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

Keeping in mind the vasodilator action of prostaglandins, the control that they exercise over the vascular supply of kidneys and the sympathetic activity, research was conducted in order to establish the effect of arachidonic acid, the precursor of PGE2, on experimental hypertension in the rat. The experimental hypertension was induced by unilateral nephrectomy, followed by the administration of DOCA and the elevated sodium diet. The treatment was short in one group, long in the other, and both groups were compared to a control hypertensive group which received no treatment at all. Arachidonic acid worsened the experimental hypertension by 37% in the long treatment, and by 25% in the short treatment. The administration of lysine-acetylsalicylate diminished this hypertension. A non-saturated acid, oleic acid, which is not involved in prostaglandin synthesis, has no action. The authors would like to emphasize that in one of the previous experiments, L-tyrosine, the precursor of catecholamines, diminished the experimental hypertension in the rat, and also that L-DOPA and IMAO (MAOI) have comparable effects. It seems, therefore, that the depression of the central catecholaminergic activity, which is supposed to be the action of arachidonic acid via an increase in the PGE2 synthesis, appears to increase hypertension. It is noteworthy that the medial forebrain bundle (MFB) is catecholaminergic and that the periventricular system (PVS) is cholinergic. Thus hypertension may represent the peripheral vascular response to anguish which results from the activation of PVS and from the depression of MFB.
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PMID:The action of arachidonic acid on experimental hypertension in the rat. 112 60

Measurement of the sinus node recovery time has been proposed as a diagnostic tool for recognition of the sick sinus syndrome. The latter is most frequently encountered in elderly patients with hypertension, coronary heart disease, and atherosclerosis. In order to provide normal values for the sinus node recovery time in this particular population group, atrial pacing studies were carried out in 30 subjects over 50 years of age, all with peripheral vascular disease and some with angina pectoris (10), residua of infarction (6), or hypertension (7). On stimulation, 7 patients maintained a I:I atrioventricular conduction up to the rate of 180/min. Second degree atrioventricular block developed in all other cases. On six occasions, Wenckebach's periods appeared at the relatively slow pacing rate of 120/min. The maximum postoverdrive pause ranged from 680 to 1600 ms with an average of 1100 ms plus or minus 190 (10). For each pacing speed, a correlation was found between the duration of the pause and the control intrinsic cardiac rate, longer pauses being associated with longer resting PP intervals. Beyond 120/min, the duration of the pause was seen to shorten progressively as the driving rate was increased. Finally, the behavior of the sinus node pacemaker following interruption of pacing showed individual variations. After pacing at relatively slow rates, a prompt return to near control values was consistently observed, whereas, after fast rates of driving, a phase of secondary depression developed in about one-half of the studied cases.
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PMID:Sinus node recovery time in the elderly. 112 18

Significant reduction of angina threshold (145 Imp./min to 134 Imp./min) and increase of ST-segment depression (0.13 to 0.17 mV) indicating progression of coronary artery disease was seen in 34 subjects studied by atrial pacing at intervals betion (0.22 mV to 0.12 mV) during exercise, which correlated significantly with decrease of heart rate (121 to 110 beats/min), is interpreted as consequence of diminished sympathetic activity and myocardial O(2)-demand. The change of hemodynamic parameters during controlled exercise does not allow evaluation concerning the progress of coronary artery disease, whereas cardiac stress test with atrial pacing is reproducible. There was no difference in relation to reduction of angina threshold between the group after combined longterm medication with nitrate and ss-blocking agent and the control group. Plasma lipid abnormalities were predictive of subsequent reduction of angina threshold. Severe 2 and 3 vessel obstruction was seen more frequently in patients exhibiting reduction of angina threshold. Level of uric acid, obesity, hypertension, age, combination of risk factors, the initially studied myocardial lactate production and angina threshold during exercise and atrial pacing had no predictive value concerning reduction of angina threshold.
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PMID:[Course of coronary disease. Evaluation of prognosis and progression of coronary insufficiency with atrial pacing and ergometry]. 113 Jan 29

