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

Retinal depression, a newly observed sign, has been observed as an abnormality in the reflection from the internal limiting lamina produced by depression of the inner surface of the retina after a small retinal infarct. These depressions were first observed in 16 patients with sickling hemoglobinopathies. Additionally, I examined a patient with systemic hypertension, a patient with retinal arteriolitis, and a patient with juvenile onset diabetes mellitus who also had retinal depression.
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PMID:Retinal depression sign indicating a small retinal infarct. 67 32

The review is based on three studies previously reported and involving the clinical, epidemiological and hemodynamic aspects of this problem. Schistosomasis may give frequently (21.6 p. 100) an arterial pulmonary hyperpressure related to the development of granulomas and arteriolitis. A myocarditis may be suspected but is rarely proved. Anemia and specific treatment are also responsible for myocardial deficiency. The parasitic changes of the urinary tract may give a systemic hypertension. Some very rare cases of acute pulmonary heart insufficiency have been reported and the responsibility of schistosomiasis in constrictive fibrous endomyocarditis is still questionned.
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PMID:[Heart and schistosomiasis (author's transl)]. 72 48

Immunohistological analysis of 1146 renal biopsies revealed IgA associated glomerulonephritis (IgAGN) in 83 (7.24%) patients (33 children, 50 adults). Clinical features were unusually severe in a high proportion. Nephrotic syndrome (NS) responding poorly to prednisolone was found in 24%, hypertension (HT) in 39%, and azotemia in 34% of patients. NS was slightly more frequent in children than in adults, but HT and azotemia occurred twice as often in adults as in children. Histologically, extensive glomerular crescents and sclerosis were prominent. In addition, moderate arteriolitis and arteriolosclerosis and marked tubulointerstitial nephropathy were notable features. Thus, a low incidence and marked severity characterized IgAGN in this study.
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PMID:IgA associated glomerulonephritis. 148 90

We reported an autopsy case of thrombotic occlusion of the superior cerebral vein with hemorrhagic laminar necrosis of the right parietal cortex. A 68-year-old woman was admitted to our hospital because of a severe headache and left hemiplegia of acute onset. There was a past history of hypertension, fever of unknown origin, leukocytopenia and nasal dermatitis. Magnetic resonance images (MRI) disclosed thrombosis of the superior sagittal sinus and of the right parietal cortical vein as well as right parieto-occipital cerebral infarction. Although she improved with mild sequelae, the subsequent MRI showed a recurrent thrombosis of the superior sagittal sinus. Ten months after the onset she died suddenly, presumably due to acute myocardial infarction. Pathologically, thrombotic occlusion of the right parietal cortical vein, recurrent thrombosis of the superior sagittal sinus and old hemorrhagic cortical laminar necrosis of the right parietal region were revealed. Moreover, intracranial arteritis and phlebitis were observed, as well as arteriolitis in the peripheral nerves. In our case, MRI was useful for the diagnosis and following the course of cerebral venous thrombosis. Cerebral noninfective vasculitis may well have caused the venous thrombosis.
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PMID:[Thrombosis of the superior cerebral vein with hemorrhagic cerebral infarction--serial MRI and pathological study of a case]. 225 22

In order to evaluate whether immunoglobulin deposition in vessels plays some role in the development of vascular lesions in severe hypertension, an immunohistochemical study was performed in spontaneously hypertensive rats (SHRs), to which deoxycorticosterone acetate (DOCA) and salt were administered. DOCA and salt rapidly induced severe hypertensive vascular lesions, including necrotizing arteriolitis and productive endarteritis. In these rats, considerable deposits of IgG and IgM were found in the small arteries and arterioles of the kidneys. These deposits were accompanied by complement (C3), and could be eluted by acid incubation. They were localized in periodic acid-Schiff-positive insudative lesions, which were thought to be an early phase of the hypertensive vascular lesions. These results suggest that the immunoglobulins might be bound to an unknown antigen in the vascular lesions and that some immunological mechanism mediated by the immunoglobulins is involved in the development of vascular lesions in severe hypertension.
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PMID:Immunohistochemical study of vascular lesions in severe hypertension induced by DOCA and salt administration to spontaneously hypertensive rats. 226 Nov 49

To study the frequency, cost, sociodemographic profile, and previous care correlates of hospital admissions for hypertensive emergency, we used specific case criteria to identify a series of 100 cases at Presbyterian Hospital in New York City. Approximately 58 cases were admitted per year. Mean length of hospital stay was 11.8 days, 75 per cent of patients received intensive care, and estimated annual hospital charges were $438,828 (1986 dollars). Cases had severe hypertension on admission (mean systolic blood pressure, 229.8 mmHg; mean diastolic blood pressure, 143 mmHg). Two-thirds had clinical evidence of acute arteriolitis. Cases were predominantly young, male, Black or Hispanic, and of lower socioeconomic status. At least 93 per cent of cases were previously diagnosed, and at least 83 per cent were aware of their diagnosis of hypertension. Improved management of chronic hypertension rather than more intensive screening may be a useful strategy to reduce the incidence of hypertensive emergency.
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PMID:Hypertensive emergency: case criteria, sociodemographic profile, and previous care of 100 cases. 336 91

