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)

We adapted a highly sensitive and reproducible ELISA technique for the determination of anti-elastin peptide antibodies of IgG type AEAb-IgG) and IgM type AEAb-IgM) in human sera. The determination was performed in the sera of 265 normal and diseased persons. The pathologies studied included obliterative arteriosclerosis of the legs, ischemic heart disease, stroke, diabetes mellitus, type IIb and IV hyperlipoproteinemia and hypertension. No clearcut correlation could be found between AEAb and age. In contrast, in arteriosclerotic patients and especially in obliterative arteriosclerosis of the legs and ischemic heart disease, the concentration of AEAb-IgG was significantly increased. The AEAb-IgM showed no change in the studied diseases. Both types of AEAb were decreased in type IV hyperlipoproteinemia. Anti-elastin antibodies may be involved in the pathomechanisms of the above diseases and the determination of antibody concentrations may be of some help in obliterative arteriosclerotic diseases.
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PMID:Determination of anti-elastin peptide antibodies in normal and arteriosclerotic human sera by ELISA. 264 31

A study of 35 patients with uncomplicated essential hypertension (EH) (labile hypertension, stages IB-IIA or stable hypertension, stage IIB) demonstrated a higher rate of Na+-Li+ countertransport in patients with hypertensive hereditary predisposition to EH (group 1), as compared to those with unaggravated heredity (group 2). A suppression of plasma renin activity (53%), and a higher rate of hyperlipoproteinemia (55%) were observed in group 1, as opposed to group 2 where Na+-Li+ countertransport was lower, plasma renin activity was normal, and hyperlipoproteinemia occurred in 33%. There was a direct correlation between Na+-Li+ countertransport and renin-angiotensin-aldosterone components in group 2. A conclusion is made that aggravated heredity, RAAS components and hyperlipoproteinemia should be taken into account in the assessment of Na+-Li+ countertransport in hypertensive patients.
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PMID:[Study of the relation of various genetic and pathophysiologic factors participating in the regulation of blood pressure in patients with hypertension]. 266 4

The second generation fibric acid derivative, bezafibrate (Bezalip, Norlip) is widely used as a hypolipemic agent throughout Europe and Israel. Its side-effects are well documented, and include myositis, which is considered very rare. We report a 55-year-old diabetic woman with hypertension who had mild renal dysfunction (creatinine 2.0 mg/dl) who received 400 mg/d bezafibrate because of combined (Type IIb) hyperlipoproteinemia. She developed acute myositis, with extreme muscle weakness, pain and CPK levels of up to 3500 units. On discontinuation of the drug all clinical and biochemical features ceased and complete cure followed. No other symptoms have appeared during 2 years of followup. The few reports of such cases in the German literature point to a greater prevalence of myositis in those with renal dysfunction. Early diagnosis of bezafibrate-induced myositis is crucial, a discontinuation of the drug results in cure.
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PMID:[Acute severe myositis due to bezafibrate treatment]. 272 79

The fertile woman is generally protected by her hormone status from myocardial infarct. Since the introduction of oral contraceptives, however, isolated cases of myocardial infarct have been observed in young women. Although some authors have assigned a causal effect to oral contraceptives, other studies have indicated a simultaneous occurrence of such risk factors as smoking, high blood pressure and hyperlipoproteinemia (HLP). In this study 68 women who had undergone definite myocardial infarct and who had not reached 49 years of age or menopause were studied for the occurrence of these risk factors. None of the patients were found to be without other risk factors. Oral contraceptives, carbohydrate intolerance, hyperuricemia and obesity were never observed as single risk factors. High blood pressure and obesity affected 2 out of 5 under 40 years old, 4 out of 5 between 40-44 years, and 17 out of 18 between 45-49 years. The combination of carbohydrate intolerance and obesity rose in the 3 age groups from 1 in 5 to 2 in 5 to 10 in 18. 86% of the patients with body weight 120% of normal also had high blood pressure. Obesity was always associated with other risk factors among these patients. With a prevalence of 38%, diabetes was an important factor in the 45-49 year group. Before prescribing oral contraceptives, the physician should always determine the presence of other factors such as smoking, HLP, diabetes and obesity and attempt to remove these factors before proceeding with oral contraception.
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PMID:[Profile of cardiovascular risk factors in females with a definitive myocardial infarct up to 49 years of age]. 272 60

