory assistance were at highest risk of death. Associated disease was common (67%), with hypertension (32%), diabetes (21%), and alcoholism (21%) being most frequent. Medications known to predispose to heatstroke were used by 56% of patients. Hematologic abnormalities were nonspecific, and clinical evidence of renal or hepatic failure was rare. Hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia, hypophosphatemia, and elevated levels of creatine phosphokinase and glucose were frequent but did not correlate with outcome. The predominant arterial blood gas abnormality was metabolic acidosis or a combined metabolic acidosis and respiratory alkalosis.
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PMID:Classical heatstroke: clinical and laboratory assessment. 396 67

This study's objectives were to determine the influence of age and occupational factors on cardiovascular disease (CVD) incidence among U.S. Navy pilots diagnosed with CVD during a 12.5-year time period (n = 150) and to identify precursory diseases associated with CVD. Results showed a relationship between CVD and age; pilots, on the average, were more than 3 years younger at the time of CVD onset than other officers. No occupational factor was associated with CVD; fighter pilots had the highest rates of acute myocardial infarction and chronic ischemic heart disease. Angina pectoris was observed as a precursory disease of chronic ischemic heart disease, and several behaviorally related disorders (e.g., alcoholism) occurred with hypertension. Subsequent research should include all U.S. military pilots to examine, in a larger population, the influence on CVD of such occupational factors as flight in high-performance aircraft. An intervention program should be implemented to modify the lifestyles of pilots who had been hospitalized for hypertension and/or such conditions as obesity and alcoholism.
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PMID:Cardiovascular disease among U.S. Navy pilots. 400 72

This report gives results from eight intensive, exploratory interviews with Black women who suffered infant deaths within one year after delivery. Interviews were conducted as a final step in a research project to discover the correlates of very low birthweight among disadvantaged women in a city which maintains among the highest low birthweight and infant mortality rates in the United States. Qualitative results are presented within the context of a case/control study based on an in-depth medical record review. Statistical results showed that prenatal care, alcoholism, migrant status, smoking, hypertension history and previous poor pregnancy outcome distinguished women with very low birthweight infants. The medical record review also implicated violence, weak social support systems, poor social and psychological adjustments and ineffective contraception. Interview results further explore the social and psychological context of pregnancy for the disadvantaged inner city Black woman. Three-quarters of all women are unmarried at the time of delivery, and interviewed women expressed bitterness and resentment toward the men in their livers for non-support. They received the most help from 'girlfriends', and not consistent support--as expected--from mothers and female kin. Answers to open-ended questions and responses to a specially designed interview section on attitudes and beliefs suggest that these women conceptually dissociate three important areas of cultural focus: relationships with men, pregnancy and childbirth; and, that they value the 'gestator' role as separate from the role of 'mother'. They espouse contradictory beliefs about men: they believe that men are predatory and not trustworthy, but also more mainstream beliefs that call for reliance on the opposite sex. Because of their unstable relationships with men and their long histories of poor pregnancy outcome and termination, they face frequent disappointment. Responses to items in the attitudes and beliefs section suggest that these women feel powerless, hopeless and that life is somewhat meaningless. However, items designed to test Lewis' 'culture of poverty' do not support the concept of a consistent intergenerational poverty lifestyle. The report closes with a section on program and policy development in several areas: public health recordkeeping, health style education programs, special training programs for physicians and other health personnel, and some type of program to combat the social alienation and psychological distress of inner city women during pregnancy.
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PMID:Social and cultural factors in the etiology of low birthweight among disadvantaged blacks. 401 45

A reliable method of producing physical stress in the rat was developed using heat irradiation, and the possible interaction between chronic ethanol consumption and stress was investigated in a rat model of alcoholism. Chronic heat stress and chronic ethanol consumption each produced mild hypertension in rats. When combined, the two treatments resulted in hypertension more severe than that produced by either stress or ethanol consumption alone. The group of animals receiving both treatments also exhibited high mortality. Investigations into the mechanisms responsible for the apparent additive effects of the two treatments revealed that the animals in this group had the highest circulating norepinephrine levels. The plasma volumes, however, were not different between the stressed groups and their unstressed counterparts. As the plasma norepinephrine level usually reflects overall sympathetic tone of an animal, our results suggest that the additional hypertensive effect of chronic stress on the ethanol-treated animals is associated with increased sympathetic nervous activity and is not a result of expanded plasma volume. These findings may have clinical implications for human alcoholics and in the analysis of cardiovascular risk factors in hypertensive patients.
Hypertension
PMID:Chronic ethanol consumption, stress, and hypertension. 404 Jan 23

