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

The experience with bundle branch block at the USAF School of Aerospace Medicine was reviewed. The clinical and follow-up status was evaluated in 394 subjects with right bundle branch block (RBBB) and 125 subjects with left bundle branch block (LBBB). The majority of subjects were asymptomatic at the time of bundle branch block diagnosis. The subjects were divided into subfroups based on electrocardiographic (EEG) findings to determine if any one subfroup was at higher risk for initial or follow-up morbidity of cardiobascular disease or follow-up mortality. At initial diagnosis and clinical evaluation, 94% of RBBB and 89% of LBBB subjects had no evidence of cardiobascular disease. In the RBBB group, 3 and 2% had cornary heart disease and hypertension, respectively; in LBBB subjects, 9 and 7% had cornary heart disease and hypertension, respectively. No one ECG subfroup in either the RBBB or LBBB group had a higher incidence of cardiobascular disease. Complete follow-up information was available in 94% of the RBBB subgroup subjects and 91% of the LBBB group. In the follow-up period, new cases of coronary heart disease and hypertension occurred in 6% of the RBBB group and 5 and 8%, respectively, in the LBBB group. Fourteen (4%) RBBB and nine (8%) LBBB subjects died during the follow-up period. No differences for follow-up groups. Progressive electrical dysfunction in the form of complete heart block occurred in one subject each absence, and degree of associated cardiobascular disease. Furthermore, within the age limits of the present aeromedical implications of bundle block are discussed.
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PMID:A clinical and follow-up study of right and left bundle branch block. 113 86

1. In thirty six patients with various circulatory diseases, the influence of exercise on myocardial carbohydrate metabolism was observed by use of coronary sinus catheterization. Bicycle ergometry was performed in supine position at a level of fifty watts for fifteen minutes. 2. The myocardial carbohydrate metabolism was not significantly affected by the manipulations with coronary sinus catheterization. 3. At resting state, there was no significant difference among disease groups except that myocardial lactate extraction ratio showed lower values in some cases of the patients with coronary heart disease. 4. During exercise, in cases of neurocirculatory asthenia and hypertension without coronary insufficiency, the myocardial carbohydrate usage was increased with the increase in coronary blood flow and the arterial concentration, maintaining of the carbohydrate extraction ratio. In cases of hypertensive coronary failure, the myocardial carbohydrate usage was maintained chiefly with remarkable increase in the arterial concentration in spite of no significant change of coronary blood flow and the carbohydrate extraction ratio. In normotensive coronary heart disease, the myocardial carbohydrate usage decreased or slightly increased, chiefly due to strong decrease in the extraction ratio and to the lowest increase in coronary blood flow. In many cases the carbohydrate release out of the heart muscle was observed. For the most of the cases of the other heart diseases, the latent disturbance of myocardial carbohydrate metabolism was revealed by exercise in spite of the good response of coronary circulation. 5. The myocardial uptake, extraction ratio and usage of lactate were significantly lower in the ischemic ECG positive group than in the negative group, in spite of significantly higher increase in the arterial concentration in the positive group. The myocardial metabolism of pyruvate during exercise was similar to that of lactate, but the myocardial metabolism of glucose was not clearly correlated with ECG changes.
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PMID:[Study on myocardial carbohydrate and energy metabolism during exercise in patients with circulatory diseases (author's transl)]. 115 95

A study of coronary heart disease (CHD) among Japanese migrants compared with Japanese living in Japan provided the opportunity to study factors possibly responsible for the high rates of CHD in America as compared with Japan. Comparable methods were employed in examining 11,900 men of Japanese ancestry aged 45--69 living in Japan, Hawaii and California. The age-adjusted prevalence rates for definite CHD as determined by ECG were: Japan 5.3, Hawaii 5.2 and California 10.8/1000. For definite plus possible CHD the rates were 25.4, 34.7 and 44.6. The prevalence of angina pectoris and pain of possible myocardial infarction, determined by questionnaire, showed a similar gradient. Elevated serum cholesterol showed a Japan-Hawaii-California gradient, but the prevalence of hypertension in Japan was intermediate between the prevalence in Hawaii and the higher prevalence in California. The three geographic locations were compared as to prevalence of CHD at comparable levels of blood pressure and cholesterol. At each blood pressure level and at each cholesterol level, the greater prevalence of CHD in California persisted. These facts, plus the near universality of smoking in Japan, suggest that conventional risk factors only partly explain the observed gradient in CHD.
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PMID:Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: prevalence of coronary and hypertensive heart disease and associated risk factors. 120 53

