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

The purpose of this study was (1) to ascertain whether or not the elderly utilized the health care system and did follow-up after the initial free health check-up and screening; (2) to investigate the types of chronic health problems the elderly who utilize health care had and their reasons for using the health care system; and (3) to explore related factors that influence the utilization of health care by the elderly. In this study, 484 elderly individuals were interviewed by home visits. All names were from the 11 public health clinics in Kaohsiung City, and all subjects had been diagnosed with one of the following disorders: heart disease, diabetes mellitus, hypertension, liver and biliary disorder, urinary disorder, or lung disease. Data were statistically analyzed by means of descriptive and analytical methods, %, t-test, Chi-Square test and odds ratio. The major findings of this study were as follows: (1) the utilization rate by chronically ill elderly was 80.2%. (2) elderly with multiple utilization of the health care system comprised 33.8%. (3) the variables influencing the utilization of the health care system included: perceived susceptibility, fixed physician, medical insurance, doctor's attitude, social support, community health nurse follow-up, the number of diseases, perceived severity of the illness, and attitude of health.
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PMID:[The utilization of health care by the elderly with chronic health problems in Kaohsiung City]. 780 15

Age related cataract is the most common cause of blindness in the world. Most of these patients are elderly and are likely to have various associated systemic diseases. Higher mortality has been reported in patients undergoing cataract surgery. In order to determine the prevalence of associated systemic disease, we carried out a large eye camp based study in 6103 age related cataract patients. Seventeen percent of our patients had systemic problems. Pulmonary disease was seen in 4.3%, cardiovascular disease and hypertension in 4.1%, diabetes mellitus in 3.8%, skin disorder in 1.4%, orodental disease requiring tooth extraction in 3%, and other diseases were seen in 0.4% of the cases. Seventy eight patients (1.27%) had significant systemic complications post-operatively, 46% of whom required hospitalization in a tertiary care center. Thus, all patients undergoing cataract surgery should be evaluated for associated systemic diseases to prevent morbidity and mortality in the preoperative, operative and postoperative period.
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PMID:Systemic diseases in age related cataract patients. 785 16

We studied the physiologic and clinical responses to moderate altitude in 97 older men and women (aged 59 to 83 years) over 5 days in Vail, Colorado, at an elevation of 2,500 m (8,200 ft). The incidence of acute mountain sickness was 16%, which is slightly lower than that reported for younger persons. The occurrence of symptoms of acute mountain sickness did not parallel arterial oxygen saturation or spirometric or blood pressure measurements. Chronic diseases were present in percentages typical for ambulatory elderly persons: 19 (20%) had coronary artery disease, 33 (34%) had hypertension, and 9 (9%) had lung disease. Despite this, no adverse signs or symptoms occurred in our subjects during their stay at this altitude. Our findings suggest that persons with preexisting, generally asymptomatic, cardiovascular or pulmonary disease can safely visit moderate altitudes.
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PMID:How well do older persons tolerate moderate altitude? 786 54

There are several reports on cardiac adverse reactions attributed to the antimigraine drug sumatriptan in the recent literature. In order to assess the frequency and the character of adverse reactions to sumatriptan, a postmarketing cohort study was performed one year after registration of the drug in The Netherlands. With assistance of 86% of the drug dispensing general practitioners in The Netherlands, 1727 patients who had received sumatriptan were traced in July, 1992. Via their general practitioners, a questionnaire about use of sumatriptan, adverse reactions and other medication was sent to the patients in December 1992. During the study period, seven patients were lost to follow-up. Of the 1720 remaining patients, 1202 (70%) responded to the questionnaire, of whom 1187 had actually used sumatriptan. The most frequently reported suspected adverse reactions were paraesthesiae (139 patients, 95% CI 9.9%-13.5%) and dizziness (96 patients, 95% CI 6.5%-9.7%). Chest pain after use of sumatriptan was reported by 94 patients (7.9%, 95% CI 6.4%-9.4%), and according to the close temporal relationship with the intake of sumatriptan and a positive rechallenge, a causal relationship was probable in most of those patients. The frequency of chest pain attributed to sumatriptan was higher in females (9.0% vs 4.6%; relative risk 1.9, 95% CI 1.1-3.4). Age and hypertension were not associated with chest pain attributed to sumatriptan. Dyspnoea attributed to sumatriptan was reported by 26 patients (2.2%), and was associated with obstructive lung disease (relative risk 5.4 95% CI 1.7-16.9).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Adverse reactions attributed to sumatriptan. A postmarketing study in general practice. 787 79

The induction of cardiac effects in hard metal workers is uncertain. This study investigates cardiac function of a group of 31 hard metal workers with or without pulmonary disease. The average duration of exposure to cobalt containing dusts was 10.4 years (range 1-30), while the environmental levels of cobalt exposure ranged from 0.09 to 13.6 mg/m3 Co. Cardiac function has been studied by: ECG (electrocardiogram), exercise test (ET), ECG 24 h according to Holter (ECGH), echocardiogram (ECHO) and radionuclide angiocardiography with 99Tc (RNA). The aims of this work were (i) to show the existence of cobalt myocardiopathy in the workers analyzed and, (ii) to find an early indicator of cardiac dysfunction which could be used in the clinical examination of hard metal workers. Within the group of patients with hard metal lung disease, cases of myocardiopathy of doubtful aetiology have been found. The cardiac indexes obtained through RNA show ventricular dysfunction in healthy hard metal workers which could be a manifestation of initial pulmonary artery hypertension or of an early occult cor pulmonale due to an unknown fibrotic lung disease.
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PMID:Cardiac function study in hard metal workers. 793 94

