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)

Pulmonary blood volume (PBV) measurements have been reported in chronic lung disease that do not include diffuse interstitial lung disease (ILD) and cor pulmonale (CP). In this study, PBV was measured using the double injection single sampling method, at rest and at exercise in ten patients with ILD due to extrinsic allergic alveolitis (n = 6) or usual interstitial pneumonia (n = 4). Lung biopsies were obtained in 8 patients, and in none of them the stage of fibrosis was predominant over inflammation. The degree of vascular lesions was in four patients grade I and in four grade II (Heath-Edwards classification). At rest, most of the patients had elevated mean pulmonary artery pressure (PAP) and vascular resistance (PVR), (mean PAP 30 +/- 4 mmHg and 336 +/- 171 d.s. cm.-5, respectively), hypoxemia (paO2 = 48 +/- 2 mmHg) and a severely reduced PBV (53.6 +/- 11 ml.s.qm.). At exercise, pulmonary arterial hypertension worsened and, although PBV value increased significantly (rest = 53.6 +/- 11.6 ml.m2, s.qm. exercise 132 +/- 28 ml.s.qm.p less than 0.01) it remained abnormally low with respect to normal value. Comparison of the mean intravascular pressure-PBV measurements relationship in different lung diseases showed that ILD patients with CP have the greatest abnormality. Possible explanations for the severe reduction in PBV include restriction of extra-alveolar vessels as a consequence of lung volume loss, restriction of intra-alveolar vessels due to structural and functional changes imposed by the inflammation-fibrosis process and vascular restriction due to vasoactive factors (alveolar hipoxia).
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PMID:[Pulmonary blood volume in patients with interstitial pneumopathy and pulmonary heart disease. Its study at rest and during exercise]. 319 Mar 62

The majority of late recipients of heart transplantation have returned to age-appropriate activities and are showing normal linear growth. The only child who has significant symptoms is an 11-year-old heart-lung transplant recipient who developed airway rejection with restrictive pulmonary function 14 months after transplantation. Rejection continues to be a major threat to these children more than a year removed from their transplantation procedure. Until a satisfactory noninvasive method is developed to monitor graft rejection, endomyocardial biopsies will continue to be performed at 6-month intervals. Cyclosporine nephrotoxicity and systemic hypertension remain important and unresolved problems that could limit the initial success of transplantation. We believe that heart transplantation is an acceptable option for children with end-stage heart and heart-lung disease who have a grim outlook. Future improvements in immune suppression, and the development of improved methods of assessing rejection, will allow for improved survival.
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PMID:Late follow-up of children after heart transplantation. 327 65

A retrospective study of nine sick premature infants with chronic lung disease who received captopril for control of systemic hypertension (systolic blood pressure (BP) greater than 113 mm Hg) was carried out to determine efficacy of therapy and associated complications. All nine infants had markedly elevated peripheral renin values, 134.3 +/- 128.1 ng/mL/hr (mean +/- SD). Five infants had abnormal renal sonographic and perfusion scans with evidence of renal artery thrombosis, parenchymal disease, or both. Captopril therapy (0.3 mg/kg) was instituted at a postnatal age of 123 +/- 108 days. After the initial dose, the systolic BP decreased significantly in all infants, the decrease ranging from 21% to 58% of the pretreatment value. Dosage was subsequently halved in all infants. Seventeen episodes of unpredictable decreases in BP more than 40% from baseline occurred during the reduced maintenance therapy. Four infants had a total of seven episodes during which the BP decreased by 57 +/- 10% from baseline; this decrease persisted for 17 +/- 6 hours and was unresponsive to volume reexpansion and inotropic therapy. All seven episodes were accompanied by oliguria (urine output less than 1 mL/kg/hr) that persisted for 18 +/- 12 hours. These episodes were accompanied by neurologic signs (subtle seizures, lethargy, and/or apnea) within 18 +/- 6 hours after the onset of oliguria. The remaining five infants had a total of 13 episodes of decreased BP of 50 +/- 8% of baseline, which were of significantly shorter duration and responded to volume reexpanders, inotropic therapy, or both and were unaccompanied by oliguria. These data suggest the need for close observation of BP in infants receiving maintenance captopril therapy.
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PMID:Renal failure in sick hypertensive premature infants receiving captopril therapy. 328 14

