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

First prophylactic and therapeutic possibilities in cor pulmonale are shown on the basis of its pathogenesis. Our own results illustrate the effect of therapy of the underlying lung disease and of the concomitant respiratory insufficiency on the pulmonary arterial hypertension. The relationship between pulmonary artery pressure (PAp), arterial oxygen tension, forced expiratory volume of 1 second (FEV1%VC) and slow inspired viral capacity (VC) is analysed. In obstructive respiratory disorders the PAp rises when FEV1 falls below 40% of VC, in restrictive disorders when VC falls below 70% of predicted rate. 27 patients with chronic obstructive lung disease were treated with bronchodilator aerosols by intermittent positive pressure breathing (IPPB) during 2 years after a control period of 2 years: VC and FEV1 improved, the increase of total lung capacity and the deterioration of arterial blood gases came to a halt. The elevated PAp was always significantly reduced by oxygen therapy or IPPB or the combination of both. Finally, the rationale for avoiding physical stress in established cor pulmonale is illustrated: in healthy men PAp increases by less than 20% when cardiac output is doubled. In patients with cor pulmonale PAp rises to three times the initial value under the same conditions.
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PMID:[Prevention and therapy of chronic cor pulmonale (author's transl)]. 2 May 29

In chronic obstructive lung disease and pulmonary artery hypertension a cranialisation of both ventilation and perfusion can be observed. Nitroglycerine induces a decrease of tension and peripheral resistance. A ventilation-perfusion mismatching induces arterial hypoxemia. If bronchospasmolytic agents are added, hypoxemia can be prohibited.
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PMID:[The distribution of ventilation and perfusion in the obstructive syndrome during nitroglycerin and bronchospasmolytic therapy]. 11 69

Left ventricular function was evaluated prospectively during 1 year in a controlled clinical study of 73 patients with chronic obstructive lung disease. The control group comprised 68 patients matched for age and sex and with no evidence of airways obstruction. Left ventricular hypertrophy was found in 52% and systemic hypertension in 58% of patients in the study group compared with 6% and 15% respectively in the controls. Left ventricular hypertrophy was diagnosed in 70% of patients with chronic bronchitis and in 19% of those with chronic emphysema. Systemic hypertension was observed in 45% of the bronchitic type patients and in 81% of those with emphysema. The incidence of myocardial infarction in the study group was not lower than in the controls. The high frequency of left ventricular hypertrophy in patients with chronic obstructive lung disease can probably be related to a similar high frequency of systemic hypertension. Hypertension per se does not explain left ventricular hypertrophy in all patients with chronic bronchitis, but hypoxemia and acidosis seem to be of pathogenetic importance in these cases.
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PMID:Systemic hypertension, left ventricular hypertrophy and myocardial infarction in patients with chronic obstructive lung disease. 14 14

Beta-adrenergic blocking agents are widely used to treat disorders of cardiac rhythm and rate, angina, and hypertension. Propranolol is the most widely used beta-adrenergic blocking agent in this country. Because of its nonselective beta-adrenergic blocking effect, propranolol may be associated with significant bronchoconstriction in asthmatic subjects and in some patients with chronic obstructive pulmonary disease. Since tolamolol, a new beta-adrenergic blocking agent, has cardioselectivity in animals, we studied asthmatic subjects for six hours on three separate days in a double-blind crossover comparison of oral therapy with 40 mg of propranolol, its beta-adrenergic blocking equivalent dose of tolamolol (50 mg), and a high dose of tolamolol (100 mg). All three dosages had equipotent effects on heart rate and systolic pressure. The 50-mg dose of tolamolol had no effect on pulmonary function over six hours; however, both propranolol (40 mg) and the 100-mg dose of tolamolol had equivalent deleterious effects on airway resistance and on rates of expiratory flow. We conclude that the cardioselectivity of tolamolol is dose-limited but is present at the dosage of 50 mg, which is equivalent to the usual antiarrhythmic beta-adrenergic blocking dose of propranolol (40 mg).
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PMID:Beta-adrenergic blockade of the lung. Dose-dependent cardioselectivity of tolamolol in asthma. 35 May 12

During the last four years we have used a new cardioselective beta-adrenergic blocking substance, ICI 66.082 (atenolol or Tenormin), alone or in combination with other drugs for treatment of hypertension in a total of 104 patients, including 15 with a chronic obstructive lung disease. Fifty-one patients started treatment with atenolol because of side-effects--especially from the central nervous system--during previous treatment with non-selective beta-blockers, mostly propranolol (Inderal). Mean duration of treatment was 16 months (range 8--36) and mean dosage 163 mg/day. In 18 patients treatment with Tenormin was withdrawn, but only in 10 of them could this be referred to side-effects. Of the 51 patients who complained of or showed side-effects from another beta-blocker, 80% were improved after changing to Tenormin. Of the patients with side-effects from the central nervous system, 73% improved, especially those who complained of nightmares, hallucinations, insomnia or mild depression.
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PMID:Long-term clinical experience with atenolol--a new selective beta-1-blocker with few side-effects from the central nervous system. 36 88

