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

The treatment of hypertension was discovered long before the mechanisms of the disease became known. Only recently has it been appreciated that blood pressure is controlled physiologically in many ways. Hypertension has suddenly achieved celebrity status. It is now recognized as the second leading cause of death in the United States. New programs have made the public aware of it and have prompted many individuals to have their blood pressure checked. Office diagnostic measures usually suffice to determine the presence of the disease. Treatment should generally be initiated with a slow-acting diuretic or with propranolol; other drugs may be added later. Treatment is a lifelong undertaking, and engaging the patient as a partner in the venture by means of home blood pressure measurements and an educational program contributes to its success. Treatment of hypertension is the first step in the prophylaxis of atherosclerosis.
 ...
PMID:Hypertension--the fledgling of modern medical practice. 83 79

Adrenal regeneration hypertension (ARH) was induced in virgin and breeder, spontaneously hypertensive (SHR) and Sprague-Dawley (SD) rats. The blood pressure of the previously normotensive, virgin, SD rats and the SD breeder rats with preexistent mild hypertension became greatly elevated. ARH caused an increase in the preexisted severe hypertension in SHR virgin and breeder rats. Serum enzymes, e.g., CPK, SGOT and LDH, were greatly elevated concomitant with the finding of old and new foci of myocardial necrosis. ARH produced a dichotomous metabolic effect, i.e., elevated cholesterol, glucose, and corticosterone levels in SD rats but reduced levels in SHR rats. The zonae glomerulosae of the the regenerated adrenal glands of SD rats were devoid of lipid whereas the zonae glomerulosae of SHR rats were full of lipid. Intact SHR breeder rats develop arterial lesions confined to their reproductive organs but after ARH treatment, they were found to have aortic, coronary and renal arterial lesions which were similar to those which occur, spontaneously, in SD breeder rats. It is suggested that changes in the spectrum of adrenal steroids produced during ARH may contribute to the diverse metabolic changes and the alterations in the usual cardiovascular degenerative changes found in these two strains.
Atherosclerosis 1977 Jan
PMID:Comparative effects of adrenal regeneration hypertension on non-arteriosclerotic and arteriosclerotic Sprague-Dawley vs spontaneously hypertensive rats. 83 44

Hypertension is associated with an increased incidence of generalized vascular disease. Antihypertensive drug therapy, while decreasing overall mortality due to cerebral hemorrhage, myocardial hypertrophy or renal failure, paradoxically does not appear to reduce the incidence of coronary atherosclerosis. This study investigates whether the drugs, as a possible side effect, may have an adverse influence on the development of atherosclerotic plaques. Groups of rabbits were fed an atherogenic diet containing 1% cholesterol for 12 weeks. Two commonly used antihypertensive agents (methyldopa and chlorthalidone) were added to the diet of some groups at levels of 100 mg and 10 mg per day respectively. No significant increase in total atherosclerotic plaque area was produced by either of the drugs tested singly or in combination. Plasma renin levels were only mildly elevated and in this experimental system there was no correlation between renin activity and atherosclerotic plaque intensity. There is thus no evidence from this study that antihypertensive drugs have any adverse effects on atherosclerotic plaque formation. While the ineffectiveness of these drugs against coronary atherosclerosis may indicate that normalization of pressure cannot arrest changes already initiated, it also supports the possibility that association of atherosclerosis with hypertension may be symptomatic of a common underlying defect not correlated by normalizing blood pressure.
Atherosclerosis 1977 Jan
PMID:Anti-inflammatory agents in experimental atherosclerosis. Part 2. Failure of antihypertensive drugs to exacerbate atherosclerotic plaque formation. 83 50

A six year old girl complained of sudden severe headache, became hemiplegic and unconscious. A right carotid arteriogram revealed an obstruction of the right anterior cerebral artery and many sulvian branches. Death occurred four days later. At autopsy, a recent softening of nearly all the right middle cerebral arterial territory was found. Thrombus filled the sylvian artery and its main branches. Histologic examination of the vessel walls showed a dissecting infiltration of blood between the internal elastic lamina and the media. This particular form of dissecting aneurysm, occurring in young subjects, in the absence of atherosclerosis, high blood pressure and idiopathic medial necrosis, represents a distinct medial necrosis, represents a distinct nosologic entity that has been called "Obstructive parietal hemodissection of intracranial vessels." The pathogenesis of the disease is unknown: trauma has been mentioned, also congenital defects in the elastic lamina or other morphologic abnormalities of that lamina.
 ...
PMID:[Obstructive parietal hemodissection of the intracranial vessels, a particular form of dissecting aneurysm]. 83 66

Managing hypertension effectively requires careful evaluation of the patient, in particular for the presence of target-organ damage and of other risk factors for atherosclerosis. Dietary management has proved to be unsatisfactory in most hypertensive patients, as patients resist dietary restrictions or any other changes in life-style. Drug treatment has been shown to significantly reduce morbidity and mortality in patients with diastolic blood pressures above 104 mm Hg. Evidence suggests that drug treatment is also effective in those with diastolic pressures between 90 and 104 mm Hg. Selection of drugs is still an empirical decision--treatment with an oral diuretic usually is effective for mild hypertension (diastolic pressures 90 to 115 mm Hg). A sympathetic depressant, often propranolol, may be added to the regimen next, and if this is ineffective, a vasodilator (usually hydralazine) is included. Common side effects of antihypertensive drugs are seldom serious but can be annoying. Patients should be forewarned about them, and about the effects of untreated hypertension in an effort to improve compliance.
 ...
PMID:Managing hypertension: the postgraduate medicine lecture. 84 Aug 1

