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

The pathophysiology of hypertension in dogs and cats, the methods available to monitor blood pressure, and the signs and treatment of hypertension are reviewed. Clinical signs of hypertension are usually referable to target organ damage, most notably in ophthalmic, renal, and cardiovascular tissues, which have a rich arteriolar supply. Blood pressure should be measured in any animal with renal disease, hyperthyroidism, hyperadrenocorticism, retinal detachment or hemorrhage, hyphema, or echocardiographically determined cardiac hypertrophy. All cats with acquired cardiac murmur should also be evaluated for hypertension. Antihypertensive medication should be administered if the indirect blood pressure in cats is consistently over 170/100 mmHg, or if the indirect blood pressure in dogs is greater than 180/100 mmHg.
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PMID:Systemic hypertension and its management. 934 34

Atrial fibrillation (AF) is in most patients (approximately 70%) associated with organic heart disease including valvular heart disease, coronary artery disease, hypertension, hypertrophic cardiomyopathy, dilated cardiomyopathy, and congenital heart disease, mostly atrial septal defect in adults. In many chronic conditions, determining whether AF is the result or is unrelated to the underlying heart disease, remains unclear. The list of possible etiologies also include cardiac amyloidosis, hemochromatosis and endomyocardial fibrosis. Other heart diseases, such as mitral valve prolapse (without mitral regurgitation), calcifications of the mitral annulus, atrial myxoma, pheochomocytoma, and idiopathic dilated right atrium may present with AF. Atrial fibrillation may occur in the absence of detectable organic heart disease, the so-called "lone AF", in about 30% of cases. The term "idiopathic AF" implies the absence of any detectable etiology including hyperthyroidism, chronic obstructive lung disease, overt sinus node dysfunction, and overt or concealed preexcitation (Wolff-Parkinson-White syndrome), only to mention a few of other uncommon causes of AF. The autonomous nervous system may contribute to the occurrence of AF in some patients. AF occurs commonly. In patients with valvular heart disease, AF is common, particularly when the mitral valve is involved. The occurrence of AF is unrelated to the severity of mitral stenosis or mitral regurgitation but is more common in patients with enlarged left atrium and congestive heart failure. In patients with coronary artery disease, AF occurs predominantly in older patients, males, and patients with left ventricular dysfunction, Important predictive factors of AF include hypertension, left ventricular hypertrophy and diabetes. The risk of the development of AF, in an individual patient, is often difficult to assess. Increasing age, presence of valvular heart disease, and congestive heart failure increase the risk of atrial fibrillation.
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PMID:Factors predisposing to the development of atrial fibrillation. 935 13

Congenital hyperthyroidism is a very rare disease. But, for each affected child it has to be considered as a serious condition because of the negative impact of hyperthyroidism on fetal and postnatal development. If the manifestation occurs during fetal life tachycardia, cardiac arrhythmia, growth retardation and, most significant, prematurity are the consequences. Postnatal signs of hyperthyroidism are irritability, tachycardia, hypertension, poor weight gain and thyroid enlargement. Even cardiac failure may occur if hyperthyroidism is severe and treatment not adequate which explains the high early mortality rate of 16%. The main complication of persistent hyperthyroidism in the neonatal period and during infancy is craniosynostosis. Severe developmental delay or even mental retardation can be the consequence of inadequate high T4-levels during fetal and neonatal life. Congenital hyperthyroidism was first recognized in infants born to mothers with Graves' disease. The description of transplacental passage of the maternal thyroid stimulating antibodies elucidated the molecular mechanism in this major group of patients with "autoimmune congenital hyperthyroidism". In contrast to this transient, self-limited character of "autoimmune congenital hyperthyroidism", due to the clearance of maternal antibodies from the infant's circulation, some cases of persistent congenital hyperthyroidism without signs of thyroid autoimmunity have been recognized. Activating mutations in the thyroid-stimulating hormone receptor were described recently as the underlying molecular pathogenesis in this group of "non-immune congenital hyperthyroidism". Therefore the possibility of a molecular differential diagnosis of both groups of congenital hyperthyroidism now exists and opens the opportunity of optimal treatment for each patient.
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PMID:Congenital hyperthyroidism. 943 7

