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)

Coffee is the most commonly used drug in the United States. The medical literature is conflicted regarding the harmful effects of coffee and caffeine. Because the articles that have appeared are so different, a formal meta-analysis is not the ideal way to summarize the data. However, this literature review suggests that coffee does not have an appreciable effect on hyperlipidemia, hypertension, ischemic heart disease, or cancer. The effects of decaffeinated coffee are much less well-defined, and there is little rationale for recommending that patients switch to decaffeinated coffee. A less appreciated problem with caffeine is that it may increase the risk of osteoporosis and hip fracture.
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PMID:Coffee: brew or bane? 801 Mar 38

A 28 year old patient presented with primary amenorrhoea, streak ovaries, mosaicism with 46,XX/47,XXX, hypertension resistant to a tri-therapy and osteoporosis. The presence of hypergonadotropic hypogonadism, increased levels of corticosterone and desoxycorticosterone, a decreased response of cortisol and aldosterone to i.v. ACTH were characteristic of a 17 alpha-hydroxylase deficiency. Administration of 0.5 mg of dexamethasone normalized the blood pressure. Genetic origin of this disease and the different aspects of the ovaries that have been observed are discussed.
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PMID:[Primary amenorrhea and arterial hypertension in a case of 17 alpha-hydroxylase deficiency]. 804 May 69

Corticosteroids are commonly used in combination with cyclosporine in clinical kidney recipients, and administered indefinitely to many patients. Long-term administration of steroids is associated with a number of serious side effects including hypertension, obesity, hyperlipidemia, diabetes mellitus, cataract, osteoporosis, infection, moon face, and so on. A disturbance of growth is also a serious problem in pediatric patients. It is therefore desirable to discontinue the administration of steroid in renal allograft patients. For the withdrawal of steroid, it is quite important to thoroughly inhibit the recipient immune responses during the induction phase of immunosuppression without any serious adverse effect, that the patient may not retain immunological memories against donor antigens for a long period. Thus, we have been performing extensive immunosuppressive therapy using quadruple drugs, that is, DSG, cyclosporine, mizoribine, and prednisolone, during the early stage after kidney transplantation for withdrawal of prednisolone during the maintenance stage. Up to now, 19 recipients were treated with this protocol. In these patients, 8 were completely discontinued on the steroid and have been maintaining excellent graft function 9.2 to 32 months after transplantation, and 2 were reduced on the steroid to 5 mg. The present protocol may contribute greatly toward the quality of life in renal recipients.
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PMID:Deoxyspergualin. Mode of action and clinical trials. 810 31

Few family planning specialists are examining the potential bone-protective effects of oral contraceptives (OCs) in premenopausal and perimenopausal women. Osteoporosis is a major public health problem worldwide, as reflected in its associated morbidity and mortality and economic impact. For example, more than 25 million people in the US have osteoporosis, which costs society $7-10 billion each year. These costs are largely due to the more than 1.3 million fractures each year. The 250,000 hip fractures are responsible for the highest personal and societal cost. 12-20% of women with a hip fracture die within 2-3 months of the fracture. At least 50% need assistance with daily activities. Clinicians and public health specialists are not putting their energy into developing strategies that may preserve bone density in the premenopausal and perimenopausal years. More emphasis is needed on such strategies, since menopause is the time when bone loss accelerates. Clinicians do stress hormone replacement as a preventive therapy, but this is restricted to postmenopausal women. Extensive research and development of lower-dose OCs and data on appropriate screening of women with risk factors (e.g., smoking, obesity, and hypertension) demonstrate that healthy, nonsmoking women can use OCs safely and effectively throughout most of their reproductive years. Perhaps OC use can provide women the noncontraceptive benefit of maintenance and build up of bone mass up to menopause.
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PMID:Rational use of oral contraceptives in the perimenopausal woman. 812 Aug 61

The purpose of this study was to identify diseases frequently found in elderly populations in rural areas as well as to discuss the role of geriatric physicians in medical care for elderly patients. The study was conducted using ICHPPC-2-Defined (Japan version) which had been compiled by WONCA for the classification of diseases. The acute health problems treated by the clinic consisted of 183 types (2070 items) in 1916 patients seen during 19 months compared to 66 types of chronic problems consisting of 505 items in 179 patients. The most frequent acute complaints and health problems were acute infections of the upper respiratory tract, followed by diseases of the stomach and duodenum, then osteoarthritis and allied conditions. The most common chronic health problems were uncomplicated hypertension, osteoarthritis and allied conditions, osteoporosis, lipid metabolism disorders, complicated hypertension, cataract, and various other illnesses extending over all specialties of medicine. Geriatric physicians are required to have broad and multidisciplinary knowledge and skill to provide comprehensive and continual medical care for elderly patients in rural areas.
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PMID:[Health problems of elderly patients in a rural area]. 815 70