Massive cardiomegaly (heart weight above 400 g in females and 450 g in males) was studied in 26 Zambians examined post mortem. The aetiologies found were: hypertensive heart disease alone in six cases; hypertensive and alcoholic heart disease in two cases; alcoholic heart disease alone in five; alcoholic and pulmonary heart disease in one; alcohol with possible hypertensive heart disease in one. Eleven cases were classified as being idiopathic mainly due to lack of data and in five of these hypertension was suspected as being the cause. The series qualitatively represented the spectrum of non-rheumatic heart disease seen in patients admitted to the Central Hospital, Ndola, Zambia. Hypertension had a central role in the causation of massive cardiomegaly. Follow-up of several patients enabled observations on the cardiac effects of hypertension and alcoholism operating simultaneously and on the relationship between hypertension and congestive cardiomyopathy.
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PMID:Cardiomegaly in Northern Zambia: clinico-pathological observations. 622 32

Since chronic alcoholics may accompany with asymmetric septal hypertrophy (ASH), the purpose of this study was to find the difference in cardiac function of such cases from the patients with hypertrophic cardiomyopathy. Ninety-seven alcoholic patients (59 non-cirrhotics and 38 cirrhotics) were examined by non-invasive methods including two-dimensional echocardiography and dye dilution method, and these data were compared with those of 16 normal subjects and 26 patients with hypertrophic cardiomyopathy. The results were as follows: Interventricular septal thickness of more than 12 mm was observed in 25.4% of the non-cirrhotics and 28.9% of the cirrhotics. Furthermore, ASH was present in 23.7% of the former and 18.4% of the latter, when ASH was defined as the septal to posterior wall ratio greater than 1.3 with the interventricular septal thickness greater than or equal to 12 mm. In 66.7% of the chronic alcoholics with ASH, hypertrophy was predominantly located in the septum, however 53.8% of the patients with hypertrophic cardiomyopathy had ASH in association with the thickened left ventricular posterior wall. In 21 chronic alcoholics with ASH, ejection indices such as ejection fraction and mean VCF were moderately increased, although scattered widely, as compared with those of the normal subjects. Latent reduced ventricular function compensated by sympathetic overactivity was postulated based on left ventricular performance maintained normally as indicated by a decrease of end-systolic wall stress. Several possible factors including hypertension, catecholamine and metabolic abnormalities were analyzed to explain the genesis of ASH in chronic alcoholics, but the true etiology remained unknown. In conclusion, ASH associated with chronic alcoholism is a type characteristic of alcoholic cardiomyopathy, and seems to belong to a clinical entity different from hypertrophic cardiomyopathy from a standpoint of clinical symptoms, age and the pattern of left ventricular hypertrophy.
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PMID:[Echocardiographic evaluation of cardiac involvement in patients with chronic alcoholism]. 623 96

Reversible Cushing's syndrome with typical physical appearance and increased basal plasma-cortisol level developed in a 48-year-old man with essential arterial hypertension, as a result of chronic alcohol abuse and could not be supressed by prolonged dexamethason inhibition. Alcohol abstinence within a few weeks produced remission with normal adrenocortical function and regulation without any other therapeutic measures. Renewed alcohol consumption quickly brought about again the alcohol-induced Cushing's syndrome. An abnormality of central regulation with inadequate ACTH secretion was the cause of the hypercortisolism. Previously reported cases of alcohol-induced Cushing's syndrome are not uniform: in some the diagnosis is in doubt.
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PMID:[Alcohol-induced Cushing's syndrome: case report (author's transl)]. 625 Jul 82


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