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

Diabetes, and possibly the hypothyroidism that attends diabetes, impairs mechanical relaxation of ventricular muscle, in part by depressing the rate of Ca2+ uptake by sarcoplasmic reticulum. Left ventricular hypertrophy exacerbates the adverse effects of diabetes on cardiac performance, but its effects on relaxation variables have not been well characterized. We examined the impact of streptozotocin-induced diabetes (8 weeks) on ventricular pressure load-dependent relaxation and sarcoplasmic reticular calcium uptake of hearts from spontaneously hypertensive rats and Wistar-Kyoto rats. Subsets of diabetic hypertensive rats were treated with either insulin (10 units/kg/day) or triiodothyronine (8-10 micrograms/kg/day). Diabetes impaired load-dependent relaxation and depressed sarcoplasmic reticular calcium uptake only in spontaneously hypertensive rat hearts. Either insulin or triiodothyronine treatment prevented the diabetes-induced depressions of both mechanical and biochemical indexes of relaxation. The results suggest that 1) hypertrophic ventricles of spontaneously hypertensive rats are more susceptible to the detrimental effects of diabetes on relaxation indexes than are the nonhypertrophic Wistar-Kyoto rat ventricles, and 2) the hypothyroidism that attends diabetes may contribute to the impaired relaxation of diabetic spontaneously hypertensive rat left ventricle.
Hypertension 1990 Jun
PMID:Ventricular relaxation of diabetic spontaneously hypertensive rat. 214 Aug 16

Measurement of exchangeable sodium by isotope dilution is a relatively simple, reliable method for the determination of body sodium contents, which can be used in the clinical practice without significant health hazard to the patient. When computed to body surface area, the values for exchangeable sodium can be compared in patients of different body build. Exchangeable sodium may be variably increased in different clinical conditions associated with hypertension, thus increased sodium contents of the body is of major importance in the pathogenesis of hypertension caused by all forms of mineralocorticoid excess, and in the majority of patients with chronic renal insufficiency. In several endocrine disorders, e. g., acromegaly, hypothyroidism, increased sodium space does not play any significant part in the pathogenesis of hypertension. In diabetes mellitus, exchangeable sodium may be increased already prior to the development of hypertension, however it is still a matter of debate whether this abnormality is involved in the pathogenesis of hypertension in these patients. It seems now beyond any doubt that body sodium is normal in patients with essential hypertension, including those with the low renin form of the disease; nevertheless, some data indicate that blood pressure may be volume dependent in elderly patients with essential hypertension.
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PMID:[The role of exchangeable sodium content of the body in cases of hypertension of various etiology]. 219 11

Little notice has been paid in the surgical literature to problems with psychoeffective lithium, which by interfering with adenylate cyclase affects thyroid and parathyroid function, causing hypercalcemia, hyperparathyroidism, and hypothyroidism. Seven patients with lithiumogenic hyperparathyroidism occurring after years of lithium therapy underwent treatment and manifested osteoporosis (n = 2), hypertension (n = 2), nephrolithiasis (n = 1), coma (n = 1), rising hypercalcemia (n = 1), goitrous myxedema (n = 4), nephrogenic diabetes insipidus (n = 2), renal failure (n = 2), and hyperlipidemia (n = 1). Disease-directed parathyroidectomy (without morbidity) was curative. Unique laboratory findings included normal serum phosphorus and reduced urinary calcium and cyclic adenosine monophosphate values. Three separate cases of thyroid carcinoma after long-term lithium therapy were also treated, being preceded by myxedema (n = 2) and concurrent with hyperparathyroidism (n = 1). There has been only one previous report of lithium-associated thyroid carcinoma. All patients taking lithium should undergo surveillance for thyroid and parathyroid dysfunction and neoplasia, and appropriate surgical and medical treatment should be considered in each situation. Although hyperparathyroidism may be reversible with lithium discontinuance, such therapy may be obligatory for patient well-being, thus dictating parathyroidectomy.
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PMID:Lithiumogenic disorders of the thyroid and parathyroid glands as surgical disease. 224 24

This article reviews the history of screening in the elderly, the conditions that should be considered, whether or not screening in the elderly is of benefit, whether we should look for disability or diseases and where screening should take place. Thirteen conditions are discussed: hearing loss and anaemia in some detail. Both disability and precise diagnostic criteria are considered. The place where screening is best carried out depends on the mobility of the subject and the nature of the particular screening tests selected for the 13 conditions. The desirability of screening was assessed on the following criteria: prevalence of the condition, severity of the problem, acceptability by the patient of the screening test, false positive rate, consequences of making a false positive diagnosis, the false negative rate and the consequences of this error, the effect of treatment, the cost of the screening test and the burden on the health services produced by the screening test. The criteria were scored 1-5 on a scale defined for each assessment, with higher scores favouring screening. We provide evidence that screening may be worthwhile for: need for chiropody, varicose veins/ulcer, hearing loss, obesity, visual impairment, hypothyroidism, hypertension, anaemia and diabetes mellitus. However, the assessments discussed in this paper need to be tested prospectively in randomised controlled trials.
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PMID:Should medical screening of the elderly population be promoted? 227 26