The Minnesota Multiphasic Personality Inventory was completed by 101 patients 16 to 18 months after a proved myocardial infarction. The data suggested a bimodal distribution of patients. One class of patients had a relatively "normal" personality score apart from a tendency to hypomania. The second class had severe depression, with associated hysteria, hypochondriasis and psychasthenia. The severely depressed patients were older, with a greater tendency to hypertension and angina, and a tendency to smaller gains in aerobic power despite an equal intensity of endurance training. The distinction between "normal" and "depressed" postinfarction patients seems of some clinical importance, for the two classes of patients require opposite supportive techniques--restraint and encouragement, respectively.
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PMID:Depression after myocardial infarction. 114 70

Restovar, a low dose combined oral contraceptive containing .75 mg lynestrenol and 37.5 mcg ethinyl estradiol was given to 83 women for up to 25 cycles or 1265 total. A cycle contained 22 pills begun on the first day of menstruation or withdrawal bleeding from previous pill cycles. Each woman was questioned regularly on side effects and bleeding, had weight and blood pressure taken, and received gynecologic exams before and after pill treatment. There were no pregnancies. Latency from end of the cycle to bleeding was 2-3 days in 87%; cycles lasted 28 days in 80%; bleeding lasted 3-4 days in 84%; flow was moderate in 72%; and spotting occurred in 4.2% of cylces and breakthrough bleeding in 2.4%; withdrawal bleeding was absent in 4.2% of cycles. The most common side effects were breast pain in 1.9% of cycles and headaches in 1.2%. These complaints as well as nausea, vomiting, leucorrhea, nervousness and depression were reported as less frequent or absent more often than present or aggravated. 6 women quit for drug related reasons. There was no significant weight change or hypertension (means 126/82 and 120/80 before and during Restovar. Thus this low dose pill is remarkably effective and well tolerated.
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PMID:[Clinical study of restovar, an oral contraceptive with a low estrogen content]. 114 76

Phencyclidine is now one of the most frequently used main ingredients of "street drug" preparations. Its effects are highly dose dependent and three varieties of acute intoxication have been seen clinically associated with different dosages and routes of administration. Most persons using phencyclidine smoke it sprinkled on parsley in low doses. The presence of horizontal and vertical nystagmus associated with hypertension in a patient who is agitated or comatose are diagnostic of a phencyclidine intoxicated state. Sensory isolation and intravenous administration of diazepam in the event of seizure activity have proved effective in the treatment of acute intoxicated states. Phencyclidine has pronounced behavioral toxicity and several deaths due to this agent have now been documented. It is unknown whether seizure activity or respiratory depression is the primary cause of death in pharmacological overdoses.
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PMID:Phencyclidine--states of acute intoxication and fatalities. 121 Mar 29

To evaluate possible cardiovascular effects of emotional stress, a specially designed 12 minute tape-recorded stress quiz was administered to 43 subjects while blood pressure and the electrocardiogram were monitored. For the entire group, the heart rate and blood pressure rose from respective control levels of 76 beats/min and 136/87 mm Hg to a mean during the quiz of 87 beats/min and 158/94 mm Hg. This difference was highly significant. Of the 43 subjects, 33 were classified as executives and 10 as nonexecutives. There were three groups of executives: control and angina with and without a history of hypertension. Both groups of executives with angina responded with a significantly higher heart rate than that of the executive control group. Blood pressure response was significantly greater in executives with angina and hypertension than in the other groups. Heart rate and systolic blood pressure responses to the quiz were lower in nonexecutives with angina than in executives with angina. During the quiz, 10 of 14 executives with angina had S-T segment depression greater than 0.5 mm; of these, 7 evidenced greater than 1.0 mm depression, andin 3 of these the depression was greater than 1.5 mm and in 2 greater than or equal to 2.0 mm. None of the executive control subjects had S-T depression greater than 0.5 mm Among nonexecutives, 2 had S-T depression greater than 0.5 mm but none greater than 1.0 mm S-T depression. Seventeen of the patients also were given a bicycle exercise tolerance test. There was a significant correlation between S-T depression in response to exercise and to the quiz (r = 0.63; P less than 0.01). The quiz electrocardiogram is presented as a new research technique and diagnostic test for evaluating the relation of emotional stress to ischemic heart disease.
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PMID:The quiz electrocardiogram: a new diagnostic and research technique for evaluating the relation between emotional stress and ischemic heart disease. 124 33