Glucocorticoids are highly valuable medication available to a physician, yet, their serious side effects have severely limited their use. Thus, the major purpose of our review is to provide a practical approach to increasing efficacy and minimizing side effects, that is increasing the benefit/risk ratio, of glucocorticoid therapy. The most effective way of avoiding their side effects, including infection, osteoporosis, atherosclerosis, is simply to avoid the overuse of glucocorticoids and to restrict their use to the truly indicated disease. Side effects can be reduced in part by the development of drug delivery systems, such as topical administration and targeting therapy. Combinations of calcium, vitamin D and sometimes thiazide or calcitonin, as compensatory therapy, have shown some favorable results for the prevention of osteoporosis. Although glucocorticoid therapy causes an increase of high-density lipoprotein and a decrease of lipoprotein (a) in serum, both are possibly preventive for atherosclerosis, hypertension and diabetes mellitus which are risk factors of atherosclerosis should be controlled. Future trends to remove their side effects will be obtained by more specific therapy based upon their pathogenesis.
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PMID:[Minimizing side effects of glucocorticoid therapy]. 816 80

Pertrochanteric fractures are typical injuries of elderly people, that can be treated with osteosynthesis in most cases. From 1984 to 1991 we performed 105 implantations of tumor-endoprosthesis in elderly patients with comminuted pertrochanteric fractures with simultaneous coxarthrosis or osteoporosis. The mean age of these patients was 82.7 years. 81.9% of the patients had concomitant systemic diseases (coronary heart disease, hypertension, diabetes etc.), 51.4% showed several risk factors. General postoperative complications were diagnosed in 63.8% of all cases, mostly nosocomial urinary tract infections, pressure sores and cardiovascular disorders. In 14.3% of the patients local (surgical) complications occurred. 83.3% of the patients were able to walk when they left the hospital, the in-hospital mortality was 13.3% (30-day-mortality 12.4%). Although primary osteosynthesis of pertrochanteric fractures with dynamic hip screw or gamma-nail show a smaller risk, implantation of a tumor-endoprosthesis can be an alternative in patients with severe osteoporosis, coxarthrosis or after instable osteosynthesis.
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PMID:[Results of management of pertrochanteric comminuted fractures in the elderly with a tumor shaft endoprostheses]. 816 60

The relation of bone mineral density of the ultradistal radius, midshaft radius, hip, and lumbar spine to thiazide use were examined in a community-based sample of 1,696 white men and women aged 44-98 years. Male thiazide users had higher age-adjusted bone mineral density levels only at the midshaft radius (p < 0.05). Among women, thiazide users had significantly higher bone mineral density levels at all four sites (p < 0.05), both before and after controlling for the effects of age, body mass index, smoking, and estrogen use. The association was explained by current thiazide use; no significant association was found between past use or duration of use and bone mineral density levels. Results were similar when hypertensive women were excluded from the analyses, suggesting the effect was drug-related and not due to hypertension or some other factor related to hypertension. At all sites, the highest bone mineral density levels were seen in women currently using both estrogen and thiazide. Overall, these findings suggest that thiazides may be useful in the prevention of osteoporosis in postmenopausal women.
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PMID:Thiazides and bone mineral density in elderly men and women. 819 43

The menopause is defined as cessation of menstruation, ending the fertile period. The hormonal changes are a decrease in progesterone level, followed by a marked decrease in estrogen production. Symptoms associated with these hormonal changes may advocate for hormonal replacement therapy. This review is based on the English-language literature on the effect of estrogen therapy and estrogen plus progestin therapy on postmenopausal women. The advantages of hormone replacement therapy are regulation of dysfunctional uterine bleeding, relief of hot flushes, and prevention of atrophic changes in the urogenital tract. Women at risk of osteoporosis will benefit from hormone replacement therapy. The treatment should start as soon after menopause as possible and it is possible that it should be maintained for life. The treatment may be supplemented with extra calcium intake, vitamin D, and maybe calcitonin. Physical activity should be promoted, and cigarette smoking reduced if possible. Women at risk of cardiovascular disease will also benefit from hormone replacement therapy. There is overwhelming evidence that hormone therapy will protect against both coronary heart disease and stroke, and there is no increased risk of venous thrombosis or hypertension. A disadvantage of hormone replacement therapy is an increased risk of forming gall-bladder stones and undergoing cholecystectomy. Unopposed estrogen therapy gives a higher incidence of endometrial cancer in women with an intact uterus, but the contribution of progestins for about 10 days every month excludes this risk. Breast cancer in relation to estrogen-progestogen therapy has been given much concern, and the problem is still not fully solved. If there is a risk, it is small, and only after prolonged use of estrogen (15-20 years). The decision whether or not to use hormone replacement therapy should, of course, be taken by the individual woman in question, but her decision should be based on the available scientific information. It is the opinion of the authors that the advantages of hormone replacement therapy far exceed the disadvantages. We suggest that every woman showing any signs of hormone deprivation should be treated with hormone replacement therapy. This includes women with subjective or objective vaso-motor symptoms, genito-urinary symptoms, women at risk of osteoporosis (fast bone losers), and women at risk of cardiovascular diseases.
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PMID:Postmenopausal hormone replacement therapy--clinical implications. 819 55

Two-thirds of all adults age 65 or older are either irregularly active or completely sedentary. With this inactivity comes an increased risk of chronic diseases, including coronary heart disease, hypertension, diabetes, osteoporosis, and depression. Adequate aerobic exercise--even when started as late as age 60--is associated with a 1- to 2-year increase in life expectancy, as well as increased functional independence. Even chairbound patients can benefit from a program of simple exercises. To help prevent injuries, your exercise prescription should include stretching exercises and exercises to strengthen the muscles surrounding weak joints.
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PMID:Exercise for older patients: why it's worth your effort. 822 27


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