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

A progressive rise in arterial calcium content is the most characteristic age-associated alteration in the arterial wall and the decisive factor in arteriosclerotic degeneration. Experimental studies have demonstrated that calcium antagonists can prevent or retard the development of arterial calcinosis associated with vitamin D overload, hypertension or alloxan-induced diabetes. Although similar effects are more difficult to observe in humans, they have been demonstrated in patients with coronary artery disease and in patients with end-stage renal disease, which is characterised by an acceleration of the normal arterial aging process.
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PMID:Arterial calcinosis, chronic renal failure and calcium antagonism. 128 73

Vitamin D, a fat-soluble vitamin, can be associated with significant morbidity when prescribed in large doses. We describe a hypoparathyroid patient with vitamin D intoxication who developed painful periarticular calcinosis, nephrocalcinosis with hypertension and chronic renal failure in addition to band keratopathy and hearing loss. He was treated with combination therapy including prednisone, phosphate-binding antacid, phenytoin and disodium etidronate. After 20 months of follow-up there was a significant reduction of periarticular calcinosis, but no improvement in renal function, band keratopathy or hearing loss and possible calcification of the ossicles. The clinicopathologic features of metastatic calcification and the various treatment modalities are reviewed.
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PMID:Calcinosis and metastatic calcification due to vitamin D intoxication. A case report and review. 139 78

Data on the influence of antihypertensive drug treatment on mortality of hypertensive rats are reviewed. Dihydropyridine calcium antagonists, verapamil, the angiotensin-converting enzyme (ACE) inhibitor captopril, and a triple combination of reserpine, hydralazine, and chlorothiazide normalized or markedly prolonged survival. Captopril was less effective in sodium chloride-induced, low-renin Dahl rat hypertension. Dihydralazine prolonged but did not nearly normalize survival. The K(+)-channel activator minoxidil was relatively ineffective. Data on diuretics or beta-blockers are insufficient or unavailable. Calcium antagonists nitrendipine and nimodipine and the ACE inhibitor captopril improved survival and prevented vascular lesions and calcinosis even at doses that failed to achieve normotension. All drugs that normalized survival also reduced heart weights. Minoxidil invariably increased heart weights and failed to improve survival. (Di)hydralazine assumed an intermediate position.
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PMID:Effects of different antihypertensive drug classes on survival in animal models. 171 94

Using specific calcium antagonists as experimental tools, both the physiological messenger and current carrying function of calcium ions as well as their pathogenetic potencies could be elucidated. Notably, excess intracellular calcium signalling and intra- and extracellular calcium overload turned out to be pathogenetic principles of general importance. In this context, progressive calcium overload of arteriosclerotic vascular walls and the antiarteriosclerotic effects of calcium antagonists, deserve particular interest. In fact, with the help of calcium antagonists, arterial calcium overload as decisive component of various types of experimental arteriosclerosis became accessible to a direct therapeutic intervention. According to their responsiveness to calcium antagonists, two pathophysiologically different types of experimental coronary plaques could be characterized: (1) The calcium type, i.e. coronary calcinosis of vitamin D3-intoxicated rats highly sensitive to calcium antagonist treatment, (2) the cholesterol type, represented by coronary atheromata of cholesterol-intoxicated rabbits; this primary coronary cholesterol accumulation could not be inhibited by calcium antagonists. The formation of conventional human coronary artery plaques is characterized from the very early lesion onwards by a progressive local uptake of calcium, finally leading to lethal consequences. Conversely, the analysis of the mural cholesterol does not allow to discriminate arteriosclerotic from normal coronary artery segments. Thereby, conventional human coronary plaques typically represent a calcium-dominated type of human arteriosclerosis and differ widely from plaques produced in cholesterol-fed rabbits. The results indicate the decisive pathophysiological role of calcium and calcium overload in both calcium-dominated types of experimental arteriosclerosis and conventional human coronary artery plaques. Moreover, the antiarteriosclerotic effects of calcium antagonists are demonstrated to be based--in various types of experimental arteriosclerosis--on the inhibition of intra- and extracellular calcium overload of arterial walls evoked by various risk factors (vitamin D3 intoxication, hypertension, nicotine, diabetes).
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PMID:Calcium--a neglected key factor in arteriosclerosis. The pathogenic role of arterial calcium overload and its prevention by calcium antagonists. 175 29

The authors analyze the results of 143 ++roentgeno-endovascular dilatations (RED) made in 89 patients during 1986-1990. RED of stenoses and occlusions of the iliac and femoral arteries over a length of less than 10 cm is feasible practically in all the patients. This intervention is safe and well tolerated by patients. As for RED of occlusions of the femoral arteries over a length of more than 15 cm beginning from the arterial ostium, the authors recommend that a popliteal access to the femoral artery be employed. Otherwise the passage of the occlusion area in the antegrade direction is impossible. At the same time in order to prevent thromboembolic complications, it is necessary to carry out intra- and postoperative anticoagulant therapy. Extended occlusions of the femoral arteries can be subjected to RED in cases where calcinosis of the arteries and thrombotic component are lacking in occlusion. RED of renal artery stenosis can be used as a method of choice in the treatment of vasorenal hypertension. RED is likely to be used for the management of stenoses of unpaired visceral arteries.
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PMID:[Roentgeno-endovascular dilatation and recanalization of the arteries in thrombosis and other occlusive diseases]. 180 Dec 27

