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

Alcoholic cardiomyopathy is a consequence of toxic effects of ethyl alcohol. Acute effects must be distinguished from chronic effects over many years. Chronic abuse of alcohol of 1.5-2 g ethyl alcohol per kg body weight (i.e. about 100-150 g/70 kg) per day for years can cause congestive cardiomyopathy in predisposed persons, usually between 30 and 50 years of age. The diagnosis is associated with some criteria for exclusion, i.e. coronary heart disease, hypertension, valvular heart disease, in addition all obstructive and restrictive cardiomyopathy must be excluded. On the other hand, a specific constellation of findings can be considered characteristic of alcoholic cardiomyopathy, namely the coincidence of a radiologically established cardiomegaly in the form of a congestive cardiomyopathy with a raised serum concentration of immunoglobulin A and a negative myocardial immunofluorescence test. Therapeutically, in addition to the classical principles of the treatment of heart failure, absolute abstention from alcohol and physical stress seemed to be effective.
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PMID:[Alcoholic Cardiomyopathy (author's transl)]. 13 Dec 48

Hypertension, congestive heart failure, and valvular heart disease are frequently seen among hospital inpatients in the United Republic of Tanzania. A population survey was therefore carried out to determine the prevalence of hypertension and cardiac murmurs in a random sample of people aged 25-64 years living in an undeveloped rural area. Standard cardiovascular survey methods as recommended by WHO were used. Only mean systolic blood pressure in women increased with age; even so, the difference in mean levels between those aged 25-34 and 55-64 years was only about 1.6 kPa (12 mmHg). Hypertension was found to be uncommon, only 2% of subjects having blood pressures >/= 21.3/ 12.7 kPa (>/= 160/95 mmHg). By means of multiple regression analysis, less than 10% of the variance in blood pressure levels could be explained by age and anthropometric measurements. Murmurs of grade 2 or more were detected in 17% of the men and 22% of the women, being most commonly heard at the apex (54%) and the left lower border of the sternum (31%). Mitral valve diastolic murmurs were heard in 4 of 275 women and these were asymptomatic. The cause of the high prevalence of systolic murmurs is unknown.
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PMID:Blood pressure and heart murmurs in a rural population in the United Republic of Tanzania. 31 15

A population of 199 patients from Rochester, MN, was followed from the time of their first carotid or vertebral-basilar transient ischemic attack (TIA). Patients treated with anticoagulants had no significant difference in survival from untreated patients. Among patients with carotid TIA who received anticoagulants, the net probability of stroke was slightly but not significantly lower than in untreated patients. The difference favoring treated patients with vertebral-basilar TIA was significant starting at three months. The rate of intracranial hemorrhage was higher higher among all patients receiving anticoagulant treatment than among untreated patients and was significantly higher among those 55 to 74 years old. Almost all the hemorrhages occurred after a year or more of anticoagulant treatment and in patients more than 65 years old. Patients with high diastolic blood pressure had a significantly higher net probability of stroke than did patients with lower blood pressure and those receiving antihypertensive drugs. By implication, treatment of hypertension was effective in preventing stroke in patients with TIA. Linear discriminant analysis and actuarial analysis indicated that diastolic blood pressure and anticoagulant therapy were the only factors that influenced stroke occurrence. There was no suggestion that previous myocardial infarction, angina pectoris, valvular heart disease, cardiac arrhythmia, or congestive heart failure--individually or in combination--influenced the occurrence of stroke or survival.
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PMID:Carotid and vertebral-basilar transient ischemic attacks: effect of anticoagulants, hypertension, and cardiac disorders on survival and stroke occurrence--a population study. 65 61

In a medical survey of an urban population in Ghana, abnormal cardiovascular findings were present in 25% of the population aged from 15 to 64 years. This was largely due to hypertension and to cardiomegaly of obscure origin. The prevalence of valvular heart disease was comparatively low. Abnormal cardiovascular findings were commonest in the lowest third of the socio-economic stratum and next most frequent in the highest third. Abnormal findings were not related to smoking or drinking habits; these seem to be only marginally important in the population at present.
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PMID:Cardiovascular status and blood pressure in a population sample in Ghana--the Mamprobi survey. 73 57

Two hundred eighty patients were admitted to an intensive care stroke unit over a one-year period. Subsequent investigation indicated that only 199 of these patients actually had cerebral ischemic or hemorrhagic lesions, 10 had other cerebrovascular lesions, and the remaining 71 patients had unrelated diseases, predominantly seizures. Detailed analysis of 103 stroke patients revealed an overall incidence of 59% hypertension, and 72% had hypertensive, ischemic or valvular heart disease. Fifty percent of the patients had various cardiac arrhythmias, some of which were responsible for the acute cerebrovascular lesion. Fourteen patients died during the acute phase, 11 from apparently irreversible cerebral selling, mainly due to cerebral hemorrhage. Secondary complications such as pneumonia, pulmonary embolism, pressure sores and urinary infection were almost nonexistent, but beneficial effects on the primary cerebral lesions were more difficult to demonstrate.
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PMID:Intensive care management of stroke patients. 100 32

