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)

Atenolol is a beta-selective (cardioselective) adrenoceptor blocking drug without partial agonist or membrane stabilising activity. Its profile of action most closely resembles that of metoprolol which differs only in that it has some membrane stabilising activity. Atenolol has been well studied and is effective in the treatment of hypertension and in the prophylactic management of angina. Its narrow dose response range obviates the need for highly individualised dose titration. In patients with angina its long duration of beta-blocking activity allows once daily dosage, whereas other beta-blockers, unless in sustained release dosage forms, need to be given in divided doses. Other beta-blockers can be given once daily in hypertension, but at presnt the evidence for effective control with a once daily regimen is more convincing with atenolol. Further studies are need to clarify any important differences in blood pressure control between the various beta-blocking drugs, both in conventional or sustained release dosage forms. As with metoprolol, atenolol is preferable to non-selective beta-blockers in patients with asthma or diabetes mellitus. Atenolol has been well tolerated in most patients, its profile of adverse reactions generally resembling that of other beta-blocking drugs, although its low lipid solubility and limited penetration into the brain results in a lower incidence of central nervous system effects than seen with propranolol. Atenolol is eliminated virtually entirely as unchanged drug in the urine and dosage needs to be reduced in patients with moderate to severely impaired renal function (glomerular filtration rate less than 30 ml/min). There is no need for modification of dosage of atenolol in liver disease.
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PMID:Atenolol: a review of its pharmacological properties and therapeutic efficacy in angina pectoris and hypertension. 3 96

Acute and/or recurrent gastrointestinal bleeding due to ruptured gastric varices from an isolated thrombosed splenic vein is a distinct entity. Incidence of this syndrome is probably less than 1%. Typical clinical features of this syndrome include evidence of splenic hypertension without liver disease and no demonstrable cause of gastrointestinal hemorrhage. Diagnosis can easily be missed unless the surgeon is familiar with this syndrome. Typical findings at the time of surgery are an enlarged spleen, varicose veins usually involving the upper third of the stomach, and pancreatic and peripancreatic inflammation. Portal vein and portal pressure will be normal. Meso-portography is a convenient and safe procedure and will lend support to suspicion when a retrograde nonfilling of the splenic vein is present. Splenectomy offers the expectation of a long-range cure. A representative case of a 39-year-old man is discussed. He had at least six episodes of gastric bleeding in less than 3 years. At a previous laparotomy, the cause of bleeding could not be determined. A splenectomy in December 1970 has been able to control the gastric bleeding since then.
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PMID:Splenic vein thrombosis: an unusual case of gastric bleeding. 30 66

Clinical pharmacology of the steroidal oral contraceptives (OCs) is reviewed. The review includes: effectiveness and mechanism of action; structure-activity relationship; minor side effects (estrogen excess, estrogen deficiency, progestogen excess, progestogen deficiency, management of minor side effects); major side effects (thromboembolic disease, hypertension, OCs and neoplasia); and selection of an OC (effectiveness, safety, patient acceptability). Over the past 2 decades the steroidal OCs have proved to be among the most effective pharmacologic products ever marketed. OCs have proved to be relatively benign in terms of morbidity and mortality. Because the decision to use OCs is complex, only contraindications to its use have been considered here. Absolute contraindications include: 1) history of cerebrovascular disease, thromboembolic disease, thrombophlebitis, or conditions predisposing to these disorders; 2) active liver disease or impaired liver function; 3) carcinoma of the breast; 4) estrogen-dependent neoplasia; 5) undiagnosed genital bleeding; and 6) pregnancy. Relative contraindications include: 1) women over age 40; 2) migraine headaches; 3) Hypertension; 4) leiomyomata of the uterus; 5) epilepsy; and 6) history of idiopathic jaundice of prepregnancy. There is no firm evidence that OC use results in an increased incidence of benign neoplasms of the liver and breast.
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PMID:Clinical pharmacology of the steroidal oral contraceptives. 37 70

