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

Men who do not drink are frequently used as a baseline against which the effects of alcohol consumption are measured. The characteristics of such men have been examined in a large-scale prospective study of cardiovascular disease involving 7735 middle-aged men drawn from general practices in 24 British towns. Non-drinkers include lifelong teetotallers and ex-drinkers, both long-term and recent. Long-term ex-drinkers have many characteristics likely to increase their morbidity and mortality; recent ex-drinkers have similar characteristics but to a less marked degree. Ex-drinkers are older than the other groups and include an increased proportion of unmarried men and men in manual occupations. They have the same high percentage of current cigarette smokers as moderate/heavy drinkers and a prevalence of hypertension and obesity similar to moderate/heavy drinkers and higher than lifelong teetotallers or occasional/light drinkers. Ex-drinkers have the highest percentage of men with multiple doctor-diagnosed disorders. In particular, they have the highest prevalence rates of angina and possible myocardial infarction on standardized questionnaire, of myocardial infarction on electrocardiogram and of recall of a doctor-diagnosis of ischaemic heart disease. They also have high prevalence rates of recall of high blood pressure, peptic ulcer, diabetes, gall bladder disease and bronchitis. They have the highest rates for regular medical treatment and the highest proportion of men who consider their health to be poor. It is abundantly clear that the general category of non-drinkers, which includes a large proportion of ex-drinkers, should not be used as a baseline against which to measure the effects of alcohol consumption. Overall, it would appear that the occasional/light drinking category (less than 15 drinks/week) provides a large and satisfactory baseline group for comparative purposes in the study of cardiovascular and other organic disorders.
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PMID:Men who do not drink: a report from the British Regional Heart Study. 340 25

This study reports the prevalence of psychosomatic disorders in psychiatric patients in India. The psychosomatic disorders studied were hypertension, peptic ulcer, bronchial asthma, rheumatoid arthritis, ischaemic heart disease and chronic pain. 21.5% of psychiatric patients had psychosomatic illnesses. Fifty five cases had two psychosomatic illnesses. Chronic pain (14.4%) and hypertension (9.9%) were the commonest. Patients with psychosomatic disorders were significantly more often older in age, females, married and from an urban habitat. Neurotic illness was the commonest diagnosis in them. Psychosis was significantly and inversely associated with psychosomatic disorders. This report emphasises the need for as much attention on psychosomatic problems in developing countries as in affluent ones.
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PMID:Psychosomatic disorders in psychiatric patients in a developing country. 341 Jun 57

Over a period of 42 years, 581 patients with presumed hyperparathyroidism underwent an initial cervical exploration. Abnormal parathyroid glands were removed from 495 patients (85.2%). There was a greater probability of operative success in women, patients over 50 years of age, and patients with hypercalcemia, hypertension, or nonspecific abdominal pain. There was no association of operative outcome with some of the "classic" manifestations of hyperparathyroidism--peptic ulcer disease, neuropsychiatric symptoms, pancreatitis, bone disease, or urolithiasis. The probability of surgical success improved with time, increasing from 56 per cent in the 1950s to 97 per cent in the present decade. This improvement appears to be related to greater operative experience, since all four parathyroid glands were more likely to be found with increased experience, and there was a strong correlation between finding four parathyroids and achieving persistent normocalcemia. The most common causes of operative failure were inaccurate calcium assays (the patient was not truly hypercalcemic), an inappropriate diagnosis ("normocalcemic hyperparathyroidism"), and surgical inexperience. These three factors accounted for at least three fourths of all negative explorations. More accurate diagnostic studies, and careful exploration by an experienced surgeon should maximize the probability of a successful operation for primary hyperparathyroidism.
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PMID:Causes of the failed cervical exploration for primary hyperparathyroidism. 341 98

