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

Tranylcypromine (TCP) is a monoamine oxidase inhibitor used extensively in the treatment of patients with reactive depression. Hypertensive crisis can complicate drug therapy, but the mechanism through which TCP causes high blood pressure is unknown. The present study was undertaken because recent investigations have shown that TCP can inhibit production of a potent vasodilator hormone, prostacyclin (PGI2), by blood vessels, possibly explaining the mechanism of pressor effects by the drug. Heart rate, left atrial, pulmonary artery and aortic pressures were monitored in dogs under control conditions and continuously following the IV infusion of TCP at the rate of 1 mg/kg over a period of one minute. Right femoral and the left internal mammary arteries were obtained during the control period and the left femoral and right internal mammary arteries resected between 6 and 30 minutes following drug infusion for PGI2 studies. Concentrations of the drug that caused significant elevation of the mean systemic pressure to 203 +/- 8 mmHg had no inhibitory effect on PGI2 production. Therefore, the influence of TCP on the hemodynamic parameters does not appear to be mediated through the inhibition of vascular PGI2 synthesis.
 ...
PMID:Tranylcypromine induced hypertension is not mediated by the inhibition of prostacyclin synthesis. 39 90

Women with severe pregnancy-induced hypertension or chronic hypertension with superimposed preeclampsia are at risk for the development of hypertensive crisis. Hypertensive crisis is an emergent situation that carries great maternal and fetal morbidity and mortality. Effective assessment and comprehensive care of the patient in hypertensive crisis requires a thorough understanding of the underlying disease preeclampsia, common hemodynamic findings, and therapies available. Nurses in any perinatal environment must be prepared to respond immediately to this critical obstetrical circumstance.
 ...
PMID:Perinatal hypertensive crisis. 138 95

Hypertensive crisis is an acute emergency requiring aggressive management. Its incidence has decreased in recent years but still is prevalent in the medical community. From review of past and present treatment regimens, the following recommendations can be considered. (1) In the treatment of malignant hypertension with associated CHF, sodium nitroprusside is still an excellent agent. It has a rapid onset of action and blood pressure can be easily titrated. Nitroglycerin is also another agent that can be used in this situation. (2) In the treatment of malignant hypertension with associated aortic dissection, trimethophan camsylate is the preferred agent. An alternative choice is the combination of nitroprusside and labetalol. (3) In the treatment of malignant hypertension with associated myocardial ischemia, an excellent choice is nitroglycerin. Labetalol also should be considered in this situation. (4) In the treatment of hypertension during pregnancy, hydralazine is still a good choice. Labetalol has also been shown to be efficacious. (5) In the treatment of malignant hypertension with associated cerebral ischemia, the following drugs should be considered: nitroprusside, nitroglycerin, and labetalol. The most important attribute of these agents is that they are nonsedating and rapid in onset. (6) In the treatment of postoperative hypertension the choices best suited are labetalol, enalapril, nitroprusside, and nitroglycerin. These agents are rapid in onset and all can be administered intravenously.
 ...
PMID:Hypertensive crisis. 267 90

After ingesting 3,4-methylene-dioxy-methamphetamine (MDMA) and the monoamine oxidase (MAO) inhibitor phenelzine, a 50 year old male developed marked hypertension, diaphoresis, altered mental status, and hypertonicity lasting 5-6 hours. This clinical course is typical of interaction between MAO inhibitors and some sympathomimetics including amphetamines. Such interaction has not previously been described involving MDMA. Sympathomimetic-MAO inhibitor interactions can cause excessive release of endogenous bioactive amines (e.g. norepinephrine, serotonin). Hypertensive crisis, intracranial hemorrhage, hypertonicity, and severe hyperthermia have occurred due to sympathomimetic-MAO inhibitor interactions. MDMA shares structural and pharmacologic features with other agents capable of causing this interaction, and this case suggests that MDMA can cause significant toxicity in patients taking MAO inhibitors.
 ...
PMID:A case of MAO inhibitor/MDMA interaction: agony after ecstasy. 288 26

Hypertensive crisis in a patient with pheochromocytoma can be induced by endoscopy premedication. Opiates, glucagon, and metoclopramide are commonly used in the gastrointestinal laboratory and capable of releasing catecholamines from a pheochromocytoma. Patients who have just had endoscopy can display untoward effects such as nausea, weakness, and diaphoresis. Such patients should probably have their blood pressure carefully recorded. Although hypotension is expected, endoscopists should be alert to the finding of severe hypertension and consider pheochromocytoma. The need for this becomes even greater considering that primary gastrointestinal endoscopy is often being done in doctor's offices away from hospitals and more acute resuscitative resources. In the case reported, a life-threatening hypertensive crisis was induced by fentanyl. The hypertensive crisis was correctly ascribed to pheochromocytoma, enabling institution of lifesaving treatment.
 ...
PMID:Inadvertent diagnosis of pheochromocytoma after endoscopic premedication. 291 Jun 72

