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

The prevalence of congestive heart failure was studied in the medical departments of eight Norwegian hospitals for two days. A mean of 179 patients with heart failure was identified, representing 20% of the total number of in-patients in the participating hospital departments. About 60% of the patients studied were over 70 years of age. There were equal numbers of men and women, but men dominated below 70 years. Ischemic heart disease (59%), valvular heart disease (15%) and hypertension (14%) were the most common primary heart diseases. The drugs used most frequently were diuretics (91%), digitalis (60%), nitrates (40%), and ACE-inhibitors (38%); the last were used more often among patients with severe heart failure (56%).
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PMID:[Heart failure in Norwegian hospital departments. Prevalence, diagnostic and therapeutic aspects]. 794 Apr 46

Previous reports indicate that cardiac output is increased early in the course of hypertension. The purpose of this study was to identify with echocardiography hemodynamic features in normotensive adults that predicted the development of hypertension. Framingham Heart Study subjects were eligible for this investigation if they were normotensive at the baseline examination (systolic blood pressure < 140 mm Hg, diastolic blood pressure < 90 mm Hg, and no antihypertensive medications) and if they were free of coronary heart disease, congestive heart failure, valvular heart disease, atrial fibrillation, hypertrophic cardiomyopathy, diabetes mellitus, and renal insufficiency. The study included 1118 men (mean age, 44 years) and 1559 women (mean age, 46 years). After 4 years of follow-up, of this normotensive cohort, 201 men (18.0%) and 257 women (16.5%) had developed hypertension. In separate, age-adjusted multivariable logistic regression analyses, increased cardiac index (men: odds ratio = 1.19 for one standard deviation increment, P = .03; women: odds ratio = 1.17, P = .02) and end-systolic wall stress (men: odds ratio = 1.24, P = .006; women: odds ratio = 1.43, P < .001) were related to the development of hypertension in both sexes. In addition, increased heart rate in men (odds ratio = 1.25, P = .006) was a significant predictor of hypertension. After adjustment for age and baseline blood pressure, none of the hemodynamic variables was a significant predictor of hypertension. In addition, load-independent indexes of contractility revealed only a minimally greater proportion of subjects with increased contractility at baseline in the group that developed hypertension compared with those who remained normotensive.(ABSTRACT TRUNCATED AT 250 WORDS)
Hypertension 1994 Nov
PMID:Hemodynamic predictors of incident hypertension. The Framingham Heart Study. 796 17

Atrial fibrillation (AF) carries a high risk of systemic embolism, in particular stroke. This is true not only when AF is associated with rheumatic valvular heart disease, but also in the so-called nonvalvular AF (NVAF). The recent randomized clinical trials assessing antithrombotic therapy as primary prevention in NVAF have shown that, untreated, disabling stroke occurs in 2.5%/year, ischemic stroke in 5%/year, stroke and transient ischemic attack in 7%/year, and stroke, transient ischemic attack and silent stroke in > 7%/year. All AF does not carry identical stroke risk. A risk stratification is important in order to decide long-term antithrombotic prophylaxis. A number of important clinical predictors of stroke have been identified. They include age, hypertension, congestive heart failure, previous arterial thromboembolism and previous myocardial infarction. Idiopathic or "lone" AF in patients < 60 years old, without hypertension and diabetes mellitus, carries an extremely low risk of stroke. Also in paroxysmal AF, when patients are < 60 years old and without organic heart disease, the embolic risk is low. The recent onset of AF does not seem to be associated with an excess of embolic risk, in comparison with long-standing AF. In conclusion, the underlying heart disease represents the main determinant of embolic risk. Within the broad spectrum of patients with NVAF a satisfactory risk stratification for thromboembolism can be accomplished by the analysis of clinical risk factors, possibly in association with echocardiographic variables.
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PMID:[Atrial fibrillation: incidence and prognostic factors of embolic risk]. 802 29

