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)

The efficacy of low-dose cyclosporin-A (CyA) has been clearly demonstrated for rheumatoid arthritis. However, the long-term benefit-risk ratio remains to be investigated in patients with refractory RA. Thirty one patients were included in a prospective open study (24 females, seven males, mean age = 55 years). The mean duration of RA was 11 years and refractory RA was defined by the need of corticosteroid treatment in 26 patients and the previous failure of at least five second line drugs including methotrexate in 27 patients. Initial dosage of CyA was 3 mg/kg/d and could be progressively increased up to 5 mg/kg/d. The mean duration of the study was one year (3-39 months). At 3 months, clinically relevant improvement occurred in 22 patients (71%). Seven were withdrawn due to inefficacy. The main side-effects were hypertension (22 cases) and nephrotoxicity (18 cases) requiring the withdrawal from the study, respectively in one case and in four cases. Raised serum creatinine level had required reduction of the dosage with loss of efficacy in four cases. CyA appears to be an effective therapy for severe treatment refractory RA. Despite a high incidence of side-effects, the efficacy and the monthly management of the patients lead to a good benefit/risk ratio with a percentage of continuation of treatment of 42% at one year.
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PMID:[Treatment of refractory rheumatoid arthritis with cyclosporine]. 805 30

We review data concerning site and regulation of erythropoietin (EPO) production, its effects on target tissue, routes of administration and clinical applications. In the anaemia of chronic renal failure (ACRF) treatment with recombinant human erythropoietin (r-Hu-EPO) has been shown to be effective in both improvement of the anaemia and increase in quality of life. In the anaemia of chronic disease (ACD), associated with various malignant, infectious and inflammatory disorders, many investigators have demonstrated an inappropriately low EPO response to anaemia. Therapeutic trials in patients with ACD mostly lacked sufficient numbers of patients for evaluation of the effects. The results obtained from some studies in AIDS and rheumatoid arthritis and the effect on the number of units of autologous blood obtained from patients planned for elective surgery are encouraging, however. Adverse reactions of r-Hu-EPO treatment are mainly confined to the ACRF population and include hypertension, shunt thrombosis and pain at the injection site. The exact mechanism of action of EPO is not yet fully understood. Large scale clinical trials are required to establish its effects on both the anaemia and quality of life in anaemias other than ACRF.
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PMID:Erythropoietin: mechanisms of action and indications for treatment. 837 77

Previous hypotheses concerning the negative association between pre-eclampsia (or pregnancy-induced hypertension) and breast cancer risk have focused on hormone-related factors. A hypothesis is presented that certain non-specific cellular immune responses could be involved in this association and in the negative association between autoimmune diseases (i.e., systemic lupus erythematosus and rheumatoid arthritis) and certain cancers. Future directions for epidemiological and laboratory research suggested by this hypothesis are discussed.
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PMID:Pre-eclampsia, autoimmune diseases and breast cancer etiology. 858 75

A 62-year-old man with longstanding rheumatoid arthritis (RA) presented with dyspnea. Active rheumatoid interstitial lung disease was documented by high resolution computed tomography, gallium scan, and bronchoalveolar lavage. He responded to high dose prednisone, but had unacceptable side effects. Chlorambucil and cyclophosphamide were not steroid sparing. After starting cyclosporine 3 mg/kg/day he was able to stop prednisone and his symptoms improved and stabilized. Pulmonary function showed sustained improvement during 2 years of followup. His RA has been well controlled. Side effects have been mild hypertension and increased serum creatinine.
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PMID:Treatment of progressive rheumatoid interstitial lung disease with cyclosporine. 859 63

For the person with arthritis, the consequences of prolonged inactivity add measurably, and unnecessarily, to disease-related impairments, functional limitation, and disability. Inadequate levels of regular physical activity also increase the risk of cardiovascular disease, hypertension, diabetes, and obesity. This article reviews the benefits of regular physical activity for general health as well as the literature on conditioning exercise in rheumatoid arthritis and osteoarthritis. Recommendations and guidelines are given for including conditioning exercise in comprehensive management.
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PMID:Recreational exercise in arthritis. 884 14

Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most valuable groups of available medications because of their effectiveness in relieving pain, particularly that associated with rheumatoid arthritis. They are also among the most commonly prescribed drugs and, because of their availability over-the-counter, they are among the most widely consumed agents, especially by elderly people. Older individuals are more predisposed to the renal adverse effects of NSAIDs, because of: (i) age-associated changes in renal function; (ii) the prevalence of comorbid conditions (congestive heart failure, hypertension, hepatic cirrhosis, renal insufficiency); and (iii) the pervasive use of concomitant drugs that affect kidney function (diuretics, antihypertensives). However, because the incidence of NSAID-induced acute renal failure (ARF) is relatively low, and because it occurs in an identifiable and therefore preventable setting, the benefits of limited NSAID use outweigh the risks of this adverse effect. Using NSAIDs for a restricted period of time at the lowest effective dosage, and informing patients of the conditions in which ARF can occur, should minimise the risk of this effect. If the use of an NSAID in a patient at potential risk of ARF is necessary, close monitoring of renal function should further reduce the already low risk:benefit ratio for this adverse effect.
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PMID:Nonsteroidal anti-inflammatory drugs and acute renal failure in the elderly. A risk-benefit assessment. 892 61