Computerised apex- and echocardiography was used to study left ventricular dimensions and function in 13 patients with untreated malignant hypertension and eight with severe benign hypertension. All patients had normal left ventricular cavity dimensions. Five benign hypertensives and malignant hypertensives with a previous history of hypertension had significant thickening of the septum and posterior wall. In eight malignant hypertensives without a previous history wall thicknesses were normal. The absence of ventricular hypertrophy in some cases of malignant hypertension suggests that it is sometimes of rapid onset and not preceded by a non-malignant phase. although fractional shortening and peak Vcf were normal in all the hypertensives, diastolic left ventricular function was frequently abnormal with delayed mitral valve opening, reduced peak rate of filling, and outward endocardial motion during isovolumic relaxation. Malignant hypertensives showed a cavity shape change during isovolumic contraction, and in those without a previous history the aortic second heart sound occurred earlier. The abnormalities of function are probably the result of a combination of factors including pressure overload, abnormal myocardial properties, and myocardial ischaemia, either regional or generalized and secondary to arteriolitis.
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PMID:Echocardiographic features of malignant hypertension. 645 15

The effects of MPC-1304, a newly developed 1,4-dihydropyridine derivative, on blood pressure and hypertensive complications in stroke-prone spontaneously hypertensive rats fed a high-salt diet (0.8% NaCl), were investigated. The antihypertensive effectiveness of nicardipine was used for the purpose of comparison. MPC-1304 and nicardipine were added to the diet, in doses of 0.01% (0.01% MPC-1304 diet), 0.03% (0.03% MPC-1304 diet) and 0.1% (0.1% nicardipine diet), respectively, throughout the experimental period (8 to 30 weeks of age). This chronic ingestion of MPC-1304 and nicardipine inhibited the development of hypertension and reduced the concentration of blood urea nitrogen, creatinine, triglyceride and total cholesterol in serum. Treatment with MPC-1304 inhibited the incidence of cerebral stroke, cardiac fibrosis, proliferative and fibrinoid arteriolitis and malignant nephrosclerosis. There was no significant difference in the antihypertensive effectiveness between 0.01% MPC-1304 and 0.1% nicardipine diets. Thus, MPC-1304 had antihypertensive effects in stroke-prone spontaneously hypertensive rats.
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PMID:Effects of MPC-1304, a novel calcium antagonist, on stroke-prone spontaneously hypertensive rats. 784 14

Chronic thromboembolic pulmonary hypertension is a condition that has long remained in the shadows, a kind of orphan disease, because of the lack of any curative treatment. The renewal of interest by pulmonary specialists, cardiologists and thoracic surgeon is due to the development over the past 20 years of major new treatments: lung transplantation, continuous prostacyclin infusion, and pulmonary endarterectomy, in chronological order. Most patients with postembolic pulmonary arterial hypertension (PEPAH) in a sufficiently proximal location can benefit from curative surgical treatment by bilateral endarterectomy of the pulmonary arteries. This complex surgery, performed under deep hypothermic circulatory arrest, clears out the pulmonary vascular bed down through its subsegmental branches and results in a frank reduction in pulmonary vascular resistance and normalization of cardiopulmonary function. It is a curative procedure with a perioperative mortality rate less than 7% and a definitive result, unlike pulmonary and cardiopulmonary transplantation, which have a postoperative mortality rate of 20% and a 5-year survival rate of 50%. It is difficult to recognize the postembolic nature of pulmonary hypertension because there is no known history of venous thrombosis or embolic phenomena in more than 50% of cases. Diagnosis is based on the presence of mismatched segmental defects in the radioisotopic ventilation-perfusion scanning. To be accessible to endarterectomy, lesions must involve the main, lobar, or segmental arteries. When conducted by experienced operators according to specific protocols, pulmonary (frontal and lateral views of each lung) and multislice CT angiography optimize assessment of the lesion site. When the pulmonary vascular resistance evaluated by catheterization is correlated with the anatomical obstruction visible on the images, pulmonary endarterectomy has a mortality rate below 4% and offers the patient a substantial chance to regain normal cardiorespiratory function. In cases of pulmonary arterial hypertension due to older embolisms, major arteriolitis occurs in the nonobstructed areas and aggravates the pulmonary hypertension, which may become suprasystemic. The endarterectomy mortality rate is then higher, and in specific cases justifies preoperative medical treatment. Pulmonary or cardiopulmonary transplantation is indicated in this disease only when the lesions are too distal and thus inaccessible to endarterectomy.
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PMID:[Surgical treatment of chronic thromboembolic pulmonary hypertension]. 1630 79

The most accurate treatment of obstructive pulmonary arterial hypertension (PAH) is the obstruction relief by surgery. Pulmonary endarterectomy is the treatment of choice of chronic thromboembolic pulmonary disease, the major cause of obstructive PAH. This procedure is associated with a low mortality rate in experienced centres and results in a dramatic improvement of hemodynamic parameters, functional status and survival rate. This surgery must be performed as early as possible in the history of this disease, preferentially before arteriolitis development in the non obstructed territories. The other obstructive PAH such as angiosarcomas, echinococcosis, arteritis, fibrosing mediastinitis can also be surgically treated by endarterectomy, tumorectomy or by pass according to their aetiology. By contrast lung transplantation is a palliative treatment indicated only after failure of medical treatment in an end-stage disease. Lung and heart-lung transplantation for PAH are associated with a 5 and 10 year actuarial survival rate of 50% and 35% respectively related to a higher postoperative mortality rate than for other organ transplantation and frequent development of graft obliterans bronchiolitis.
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PMID:[Surgical treatment of pulmonary arterial hypertension]. 1914 75


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