Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A study was conducted in Ibadan, Nigeria over a period of 11 years, 1 January 1976 to 31 December 1986, on 810 patients who agreed to use depo-medro progesterone acetate (DMPA) for contraception. DMPA is a long-acting injectable contraceptive agent which provides protection over a period of time. It is given on a 3-monthly basis, and is thought to be an ideal contraceptive agent for women who have a poor compliance with taking oral contraceptives or do not wish to run the risk of using an intrauterine device. The women's medical histories were recorded and each of the women were thoroughly examined; women with hypertension, diabetes mellitus, positive cervical cytology, or irregular menstrual patterns were excluded from the study. The women were given 3-monthly intramuscular injections, and at each visit all side-effects reported were recorded. If the patient decided to discontinue use, the reasons were also noted and recorded. The results of the study are as follows. 490 (60.5%) of the women had protection for between 3 months and 12 months; 230 (28.4%) had protection for 13-24 months; while only 90 (11.1%) had protection for 25-33 months. Side effects noted were amenorrhoea (36.3%), weight gain (15.8%) and loss (10.6%) abnormal bleeding patterns (12.7%), and minor symptoms such as headaches (2.5%), dizziness (1.5%) and palpitations (1.1%). Reasons for discontinuation included amenorrhoea (16.2%), abnormal bleeding habits, (7%), hypertension (2.2%), and/or the desire to get pregnant (2%). Further discussion is given to the use of DMPA as an enhancement for lactation and an effective option to oral contraceptives.
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PMID:Experience with the use of depo-medroxyprogesterone acetate in a Nigerian population. 285 67

Medroxyprogesterone acetate injections (Depo-Provera) were given to 625 women at 3 monthly intervals involving 693 episodes. Ages at entry to the study ranged from 15-51 years with the majority in their 20s and a mean age of 30. Length of exposure ranged from 3-168 cycles. 4 women have received more than 160 continuous cycles of DMPA. Of the medication-induced reasons for discontinuing DMPA, bleeding was the most common with an incidence of 10.5% followed by depression (1.4%), weight gain (1.4%), and loss of libido (1.6%). No patient ceased treatment because of headaches, recurrent vaginal infections, mastalgia, nausea, chloasma, hypertension, or other vascular illnesses. The 59 women who move away or were lost to follow-up accounted for 405 cycles of treatment. The solitary unplanned pregnancy occurred in a 28-year-old obese woman who had previously had other method failures, once with an IUD and once with oral contraceptives (OCs). No association was found with carcinoma of the cervix. Of 80 women ceasing treatment to become pregnant, only 1 women has required the assistance of chlomiphene and conceived 2 years after ceasing DMPA. Amenorrhea was the side effect most appreciated by the women using DMPA. Due to the problem of irregular bleeding, it is wise to warn prospective patients about the lack of bleeding control that they have 1 chance in 10 of having relative menorrhagia. Women using OC subject to frequent vaginal moniliasis had a marked reduction in episodes after switching to DMPA. Chloasma, 1 of the minor stigmas of OC, was not induced in any of the patients. DMPA is a safe and efficient reversible method of contraception for women who have various gynecological conditions or problems associated with using OCs.
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PMID:Medroxyprogesterone acetate as an injectable contraceptive. 296 70

In order to study the relationships between hypertension, obesity and perinatal morbidity and mortality, we have studied a group of 264 women included in a cooperative prospective study with respect to obesity arbitrarily defined as a body mass index greater than or equal to 27 kg/m2. The obese and normal-weight groups comprised respectively 55 and 209 women of similar age (29.1 +/- 5.5 vs 30.2 +/- 5.3 years, NS). Obese women were less often primiparous than women with a normal weight (29.1 vs 50.2 p. 100, p less than 0.01). Hypertension before pregnancy was similarly frequent in both groups (41.8 vs 31.6 p. 100). Hypertension begun sooner during the pregnancy in the obese than in the normal group (17.1 +/- 11 vs 22 +/- 11 weeks of amenorrhea, p less than 0.01), the first abnormal blood pressure being comparable in both groups (156 +/- 15/96 +/- 14 vs 152 +/- 15/95 +/- 10 mmHg, NS). Indicators of perinatal risk were less often observed in the obese group: hypertension begins less often during the second trimester of the pregnancy (7.4 vs 21.7 p. 100, p less than 0.05), proteinuria greater than or equal to 2+ is more rare (13.0 vs 25.1 p. 100, p = 0.07), plasma urates are lower (maximum recorded value: 272 +/- 63 vs 322 +/- 96 mumol/l, p less than 0.001). No perinatal death occured in the obese group, as compared with 15 in the normal group (p less than 0.05). The weight of surviving babies was higher in the obese than in the normal group (3,294 +/- 596 vs 2,947 +/- 702 g, p less than 0.001), despite a comparable gestational age (38.3 +/- 2.3 vs 38.9 +/- 1.8 weeks, NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Does hypertension have fewer complications in pregnancy in obese patients?]. 311 95