Blood pressure, which ist the product of cardiac output and peripheral vascular resistance is regulated by a complex feedback mechanism involving the sympathetic and parasympathetic systems and hormones. An acute disturbance of regulation may lead to a life-threatening increase in blood pressure. Diagnosis is based upon a careful measurement of blood pressure, which must be performed under internationally standardized conditions. Hypertensive crisis refers to a rapid blood pressure increase greater than 30 mmHg above the age-related 95th percentile. The main causes of hypertension in childhood are renal diseases, which may be aggravated by additional conditions either by the clinician himself (e.g. cyclosporin, steroids) or by the patient (lack of compliance). Crisis affects the brain (hypertensive encephalopathy), the heart (left ventricular insufficiency), the retina (visual disturbances) and the mucous membranes (epistaxis). Hypertensive encephalopathy is induced by a break-through of the autoregulation of brain flow, leading to hyperperfusion and, thus to cerebral oedema. The clinical manifestations are characterized by restlessness, severe and diffuse headache, vomiting, nystagmus, impaired vision, dizziness, paraesthesia, seizures and palsies, which may lead - if untreated - to coma and death. The course is usually prolonged and reversible by adequate treatment. The morphological consequences are purpura cerebri, fresh retinal haemorrhages and papillary oedema, apart from left ventricular dilatation and hypertrophy. The diagnostic procedure rests on the quick realization of essential anamnestic (blood pressure, renal disease, drugs), clinical (oedema, cardiac action, central nervous system, fundus) and laboratory parameters (serum creatinine, electrolytes, glucose, blood count, urine). Treatment should start before the manifestation of clinical signs (hypertensive emergency) with rapidly acting antihypertensive drugs.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[The hypertensive crisis in childhood]. 305 87

Studies with school aged children of several communities of the United States have indicated that between one and two percent of them should be considered hypertensive. These findings contradict previous statements of a very rare incidence of hypertension in childhood. Some studies show that children of Black and Hispanic American ancestry, especially females, have a higher incidence of hypertension. The highest incidence of hypertensive children was related to a history of familial hypertension and obesity. In children less than three years of age and in infants, hypertension is less frequent. A disease of the urinary apparatus (nephropathy) or of the cardiovascular system (aorta coarctation) can often be identified as the primary cause of the hypertension. Less frequent is hypertension sustained by adrenal cortical dysfunction or a neoplasm of the adrenal medulla. Hypertensive crisis also frequently develops in children after thermal injury or renal transplant. In children, the use of antihypertensive drugs should be reserved for cases where the disease is very severe. Effective regulation of dietary and hygienic habits should be recommended, particularly for those cases of "mild" or "borderline" essential hypertension.
 ...
PMID:Considerations of the renin-angiotensin aldosterone system in the pathogenesis of hypertension in infancy. 675 76

Hypertension is seen in 1-2% of children. It is multifactorial in origin. An analysis of 245 children with hypertension seen in 3 years in the Southern Railway Hospital, Madras is presented. In this series, all cases are secondary to some underlying causes. The so called "Benign Essential Hypertension" is not so uncommon in children but the authors have not had a case til now. In more than 80% of the cases, it is due to acute glomerulonephritis where hypertension is temporary. 8% of all the cases can be cured by surgery (If acute glomerulonephritis is excluded, this forms 50%). In another 8%, hypertension is permanent. Routine measurement of blood pressure in all children during physical examination is essential to detect the cases early. Extensive investigations are necessary to diagnose the cause in some cases. Three typical case histories are presented. Hypertensive crisis is an emergency and should be managed by intensive medical care. Today, even in India, various sophisticated investigations can be done for the detection of the cause, and surgical treatment including cardiac surgery can be done, aggressive medical treatment can be given with the availability of all anti-hypertensive drugs, and so the paediatricians and paediatric surgeons must diagnose the cases early and institute appropriate treatment.
 ...
PMID:Hypertension in childhood. 734 78

Six cases with acute onset of neurological symptoms and extremely high blood pressure (BP) are reviewed. Hypertensive crisis or stroke were the main differential diagnoses. According to what is advocated for both situations, prompt antihypertensive therapy was instituted. Although recommended doses of hydralazine, reserpine or furosemide were given, the systolic BPs fell to less than 100 mmHg. Intracerebral hemorrhage or infarction was subsequently established in all patients and only one survived. Convincing evidence for a beneficial effect of BP reduction in acute stroke is lacking. Our data indicate excessive response to therapy in some patients. Also, moderate lowering of BP might reduce cerebral blood flow in these patients, often chronically hypertensive and with raised intracranial pressure. Extreme caution with antihypertensive therapy seems therefore warranted if the diagnosis of hypertensive crisis is not certain and a stroke is suspected.
 ...
PMID:Hazards of therapy for excessive hypertension in acute stroke. 738 20

Hypertensive crisis may be defined as a condition characterized by a sudden rise in blood pressure, of varying length, that can damage arteries, arteriolas, and capillary vessels, producing impairment of end-organs. Hypertensive crises may occur under different clinical conditions, for this reason it is necessary to classify them according to their clinical context. Hypertensive crises are generally classified as hypertensive emergencies or urgencies on the basis of the clinical evaluation and according to the level of blood pressure and the presence of acute or ongoing end-organ damage. Hypertensive emergencies are conditions characterized by a great rise in blood pressure in the presence of acute or ongoing end-organ damages. A severe elevation of blood pressure is considered an emergency if there is an evidence of rapid or progressive damage to the central nervous system and myocardial, or renal deterioration. These are situations in which greatly elevated blood pressure must be lowered within one hour in order to reduce actual risk for the patient. Hypertensive urgencies are conditions in which severe elevations in blood pressure do not cause immediate end-organ damages but should be controlled within 24 hours in order to reduce potential risk for the patient. This group includes accelerated hypertension, severe elevation of blood pressure with minimal end-organ damages and no impending complications. In order to formulate a correct therapeutic plan and make the best use of the powerful antihypertensive drugs at our disposal, it is therefore necessary to distinguish hypertensive emergencies from hypertensive urgencies.
 ...
PMID:[Hypertensive emergencies. Clinical evaluation and therapeutic methods]. 805 79


1 2 3 4 Next >>