The prevalence of coronary artery disease (CAD) and peripheral artery disease (PAD) was studied in 280 (203 males, 77 females) patients with different types of primary hyperlipoproteinemia. In primary hyperbetalipoproteinemia the prevalence of CAD (45% for Type IIa and 47% for Type IIb) is significatly higher than that in the other types of hyperlipoproteinemia (38% for Type IV and 17% for Type V). On the other hand, PAD prevalence is much higher in hypertriglyceridemia (21% in Type IIb and 20% in Type V) than in hypercholesterolemia alone (9% in Type IIa). These results suggest ths atherosclerotic complications are concerned. Moreover, the high frequency of PAD found in hypertriglyceridemia can be related to the high occurrence of diabetes in these patients. The effects of other major risk factors of atherosclerosis (smoking and hypertension) were also evaluated. Our results indicate that the association of hypercholestolemia and hypertension is more dangerous than the co-occurence of hypercholesterolemia and smoking.
Atherosclerosis 1977 Apr
PMID:Prevalence of coronary artery disease and peripheral artery disease in patients with different types of primary hyperlipidemia. 85 27

Borderline hypertension is widespread. Though the increased blood pressure appears to be innocent, and upon rest frequently returns to the normal range, signs of complex and profound alteration of the physiologic control of the circulation can already be found. The pathophysiology of borderline hypertension is of particular interest since it may reveal clues about the processes which initiate the hypertension rather than the consequences of the primary blood pressure elevation. Patients with borderline hypertension are at a higher risk of developing future sustained hypertension and its consequences. The risk, however, is not sufficient to justify treatment in all cases. Patients must be followed to observe blood pressure trends and treatment attempted in the selected minority which has the highest risk. The determination of risk is based on repeated measurements of blood pressure and on the assessment of risk factors for atherosclerosis and for future hypertension.
 ...
PMID:Borderline hypertension. An overview. 85 4

In hypertensive patients over 50 years of age, the high prevalence of renovascular hypertension (31 per cent), the low operative risk for its correction (1 to 2 per cent), and the frequency of benefit from operation (80 to 87 per cent) support an aggressive attitude toward screening and management. Diastolic hypertension greater than 105 mm Hg in the older patient warrants investigation. If such a patient has advanced atherosclerosis with evidence of significant cardiac disease or cerebrovascular disease, the indications for operative management of renovascular hypertension correlated with the severity of hypertension, difficulty of control, and imminence of renal function deterioration. If complicating risk factors are not severe, any patient with diastolic hypertension greater than 105 mm Hg is considered an appropriate operative candidate. In contrast, when risk factors are severe, operative management is undertaken only when hypertension is difficult to control or deterioration of renal function is thought to be secondary to the renal artery stenosis. In these patients the risk of operation is obviously greater and the long term benefits are more limited. Nevertheless, based on our experience, we feel the risk of poorly controlled hypertension or impending renal failure is even higher and justifies operative intervention. Hypertension accelerates the progress of atherosclerosis, and halting or slowing the unrelenting course of atherosclerosis is worthwhile objective if this can be done without unnecessary risk.
 ...
PMID:Surgical management of renovascular hypertension in older patients. 85 6

The major reason for treating hypertension is to avoid complications of the disease as it affects "target organs." Treatment of the blood pressure is not the only way to avoid these complications, but it is part of the total practice of preventive medicine. Hypertension lasts for several decades in most patients, and there is time to destroy the patient through target organ effects or to save the patient through treatment. Diabetes, atherosclerosis, and other illnesses and operations pose special hazards to the patient with hypertension. Patients take many other drugs as well, and some of them react adversely with antihypertension medicines. Complications from blood pressure drugs involve nearly every organ system, more than most physicians can remember. These may be dose-related and can often be avoided by using smaller doses of more than one drug. Certain problems occur so frequently that they should be learned well. The physician should bear in mind that whatever develops may be due to the antihypertensive therapy. On the whole, however, medications for treatment of hypertension are remarkably safe and free from side effects.
 ...
PMID:Prevention of some complications of essential hypertension. 86 7

A case of gallbladder infarction, occurring in a 34-year old man with severe hypertension is described, with uneventful recovery following cholecystectomy. In the absence of other obvious etiologic factors, the gallbladder infarction is presumed to be directly related to hypertensive vascular disease. Infarction of the gallbladder is rare; a few cases associated with hypertension have been previously reported. Other types of vascular disease including embolization, thrombosis complicating atherosclerosis and celiac angiography, polyarteritis nodosa, occlusion following torsion and cystic vein thrombosis have been reported to cause gallbladder infarction.
 ...
PMID:Infarction of the gallbladder: a complication of hypertension. Case report. 86 44


<< Previous 1 2 3 4 5 6 7 8 9 10