To examine whether atrial natriuretic factor (ANF) is secreted adequately in the early phase of myocardial infarction, plasma ANF concentration and clinical parameters, including hemodynamic variables, were studied in 118 patients with acute myocardial infarction (AMI). The patients were divided into 2 subgroups according to the absence (group A, n = 41) or presence (group B, n = 77) of a history of valvular heart disease, previous myocardial infarction, hypertension, or renal failure. Although no significant difference in atrial pressure after the infarction was found between the 2 groups, the plasma ANF level was significantly lower in group A than in group B (76 +/- 6 vs. 185 +/- 26 pg/ml; mean +/- SEM, p < 0.01). Plasma ANF was correlated with pulmonary capillary wedge pressure in group B (r = 0.54, p < 0.001), whereas no relationship with hemodynamic parameters was observed in group A. In 56 of the 118 patients (group A, n = 18; group B, n = 38), the pulmonary arterial plasma level was significantly higher in group A (p < 0.05), whereas the difference was not significant in group B. Seven of the 8 expired cases among these 56 patients had peripheral plasma ANF levels of more than 150 pg/ml, which were higher than those in pulmonary arterial plasma. These observations suggest firstly that the plasma level of ANF is lower in patients with a new onset of myocardial infarction compared to those with a history of cardiac or renal diseases, and secondly that stimulated ANF release originates not only from the right side of the heart, but also from additional site(s), particularly in patients with chronic ventricle overload and a poor prognosis.
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PMID:Plasma atrial natriuretic factor in patients with acute myocardial infarction. 128 94

Patients with different heart diseases, dilated cardiomyopathy, valvular heart disease, hypertension, ischemic heart disease or myocarditis showed manifestations of autoimmunity and down-regulation of beta-adrenergic receptors. Autoantibodies against beta-adrenergic receptors in these patients were detected with radioligand binding inhibition assay. The results suggested that the down-regulation of cardiac beta-adrenergic receptors in these patients may be mediated by autoimmunity. Autoantibodies against beta-adrenergic receptor were not related to any specific heart diseases, but to the severity of heart failure irrespective of its etiology. The significance of these autoantibodies in heart failure was discussed.
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PMID:[Circulating autoantibodies against beta-adrenergic receptors in patients with heart diseases]. 133 2

The most severe arteritis due to Takayasu's disease are those related to renal and coronary arteries. The first one because it produces severe arterial hypertension and the second one because it puts the patient in high risk of suffering either myocardial ischemia or infarction. These situations worsen when this entity is associated to valvular heart lesions. The authors present the clinical cases of two female patients with Takayasu's disease. One of them in acute phase of the illness, where coronary arteritis, mild coarctation of the aorta, right pulmonary artery stenosis, and pulmonary valve stenosis were present. The second patient was seen during the remission phase of the disease with obstruction of the left subclavicular artery, renal arteritis, severe arterial hypertension and aortic valve insufficiency. The authors discuss the prognosis of patients with Takayasu's disease associated to valvular heart disease and its role in the etiology of pulmonary valvular stenosis. Finally, the authors point out the importance of recognizing the active and non active phases of the Takayasu's disease in relation of the adequate stage for surgical treatment of the lesions caused by this disease.
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PMID:[Takayasu arteritis associated with heart valve diseases (pulmonary and aortic) and arteritis (coronary and renal)]. 134 15

Sneddon's syndrome refers to the rare association of extensive livedo reticularis with multiple ischaemic cerebrovascular episodes. Endarteritis obliterans is the most common cutaneous pathology. It is likely that several pathogenic mechanisms may give rise to Sneddon's syndrome, as the condition is associated with a high incidence of generalised atherosclerosis, hypertension, valvular heart disease and the presence of antiphospholipid antibodies.
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PMID:Sneddon's syndrome. 145 2

A questionnaire on the use of adrenaline in obstetric analgesia was completed by 87 obstetric anaesthetists: 71% of consultants in teaching hospitals were prepared to use adrenaline mixed with local anaesthetics compared with 33% of consultants in district hospitals; they had a similar duration of obstetric anaesthetic experience. Test doses containing adrenaline were not commonly used in labour, but were more often used prior to elective Caesarean section. Adrenaline was used with either lignocaine or bupivacaine; few consultants used both solutions. Contraindications to the use of adrenaline in the nonuser group were in decreasing order of rank: neurological damage, pregnancy-induced hypertension, stenotic valvular heart disease, sickle cell disease or trait of fetal distress. Overall, the contraindications related to the systemic absorption of adrenaline were most common.
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PMID:Use of adrenaline in obstetric analgesia. 146 45


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