Nitric oxide generated from L-arginine is a messenger for cell-to-cell communication. Abnormalities in nitric oxide release have been implicated in diseases ranging from hypertension and atherosclerosis to septic shock and rheumatoid arthritis. We report here the in vivo and in vitro measurements of nitric oxide in the cardiovascular system using a porphyrinic sensor specific for NO. The sensor has a detection limit 10(-9) M, response time of 0.1-10 ms and diameter of 1-20 microns. Protected by an intravenous catheter or Swan-Ganz catheter, the sensor can be implanted into tissues as well as into the blood stream. Nitric oxide concentrations were measured directly in the heart and also in veins and arteries, ranging in diameter from 100 microns to 5 mm. Nitric oxide production was induced by the action of different physical agents (shear stress, stretching) as well as various chemical substances agonists (bradykinin, acetylcholine, ATP).
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PMID:Direct measurement of nitric oxide in the cardiovascular system. 908 50

Omega-3 fatty acids (n-3) found specially on fish oil are represented by the acid alfa-linolenic, eicosapeniaenoic and docosahexaenoic. After 72 hours of n-3 fatty acids intake there are changes on membrane composition and decrease of synthesis of prostaglandin (PG), leucotriens (LT) and thromboxanes (TX) of the 2 and 4 series production and substitution for prostaglandin, thromboxanes and leucotriens of 3 and 5 series respectively. These alterations can modulate the inflammatory response in some diseases. N-3 fatty acid have been used in cardiology on hypercholesterolemy and hypertension control and on immunologic diseases as psoriasis, rheumatoid arthritis and Crohn disease. Experimentally the n-3 fatty acid inhibit tumor growth and metastasis. The authors consider the biophysiological actions of n-3 fatty acids and discuss the results of its use on clinical results.
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PMID:[Biological activity of fish oil]. 920 31

Among 138 inpatients with rheumatoid arthritis (RA) 18.1% had arterial hypertension (AH). AH in RA appeared in subjects with hereditary predisposition to AH. The presence of AH in RA is associated with rheumatoid vasculitis as the number of extraarticular manifestations of RA in AH patients is higher and is unrelated to renal affections. The levels of free radical lipid peroxidation in plasma and saliva are determined to a large extent by the hereditary factor in RA and are related to the presence of predisposition to AH.
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PMID:[The characteristics of arterial hypertension in rheumatoid arthritis]. 923 49

A follow-up study was conducted among men and women aged 55 years and over living in the community in order to estimate the incidence of initiation of antidepressant drug use and the association with chronic diseases. The study population consisted of 7,812 individuals. Overall, the incidence density for starting therapy with an antidepressant drug was 13.5 per 1000 person-years. The cumulative incidences after 1, 2 and 3 years were 1.3, 2.7 and 4.0%, respectively. The incidence in women was almost twice that in men and slightly higher in participants older than 70 years than in those younger than 70 years. The majority of the antidepressants prescribed were tricyclic antidepressants (65%), followed by selective serotonin reuptake inhibitors (23%) and other (12%) antidepressants. Only a minority (23%) received a dose considered effective for the indication of depression. Selective serotonin reuptake inhibitors were more often prescribed in an adequate dosage (68%) than were tricyclic antidepressants (12%) and other antidepressants (8%). Of the chronic diseases studied, only osteoarthritis and a history of stroke were predictors of initiation of antidepressant drug use after adjustment for age, sex and medical consumption. Hypertension, history of myocardial infarction, diabetes mellitus, rheumatoid arthritis, glaucoma, cognitive impairment and Parkinson's disease were not associated with future antidepressant drug use. No relevant differences were observed with respect to the choice of type of antidepressant drug among patients with chronic diseases. The present study indicates that each year antidepressant drug therapy is initiated in approximately 1.3% of the elderly. In general, the presence of chronic somatic diseases was not predictive of initiation of antidepressant drugs. Tricyclic antidepressants in this age group and in patients with certain chronic diseases may not be the optimal choice given their side-effects profile and drug-drug and drug-disease interactions. The predominance of these agents in the present study calls for further attention.
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PMID:Incidence of antidepressant drug use in older adults and association with chronic diseases: the Rotterdam Study. 934 83


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