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

The patient, a manic depressive who was treated with lithium for three years, suddenly developed severe neurotoxicity and a glomerulonephritis-like syndrome. The author believes that the lithium toxicity was facilitated by hot weather with excessive sweating, gall bladder pathology with fever, and decreased water and salt intake. The patient improved except for a persistent hypertension. Propranolol not only improved the hypertension but alleviated a lithium-induced tremor as well.
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PMID:Severe neurotoxicity and lithium therapy. 74 6

There has been a long-held belief that lithium salts cannot be used in the presence of thiazide diuretics. Recently, however, thiazides have been demonstrated to be not only safe, but actually indicated in two situations in which lithium salts are used. The first is in the treatment of lithium-induced nephrogenic diabetes insipidus and the second is in severe manic depressive illness in which high doses of lithium do not produce therapeutic serum or intraeythrocytic lithium concentrations. This new information now makes it possible for some manic depressive patients with serious medical illnesses (such as hypertension or congestive heart failure), in whom thiazide diuretics are routinely used, to be treated cautiously with lithium carbonate. This paper analyzes data from 13 patients taking lithium carbonate and varying doses of chlorothiazide in order to indicate the approximate magnitude of downward adjustment of daily lithium dose which the clinician must make to safely give 500, 750, and 1,000 mg/day of chlorothiazide.
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PMID:Adjustment of lithium dose during lithium-chlorothiazide therapy. 88 23

American former prisoners of war (POWs) are an aging group who seek health care with increasing frequency. To examine the prevalence of long-term physical and emotional consequences of captivity in this population, the authors analyzed medical and psychiatric examination data for 426 former POWs. Detailed psychiatric diagnostic criteria were used to assess the POWs' mental health. Compared with general population groups, POWs had moderately elevated lifetime prevalence rates of depressive disorders and greatly elevated rates of posttraumatic stress disorder (PTSD), although their rates of hypertension, diabetes, myocardial infarction, bipolar disorder, schizophrenia, and alcoholism were not elevated. POWs who lost more than 35 percent of their body weight during captivity had higher rates of anxiety disorder, depressive disorders, PTSD, and schizophrenia, compared with other POWs.
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PMID:Prevalence of somatic and psychiatric disorders among former prisoners of war. 189 54

We describe two patients with unusual neuro-ophthalmologic complications during long-term therapy with lithium carbonate given for bipolar affective disorder, "benign" intracranial hypertension in one, and downbeat nystagmus, with oscillopsia in the other. A review of the literature is proposed. Though rare, such neuro-ophthalmologic manifestations are worth being recognised since they usually disappear with cessation--when possible--of lithium therapy.
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PMID:[2 rare neuro-ophthalmologic complications of long-term treatment with lithium salts]. 250 94

A 23 years old woman, diagnosed as having manic-depressive psychosis, in treatment with lithium carbonate for eight months, developed a benign cranial hypertension secondary to the lithium. Suppression of the lithium gave place to the normalization of the pressure of the cerebrospinal liquid which increased again with the reintroduction of the drug. This rare complication of the lithium salts, has only been described in five other cases, all women, with a relative short time of treatment, non-toxic lithium serum levels and without precipitating factors.
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PMID:[Benign cranial hypertension secondary to treatment with lithium]. 257 50

1. The association of hypertension and depression has long been recognized. The purpose of this study was to explore the relationship between RBC level/plasma level of lithium (Li), blood pressure (BP) and weight in bipolar affective disorder patients. 2. All patients were evaluated by the same examiner using DSM-III Diagnostic Criteria. Measurement of patients' Li values, BP and weight were carried out on the same day or within 24 hours. 3. We evaluated 103 bipolar patients treated with lithium (mean age: 44 years, mean duration of Li treatment, 6 years). Ten percent of these patients were hypertensive. 4. No significant difference was found between hypertensive (H) and non-hypertensive (NH) patients with respect to their RBC, plasma or RBC/plasma Li ratio. This finding was consistent in patients treated with Li alone or Li combined with other neuroleptics. 5. Our study did not confirm previous findings (McCoy et al, 1982) indicating that there is a correlation between low Li ratio (less than 0.30) and hypertension in bipolar affective disorder patients.
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PMID:Transmembrane lithium distribution and hypertension in manic depressive patients. 274 74

100 patients with affective disorder (unipolar affective disorder and bipolar affective disorder) were evaluated for evidence of increased risk for the major cardiovascular risk factors including hypertension, hypercholesterolemia, obesity, and cigarette use. Unipolar affective disorder patients showed no evidence of increased cardiovascular risk compared to population controls. Bipolar affective disorder patients displayed increased systolic blood pressure, definite hypertension, and use of cigarettes. These findings are consistent with a link between affective disorders and excess cardiovascular mortality.
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PMID:Cardiovascular risk factors in affective disorder. 295 3

Erythrocyte lithium transport mechanisms--lithium-sodium countertransport (LSC), lithium-potassium cotransport (LPC) and passive lithium efflux (PLE)--were measured in 46 patients with bipolar affective disorder on prophylactic lithium therapy and in 20 healthy control subjects. Maximal velocity of LSC measured at saturating intracellular lithium concentration was lower in the patients than in the controls; this may concur with previous reports on possible links between impaired activity of LSC and bipolar affective illness. When measured at therapeutic lithium concentration, LSC was 4 times lower and Km for LSC was 5 times higher in lithium-treated affective patients than in control subjects. The in vivo erythrocyte:plasma lithium ratio was inversely correlated with LSC in lithium-treated patients; higher ratios were found in females than in males. No differences were found between affective patients and control subjects in other erythrocyte lithium transport measurements. The values for lithium transport were not related to age, duration of lithium therapy, concomitant neuroleptic treatment, hypertension or obesity. Lower activity of LSC was found in patients with lithium-induced thyroid enlargement than in the other patients. The results obtained are discussed in the light of contemporary findings concerning erythrocyte lithium transport mechanisms in affective disorders and other conditions.
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PMID:Erythrocyte lithium transport during lithium treatment in patients with affective disorders. 308 11

Two patients on long-term lithium therapy for manic-depressive psychosis developed serious toxicity within days of being prescribed a combination of triamterene (50 mg) and hydrochlorothiazide (25 mg) for mild symptomless hypertension. Reduced clearance of lithium has been reported to follow its concurrent administration with diuretics that deplete both sodium and potassium. A combination of triamterene with thiazide has not been shown previously to precipitate lithium toxicity.
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PMID:Lithium toxicity induced by triamterene-hydrochlorothiazide. 726 81

Although monogenic diseases often show extreme clinical phenotypes, the major burden of genetic ill health lies in the more prevalent polygenic disorders, such as diabetes, hypertension and multiple sclerosis. These conditions affect many thousands of individuals and their management consumes vast amounts of health care resources: in the UK some 80,000 people have multiple sclerosis; the estimated financial cost to society of introducing treatments, such as beta interferon, could be as high as 250 million pounds per year. Knowledge on the genetics of these common diseases is poor, but has potentially received a considerable boost with the arrival of whole genome screening. The genome screen in insulin-dependent diabetes mellitus (IDDM) reported in 1994 was the first in a human polygenic disease. Since this publication, whole genome screening has been performed in a variety of human polygenic diseases, including schizophrenia, bipolar affective disorder, non-insulin-dependent diabetes mellitus (NIDDM), inflammatory bowel disease, asthma and multiple sclerosis.
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PMID:The genetic analysis of multiple sclerosis. 919 29


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