The investigation of elderly patients presenting with raised PCV values has been described. Suitable clinical and laboratory investigation enables the separation of those with a raised red cell mass (RCM) into three groups: primary proliferative polycythaemia (PPP), secondary polycythaemia and idiopathic erythrocytosis. Those patients with a raised PCV but normal RCM either have apparent polycythaemia (normal plasma volume) or relative polycythaemia (low plasma volume). PPP is a clonal disorder with a peak incidence in the elderly. It commonly presents with vascular occlusive symptoms/signs involving larger vessels, both arterial and venous. The microvasculature may also be involved, particularly when there is associated thrombocythaemia. Effective treatment is required to minimize the future vascular occlusive incidence and diminish the complication rate of surgery if it is ever required. Both the PCV and the platelet count, if elevated, should be adequately controlled. 32P is probably the simplest treatment and is very effective, but venesection and intermittent low-dose busulphan is equally satisfactory in the co-operative patient with good peripheral veins. Secondary polycythaemia may arise from a variety of causes, particularly from arterial hypoxaemia and renal lesions. Occasionally, more than one pathology is identified in the elderly patient. Lung disease is the most common cause of hypoxaemia. Venesection may be indicated in those patients with excessively raised PCV values. The term idiopathic erythrocytosis should only be used for patients who have been adequately investigated. These patients most commonly present with ischaemic or vascular occlusive symptoms/signs. Relative polycythaemia may be caused by fluid loss, but generally the origin of the low plasma volume is not established. Apparent polycythaemia may represent a physiological variant or a stage before the development of a definitely raised RCM. The management of idiopathic erythrocytosis, and relative and apparent polycythaemia, should initially involved removal of known risk factors if present (e.g. hypertension) with the addition of venesection in selected patients. Reactive thrombocytosis in the elderly is most commonly due to malignant disease of chronic infection. The high platelet count is usually asymptomatic, and antiplatelet therapy is rarely required. Primary thrombocythaemia (PT) is a clonal myeloproliferative disorder similar to PPP. The finding of splenomegaly, abnormal platelet morphology or function helps to separate PT from reactive thrombosis. PT most commonly presents with digital or transient cerebral ischaemia or haemorrhage.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Polycythaemia and thrombocythaemia in the elderly. 332 42

Various pathomechanisms are responsible for the development of pulmonary arterial hypertension (PAH) in cystic fibrosis (CF). Main factors are chronic hypoxia and the loss of peripheral vessels caused by recurrent infectious lung disease and lung fibrosis. Measurement of pulmonary artery pressure and pulmonary resistance provide reliable information on PAH. Many non invasive procedures, including echocardiography, myocardial and pulmonary imaging by radionuclide, proved to be not sensitive enough to diagnose PAH. Arterialized pO2 (taken from the hyperemized ear lobe), however, measured during standardized submaximum work load, seems to be a valuable parameter to estimate PAH (r = 0.92). Treatment of PAH in CF-patients is, at the moment, predominantly based on the improvement of the general therapeutical regimen of CF and on long-term oxygen insufflation, which should be initiated as soon as there are first signs of PAH.
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PMID:[Mucoviscidosis and precapillary pulmonary hypertension]. 332 92

Epidemiologic evidence shows a strong relationship between gastric cancer and cerebrovascular disease. It was speculated that salt intake might be the linking factor causing hypertension and vascular damage as well as damage to the gastric mucosa. This study tested whether hypertensive diseases, such as ischemic heart disease and cerebrovascular disease, occurred more frequently in patients with gastric cancer and gastric ulcer than expected by chance alone. In addition, it was studied whether gastric and duodenal ulcer coincided more frequently with other diseases that in the past have been associated with peptic ulcer, such as liver cirrhosis, chronic lung disease, and rheumatoid arthritis. The German statistics of rehabilitation were used to assess the frequency of coincidences. The statistics include a description of the primary, secondary, and tertiary diagnoses leading to rehabilitation. This study confirms the presence of a high coincidence of both ulcer types with liver cirrhosis. In patients with rheumatoid arthritis, both ulcer types also occurred more frequently than expected from their general distribution. Gastric but not duodenal ulcer coincided more frequently with ischemic heart disease than expected. Gastric cancer occurred more frequently in patients who had concomitant ischemic heart disease or cerebrovascular disease. Duodenal ulcer was not associated with an increased risk for any disease related to hypertension. The results of the study support the contention that gastric diseases and diseases related to hypertension share a common etiologic factor.
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PMID:Concordant occurrence of gastric and hypertensive diseases. 337 23

