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

Drug abuse has become a social and medical problem. Amphetamine and cocaine have a potent sympathicomimetic action, so they have important effects on the Central Nervous and Cardiovascular Systems. Their neurological complications are principally: psychic alterations, seizures and stroke (hemorrhagic and ischemic). The latter are the most important in the clinical practice. Their capacity to produce transit arterial hypertension and cerebral vascular constriction could be the physiopathological substrate of such alterations. Angiographic studies have shown lesions suggesting vasculopathy. In the last ten years cocaine abuse has become an authentic epidemic. We have reviewed its neurological complications, particularly the vascular ones--42 hemorrhagic and 24 ischemic--and the following conclusions were drawn: it should be considered as a risk factor in the younger age group; a short period of time between the last drug dose and the clinical picture is frequently seen; clinical features may appear with the first drug administration; no characteristic lesion in relation to the way of administration or consumption time was elicited.
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PMID:[Neurologic complications caused by use of cocaine, amphetamines and sympathomimetics]. 270 Feb 92

We reviewed our experience with 72 patients, aged 15 to 45 years, who were hospitalized for nontraumatic intracerebral hemorrhages (ICHs) between 1978 and 1985. Evaluation included arteriography in 61 patients. Computed tomography demonstrated 41 lobar, 11 putaminal, four thalamic, four pontine, four intraventricular, two caudate, two midbrain, two cerebellar, one globus pallidum, and one corpus callosum hemorrhage. Forty-three patients, with either progressive neurologic deterioration, arteriovenous malformations (AVMs), or saccular aneurysms underwent surgery. The overall in-hospital survival, including those patients treated medically, was 87.5%. A presumed cause for the ICH was found in 55 (76.4%) patients. The main causes were ruptured arteriovenous malformations (21), hypertension (11), ruptured saccular aneurysms (seven), and sympathomimetic drug abuse (five). Surgical explorations demonstrated a necrotizing angiitis in one patient and arteriovenous malformations in two patients who had negative arteriograms. Young patients with nontraumatic ICHs represent a heterogeneous group. A cause can be established in most patients. Arteriovenous malformations account for less than one third of the hemorrhages in young adults, and other causes should be sought.
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PMID:Nontraumatic intracerebral hemorrhage in young adults. 357 58

In the United States, stroke accounts for 160,000 annual deaths; only 16% of the 1.8 million stroke survivors are fully independent. The incidence of stroke increases with age. Hemorrhagic strokes outnumber ischemic strokes before age 15. Japanese men in this country have a lower stroke mortality than their age peers in Japan. Excessive stroke mortality for US nonwhites may not be entirely due to the greater prevalence of hypertension among blacks. Hypertension emerges as the single most powerful and reversible risk factor in stroke and for survival after stroke. Impaired cardiac function is the second most important precursor of stroke. The recurrence of stroke in survivors is high. The frequency of completed stroke is high in persons with transient ischemic attacks, but not in those with asymptomatic carotid bruits. Other reversible risk factors are smoking, the use of oral contraceptives, alcoholic excess, a low level of physical activity, blood hyperviscosity and drug abuse.
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PMID:Risk factors in stroke. 389 97

We present the case of a 27-year-old woman with a history of drug abuse. Following her routine intravenous (IV) injection of solubilized pentazocine and tripelennamine tablets ("Ts and Blues"), the patient developed severe hypertension, a finding not characteristic of either drug alone or of the combination. The manufacturers of Talwin (pentazocine) recently have added naloxone to the tablets to discourage IV abuse of this oral preparation. Our patient unknowingly had injected the new pentazocine formulation, and she subsequently developed narcotic withdrawal symptoms. Her hypertension was treated, and she was discharged from the emergency department. We report the case as an "unusual reaction" that may develop in frequent abusers of pentazocine and its combinations.
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PMID:An acute hypertensive response after intravenous use of a new pentazocine formulation. 399 86

Four biopsy specimens of antral and body mucosa were taken from the greater and lesser curvature of the stomach in 557 Germans and 46 Turks with no gastric or duodenal lesions. The age-adjusted gastritis score in each area was related to various habits and clinical diagnoses. In contrast to the Germans the Turks had advanced antral gastritis at an early age which did not progress with age. Patients of low social class were more prone to antral gastritis than academics and civil servants. Hypertension was associated with a lower incidence of antral gastritis. Patients who had had a cholecystectomy had advanced gastritis in antral and body mucosa as compared with those with gallstones but intact gallbladders. The incidence of fundic gastritis was higher in patients with degenerative joint disease than in the controls. It is concluded that alcohol, nicotine, drug abuse and various diseases do not play an important role in the frequency of occurrence of gastritis.
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PMID:The role of certain habits and various diseases in the occurrence of gastritis. 667 45