Clinical experience and epidemiological observations have demonstrated that some hypertensive patients experience progression of atherosclerotic vascular disease despite successful control of hypertension. Thus, there appears to be a discordance relative to the benefits of antihypertensive therapy--'pressure'-related but not 'atherosclerotic' complications are prevented by BP control with conventional antihypertensive therapy. The effects of antihypertensive drugs on atherosclerotic complications of hypertension is a subject of major clinical importance. The question is whether or not different classes of antihypertensive drugs exert dissimilar vasculoprotective actions independent of their BP lowering effects. There is considerable experimental data to implicate a relationship between calcium and lipoprotein metabolism at the vascular site. The calcium ion may play a role in the steps culminating in the formation of atherosclerotic plaques. Evidence has been presented that calcium channel blockers may modify experimental arterial calcinosis and atherosclerosis. At least a couple of published trials have shown that calcium antagonists indeed prevent/attenuate atherosclerotic lesions in patients with coronary artery disease. These observations underscore the significance of a new dimension in cardiovascular drug therapy--that is the vasculoprotective and antiatherosclerotic effects of calcium antagonists.
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PMID:Antiatherosclerotic and vasculoprotective effects of calcium antagonists: clinical implications. 209 Aug 36

11 cases of primary hyperparathyroidism were seen during 1975-1988. Follow up has varied from 1-10 years. Renal disease in the form of renal calculi and nephro-calcinosis was observed in nine cases (81.8%). Two presented in chronic renal failure and required dialysis. Bone disease was found radiologically in six patients (54.5%); two had bone cysts in multiple bones while all six had subperiosteal bone erosion. Hypertension was found in three patients (27.3%). Proximal myopathy was observed in two cases (18.1%). One patient each presented with hypercalcaemic crisis, chondrocalcinosis and acute pancreatitis. The calcification of blood vessels and cornea was seen in two cases.
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PMID:Primary hyperparathyroidism. 238 Jan 35

The broad availability of new pharmacologic agents is usually followed by both the search for similar compounds with more specific and refined actions and the expansion of clinical applicability for these agents. During the last twenty years extensive investigations have revealed that calcium (Ca) antagonists hold a multifaceted pharmacodynamic potential that includes not only the antiarrhythmic and antihypertensive effects of the drug but also the protection against excessive Ca entry into the cells of the cardiovascular system and subsequent cell damage. The physiologic age-dependent Ca accumulation in the arterial wall, which inevitably appears after the second decade, reaches maximal values in the age group of eighty-one to ninety years when the aortic wall exhibits a total Ca content that is 100 times higher than in arteries of infants. In animals we also find age-dependent accumulation of Ca in the arterial wall that is severely aggravated by uncontrolled diabetes or hypertension. Fleckenstein has shown that this arterial calcinosis can be prevented by chronic administration of Ca antagonists. Furthermore, Fleckenstein has demonstrated that excessive Ca overload of myocardial tissue constitutes a basic pathologic process in the development of cardiac necroses--brought about by extreme beta-adrenergic drive (overdoses of catecholamines), high doses of vitamin D3, dihydrotachysterol, alimentary factors such as K or Mg deficiency, or genetic defects (hereditary cardiomyopathy). Even cardiac hypertrophy, either idiopathic or as a consequence of hypertension, can be prevented by the action of Ca antagonists.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Calcium antagonists: pharmacologic agents in search of new clinical indications. 240 53

There are several reasons to expect that the use of calcium antagonists to treat cardiovascular disease will continue to spread. The scope of indications for existing calcium antagonists is expanding; new calcium antagonists with more selective organ affinity are being developed and these drugs may be given over the long term for prophylaxis against hypertension and for vasoprotection. In all probability, the long-term prophylactic use of calcium antagonists offers the most promise. The long-term effects of calcium antagonists for treating hypertension as well as for preventing vascular damage due to calcinosis and sclerosis will be discussed.
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PMID:Future directions in the use of calcium antagonists. 243 33

Numerous epidemiological studies have shown that systolic and systodisystolic hypertension constitute major risk factors for damaging or fatal cardiovascular accidents in the elderly as well as the young. Furthermore reducing the blood pressure also reduces the risk. In 1983 Fleckenstein investigated the Ca++ and MG++ contact of human arteries and clearly demonstrated that titres of both but especially Ca++ in the arterial wall increased progressively with age. The Authors themselves caused calcinosis of the arterial wall in rats treated with Vitamin D3 and Dihydrotachysterol and were able to prevent the occurrence with Verapamil. It is against this background that the present study compared the efficacy and tolerability of two anti-hypertensive drug groups in the calcium antagonists and the ACE inhibitors (Enalapril Maleate) used individually on two groups of elderly hypertensives. A group of 123 out patients with a mean age of 73 and all suffering from slight-to-moderate hypertension were monitored for 6 months being subjected to the following examinations: clinical assessment including blood pressure measurements lying and standing, biohumoral tests, remote heart X-rays, echocardiography (to establish the Reichek systolic wall stress index) and ECG. The clinical examination and ECG were repeated every 2 weeks for the first 6 months and once a month thereafter. The heart X-rays, echocardiogram and biohumeral tests were performed every 6 months. The patients were divided into two groups I and II and assigned to the selected treatment. The Group I patients were then divided into 3 subgroups and treated with 3 different calcium antagonists (Nifedipine R; Verapamil R and Diltiazem). All group II patients were treated with Enalapril Maleate.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Calcium antagonists vs ACE inhibitors in the treatment of essential arterial hypertension in the aged]. 254 2


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