This paper briefly reviews the current knowledge regarding the effects of hypertension and of antihypertensive drugs on the arterial wall and their possible influence on atherogenesis. The potential clinical implications of the experimental data are discussed, and the following recommendations are made regarding therapy of the hypertensive patient: 1) Management of associated hyperlipoproteinemia, even if mild, would appear to be essential in the hypertensive patient because hypertension does not appear to promote atherosclerosis appreciably when plasma cholesterol levels are low. 2) In the mild hypertensive with diastolic blood pressure from 90-95 mmHg without associated target-organ damage or other major risk factors, treatment of the hypertension should primarily be nonpharmacologic in nature. 3) Hypertensive subjects receiving antihypertensive drugs that can have an adverse effect on plasma lipoproteins should have plasma lipids monitored closely; if unfavorable effects occur, revision of therapy should be considered. 4) Major attempts should be made to reduce other risk factors as well, particularly smoking. 5) Because of inherent difficulties in reversing atherosclerosis, treatment of hypertension and other abnormal risk factors should be instituted early in life before severe disease has developed. Finally, research efforts should intensified to delineate the mechanisms by which hypertension and antihypertensive drugs affect the arterial wall and to develop new approaches for protection against arterial injury.
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PMID:Hypertension, antihypertensive drugs, and atherogenesis. Mechanisms and clinical implications. 287 82

In normal, hypertensive and hyperlipemic subjects, diets supplemented with linoleic acid (LA) or alpha-linolenic acid (LNA) resulted in an increase of the corresponding fatty acids in serum lipids. However, their C20-derivatives, the prostaglandin precursors arachidonic acid (AA) and eicosapentaenoic acid (EPA), respectively, were not or only slightly augmented. On the other hand, an EPA-rich diet produced a marked increase of this fatty acid, especially in cholesterol esters. After this diet the decreases of blood pressure and serum lipids were more pronounced when compared with LA- and LNA-rich diets containing a 20-fold higher dose of the polyunsaturated fatty acids. The slow formation of AA and EPA from LA and LNA seems to be a characteristic finding in humans, being different from preferred laboratory animals, for instance, rats. This observation was independent of the presence of risk factors, like arterial hypertension or hyperlipoproteinemia (HLP).
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PMID:Slow desaturation and elongation of linoleic and alpha-linolenic acids as a rationale of eicosapentaenoic acid-rich diet to lower blood pressure and serum lipids in normal, hypertensive and hyperlipemic subjects. 287 92

A cooperative study has reviewed the prevalence of arterial hypertension (AH) among 40- to 59-year-old male residents of three cities (Moscow, Minsk and Kaunas) and the possibility of organizing a long-term outpatient treatment of newly-detected AH cases as well as the efficiency of the latter. Of 16,703 individuals screened, AH was detected in 27.9%. Evidence is obtained that preventive and therapeutic procedures for hypertensive patients are in need of an improvement. In a middle-aged population, moderate AH is prevalent (nearly 67.7%). Coronary risk factors, such as hyperlipoproteinemia and excessive body weight, were more frequent in AH patients, as compared to the general population, an argument in favor of the need for an improved combined approach to AM control in the population. Active combined treatment of the recognized cases over 5 years proved effective as it brought arterial blood pressure back to normal. Patient participation in the treatment and its contribution to treatment efficiency are reviewed.
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PMID:[Approaches to the secondary prevention of arterial hypertension among the population (data from a cooperative study on the multifactorial prevention of ischemic heart disease)]. 296 18