The Authors have verified in a group of 38 patients with chronic obstructive pulmonary disease (COPD) and suspected pulmonary arterial hypertension (PAH) of precapillary origin the possibility to forsee the pressure within the lesser circulation starting from some electrocardiographic and vectorcardiograhic criteria. The vectorcardiographic analysis has not been shown to be more reliable than the traditional ECG as far as the identification of an eventual PAH is concerned. The matching of both scalar and vectorial criteria has significantly increased the efficiency of the estimate, i.e. the possibility to foresee the right ventricular systolic pressure (RVSP) and the mean pulmonary arterial pressure (PAP), but the same efficiency has remained at unsatisfactory level (S = +/- 10,30 Torr as far as the PAP is concerned. With regard to the value of the various scalar and vectorial criteria or parameters, among the electrocardiographic criteria the most reliable has been the inversion of the T wave in the right precordial leads. This sign, however, did not often appear in the present series (18% of the cases). As to the VCG the analysis made by the Authors stresses as the most reliable criterion the direction of QRS loop rotation on the horizontal plane and the magnitude of the maximum rightward spatial vector. These two elements, among other things, escape detection on the traditional electrocardiographic investigation. The above mentioned conclusions, obviously, only apply to the PAH secondary to COPD, in which particular noncardiac (lung hyperinflation, lowering of the diaphgram, etc.) and cardiac (associated left ventricular hypertrophy) factors contribute to limit the diagnostic value of both the ECG and the VCG.
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PMID:[Predictability of electrocardiographic and vectorcardiographic criteria in pulmonary arterial hypertension caused by chronic bronchopneumopathies]. 45

Horses clinically affected with chronic obstructive pulmonary disease (COPD) were found to have pulmonary artery hypertension which was associated with systemic arterial hypoxia. The pulmonary hypertension in symptomatic COPD-affected horses was partially reversible upon remission of clinical signs or by oxygen administration. The induction of acute hypoxaemia caused an increase in pulmonary artery pressure in both normal and COPD-affected horses.
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PMID:Pulmonary artery pressures in normal horses and in horses affected with chronic obstructive pulmonary disease. 56 82

The clinical signs produced by the respiratory movements reveal the main patho-physiological types in patients with chronic obstructive lung disease. Roentgenological signs do not correlate with the severity of ventilatory disorders and pre-capillary hypertension. Conversely the roentgenological signs of the post-capillalry hypertension are precocious and reliable.
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PMID:[Clinical and radiological diagnosis of chronic obstructive lung syndromes]. 62 44

The physical disease profiles of 135 female and 736 male inpatient alcoholics, similar in age, social class, and referral pattern, were compared to further clarify the widespread clinical impression that female alcoholics are more illness-prone. Although the women had been drinking hazardously for fewer years, at admission the prevalence of most diseases was similar in men and women. There was, however, an excess of anemia in women and of fatty liver and chronic obstructive lung disease in men. Furthermore, the average duration of hazardous drinking before the first recorded occurrence of almost all illness events was shorter in women, the sex differences being statistically significant for fatty liver, hypertension, obesity, anemia, malnutrition, gastrointestinal hemorrhage, and an ulcer requiring surgery. These findings suggest that the development of physical morbidity in relation to hazardous drinking may be accelerated in women.
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PMID:Morbidity in alcoholics. Evidence for accelerated development of physical disease in women. 87 27

Fourteen patients undergoing surgery for aneurysm or occlusive disease of the abdominal aorta were studied. Thirteen patients had a history of hypertension or myocardial infarction; two patients had chronic obstructive pulmonary disease. Tachycardia, hypertension, and elevated pulmonary artery occluded. (PAo) pressure occurred in response to laryngoscopy and intubation in two patients; elevation of PAo pressure in response to aortic cross-clamping occurred in two patients. In three of these four patients, electrocardiographic evidence of myocardial ischemia appeared. These events are important in a consideration of the occurence of myocardial infarction in patients undergoing abdominal aortic surgery. Satisfactory treatment of myocardial ischemia has been accomplished with the use of propranolol hydrochloride and sodium nitroprusside.
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PMID:Left ventricular function during aortic surgery. 93 20


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