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

A case-control study was performed to investigate the significance of arteriosclerosis, heredity and some infections in the etiology of Parkinson's disease. The study group consisted of all traceable patients with Parkinson's disease living in a defined area, a total of 444 patients, and of control subjects for each patient, matched in sex and age, chosen from among the general population residing in the same area. No significant differences were found between the patients and the controls concerning the occurrence of cardiac insufficiency, coronary heart disease, or stroke. The Parkinsonian patients, however, had a significantly lower incidence of clinical arterial hypertension when compared with the controls. In addition, the patients more often had low systolic blood pressures and more rarely high pressures than the controls. Even the mean systolic blood pressure was significantly lower in the patients than in the controls. The low blood pressure seems to be an effect of Parkinson's disease itself with a minor contribution of levodopa therapy. The observations above are considered to indicate that arteriosclerosis and Parkinson's disease are probably only concurrent disorders and not in etiological relationship with each other. There was no statistically significant difference in the proportion of the patients and the controls with relatives with Parkinson's disease or essential tremor, which suggests that genetic factors do not have a significant role in Parkinson's disease and on the other hand that essential tremor and Parkinson's disease are two separate disease entities. No other encephalitis than a lethargic one was found to precede Parkinson's disease and the occurrence of meningitis was rare both among the patients and the controls. The history of Spanish influenza was found to be as frequent in the patients as in the controls, thus not supporting the idea that influenza has etiological importance in Parkinson's disease.
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PMID:Arteriosclerosis, heredity, and some previous infections in the etiology of Parkinson's disease. A case-control study. 100 13

The results of a long-term observation (for 1 to 4 1/2 years) of haemodynamic changes in 32 non-treated patients with stage II essential hypertension are presented. In 18 patients the lesion did not progress throughout the observation period (group I). At re-examination the haemodynamic parameters in this group of patients did not change significantly, although in some of them the haemodynamic mechanism of maintenance of hypertension underwent certain changes: the cardiac output decreased and the total peripheral resistance increased. In 14 patients (Group 2) their essential hypertension was progressively developing. At the same time a deceleration of the heart contractions rate, a reduction of the cardiac and stroke outputs, a decrease of the circulating blood volume, and an increase of the total peripheral resistance were noted. The reduction of the cardiac output was directly proportional to its initial value (r = +0.78, P less than 0.01) and to the elevation of the arterial pressure (r = +0.71, P less than 0.01). The most distinct changes were noted in 3 patients who developed signs of cardiac insufficiency during the period between the two examinations. The possible mechanisms of haemodynamic changes under the progression of essential hypertension are discussed.
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PMID:[Change in hemodynamic indices in progressive hypertension]. 101 52

The paper presents the results of an examination of 62 patients with postinfarction cardiosclerosis by means of echocardiography and ultrasonic scanning. The impact of the asynergy zone on the development of cardiac insufficiency was studied with reference to the area of myocardial lesion. Myocardial hyperkinesia is characterized, its compensatory effect in postinfarction cardiosclerosis and arterial hypertension is discussed. The effect of Inderal and Ildomen on both the zones of hyperkinesia, and on the indices of cardiac haemodynamics as a whole is described.
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PMID:[Importance of myocardial asynergy zones in the development of cardiac insufficiency]. 101 9

In 56 patients aged over 60 years features peculiar to the diagnosis and the course of rheumatic heart diseases were studied. Clinical and laboratory findings, those of roentgenoscopy and roentgenography of the heart, as well as of electro- and phonocardiography were used. In 35 lethal cases clinico-anatomic comparisons and histological investigation were made for elucidating the activity of the rheumatic process. In persons aged over 60 the relapses of rheumatism have been found to be of rare occurrence and rheumatic affections run a course without any marked hypertension in the lesser circulation and become complicated by cardiac insufficiency no sooner than many years after establishiment fo the diagnosis. In individuals older than 60 an active rheumatic process according to histological investigations and the authors occurs in 14.3 per cent of the cases.
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PMID:[Characteristics of diagnosis and clinical course of rheumatic heart defects in middle- and old age]. 102 34

Exercise electrocardiograms were done on one thousand patients referred to the laboratory of exercise tests for: suggestive symptoms of acute heart failure, old miocardial infarction abnormal resting ECG, or evaluation of coronary reserve. The average value of cardiac rate reached for the group, was close to 80%. The maximum exercise loads managed by the men were superior to those of the women, and in general those managed in the negative test were superior in relation to the positive tests. Of the one thousand cases, 20.2% had positive exercise ECG's. There was no difference inthe percentages of positivity between the two sexes, 20.75% and 19.11% for men and women respecitvely. The percentages of positivity are greater in those subjects sent to the laboratory for suspicion of angina pectoris, old MI, or abnormal resting ECG, than in those referred for detection of ischemic heart disease. The groups of patients with diabetes mellitus, arterial hypertension, old MI, and abnormal resting ECG had the highest incidence of positive tests: 41%, 37.5%, 30.6%, and 28.2% respectively. The most frequent localization of the ST segment alterations was the anterior portion, with percentages of 85.1% similar to those mentioned in the literature. The frequency of arrithmias, of 12.4% in this group, is a little less than that described in similar groups, but it corroborates the predominance of non-lethal ventricular arrithmias. The mortality in the tests performed was null.
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PMID:[Results of 1000 electrocardiographic exercise tests. Their correlation with previous ischemic cardiopathy and arteriosclerotic risk factors]. 102 33