Several lines of evidence have clearly established the role of lipoproteins as risk factors for the development of atherosclerosis. Epidemiologic studies from different countries have found that about one third of myocardial infarction survivors under 60 years of age are hyperlipidemic. The acute stress reaction occurring in the first hours following an acute myocardial infarction causes distinct changes in the patient's metabolic profile, these changes include a significant reduction of total cholesterol and cholesterol associated with low density lipoproteins and a usually mild elevation of blood glucose. With the purpose of establishing the prevalence and severity of lipoprotein disorders found in myocardial infarction survivors living in Mexico city we conducted a prospective study of 106 consecutive admissions to the coronary care unit at the National Institute of Cardiology with the fully proven diagnosis of acute myocardial infarction, we included only patients younger than 60 years of age that could be sampled within the first 72 hours of the appearance of typical symptoms, at this time the coronary risk factor profile was assessed and blood samples were drawn (acute sample). After three months of the diagnosis we sampled 81 of the original 106 patients (chronic sample). The comparison of these 81 patients showed remarkable differences in the lipid values obtained on each sample. The mean value for total cholesterol in the acute sample was 225 mg/dl whereas the corresponding value for the chronic sample was 240.5 mg/dl (p less than 0.005). This difference was also highly significant for the low density fraction. On the basis of the chronic sample analysis we estimated a prevalence of hyperlipoproteinemia of 35.8%. (II: 18.5%, III: 2.5%, IV: 14.8%), an additional subgroup of 10 patients (12.3%) had the hypo-HDL phenotype raising the number of subjects at risk for atherosclerosis to as high as 48.1% considering only the lipoproteins. The prevalence figures for the rest of the risk factors were as follows: 70.3% for tobacco smoking, 35.8% for Systemic Arterial Hypertension, 33.4% for Obesity and 30.8% for Diabetes Mellitus. Among the group of 81 patients, 17 were known diabetics, eight additional cases of Diabetes Mellitus were diagnosed at the chronic phase (two with fasting hyperglycemia and six with diagnostic oral glucose tolerance tests). The "acute plase" glycemia for these eight subjects was significantly higher (mean: 98.4 mg/dl) than the corresponding value for the non diabetic patients (mean: 83.4 mg/dl p less than 0.002), the seventeen known diabetics had a mean glycemia of 150.6 mg/dl in the acute sample.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Metabolic disorders in survivors of myocardial infarct]. 296 58

The ultimate aim in treating hypertension and hyperlipidemia is to reduce cardiovascular mortality and morbidity, especially strokes and coronary events, for example, fatal and nonfatal myocardial infarction and sudden death. Extensive intervention studies in moderate-to-severe hypertension have revealed the significance of antihypertensive therapy in reducing total cardiovascular mortality and morbidity, particularly from cerebrovascular causes. However, the reduction of coronary events has not been equally successful. The situation in mild-to-moderate hypertension is even more disappointing: recent studies, such as the Medical Research Council hypertension trial, the international Prospective Primary Prevention Study in Hypertension, and the Heart Attack Primary Prevention in Hypertensives trial could not demonstrate any benefit from antihypertensive treatment with beta-blockers or diuretics in the prevention of coronary heart disease. The reasons for these negative results are not obvious. However, metabolic side effects associated with certain antihypertensive drugs, which counteract the beneficial effects of blood pressure reduction, are one topic of discussion. For the genesis of atherosclerosis of the coronary vasculature, hyperlipoproteinemia appears to be of greater importance than hypertension and has to be treated simultaneously. Two extensive intervention studies, the Lipid Research Clinics coronary primary prevention trial and the Helsinki Heart Study, showed a significant reduction of coronary events with lipid-lowering treatments with cholestyramine and gemfibrozil, respectively. These findings are in agreement with the results of a recent secondary prevention study, which showed a regression of atherosclerosis in coronary arteries and aortocoronary bypass grafts. Moreover, antihypertensive treatment aimed at a reduction in coronary heart disease has to focus on serum lipids, especially in mild hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Review of major intervention studies in hypertension and hyperlipidemia: focus on coronary heart disease. 305 87

The clinical syndrome "coronary insufficience at normal coronary arteriogram" is found in approximately 10-20% of patients with exercise-induced coronary insufficience. In most of these cases disturbances of coronary microcirculation are present. They can appear in vascular diseases (arterial hypertension, systemic immunopathies, immune complex vasculitis, etc.), in rheological diseases (paraproteinemia, hyperlipoproteinemia, polyglobulia, etc.), and in disturbances of transport and diffusion of oxygen (carbon monoxide intoxication, methemoglobinemia, hyperlipoproteinemia). The clinical diagnosis is based on usual diagnostic programs (electrocardiogram, exercise electrocardiogram, responsiveness to nitroglycerin, etc.), as well as on newer, functionally orientated diagnostic procedures (determinations of coronary blood flow and of coronary vascular reserve, production of lactate, serological findings, histology and immune histology of peripheral arteries, measurements of viscosities in both plasma and blood, etc.). Many clinically relevant disturbances in coronary microcirculation can thus be detected and treated on a rational basis by the management of the internal main disease, that is, by the treatment of the vascular, rheological, and metabolic disorders. Persistent angina pectoris in the presence of normal coronary arteriogram represents no termination of coronary diagnostics, but moreover implies the clinical task for using diagnostic possibilities to enable functional and therapeutical assessment of coronary microcirculation.
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PMID:[Angina pectoris and coronary insufficiency with a normal coronary angiogram: pathophysiological principles, diagnosis and therapeutic consequences]. 306 40


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