Cough is known to be the major respiratory side effect of treatment with angiotensin converting enzyme inhibitors (ACEI). Recently, ACEI have been implicated in drug-induced lung disease. We report a new case of diffuse pneumonitis which occurred during treatment with ACEI. A 73-year-old man was admitted for cough, dyspnea at rest, fever and weight loss. The patient had been treated with the ACEI pirindopril during 6 months for systemic hypertension. Chest radiographs showed reticular infiltrates in the upper lung fields. A CT scan confirmed the infiltrates and showed pleural thickening and airspace opacities. White blood cell counts showed 15,700/mm3 leucocytes with 940 eosinophils/mm3. Transbronchial biopsy was consistent with infiltration of the lung with eosinophils. There was no evidence for another etiology. Once the drug was withdrawn, clinical and radiological abnormalities improved but steroids were required to control symptoms. This report suggests that pirindopril, as captopril, can induce the picture of drug-induced pulmonary disease.
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PMID:[Pneumopathy induced by pirindopril. A case report]. 804 99

Hypertension at follow-up is a recognized association of chronic lung disease (CLD) in premature infants. The aim of this study was to assess the timing of maximum effect of the presence of CLD on blood pressure levels and the duration of its effect. Eighteen infants with CLD and 36 without CLD were recruited into the study. Measurements of systolic blood pressure were made using a Doppler technique, when the infants attended for routine premature baby follow-up. Comparison of the two groups' blood pressure revealed the infants with CLD had significantly higher blood pressure levels at 2-3 months (p < 0.001) and 4-5 months (p < 0.05) but not at 6-7 or 8-9 months. We conclude that differences in blood pressure levels between infants with and without CLD are maximum at 2-3 months and that the association of CLD and elevated blood pressure levels is a temporary one.
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PMID:Blood pressure levels at follow-up of infants with and without chronic lung disease. 812 34

Deliberate self-administration of recombinant human erythropoietin (rHuEpo) in a patient without anemia has never been documented. The case of a 62-year-old man who worked in an allied health care field and surreptitiously injected the drug, causing his hematocrit to increase to a dangerously high level is presented. Resultant complications of the misuse of erythropoietin in this patient included worsening hypertension, exacerbation of chronic lung disease and development of new onset angina. Medical management consisted of endotracheal intubation with mechanical ventilation, intravenous hydration, and serial phlebotomy. The unusual possibility of erythropoietin abuse must be added to the differential diagnosis with a patient with unexplained polycythemia. This case highlights the potential abuse of biological growth factors that may mask medical conditions.
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PMID:Recombinant erythropoietin overdose. 824 May 67

Ninety-four consecutive patients (60 men and 34 women; mean age 68.5 +/- 11.5 years) with acute myocardial infarction (MI) were investigated retrospectively, in order to evaluate the prevalence, clinical features, and short-term course of the atypical forms (symptoms other than chest pain). An atypical MI was found in 30 patients, with a prevalence of 32% (95% confidence limits 27-36%). It was most prevalent in women above sixty-five years old (P < 0.05). Abdominal pain, paroxysmal dyspnea, and pulmonary edema were the most frequent symptoms (33%, 17%, 13%, respectively). No differences were observed between typical and atypical MI in regard to risk factors (hypercholesterolemia, arterial hypertension, diabetes mellitus, cigarette smoking) and history of MI, cerebrovascular disease, peripheral vascular disease, or chronic lung disease. Significantly fewer patients with atypical MI had a history of angina pectoris (P < 0.05). No differences were observed in regard to previous medication, except for antiarrhythmic drugs, more often used by atypical patients (P < 0.05). Location and severity of MI (as judged by ECG and peak levels of creatine kinase in the serum) were similar in both subgroups, as were the complications (34% typical and 50% atypical) and death rate (12.5% and 16.7%, respectively). In conclusion, atypical MI is not less severe than typical. This emphasizes the need for a high suspicion index in many different clinical settings, but particularly (although not exclusively) in elderly females, in the presence of abdominal pain or otherwise unexplained paroxysmal dyspnea.
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PMID:Prevalence, clinical features, and acute course of atypical myocardial infarction. 828 84

The severity of pulmonary thromboembolism and pulmonary hypertension induced by heartworms dying after administration of 2 adulticides was evaluated. Because melarsomine dihydrochloride (RM340) has been shown to be more effective in killing Dirofilaria immitis (heartworms) than the traditional approved adulticide, thiacetarsamide, an attempt was made to determine whether this new adulticide induced more severe lung disease. Before adulticide treatment, 32 dogs with naturally acquired heartworm infections received physical examinations, semiquantitative antigen concentration tests, CBC, platelet counts, serum biochemistry analyses, arterial blood gas determinations, thoracic radiography, pulmonary arteriography, and pulmonary hemodynamic tests. Eight dogs with a low burden and 9 dogs with a high burden of heartworms were treated with thiacetarsamide, and 7 dogs with a low burden and 8 dogs with a high burden were treated with RM340. Except for the heartworm-burden test, tests were repeated at regular intervals during the first 7 weeks after treatment. None of the dogs coughed or had dyspnea after treatment. Six of 9 dogs with high worm burdens and 4 of 8 dogs with low worm burdens had surviving heartworms after thiacetarsamide treatment, in contrast to only 3 of 15 RM340-treated dogs. Differences between the 2 adulticide treatments were minimal as determined by thoracic radiography, pulmonary hemodynamic tests, clinical laboratory analyses, pulmonary arteriography, or necropsy. The RM340 treatment was a more effective adulticide, but it did not increase the severity of hypertension and thromboembolism.
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PMID:Pulmonary thromboembolism and hypertension after thiacetarsamide vs melarsomine dihydrochloride treatment of Dirofilaria immitis infection in dogs. 832 63


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