The authors study the long-term prognosis of a population of male subjects having survived 24 to 48 hours to their first myocardial infarction. The mean annual mortality is 6%. The long-term cumulated survival is particualarly influenced by a high blood pressure and by heart failure occurring during the acute episode and in a lesser proportion by age; the prognosis at long-term is not or little influenced by family history, cholesterolemia, cigarette smoking or the presence of angina before infarction. The presence or absence of heart failure and high blood pressure allows to make sub-groups with very different long-term prognosis. In the framework of secondary prevention of ischaemic heart diseases, the authors propose to start a controlled study implying both a programme of physical activity and a long-term energical treatment of arterial hypertension.
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PMID:[Long-term prognosis of myocardial infarct]. 108 65

Eighty-nine patients were treated surgically for coarctation of the aorta in a period of 16 years. In 79, the operative procedure consisted of excision of the coarcted segment and primary anastomosis; in 7 cases of hypoplastic arch and in 3 of aneurysm of the aorta, some form of aortoplasty utilizing the isthmus and the subclavian artery, or the use of a dacron prosthesis were required. In a group of 33 patients under 2 years, 76% had associated cardiac anomalies and 100% heart failure, which made immediate surgical treatment mandatory with a mortality of 42% and a recoarctation rate of 10.5%. Out of 56 cases over 2 years, 46% had other cardiac malformations; however, a less severe clinical conditions allowed for an elective operation, with a mortality of 1.8% and a recoarctation rate of 1.8%. This experience and the review of the literature support the concept of elective surgical treatment for coarctation of the aorta around the age of 4 years, prior to the occurrence of hypertension or its complications. In the neonate and infant, surgery is justified in the presence of heart failure non-responsive to medical treatment within 24 to 48 hours. A deeper understanding of the pathophysiology of the malformation in the very young and a better perioperative management of neonates, have led to a decline in mortality in recent years.
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PMID:[Aortic coarctation. Indications and results of surgical treatment. 16 years of experience]. 108 63

Despite the bewildering number of diuretics available to the physician, these drugs can be divided into 4 main groups, characterised by their site of action on sodium reabsorption in the kidney. Drugs acting on the ascending limb of the loop of Henle have a powerful but short acting diuretic effect; they include frusemide, ethacrynic acid and bumetanide. The benzothiadiazines and related compounds have a moderate diuretic action spread over a longer period, whilst the potassium-sparing diuretics, triamterene, amiloride and spironolactone, have only a weak diuretic effect but a marked ability to diminish urinary potassium excretion. The fourth group is made up of miscellaneous substances which function as vasodilator or osmotic agents. The pathogenesis of oedema formation in heart failure is outlined and a logical approach to treatment suggested. Duiretics are being increasingly used in the treatment of non-oedematous states, in particular hypertension, diabetes insipidus and hypercalciuria; their exact role in pregnancy and acute renal failure remains controversial. Side-effects can be related to their effect on electrolyte excretion and include hypokalaemia, hyponatraemia, hyperkalaemia and hyperuricaemia. The incidence of disturbed carbohydrate tolerance in previously normal individuals is low. Other less common side-effects are also discussed.
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PMID:Diuretics: mechanism of action and clinical application. 109 41

A nearly 72-old black male with sickle cell anemia suffered from heart failure, hypertension, chronic impaired kidney function with hyperuricemia and gout. Anoxemia due to refractory anemia of the sideroachrestic type most probably precipitated the sudden heart failure.
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PMID:Long survival in sickle cell anemia. 113 54

The clinical behaviour and mean peak serum aspartate aminotransferase (SGOT) values of 106 patients admitted to a coronary care unit with acute myocardial infarction who displayed acute systolic hypertension were studied. Another 106 normotensive patients with acute myocardial infarction acted as controls. Neither group had established hypertension. The mortality rate, incidence of cardiac failure, major arrhythmias, and mean peak SGOT were significantly greater in the hypertensive group, within which the duration of hypertension was correlated with mean peak SGOT levels--through there was no definite relation between the height of systolic or diastolic pressure and SGOT. Transient systolic hypertension after acute myocardial infarction was therefore associated with a relatively poor prognosis, but our observations suggest that patients with a systolic blood pressure of at least 170 mm Hg might benefit from early hypotensive treatment.
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PMID:Prognostic significance of acute systolic hypertension after myocardial infarction. 113 58


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