In two geographical areas; the Gurghiu Valley, in a mountain region, and the village of Jurilovca on the shores of the Razelm lagoon, investigations were performed in 390 subjects of both sexes over 20 years of age, first degree relatives of healthy index subjects (males aged 40 to 60 years) and 298 subjects of both sexes over the of 20, first degree relatives of index-subjects with coronary heart disease and/or hypertension. The prevalence of these diseases was found to be 40% higher in the families of diseased subjects. The authors assume the participation of a genetic factor in the etiology of these two degenerative cardiovascular diseases.
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PMID:Familial clustering of degenerative cardiovascular diseases. 121 98

Transversal epidemiologic investigations carried out in different populations from several regions of Romania : Gurghiu Valley (lumberjacks from a mountain region), Danube Delta and Razelm lagoon complex (fishermen), and Bucharest have shown that, in spite of the high caloric value of food and even of a high intake of saturated fats, mean serum cholesterol is lower in the rural areas than in Bucharest, probably owing to the strenuous physical work. However, except myocardial infarction, more frequent in the urban than in the rural regions, the other forms of coronary heart disease have a relatively higher frequency in villages, particularly atrial fibrillation and ECG signs of ischemia. These findings might be explained by a greater prevalence of hypertension in these populations. It is concluded that the risk factors, which act synergically, depend on the complex structure of the "ecologic niche".
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PMID:Coronary heart disease and risk factors in some special type collectivities. 124 94

The recent increase in coronary heart disease is real and the causes must mainly be environmental. Consequently the condition should largely be preventable. The application of what is already known is likely to be a far more effective way of reducing the mortality rate than all attempts at palliative treatment, but vigorous action will be necessary. Much greater sums are being expended on coronary-care units and cardiac surgery than in preventing the need for them, although there is little evidence that they have significantly lowered the over-all mortality rate. Conventional treatment is immensely expensive. Prevention could in the long run be much cheaper. Cardiologists on their own are unlikely to succeed in a program of prevention. They need the help of many others, including community nurses, nutritionists, public health workers, sociologists, and of course general practitioners, but they have responsibility for leadership and for providing background knowledge. For the detection of certain risk factors, health examinations are necessary and should be part of general practice. Also, advice is best given on an individual basis. The chief-known risk factors (hyperlipidemia, hypertension, smoking, physical inactivity) could be controlled. CHD occurs in adults but atherosclerosis starts many years before. Prevention should begin with appropriate infant feeding, whenever possible with breast milk, and continue into childhood, when habits are formed and attitudes to life can best be influenced. It should be possible to bring up children virtually free from risk factors. It may never be possible to prove the effectiveness of such a multifactorial program by prospective controlled intervention studies, but the evidence indicates strong probability. The stakes are too high to delay action any longer. Physicians daily give advice in areas where the evidence is much less certain. Such a program for the control of coronary artery disease is urgently needed and could become one of the most rewarding activities for the medical profession.
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PMID:The cardiologist's responsibility for preventing coronary heart disease. 124 24