The relation between body mass index and prevalence of 17 chronic diseases or groups of diseases was analysed using data from the 1983 Italian National Health Survey, based on a sample of 72,284 individuals aged 15 or over randomly selected within strata of geographical area, size of place of residence and of household in order to be representative of the whole Italian population. The prevalence of diabetes was directly and strongly related to body weight (age-adjusted relative risk estimates being 1.5 for overweight and 2.7 for obese men compared with normal weight individuals; 1.6 and 2.4 for overweight and obese women). Other conditions directly related to self-reported measures of body weight were hypertension (relative risk = 1.7 for obese men and 1.9 for women), myocardial infarction (relative risk = 1.5 for obese men, 1.6 for women), other heart diseases (relative risk = 1.7 for obese men, 1.5 for women), haemorrhoids or varices (relative risk = 1.2 for obese men, 1.5 for women), cholelithiasis (relative risk = 1.2 for obese men, 1.4 for women), urolithiasis and arthritis. Chronic respiratory disorders showed a U-shaped relation to measures of body weight, since their prevalence was elevated in both under- and over-weight individuals. Anaemias and gastroduodenal ulcer showed an inverse relation to body weight, whereas no association was apparent with allergy, liver cirrhosis, and psychiatric or neurological disorders. Allowance for the two major identified covariates (education and smoking) failed to explain the observed variations between measures of body weight and disease, while separate inspection of various strata of age indicated that for most diseases the elevated risks of obesity were higher in younger and decrease steadily with advancing age. Thus, the results of this national survey indicate that overweight has a widespread and substantial impact not only on mortality but also on morbidity from different chronic conditions.
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PMID:Body weight and the prevalence of chronic diseases. 341 82

This paper reports studies of patients with the following disorders: peptic ulcer, hypertension, bronchial asthma, irritable bowel syndrome (IBS), ulcerative colitis (UC), urticaria, psoriasis and alopecia. The investigations focused on dysthymic states, measured by Foulds' Scale of Anxiety and Depression (SAD) and--except for the first three disorders--the Present State Examination (PSE). On the SAD, all the above groups scored significantly higher than somatically ill controls in anxiety, and all except ulcer patients scored significantly higher in depression. The PSE designated more than half of these patients as cases, except in the psoriasis group. Most patients were assigned to the PSE syndromes of anxiety states or neurotic depression, with the former being more common in UC and urticaria, and the latter more common in IBS, alopecia and rheumatoid arthritis. The variation within skin diseases and within gastrointestinal diseases suggests that neurotic symptoms are typical of each disease rather than of the system involved in the disturbance.
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PMID:Dysthymic states and depressive syndromes in physical conditions of presumably psychogenic origin. 343 24

Differences between men and women regarding morbidity have been investigated in relation to tobacco smoking, among 2,009 70-year-olds in the longitudinal gerontological study in Gothenburg, Sweden. Male smokers (44%) had started smoking earlier (age 18) than female (14%, age 30), consumed more tobacco and more often inhaled tobacco smoke. Peptic ulcer, chronic bronchitis and lung cancer were examples of diseases more common in males. ECG evidences of myocardial ischemia were more common in males, while anginal pain showed the same prevalence. Cholecystectomy and antihypertensive treatment were more common among females. When adjustments were made for duration of smoking, amount of tobacco consumed, significant sex differences were still observed for ECG evidence of myocardial ischemia (dominance in males), peptic ulcer (dominance in males), intermittent claudication (dominance in females) and treatment for hypertension (dominance in females). The majority of disorders predominant in males were found to be related to smoking, while those predominating among females showed the same sex difference when adjustments were made for smoking habits. Future increasing segments of females addicted to tobacco smoking will obviously markedly influence sex difference in morbidity.
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PMID:Tobacco smoking--a major cause of sex differences in health. 345 75

Anxiety is the fifth most common clinical diagnosis in the primary care setting. Panic disorder, a severe episodic form of anxiety, has been found to occur in approximately 6% of primary care patients. These patients often selectively focus on one of the frightening autonomic symptoms and are frequently misdiagnosed. The three most common presentations of panic disorder in the medical setting are cardiac symptoms (chest pain, tachycardia), neurologic symptoms (headache, dizziness/vertigo, syncope), and gastrointestinal symptoms, especially epigastric distress. The presentation of cardiac symptoms by patients with panic disorder is especially likely to lead to expensive and potentially iatrogenic medical testing. Hypertension and peptic ulcer are the most commonly associated medical diagnoses in patients with panic disorder. Major depression, alcohol abuse, simple phobias, and posttraumatic stress disorder are the most frequently associated psychiatric diagnoses. Psychopharmacologic treatment of panic disorder has been demonstrated to be highly effective in double-blind, placebo-controlled studies. Effective psychopharmacologic agents include the tricyclic antidepressants (notably imipramine and desipramine), the monoamine oxidase inhibitors (phenelzine), and the high-potency benzodiazepines (alprazolam).
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PMID:Panic disorder: epidemiology, diagnosis, and treatment in primary care. 353 Nov 89