Atrial fibrillation (AF) is a common arrhythmia in elderly persons and a common cause of embolic stroke. Most studies of the prevalence and correlates of AF have used selected, hospital-based populations. The Cardiovascular Health Study is a population-based, longitudinal study of risk factors for coronary artery disease and stroke in 5,201 men and women aged > or = 65 years. AF was diagnosed in 4.8% of women and in 6.2% of men at the baseline examination, and prevalence was strongly associated with advanced age in women. Prevalence of AF was 9.1% in men and women with clinical cardiovascular disease, 4.6% in patients with evidence of subclinical but no clinical cardiovascular disease, and only 1.6% in subjects with neither clinical nor subclinical cardiovascular disease. A history of congestive heart failure, valvular heart disease and stroke, echocardiographic evidence of enlarged left atrial dimension, abnormal mitral or aortic valve function, treated systemic hypertension, and advanced age were independently associated with the prevalence of AF. The low prevalence of AF in the absence of clinical and subclinical cardiovascular disease calls into question the existence and clinical usefulness of the concept of so-called "lone atrial fibrillation" in the elderly.
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PMID:Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). 803 27

We compared 8 patients with COPD and fixed atrial fibrillation (group I) and 46 patients with COPD and sinus rhythm in ecg (group II). None of the patients had valvular heart disease, arterial hypertension or clinical signs of coronary artery disease. The studied groups did not differ while comparing their gas measurements, spirometry, pulmonary hypertension and right ventricular diameter (as measured in echo study). Patients with fixed atrial fibrillation had larger circuit and area of right atrium (p = 0.001), left atrial and left ventricular diameter (p = 0.001) as well as lower LV function (expressed by FS%). In conclusion, enlargement of both atria may be considered as a cause for fixed atrial fibrillation in patients with COPD. However symptomless coronary artery disease rather then COPD may be the reason for this arrhythmia.
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PMID:[Atrial fibrillation with chronic obstructive pulmonary disease]. 823 Sep 72

From 1986 to February 1993, 40 children aged 2 months to 18 years (average age 10.4 +/- 5.8 years) underwent heart transplantation. Indications for transplantation were idiopathic cardiomyopathy (52%), congenital heart disease (35%) with and without prior repair (71% and 29%, respectively), hypertrophic cardiomyopathy (5%), valvular heart disease (3%), and doxorubicin cardiomyopathy (5%). Patients were managed with cyclosporine and azathioprine. No prophylaxis with antilymphocyte globulin was used. Steroids were given to 39% of patients for refractory rejection, but weaning was always attempted and generally successful (64%). Five patients (14%) received maintenance steroids. Four patients died in the perioperative period and one died 4 months later. There have been no deaths related to rejection or infection. Average follow-up was 36 +/- 19 months (range 1 to 65 months). Cumulative survival is 88% at 5 years. In patients less than 7 years of age, rejection was monitored noninvasively. In the first postoperative month, 89% of patients were treated for rejection. Freedom from serious infections was 83% at 1 month and 65% at 1 year. Cytomegalovirus infections were treated successfully with ganciclovir in 11 patients. No impairment of growth was observed in children who underwent transplantation compared with a control population. Twenty-one patients (60%) have undergone annual catheterizations and no sign of graft atherosclerosis has been observed. Seizures occurred in five patients (14%) and hypertension was treated in 10 patients (28%). No patient was disabled and no lymphoproliferative disorder was observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pediatric heart transplantation without chronic maintenance steroids. 831 43