Autopsy findings from 170 non-smoking and mentally retarded women aged 12-51 years were analysed for any epidemiological association between the use of peroral lynestrenol for inducing therapeutic amenorrhea (TA) and arterial disease. Eighty-six women had received lynestrenol continuously for an average of 81 months (range 2-220 months) and the other 84 had not. After exclusion of 6 cases with known risk factors (diabetes, hypertension) predisposing to arterial disease, pathological arterial changes were found in 16 patients, 10 of them belonging to the TA group and 5 to the non-lynestrenol group. The incidence of arterial disease at autopsy at the age of 35 or more was 8/19 in TA patients and 1/15 in non-lynestrenol patients (p = 0.078). The benefits of prolonged TA induced by lynestrenol in this group of patients must be weighed very carefully against the possible risks involved.
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PMID:Peroral lynestrenol and arterial disease in mentally retarded women. A case-control study based on autopsy findings. 317 39

A personal series of 256 cases of acromegaly/gigantism seen over a 20-year period from 1963 is described. The insidious nature of the condition resulted in delay in diagnosis which was often made by a doctor when seeing the patient for an unrelated problem. Other features which commonly led to the diagnosis being made were headache, change in appearance, carpal tunnel syndrome, amenorrhoea and diabetes. The Hardy system for grading the radiological appearance of the pituitary tumour was used. Widely invasive tumours were not common but tended to occur in patients with younger age of onset and high GH levels. The occurrence of various symptoms and clinical features was noted and the changes resulting from reducing the GH level to normal. The incidence of hypertension, but not of coronary artery disease, is increased and the blood pressure may be reduced following successful treatment. The effects on the upper and lower respiratory tract are reported as well as sleep apnoea and problems associated with anaesthesia. Skin manifestations included sweating, pigmented skin tags, acanthosis nigricans and cutis verticis gyrata. In the skeletal system the incidence of kyphoscoliosis and osteoarthritis especially of the hip is reported: the question of hip replacement is discussed. Diabetes mellitus disappeared in most cases if the acromegaly was cured. In men but not in women the incidence of colloid nodular goitre was increased as was hyperthyroidism in middle-aged women. In two patients a parathyroid adenoma was present: hypercalcaemia was present in five additional patients, but the cause was not determined. The common occurrence of amenorrhoea in the younger women was noted, it was not always associated with hyperprolactinaemia, and often responded to successful treatment of the acromegaly. The association of acromegaly with hirsutism and galactorrhoea is confirmed. The incidence of impotence and loss of libid in the men is discussed: in a proportion of those in whom the acromegaly was cured, potency returned, but in a number depression occurred and what was believed to be psychogenic impotence persisted. Hyperprolactinaemia was found in 49 out of 151 patients with active acromegaly in whom the prolactin level was measured. Previous reports have indicated a doubling of death rates in acromegalics. In this series there were 47 deaths observed compared to 37.2 expected. The increased death rate was in women of all ages and in men under the age of 55, The increased deaths in the women were from cardiovascular and cerebrovascular causes and from breast cancer.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Acromegaly. 330 90

Hemoconcentration is prominent in preeclampsia. Concomitant changes in the flow properties of maternal blood, i.e. in whole blood viscosity (WBV), might be related to the occurrence of fetal or maternal complications. To test this hypothesis, WBV was estimated in 228 pregnancies. Patients were assigned to one of four groups according to maximum diastolic blood pressure. Significantly higher WBV values were found in the more hypertensive groups throughout pregnancy. WBV data, obtained between 26 and 36 weeks of amenorrhea, contributed significantly, independently of hypertension, to the prediction of fetal outcome. With regard to maternal complications, no significant contribution of WBV data could be established independently of blood pressure. The results support the hypothesis that WBV is a determining factor in the efficacy of placental perfusion.
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PMID:Maternal whole blood viscosity in pregnancy hypertension. 337 66

Forty-eight pregnancies were observed in 35 patients with hyperprolactinaemia divided into 3 groups according to their initial radiological appearances: normal sella turcica (Group I, n = 11), microadenoma (Group II, n = 12) or macroadenoma without suprasellar expansion, visual defect or pituitary deficiency (Group III, n = 12). Twenty-seven patients were treated with Bromocriptine (Br) from the outs six by adenomectomy + Br, one by adenomectomy alone complicated by meningitis and by corticotropic and thyrotropic hormone deficiencies, followed by amenorrhea despite normalisation of the hyperprolactinaemia requiring induction of a first pregnancy with Clomid. As regards the pregnancies induced by Br (43/48), Br was withdrawn at an early stage in Group I and in the majority of cases in Groups II and III. In all, 37 pregnancies came to term; after Br therapy we observed 5 spontaneous abortions and 3 premature deliveries; 2 caesarian sections were performed before term (one case of hypertension and one adenomatous expansion); one early termination was performed for a tumoral complication. One congenital abnormality (oesophageal atresis) was detected. These observations support the results of extensive studies showing no effects of Br on the outcome of pregnancy and no detectable teratogenic effects with this drug. Five pituitary complications occurred during pregnancy after withdrawal of Br; 1 case of headaches with expansion of a macroadenoma cured by adenometry after prophylactic caesarian section before term; 1 case of optic chiasma compression (Group III) which responded to emergency surgery and 2 cases of pituitary apoplexy (Groups II and III) which responded favourably to Br and in which pregnancy continued normally.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pregnancy and hyperprolactinemia. Review of therapeutic measures apropos of a series of 35 patients]. 356 10