The side effects of using estrogen treatments to relieve menopausal symptoms in women are presented. Estrogens are effective in relieving headaches, vertigo, palpitations, and nervous symptoms such as depression, as well as degeneration and atrophy of the genital organs. In Norway, 2.5% of women over 45 as compared with 50% in the U.S. use estrogens to relieve menopausal symptoms. The incidence of endometrial cancer has risen from 9.2/100,000 in 1955 to 15.4 in 1974. Increased susceptibility to endometrial cancer has been linked to long-term use of estrogens, obesity, hypertension, diabetes, and nulliparity. In American studies, Premarin has been associated with increased risk of cancer related to the chemical equilinine, which has a long half-life. After menopause, the need for estrogen is met by the conversion of androstenedione, which is produced by the adrenal gland. When estrogens are taken, it may result in an overstimulation of the endometrium, which could cause cancer. Estrogens have bene found useful and safe for short-term relief of menopausal symptoms, and any patient using estrogens should be under routine observation to prevent development of cancer.
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PMID:[From the Adverse Drug Reaction Committee. Can long-term estrogen treatment induce uterine neoplasms in post-climacteric women?]. 125 36

At their first visit to a hospital clinic 178 patients referred with a diagnosis of hypertension were given a self-administered questionnaire. They received a similar questionnaire 12 months later. Of the 178 patients 99 were not initially on treatment. Similarly 78 normotensive subjects were drawn randomly from the local population and sent a second questionnaire 10 months later. The symptoms at the first visit of the normotensive controls, the untreated hypertensive patients, and 477 patients on long-term treatment in the hypertension clinic were compared. Treated and untreated hypertensive patients complained more of nocturia and also of unsteadiness either on standing or in the morning. Treated hypertensives complained more of sleepiness, dry mouth, diarrhoea, and, in men, impotence and failure of ejaculation. Similarly, untreated hypertensives complained of excessive depression, blurred vision, and waking headache. Fifty-five of the normotensive subjects and 110 of the newly referred hypertensive patients responded to the second questionnaire. The proportions losing and gaining symptoms were calculated together with the proportions always complaining and never complaining of a symptom. Hypertensive patients tended to lose the complaints of unsteadiness and headache but to gain the symptoms of vivid dreams, a slow walking pace, and diarrhoea. The net improvement for a symptom was defined as the excess of patients who lost a symptom over those who gained the symptom, expressed as a percentage. Over the follow-up period the control subjects had a net improvement averaged over 14 symptoms of +2-4 per cent. A similar result was obtained for the hypertensive patients of +2-0 per cent, the symptoms lost being balanced by those gained. The changes in symptoms with time were related to the changes in blood pressure and it is suggested that only headache, 'unsteadiness, lightheadedness, or faintness' and nocturia can actually result from raised blood pressure and then only in a proportion of patients complaining of these symptoms.
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PMID:Change in symptoms of hypertensive patients after referral to hospital clinic. 125 26

The past decade has seen a shift in the strategy for hypertension treatment from stepped therapy--a highly structured monolithic series of steps--to recommendations for a more individualized selection of treatment. Severe hypertension is a clear indicator to bypass traditional steps. Demographic factors, such as age, gender, and race, are often cited, but have proved to be less helpful. Concomitant medical conditions and problems are very common and are more often the crucial determinants in the selection of antihypertensive therapy. Coronary artery disease, diabetes mellitus, heart failure, azotemia, asthma, and chronic obstructive pulmonary artery disease, anxiety, and depression are all common, and each has implications for the selection of antihypertensive therapy. Blood pressure reduction is a surrogate for reduction of cardiovascular risk, and therefore, consideration of concomitant medical problems has extended to left ventricular hypertrophy, obesity, mild hyperlipidemia, and insulin resistance, as additional risk factors in hypertension. Consideration of all these factors makes it possible to individualize antihypertensive therapy in most patients today.
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PMID:Treatment of hypertension: the place of angiotensin-converting enzyme inhibitors in the nineties. 128 28


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