Atrial fibrillation (AF) is a common clinical problem, particularly in the elderly and in patients with organic heart disease. AF generally is classified into paroxysmal and chronic forms. Chronic AF can be the end result of paroxysmal AF in about 30% of patients. Paroxysmal AF can be defined as attacks of arrhythmia lasting < 7 days separated by prolonged periods of sinus rhythm. Chronic AF is AF established for > 7 days. Therefore, the differentiation of paroxysmal from chronic or established AF is based on the history of recurrent episodes and the duration of the current episode of AF. The first episode of persistent AF or the first discovery of AF often is referred to as recent onset AF. Most epidemiologic studies highly underestimate the incidence of paroxysmal and/or asymptomatic AF. The prevalence of AF varies with the age group and patient population studied. AF is found in 3% to 5% of the population > 60 years of age. AF is associated with organic heart disease in 70% to 80% of patients. Of the patients admitted to our Cardiology Division during 1 year, 15% of hospitalized patients had a documented history of AF. The risk of an individual patient developing AF often is difficult to assess, but increasing age and the presence of valvular heart disease and congestive heart failure increase the risk of AF. Other important predictive and causative factors of AF include hypertension, diabetes in women, left ventricular hypertrophy in both sexes, and coronary artery disease, mainly in older patients and patients with left ventricular dysfunction. Other causes of AF include coronary artery disease, hypertrophic cardiomyopathy and dilated cardiomyopathy, chronic obstructive pulmonary disease, pericarditis, and congenital heart disease such as left atrial myxoma and atrial septal. AF can occur in the absence of detectable organic heart disease, so-called "lone AF," in about 30% of cases. The term "idiopathic AF" implies the absence of any detectable etiology including hyperthyroidism, overt sinus node dysfunction, and overt or concealed preexcitation. Stroke is the most important factor of mortality and morbidity associated with AF. These epidemiologic data are essential for designing appropriate therapeutic treatment of this common arrhythmia.
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PMID:Epidemiology and classification of atrial fibrillation. 972 80

A triplet pregnancy in a 23-year-old woman was terminated at 15 weeks of gestation because of her severe hypertension, lung edema, and secondary hyperthyroidism. The pregnancy consisted of a hydatidiform mole with a 46,XY karyotype and two fetuses each with 46,XX and a 46,XY karyotype. To determine the zygosity and genetic origin of the mole and fetuses, PCR- and computer-assisted genotyping were performed at 27 CA-repeat marker loci that were distributed evenly over the genome. As a result, genotypes of the three pregnancy products were distinct from each other, indicating that the triplets were trizygotic. The mole lacked any maternal alleles but inherited both of the paternal alleles and/or one paternal allele in duplicate. This, along with the XY sex chromosome constitution, indicated that the mole resulted from dispermic androgenesis. The mother developed a persistent trophoblastic tumor thereafter.
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PMID:Trizygotic pregnancy consisting of two fetuses and a complete hydatidiform mole with dispermic androgenesis. 991 46

The importance of cardiovascular system involvement in hyperthyroidism has been recognized for many years. In the elderly patient, often with mild but prolonged elevation of plasma thyroid hormones, symptoms and signs of heart failure and complicating atrial fibrillation (AF) may dominate the clinical picture and mask the more classic endocrine manifestations of the disease. Impaired cardiopulmonary function and exercise capacity, significantly more marked in older patients, is observed in hyperthyroidism. Thyrotoxicosis can aggravate pre-existing heart disease and can also lead to AF, congestive heart failure, or worsening of angina pectoris. Regarding the high incidence of AF in older patients with hyperthyroidism, it is also important to detect subclinical hyperthyroidism in older patients with AF, thus warranting the measurement of the serum thyrotropin (TSH) concentration for early recognition and treatment. Most cardiac abnormalities return to normal once a euthyroid state has been achieved, although AF may persist in a minority. Optimal treatment requires rapid and definitive antithyroid therapy. Furthermore, anticoagulation is recommended for thyrotoxic patients with AF older than 50 years, those who have histories of previous emboli, hypertension, or with echocardiographic evidence of left atrial enlargement and/or myxomatous valves.
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PMID:Cardiac risks of hyperthyroidism in the elderly. 992 Mar 73