This study examines the economic evidence on preventive health care. A discussion of benefit-cost analysis and cost-effectiveness analysis, their applications to preventive strategies, and the problems inherent in implementing these approaches precedes a review of the empirical evidence. Prevention strategies are grouped into three categories: lifestyle changes, public health measures and screening programs. Lifestyle changes include altering behavior patterns as they relate to alcohol and drug abuse, smoking and automobile safety regulations. Included in public health measures are immunizations against communicable diseases, water fluoridation and food inspection. Screening includes programs for the detection of PKU and congenital hypothyroidism in newborn infants, for spina bifida cystica in the unborn fetus, and hypertension. The paper concludes that many of the preventive health measures examined represent an efficient use of resources. Because only quantifiable changes in health status or costs are included in the benefit-cost and cost-effectiveness analyses, the actual value of prevention strategies may be understated since reductions in pain and suffering usually are omitted.
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PMID:A review of the economic evidence on prevention. 677 86

A survey of California employers with more than 100 employees at one or more sites was undertaken to determine: 1) the nature and extent of health promotion activities; 2) plans for continuation and/or expansion of these activities; 3) plans for initiation of new activities; and 4) the relationship between reported health promotion activities and other characteristics of employers. Of 511 employers with whom interviews were attempted, 49 possible respondents could not be reached and 38 respondents refused to be interviewed, leaving 424 or 83 per cent. Almost one-half of the sites where interviews were conducted had fewer than 200 employees. A total of 332 (78.3 per cent) of employers offered one or more health promotion activities. The most frequent activities provided were accident prevention (64.9 per cent) and CPR (52.8 per cent) with other frequent programs including alcohol/drug abuse (18.6 per cent), mental health counseling (18.4 per cent), stress management (13.0 per cent), fitness (11.6 per cent), hypertension screening (10.1 per cent), and smoking cessation (8.3 per cent). Employers with at least one activity averaged 2.8 activities. The likelihood of having health promotion activities increased with company size. Establishment of new programs appeared to accelerate rapidly in recent years.
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PMID:Health promotion programs sponsored by California employers. 683 18

We studied 3,942,868 Medicare patients (comprised of elderly and disabled) discharged with cardiovascular disease (CVD) during 1987, of which 41,095 (1%) had a drug disorder. Among this small subgroup, the percent of those overlapping with an alcohol and/or mental disorder is 33% for the elderly and 47% for the disabled. The presence of a drug disorder discharge diagnosis is associated with an excess of 329,650 days of hospital care and +174,498,071 in hospital charges as illustrated by a 51% increase in average annual days in the hospital for the elderly, and a similar 61% increase for the disabled. The concomitant increase in average annual discharges offers an explanation. Clinical progression in drug disorder severity (six categories were defined) is associated with increasing lengths of stay; for example, drug dependence comorbidities present longer lengths of stay than drug abuse comorbidities. Among the 12 categories of CVD defined, patients with rheumatic heart disease, hypertensive heart disease, hypertension, and other venous disorders were those whose length of stay experienced the largest percent increase when a drug disorder was present. When drug disorders compete with alcohol and/or mental disorders in a general linear model predicting average annual length of stay, they remain significant at the p < .001 level.
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PMID:Drug disorders and cardiovascular disease: the impact on annual hospital length of stay for the Medicare population. 776 47

Arterial dissection occurs when an intimal tear allows blood to enter the arterial wall, potentially compromising the lumen and reducing blood flow. Carotid and vertebral artery dissections typically occur after major trauma, although they also can arise spontaneously or after trivial injury. Arterial dissection has been associated with a variety of factors, including hypertension, fibromuscular dysplasia, Marfan syndrome, cystic medial necrosis, oral contraceptives, drug abuse (sympathomimetics), and infection [1-8]. It is important to recognize arterial dissection early so that prompt treatment can be initiated to prevent ischemic complications [1]. In this essay, we illustrate the use of MR angiography in the diagnosis of carotid and vertebral artery dissection.
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PMID:Dissection of the carotid and vertebral arteries: imaging with MR angiography. 786 92

The case of a renal transplant recipient with a known history of iv drug abuse but unknown human immunodeficiency virus (HIV) status who presents after having a stable renal allograft function for 4 yr, with acute/subacute advanced renal failure, nephrotic syndrome, and hypertension, as well as clinical and histologic findings of thrombotic microangiopathy, is reported. He was subsequently found to have a positive serology for HIV-1 with a low CD4 count but no clinical manifestations of the acquired immunodeficiency syndrome. He was treated conservatively with zidovudine (AZT). The patient never regained graft function and was ultimately discharged from the hospital on maintenance dialytic therapy. This is, to our knowledge, the first report of thrombotic microangiopathy in an HIV-1-infected patient presenting late in the course as acute/subacute renal allograft failure.
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PMID:Late renal allograft failure secondary to thrombotic microangiopathy-human immunodeficiency virus nephropathy. 801 72


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