Oral contraceptive agents are expected to be legalized in Japan in the near future. Although pills are more convenient and effective than other methods used in Japan such as condom (73%), IUD (12.4%) and Ogino Method (11.0%), they are not safe for many women. Neither will legalization of pills necessarily reduce the number of abortions. The abortion rate per 1000 women aged 15-44 is 29.3 in America where pills are legal, and 22.5 in Japan where they are illegal. Steroid hormones affect the overall physical and mental functioning of the human body. Pill-users who are near 40 and/or smokers may have such side-effects as high blood pressure, cerebrovascular-related syndrome, and thrombosis. Among very young pill users, side-effects include temporary amenorrhea after stopping pills, 4 times more cases of thrombosis triggered by emergency operations on appendixes and fractured bones, and development of uterine myoma. Side effects are more prevalent among those who have a family history of diabetes, circulatory organ dysfunction, high blood pressure, breast or ovarian cancer. Minor side-effects include weight increase, nausea, blemishes, acne and pigmentation.
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PMID:[Oral contraceptive agents]. 364 11

Synthetic progestins derived from nortestosterone provide a promising contraceptive alternative for women with contraindications for estrogens. Progesterone and synthetic progestins reduce vasodilatation and edema induced by estrogens and stop estrogen-dependent cellular multiplication in target tissue. Progestins have 2 kinds of contraceptive affect: antigonadotropic action at sufficient doses, and peripheral action at lower doses. The cervical mucus is modified in composition and volume, becoming hostile to sperm; the endometrial mucus atrophies; and tubal motility is slowed. High dose progestins are administered from the 5th or 10th to the 25th cycle day, with the earlier date preferred for women with shorter cycles. They are an ideal method for women with endometrial hyperplasia or benign breast disease or histories of breast or uterine cancer, as well as for women over 40 with dysovulatory cycles. Contraindications to high dose progestins include obesity, hypertension, lipid metabolic anomalies, and diabetes. Low dose progestin-only pills are administered at the exact same time each day including during menstruation. They are attractive for some women because they contain no estrogen, a reduced progestin dose causing fewer headaches and less somnolence, and fewer metabolic effects. Low dose progestins are indicated for lactating women, those with contraindications to estrogens such as obesity, hypertension, hyperlipidemia, and diabetes, and those with renal or cardiac insufficiency with valvulopathy. Low dose progestins are also indicated for nulliparas and other women for whom IUDS are contraindicated. Women using low dose progestins should never take drugs that act as enzymatic inductors, which speed hepatic degradation of steroids and reduce their efficiency. A resulting pregnancy is likely to be extrauterine because of slowed tubal transport. The failure rate of low dose progestins ranges from .9-3%, with higher failure rates among younger women. About 30% of users initially experience spotting, which despite its usual disappearance after 2-3 months of use is the most common reason for discontinuing the method. Low dose progestins have no metabolic or vascular effects, but they may cause a relative hyperestrogenism is some users. Other modes of administration of progestin contraception include continuous high doses, never justified solely for contraception. Trimonthly injections of medroxyprogesterone acetate of norethindrone enanthate provide contraception through a long lasting antigonadotropic effect. Metrorrhagia and amenorrhea are among possible side effects. The method is used primarily in developing countries where its ease of use is a major advantage. Subcutaneous implants releasing continuous doses of levonorgestrel provide contraceptive protection for over 5 years. The cumulative failure rate is 1.7 at 5 years. Metabolic tolerance is good. The major side effect is menstrual irregularity.
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PMID:[Progestational contraception]. 365 94

Perinatal outcome and various indicators of perinatal risk were analyzed in a prospective study of 268 pregnant women with hypertension. Poor perinatal outcome was defined by stillbirth (n = 13), neonatal death (n = 2), and in surviving babies, by birth before 32 weeks or a birthweight below 1500 g (n = 13). In multivariate analysis, proteinuria and onset of hypertension between the 27th and 36th weeks of amenorrhea were the only two independent indicators of poor outcome (relative risks of 4.0 and 3.7, p less than 0.001 and p less than 0.01 respectively). Both these indicators were more frequent in mothers with no history of pre-pregnancy hypertension.
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PMID:Factors predictive of perinatal outcome in pregnancies complicated by hypertension. 380 86


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