The objective of the study was to investigate the efficacy of long term thyrostatic versus radioiodine treatment of hyperthyroidism in old age. Our study is a retrospective analysis of the therapeutical outcome in 66 patients over 60 years of age with toxic nodular goitre. The patients were divided in two groups: Group A: 28 patients on methimazole treatment: starting dose 5-30, median (M) 10 mg, maintenance dose 2.5-15 (M = 5) mg, follow up 6 to 240 months (M = 23.5 months). Group B: 38 patients treated by either 100-300 MBq (N = 14, subgroup B1) or 325-1000 MBq (N = 24, subgroup B2) 131I, follow up: 18 to 156 months (M = 48 months). The efficacy of the different therapeutical approaches were compared by calculating the occurrence rate of persisting and relapsing thyroid dysfunctions and associated side effects. The 28 patients on methimazole treatment became euthyroid after 1-16 (M = 5) months but numerous relapses occurred in the follow up: hyperthyroidism, clinical: 5, subclinical 13, (relapse duration: M = 8 months; associated symptoms: hypertension in 4, cardiac arrhythmia in 3, cerebral embolism in 1, angina pectoris in 2, weight loss in 2 cases). Poor patient's compliance (9/28) or dose reduction by the physician (5/28) were the main causes of the relapses. Transient clinical (3 cases) or subclinical (6 cases) hypothyroidism also occurred (duration: 1-3 M = 2 months, no clinical symptoms). In 7 out of 14 (50%) patients receiving 100-300 MBq 131I (Group B1) hyperthyroidism persisted (versus 4/24 -16.7%- in Group B2 following 325-1000 MBq 131I; chi2(1) = 4.78 P = 0.028), methimazole treatment had to be continued in 9/14 patients (64.3%) (versus 5/24 -20.8%)- in Group B2., chi2(1) = 7.18 P = 0.0074) and in 5/14 (35.7%) the radiotherapy had to be repeated (versus 5/24 -020.8%- in Group B2, not sign.). Our conclusions are: 1) long term thyrostatic treatment is not safe in elderly patients with toxic nodular hyperthyroidism, mainly because of poor compliance or dose reduction by the physician; 2) radioiodine treatment as the first choice should be recommended for these patients and higher doses should be preferred.
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PMID:The efficacy of long term thyrostatic treatment in elderly patients with toxic nodular goitre compared to radioiodine therapy with different doses. 1007 59

Serum uric acid concentration (sUA) and hyperthyroidism have been reported to positively correlate with each other. Furthermore, epidemiological data indicate that uric acid may be an independent risk factor for hypertension-associated morbidity and mortality. To evaluate whether screening for hyperuricaemia might be worthwhile in patients with hyperthyroidism we determined serum concentrations of uric acid in 2359 consecutive patients (1939 female, 420 male; age: 48 +/- 17 years, mean +/- SD) with various degrees of thyroid dysfunction (hyperthyroidism: n = 242; subclinical hyperthyroidism: n = 143, hypothyroidism: n = 71, subclinical hypothyroidism: n = 212) and in 1688 euthyroid subjects. No association (r = 0.03) between sUA and total T4/TSH was detected. The significant difference (p < 0.05) in serum uric acid between hyperthyroid (4.8 +/- 1.32 mg/dl) and euthyroid (4.5 +/- 1.32 mg/dl) patients was of no clinical significance. We conclude that routine determination of sUA in hyperthyroid patients is not warranted.
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PMID:Serum uric acid concentration and thyroid-stimulating-hormone (TSH): results of screening for hyperuricaemia in 2359 consecutive patients with various degrees of thyroid dysfunction. 1037 14

A 37-year-old female showed signs of hyperthyroidism 2 weeks before death after a partial thyroidectomy was carried out 15 years previously. An examination 3 days before death revealed a normal blood cell count, an increased level of thyroidal hormones, sinus tachycardia and a high blood pressure of 170/90 mm Hg. A hyperthyroidism was diagnosed and therapy with carbimazol (2 x 10 mg) was started but 2 days later fever and chill occurred and before death short phases of unconsciousness and dyspnoea. The autopsy findings showed an interstitial inflammation of the AV-node, the His-bundle and its branches which can correlate with typical ECG changes in hyperthyroidism.
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PMID:Inflammation of the cardiac conduction system in a case of hyperthyroidism. 1043 39

The clinical features and laboratory findings of 91 Thai patients (33 males and 58 females) with CPPD crystal deposition disease were studied. Their average age was 71.54 years. Acute monoarthritis and oligoarthritis were the two most common forms of presentation and were seen in 89 per cent of cases. The knee, wrist and ankle were the three most common joints involved. Associated diseases were common and included hypertension (30 cases), renal insufficiency (23 cases), chronic obstructive pulmonary disease (17 cases), coronary heart disease (13 cases) and diabetes mellitus (12 cases). Eleven patients had malignancies. Five patients had concomitant gout and CPPD crystal deposition disease. The knee and the wrist were the two most common sites of chondrocalcinosis. Of 67 patients who had thyroid function tested, 2 had hyperthyroidism and 5 had hypothyroidism. Hypomagnesemia was seen in 19 per cent. None had hypercalcemia, hypophosphatasia, hemochromatosis or hyperparathyroidism. In contrast to the western series, acute arthritis in our series responded well to oral colchicine alone.
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PMID:Calcium pyrophosphate dihydrate crystal deposition: a clinical and laboratory analysis of 91 Thai patients. 1044 78


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