We describe the natural recovery from the aggravated hypertension, hypokalemia and suppression of the renin-aldosterone axis after the glycyrrhizin discontinuation in two mild hypertensive women aged 71 and 68 years, who had been administered 273 to 546 mg glycyrrhizin daily for 1.5 and 6 months, respectively, for the treatment of liver disease. About one month after the glycyrrhizin discontinuation, acceleration of hypertension, hypokalemia and suppression of the renin-aldosterone system still continued in both patients. At this stage, sodium restriction resulted in the normalization of blood pressure with weight loss and the subsequent sodium repletion produced a rapid increase in blood pressure to hypertensive levels observed before sodium restriction, with weight gain. Plasma renin activity and plasma aldosterone were low and did not respond to sodium restriction. Inappropriately excessive amounts of potassium were also excreted in the presence of hypokalemia. About one and a half months later, the improvements of aggravated hypertension, hypokalemia and suppressed renin-aldosterone system gradually occurred in both patients. Sodium restriction performed about three months later in case 2 no longer produced the changes in blood pressure and body weight. Plasma renin activity and plasma aldosterone responded subnormally to sodium restriction. These results demonstrate that both patients had a prolongation of the syndrome resembling primary aldosteronism except the low plasma aldosterone level about one month after the glycyrrhizin discontinuation. The possible mechanisms by which this prolongation was caused are discussed.
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PMID:Prolonged pseudoaldosteronism induced by glycyrrhizin. 39 3

A 59-year-old woman was admitted to the hospital for evaluation of her hypertension. She was treated with hydralazine; two days later a severe acute hepatitis supervened. On discontinuation of the agent, the liver damage disappeared, relapsed during inadvertent rechallenge, and healed following permanent withdrawal from the drug. Histologic study of the liver showed severe acute hepatitis with bridging necrosis (so-called subacute hepatitis). Six months after discontinuation of hydralazine, a second liver biopsy specimen showed a complete remission of the disease. This hydralazine-induced hepatitis appears to be fully reversible and to differ both on clinical and histological grounds from two previous reports documenting a granulomatous liver disease.
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PMID:Acute hepatitis with bridging necrosis due to hydralazine intake. Report of a case. 44 77

1. Of 96 alcoholics admitted for detoxification, 48% were hypertensive (systolic blood pressure greater than 140 mmHg and/or diastolic pressure greater than 90 mmHg). 2. Elevation of both systolic and diastolic blood pressures was related to the severity of alcohol-withdrawal symptoms. 3. After these symptoms had abated only 9% of patients remained hypertensive. 4. Blood pressure remained normal if patients abstained from alcohol after discharge but rose in those who started drinking again. 5. Hypertension was not consistently related to the presence or severity of alcoholic liver disease. 6. Alcohol-related hypertension may be the result of the alcohol-withdrawal syndrome; increased noradrenergic activity is suggested as the likely mechanism.
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PMID:Factors influencing blood pressure in chronic alcoholics. 54 Apr 46

A technique for the direct measurement of portal vein pressure in fully conscious patients is described. This uses a percutaneous transhepatic approach with a thin Chiba needle and is shown to be simple and safe. The technique has been applied to 123 patients with a variety of liver disorders and the pressure measurements have been compared with those obtained by the indirect technique of wedge hepatic vein catheterization. Close agreement was found between portal vein pressure and wedged hepatic vein pressure in quiescent alcoholic liver disease and alcoholic hepatitis. In chronic active hepatitis, portal vein pressure tended to be higher than wedged hepatic vein pressure, indicating a presinusoidal component to the portal hypertension. This technique is shown to be useful in assessing idiopathic protal hypertension and in demonstrating hepatofugal flow.
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PMID:Direct transhepatic measurement of portal vein pressure using a thin needle. Comparison with wedged hepatic vein pressure. 83 10

Twenty-four patients with leukopenia and/or thrombocytopenia improved these deficiencies after distal splenorenal shunts. The average white blood cell count for 23 neutropenic patients increased by an average 1000 cells/cu.mm p less than .01. The average platelet count for 13 thrombocytopenic patients increased by more than 40,000, p less than .02. Analysis of the data showed that patients older than 50 years, with a history of alcoholic liver disease and sinusoidal hypertension greater than 15mm Hg were most likely to correct leukocyte and platelet defects after distal splenorenal shunts.
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PMID:The effect of the distal splenorenal shunt on hypersplenism. 85 77

The degree of arteriosclerosis in 176 autopsies of liver cirrhosis (patients in the age range of 51 to 70 years) was compared with that of controls (without liver disease). It was found that the "protective influence" of liver cirrhosis of the process of arteriosclerosis is only true for normotonic. Associated with arterial hypertension severe arteriosclerosis is predominant in liver cirrhosis. There is even some evidence that arteriosclerosis in hypertonics with liver cirrhosis is more increased than in controls without liver diseases. The factors influencing arteriosclerosis in liver cirrhosis are discussed.
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PMID:[Arteriosclerosis and liver cirrhosis (author's transl)]. 91 28

An analysis of the work content of the physician-specialist at Apia General Hospital, Western Samoa, over a 12-month period in 1973-74 is described. Respiratory infections, rheumatic heart disease, hypertension, diabetes, peptic ulcer, and various forms of liver disease were encountered most commonly.
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PMID:The physician-specialist in Western Samoa. 105 46


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