Most cardiac patients who have cardiac arrhythmias and are treated by antiarrhythmic agents will receive other cardiovascular drugs to treat coexistent problems, for example heart failure, angina or hypertension. Also, two antiarrhythmic drugs may be simultaneously prescribed to these patients in the search for better efficacy and fewer side effects. Finally these patients may well take noncardiovascular drugs such as cimetidine for the treatment of peptic ulcer disease or other hypersecretory disorders. In all cases, complex pharmacodynamic and pharmacokinetic drug interactions are likely to occur. These interactions have been extensively reviewed by Bigger and Giardina. The purpose of this work is to focus on the potentially important interactions with antiarrhythmic drugs. It is of interest for the cardiologist to be aware of the most common and meaningful drug interactions in order to prevent lack of efficacy or a risk of drug toxicity that could result from the simultaneous administration of different drugs to a patient. In this regard the interactions of antiarrhythmic drugs with digitalis, cimetidine, beta-blocking agents and other antiarrhythmic drugs will be briefly reviewed.
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PMID:Antiarrhythmic drug interactions: are they important? 355 75

The metabolic manifestations and operative findings in 10 patients with a diagnosis of parathyroid carcinoma were analyzed to determine whether they differ from those in patients with parathyroid adenomas and similar degrees of hypercalcemia. Two groups of patients with parathyroid adenomas were used for comparison. Group A consisted of eight patients with "atypical" benign adenomas (mean preoperative level of serum calcium: 13.4 mg/dl); group B consisted of 13 patients with benign typical adenomas--all with preoperative serum calcium levels greater than or equal to 13.0 mg/dl (mean: 14.2 mg/dl). The patients with carcinoma (mean preoperative level of serum calcium: 15.3 mg/dl) had a frequency of osteoporosis and osteitis fibrosa cystica (50%) comparable with that of group A (33%) and group B (62%). Seventy percent of the patients with carcinoma had renal disease (nephrolithiasis, nephrocalcinosis, or impaired renal function), whereas only 38% of group A and 15% of group B had similar disorders. The patients with carcinomas had the highest frequency of combined bone and renal disease (50% versus 14% in group A and 15% in group B). Anemia, peptic ulcer disease, and hypertension occurred with similar frequencies in the three groups. Three patients with recurrent parathyroid carcinoma died of profound hypercalcemia, renal failure, or cardiac arrhythmia. In general, although patients with parathyroid carcinomas have more profound metabolic abnormalities than do patients with primary hyperparathyroidism, the metabolic manifestations in patients with parathyroid carcinoma are comparable with those in patients with parathyroid adenomas and profound hypercalcemia. Furthermore atypical adenomas share many anatomic and histopathologic features with parathyroid carcinomas, and distinguishing between the two is sometimes possible only in cases of tumor recurrence.
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PMID:Parathyroid carcinoma versus parathyroid adenoma in patients with profound hypercalcemia. 358 61

In a double-blind group comparative study, 36 adult, birch pollen-allergic outpatients with seasonal rhinoconjunctivitis, were treated with either oral prednisolone 7.5 mg daily for 3 weeks or an injection with 2 ml suspension of betamethasone dipropionate and betamethasone disodium phosphate (Diprospan) immediately prior to the birch pollen season. Both treatments were able to prevent an increase in symptoms from the nose and the eyes during the 3-week birch pollen season. There was no significant difference in symptom score or nasal peak flow between the two treatments. However, there was a significant suppression of adrenal gland function after oral prednisolone treatment in contrast to Diprospan treatment. Unless there are contraindications for treatment with depot steroid injections (children, pregnant women, patients suffering from peptic ulcer, tuberculosis, eye disease, herpes, hypertension or diabetes) it seems to be a reasonable alternative to oral prednisolone in hay fever patients.
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PMID:Intramuscular betamethasone dipropionate vs. oral prednisolone in hay fever patients. 359 39


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