Echocardiographic study was performed in 31 uremic patients on maintenance hemodialysis (HD) with no apparent heart failure, valvular heart disease, pericardial effusion or coronary artery disease. On the basis of blood pressure patients were classified into two groups: 1) patients with normal arterial pressure (group I) (n = 19), 2) patients with blood hypertension (group II) (n = 12). Cardiac function was assessed immediately before and after HD session. Left ventricular end-diastolic diameter (EDD), left ventricular end-systolic diameter (ESD) and ejection fraction (EF) were calculated. Body weight, heart rate and mean blood pressure (mBP) were also measured. A significant decrease of EDD was noted in both groups during HD but it was less evident in group II (p < 0.05). ESD decreased significantly in group II (p < 0.01) when it did not change in group I. EF increased significantly only in group II (p < 0.05). Blood pressure decreased during HD in both groups. A significant inverse linear association between EF and ESD was noted during HD in both groups (r = -0.685; p < 0.001) but was more evident in group II. There was no association between and EDD (r = 0.199; NS). Similar analysis shows that ESD was significantly with mBP (group II--r = 0.914; p < 0.001, group I--r = 0.565; p < 0.05). Such association were not found for EDD and RR. Only in group II the decrease in mBP was statistical significantly correlated with the increase in EF. The decrease in EDD during HD exists probably due to changes in intravascular volume.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The effect of blood pressure changes during hemodialysis on left ventricular systolic function]. 836 88

There are very few contemporary studies on the frequency and cause of congestive heart failure (CHF) in a general population. In western Sweden, inhabited by 1.64 million people, a retrospective survey was performed. All hospital records of patients with CHF, ages 16 through 65 years, were examined in all hospitals in the region. During the study period 2711 patients fulfilled the criteria for CHF or cardiomyopathy. Patients were monitored for 37 +/- 28 months. The most common cause of heart failure was coronary artery disease (IHD) (40%). Other common causes were hypertension (17%), valvular disease (13%), alcohol (11%), diabetes mellitus (10%), and systemic diseases (10%). There were positive correlations between the male sex and IHD, alcohol, and dilated cardiomyopathy; the female sex was associated with systemic diseases, valvular heart disease, and diabetes. The incidence of CHF requiring hospitalization per 100,000 in the population was 1.2 to 263 men and 1.1 to 129 women, in the youngest (age 16 to 30 years) and oldest (61 to 65 years) age groups, respectively. The 5-year survival rate was 50%. Analysis of causes performed with Cox's proportional hazards model for survival showed that age, IHD, alcohol, and diabetes were independent and powerful predictors of mortality (p < 0.001). The mode of death was progressive heart failure in 54% and sudden death in 26%. We concluded that the prognosis in patients with CHF was still very poor, even among this young population. The most common cause of CHF was IHD, and the second was hypertension.
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PMID:Spectrum and outcome of congestive heart failure in a hospitalized population. 836 19

This article discusses exercise testing in valvular heart disease, hypertension, and the evaluation of patients for surgery. It also provides information on the effects of drugs on the exercise test and the clinical significance of block patterns and arrhythmias encountered during exercise.
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PMID:Exercise testing in special situations. 850 50

Heart failure is a common and serious condition in many parts of the world and is a frequent cause for hospital admission in the Chinese population of Hong Kong. There is no published information on the epidemiology of heart failure in this community or from mainland China. Therefore, a prospective study of consecutive patients admitted with the clinical diagnosis of heart failure has been carried out to identify the main risk factors or possible causes, and other clinical data. Seven-hundred thirty consecutive patients with cardiac failure were identified and studied. Standard clinical criteria were used for diagnosis and identification of the main or most likely aetiologies and echocardiography was done in 30%. The data analysis of the 730 patients showed the following. The majority were females (56%) and the prevalence of heart failure increased with age (mean age 73.5 +/- 11.7 years) with 76% of the women > 70 years old. In contrast, the men were younger with 40% < 70 years old. The main identifiable risk factors were hypertension (37%), ischemic heart disease (31%), valvular heart disease (15%), cor pulmonale (27%), idiopathic dilated cardiomyopathy (4%), and miscellaneous (10%). In women, hypertension was the commonest cause at all ages but in men aged < 70 years ischemic heart disease was equal in frequency to hypertension (36% and 35%, respectively). Twenty-one percent had diabetes compared to a community rate of 10% for this age group (odds ratio 2.25, P < 0.0001). There was considerable overlap between diabetes, hypertension and ischemic heart disease. The estimated incidence rate was 3.8/1000 women and 3.0/1000 men aged > 45 years old.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The aetiology of heart failure in the Chinese population of Hong Kong--a prospective study of 730 consecutive patients. 852 94


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