Surgical risk factors of abdominal aortic disease. Between January 1, 1982 and October 1986, 327 surgical repairs were performed on abdominal aortic obstructive diseases and aneurysms at the St. Luc University Hospital. 150 pre-, per- and postoperative data were collected retrospectively for each patient. Ninety-one per cent of patients were smokers, 57.5 per cent had heart disease, 43 per cent arterial hypertension, 51 per cent peripheral vascular disease and 28 percent had obstructive lung disease. Concerning cardiac morbidity, the post-operative infarction rate was 4.4 per cent in patients who had previously suffered from an infarction, and 1.9 per cent in patients with no previous infarction. Post-operative angina-ischemia rate were respectively 23 and 4.7 per cent. Two hundred and thirty two elective operations resulted in 6 deaths (2.6 per cent) while 95 emergency operations resulted in 34 deaths (35.8 per cent). The causes of the death and the post-operative complications are detailed. The decrease of the morbidity and the mortality rates inherent to this pathology depends on an early diagnosis and surgical treatment by a team, knowledgeable of this pathology, who are able to prevent and correctly treat the complications, especially those affecting the cardiovascular system.
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PMID:[Risk factors in surgery of the abdominal aorta]. 338 30

Calcium channel blockers seem to be particularly suitable for elderly hypertensive patients since these agents do not cause salt and fluid retention, postural hypotension, sedation, depression, or biochemical abnormalities. Moreover, their use is compatible with several common diseases of old age, such as diabetes, obstructive lung disease, and peripheral vascular disease. We recently conducted a study in 21 patients (average age, 79 +/- 2 years) who completed an eight-week trial with 20-mg nifedipine tablets taken twice daily. Mean blood pressure decreased from 191 +/- 2/96 +/- 2 mm Hg to 151 +/- 4/80 +/- 3 mm Hg. In 15 patients (71 percent), blood pressure decreased to less than or equal to 160/90 mm Hg; in four additional patients (19 percent), diastolic blood pressure decreased by 15 to 25 percent. Thus, there was a sustained lowering of blood pressure in 90 percent of the participants receiving nifedipine monotherapy. A review of recent studies in elderly hypertensive patients revealed similarly favorable results with calcium channel blockers given alone or in combination with other agents. The accumulating data suggest that these compounds may offer a useful new approach to the treatment of hypertension in old age. However, in these studies, the number of patients and the duration of follow-up need to be extended to confirm the favorable impression obtained thus far.
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PMID:Calcium channel blockers in the management of hypertension in the elderly. 354 97

To assess the ability of indomethacin (Indo) to influence pulmonary vascular tone in patients with chronic lung disease, we studied the hemodynamic and gas exchange alterations induced by a 50-mg indomethacin infusion in 10 patients suffering from varying degrees of pulmonary artery hypertension and hypoxemia. The most pronounced effects were observed 3 h after Indo administration. Mean systemic arterial pressure (Psa) increased from 76 +/- 4 to 86 +/- 4 mm Hg (p less than 0.01), whereas mean pulmonary arterial pressure (Ppa) was unchanged. The cardiac index (CI) decreased from 3.1 +/- 0.2 to 2.8 +/- 0.2 L/min/m2 (p less than 0.02) because of the reduced heart rate, which decreased from 86 +/- 5 to 80 +/- 4 beats/min (p less than 0.05). Systemic and pulmonary vascular resistance indexes increased, respectively, from 22 +/- 2 to 27.5 +/- 2 U/m2 (p less than 0.001) and from 11.9 +/- 2 to 13.4 +/- 2 U/m2 (p less than 0.05). We measured an increase in PaO2, from 49.5 +/- 4 to 57.5 +/- 4 mm Hg (p less than 0.001) simultaneously with a reduced venous admixture, from 39.5 +/- 4 to 30.5 +/- 3% (p less than 0.001). The calculated PO2 uptake was unchanged, but mixed venous O2 tension increased from 30.5 to 33.5 mm Hg (p less than 0.01). Because Indo may interfere with the hypotensive effect of hydralazine and because hydralazine has been proposed in the treatment of patients with pulmonary hypertension, 7 of these patients also received 0.35 mg/kg hydralazine and Indo plus hydralazine (Indo + H) injected simultaneously.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of indomethacin on pulmonary hemodynamics and gas exchange in patients with pulmonary artery hypertension, interference with hydralazine. 368 36

The study of 216 hospitalised patients with essential arterial hypertension (108 males and 108 females) revealed a high percentage of essential arterial hypertension associated with other diseases, in particular chronic obstructive lung disease in males. The behaviour of bronchial hyperreactivity was studied in 10 patients by means of inhalation tests with carbachol in order to assess the extent of the condition and its response to antihypertensive treatment with alpha-methyldopa. The result showed that the drug had no effect on bronchial reactivity and is therefore to be recommended even in cases where chronic aspecific lung disease is associated with arterial hypertension.
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PMID:[Aspecific bronchial reactivity during pharmacologic treatment of arterial hypertension]. 382 25


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