Altogether 45 patients (41 women and 4 men) with benign intracranial hypertension (BIH) were observed. BIH developed in 22 women in the gestation period, in 4 during a menopause, in 2 in the presence of hypothyroidism, in 2 due to respiratory infection, in 2 due to a slight cerebrocranial injury, and in one patient with associated galactorrhea-amenorrhea. The cause of BIH in 12 patients remained unclear. Most of the women were obese (33 of 41). The clinical picture of BIH consisted of headaches, congested optic discs, and elevated pressure of cerebrospinal fluid. In most cases prognosis turned out favorable. In the residual period, 1 patient had amaurosis, 25 presented with mild headache, 19 completely recovered. Three women had recurrent BIH.
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PMID:[Benign intracranial hypertension syndrome]. 229 Mar 26

We report the case of a woman who had premature menopause, adrenal insufficiency and hypothyroidism by peripheral gland lesion, all most probably due to an autoimmune disorder, and who subsequently developed primary pulmonary arterial hypertension. The causes of this hypertension are ill-defined, but an autoimmune origin has often been envisaged since primary pulmonary arterial hypertension is not unfrequently associated with connective tissue diseases. Its association with an autoimmune polyendocrinopathy has only been reported, to our knowledge, on four occasions; in all 4 cases the thyroid gland was involved, and a connective tissue disease was present in 3 of them. Our case, which includes adrenal insufficiency and premature menopause is, as far as we know, unique. The possible link between these various diseases is their autoimmune nature, in which case primary pulmonary arterial hypertension would belong to the category of organ-specific autoimmune diseases. Our case supports the hypothesis that a number of isolated primary pulmonary arterial hypertensions could be of autoimmune origin.
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PMID:[Polyendocrinopathy combined with primary pulmonary arterial hypertension]. 252 20

Many drugs, including those prescribed in cardiology, can induce adverse cardiovascular side effects. Most of the anti-arrhythmia drugs have a negative inotropic action and proarrhythmic effects. Estroprogestative contraceptive drugs favor thromboembolitic events and increase the incidence of hypertension. Due to the risk of coronary insufficiency, substitutive hormonotherapy in hypothyroidism must be introduced gradually. Tricyclic anti-depressive drugs and neuroleptics can induce orthostatic hypotension. However, all these adverse effects can usually be avoided if every drug-specific contra-indication is respected, if doses are individually adjusted to the patient's age and physical condition and if the patient is closely monitored.
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PMID:[Drug-induced cardiovascular complications]. 261 Apr 53

Hepatic artery aneurysm is a rare vascular lesion that accounts for nearly 10% of hemobilia cases. Its etiology is most often atherosclerosis, trauma, or infection. Autoaggressive disorders are rarely associated with hepatic artery aneurysm as is thyroid dysfunction. Presented here is a case of hemobilia secondary to a rupture of one of multiple aneurysms of both right and left hepatic arteries in a women with a history of rheumatoid arthritis, hypothyroidism, and hypertension. Surgical intervention has been the rule in the past. Selective transcatheter embolization has gained clinical application in recent years, especially in the treatment of intrahepatic aneurysms. Its efficacy and safety are demonstrated by this case.
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PMID:Hemobilia in a patient with multiple hepatic artery aneurysms: a case report and review of the literature. 264 98

Hypertension can be ameliorated by certain concomitant disease states, especially those in which serum globulin is elevated. Blood pressure has been reduced in cases of cirrhosis of the liver, chronic alcoholism, congestive heart failure, arthritis, hypothyroidism, and myeloma. These clinical findings were confirmed experimentally when animals with various models of hypertension became normotensive after the development of a modest degree of liver damage with hyperglobulinemia. Other diseases, not associated with hyperglobulinemia, that can lower blood pressure are stroke, uremia, hyperparathyroidism, and malnutrition. When any of these diseases occur in hypertensive patients, their influence on blood pressure must be considered when determining treatment and prognosis.
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PMID:Disease states in which blood pressure is lowered. 261 Jul 59

Thyroid hormones may alter red blood cell (RBC) sodium content and transport. The functional importance of lithium-sodium (Li-Na) countertransport in regulating sodium (Na) transport in vascular smooth muscle and kidney by Na-H countertransport and the potential effect of thyroid hormone on these processes led us to study Li-Na countertransport and other sodium transporters in RBCs of patients with thyroid dysfunction. Patients with untreated hypothyroidism (10) and hyperthyroidism (10) were studied, along with normal subjects (10). The mean value for Li-Na countertransport was significantly higher in the hypothyroid group [0.46 +/- 0.08 (+/- SE) mmol/L cell.h; P less than 0.05] and lower in the hyperthyroid group (0.15 +/- 0.04 mmol/L cell.h; P less than 0.05) compared to that in the normal subjects (0.25 +/- 0.03 mmol/L cell.h). When all groups were combined, significant negative correlations were found between Li-Na countertransport and serum T4 (r = -0.48; P less than 0.01), free T4 index (r = -0.42; P less than 0.05), and serum T3 (r = -0.38; P less than 0.05). Li-Na countertransport was positively correlated with serum triglyceride (r = 0.57; P less than 0.01), but not with serum cholesterol levels (r = 0.28; P = NS). The values became normal in subsets of the hypothyroid (n = 5) and hyperthyroid groups (n = 5) during treatment. We found a bidirectional effect of thyroid status on RBC Li-Na countertransport, which was reversible when serum thyroid hormone levels became normal. Changes in Li-Na countertransport, a pathway of Na-H exchange, may influence renal sodium handling and vascular tone in patients with thyroid disease and contribute to abnormalities such as hypertension that occur in patients with hypothyroidism.
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PMID:Reversible alteration of red cell lithium-sodium countertransport in patients with thyroid disease. 291 49


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