Factors in the prevention of coronary heart disease (CHD) are review ed. In regards to oral contraceptives (OCs), there is some evidence that OCs significantly increase the risk of CHD in women over 40 years of age who are already at increased risk. There have also been reports that the risk of developing myocardial infarction or coronary death is 5-6 times higher in women aged 40-44 years using OCs than in nonusers. OCs can induce hypertension, though this condition is generally reversible after discontinuation of use. There also appears to be a relationship between OC use and carotid or cerebrovascular thromboses. It is recommended that caution be exercised in prescribing OCs to women over 40 years of age, those with a family history of premature CHD, and those who are heavy cigarette smokers or have other risk factors. It is also recommended that prospective OC users have their blood pressure tak en, and those with a family history of CHD or diabetes mellitus should be tested for plasma lipid levels.
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PMID:Prevention of coronary heart disease. Report of a Joint Working Party of the Royal College of Physicians of London and the British Cardiac Society. 126 63

Atherosclerosis and insufficiency of the coronary arteries and their sequelae are summarized in the term "coronary heart disease". For the evaluation of the coronary arteries the knowledge of malformations, variants and supply areas is of importance. Extension and severity of atherosclerosis of the coronary arteries and their insufficiency is being influenced by hyperlipidemia, hypertension and diabetes mellitus. The process of atherosclerosis as a cause of the proliferation of vascular smooth muscle cells in complicated by ulceration, parietal and obliterative thrombosis as well by intramural hemorrhages. Relative ischemia leeds to disseminated cell necrosis; total ischemia causes large myocardial tissue necrosis, called infarction. Localization and extension of infarction and the later scars correspond to the caliber of the obliterated coronary artery and to the significance of the collaterals. Postmortem coronary angiography can detect cause and extension of the damaged cardiac area. Functional significance of chronic coronary heart disease is related to the "critical connective tissue content" of the heart. After surgical treatment qualitative and quantitative morphology may help to explain postoperative cardiac failure.
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PMID:[Morphology of coronary heart disease (author's transl)]. 126 48

The association of cigarette smoking and atherosclerorosis was investigated in 1320 autopsied men, 25--64 years of age. Aortic and coronary lesions were evaluated visually in coded specimens and objectively by analysis of radiographs. Using schedules that had been tested on pairs of living persons, interviewers obtained estimates of cigarette smoking habits of the deceased men from surviving relatives. Data were analysed for black and white men in the total sample of cases and also in groups according to the presence (selected disease group) or absence (basal group) of diseases thought to be associated with smoking (emphysema, lung cancer, etc.) or with coronary heart disease (myocardial infarction, hypertension, diabetes, stroke, etc.). Atherosclerotic involvement of aorta and coronary arteries was greatest in heavy smokers and least in nonsmokers for both races in the total sample of cases, the basal group and the selected disease group.
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PMID:Cigarette smoking and atherosclerosis in autopsied men. 126 63

The goal of antihypertensive therapy is the reduction in morbidity and mortality associated with high blood pressure. Despite our ability to reduce blood pressure, "standard" antihypertensive therapy has not produced a general decrease in coronary heart disease. This failure might be related to the adverse metabolic consequences of diuretics and beta-adrenergic receptor-blocking agents used in most clinical trials. In the hypertensive patient population, however, the principal physiologic abnormality is increased systemic vascular resistance. This increase in vascular tone leads to compensatory changes in cardiac function that result in left ventricular hypertrophy and diastolic filling abnormalities. Diastolic ventricular dysfunction is present in approximately 50% of asymptomatic hypertensive patients and might be a precursor of the syndrome of congestive heart failure with normal systolic ventricular function. In view of the prevalence of diastolic filling abnormalities in the hypertensive patient population, one should consider the effect of an antihypertensive drug on left ventricular function. In a comparison of the angiotensin-converting enzyme (ACE) inhibitors, captopril, lisinopril, and fosinopril, only fosinopril increased stroke volume, peak ejection rate, and peak filling rate, and decreased time to peak ejection rate. These favorable inotropic and lusitropic responses to fosinopril may reflect an effect on the myocardial renin-angiotensin cascade which is dependent upon the unique chemical structure of the fosinopril molecule.
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PMID:Left ventricular hypertrophy and performance: therapeutic options among the angiotensin-converting enzyme inhibitors. 128 27


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