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

Cardiovascular diseases are the leading cause of death in Western countries, with an enormous increase in death rate and involvement of younger age groups during the last decades. This applies especially to coronary heart disease and is mainly caused by first-degree risk factors: hypertension, hyperlipoproteinemia, cigarette smoking, gout, obesity, polycythemia, lack of physical activity, and stress. These risk factors are discussed with special reference to overnutrition and increased cholesterol levels. Recent resuults of research concerning lipids and their relation to atherosclerosis are reviewed.
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PMID:[Etiology and pathogenesis of arteriosclerosis]. 20 5

The authors present a group of patients with renal carcinoma in whom there were paraneoplastic signs such as fever, liver failure, hypertension and polycythemia. They noted, moreover, the most important clinical aspects, evaluating the incidence of these signs in relation to the course and diagnosis. They discuss also the frequency of presentation of each of these paraneoplastic manifestations, commenting on the various theories which have been suggested to explain them.
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PMID:[Paraneoplastic syndromes in carcinoma of the kidney (author's transl)]. 21 99

No permanent neurologic deficit results from a transient ischemic attack, but patients with these episodes are at risk of stroke. Successful treatment depends on identifying the source of the problem--the heart, blood, or vessel wall. However, anticoagulants and antiplatelet agglutinating agents will reduce only the incidence of TIA's, not the incidence of stroke. Prompt vigorous treatment of progressive stroke may avert completed stroke. Heparin is recommended, unless a specific etiologic factor, such as polycythemia or hypertension, is identified.
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PMID:Current concepts in managing TIAs and stroke. 44 70

The observation of a non-metastatic reactive hepatopathy associated with a hypernephroma in a 39-year-old man who had had fever for 4 months led to a review of the literature and an analysis of basically three aspects of the disorder: a) The various manifestations of carcinoma of the kidney, which include a large number of paraneoplastic clinical symptoms (polycythemia, anemia, prolonged fever, hypercalcemia, hypertension, nefropathy, loss of salt, peripheral neuropathy, and amyloidosis); b) an alteracion of hepatic function known since 1961 which is characterized by an abnormal retention of sulfobromophthalein, increase of alkaline phosphatase, prothrombin decrease, dysproteinemia with hypoalbuminemia, and alpha2-globulin increase. It may or may not be accompanied by enlargement of the liver. c) Criteria of operability of the primary tumor.
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PMID:[Liver disease associated with hypernephroma. A case report (author's transl)]. 45 99

In the group of 111 patients treated for hypernephroma, 24 have shown in addition to their usual symptoms a more systolic an elevated blood pressure up to 22 mm Hg and higher. In two cases was hypertension the only symptom. In the hypertensive group, 20 patients underwent nephrectomy and blood pressure returned to normal in all but one. Four pathophysiologic mechanisms of blood pressure elevation in hypernephroma are discussed: (1) AV shunts; (2) Compression of the renal artery or its branches due to tumor expansion; (3) Polycythemia; (4) Hypernephroma with hormonal activity. The hypertension of 6 of our patients was due to AV shunts, of 7, to renal vessels compression, and of 6 others, to a polycythemia.
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PMID:[Hypernephroma as a cause of high blood pressure (author's transl)]. 63 20

Data regarding the etiology and subsequent course of 54 patients with an occlusion of the central retinal artery included the following: of 44 patients over 40 years of age at the time of the central retinal artery occlusion, eight (18%) had cerebrovascular accidents, but only two patients (5%) had a stroke clearly related to the vessels involving the affected central retinal artery. Five patients (11%) had occlusive disease of the ipsilateral internal carotid artery; two of these had cerebral involvement later or simultaneously. Ten of the older patients had cardiac valvular disease and presumed embolic occlusion of the central retinal artery. Associated medical disorders were common. Of the ten patients under 40 years of age, six occlusions were secondary to atrial myxoma, mitral insufficiency with Marfan's syndrome, polycythemia, hypercoagluopathy, hypertension, and orbital compression. Four had no apparent etiology at onset and were in good health many years later.
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PMID:Central retinal artery occlusion. 112 94

Spurious polycythemia is not a primary disease process. It sometimes may be nothing more than an unusual, but normal, physiologic state. In other instances, however, it is associated with a true abnormality of plasma volume. Although there is probably overlap between these extremes, differentiation of these subclasses may be of prognostic significance. The elevation in hematocrit bears no relation to morbidity, and, because there is no evidence of abnormal erythroid proliferation, reduction of red cell volume via phlebotomy or myelosuppression is inappropriate. Nonhematologic parameters, particularly hypertension, are the major factors of significance in the substantial cardiovascular morbidity in spurious polycythemia, and they demand attentive and aggressive management.
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PMID:Spurious polycythemia. 119 27

Nephrogenic adenofibroma is a novel kidney tumor of young people (mean age of presentation, 13 years), who present with polycythemia, hypertension, or hematuria, which resolve following nephrectomy. The typical nephrectomy specimen contains a solitary, nonencapsulated, vaguely circumscribed, irregularly shaped or spherical, firm mass with either tan, gray-white, or pale yellow coloration. Cysts are sometimes present within the tumor. The histologic appearance is distinctive and characterized by a marked proliferation of spindled mesenchymal cells resembling the classical type of congenital mesoblastic nephroma, encasing discrete nodules of embryonal epithelium similar to the hyperplastic nephrogenic rests (nephroblastomatosis) usually associated with Wilms' tumor. The mesenchymal component consists of a fascicular proliferation of tightly interlaced, uniform, benign-appearing spindled cells that immunostatin for vimentin and fibronectin, but not desmin or actin. The epithelial component consists of discrete islands of blastemal cells that are partially or fully differentiated toward tubular, tubulopapillary, or papillary structures. Psammoma bodies are plentiful. Embryonal epithelium immunostains for cytokeratin but not epithelial membrane antigen. The overall histologic appearance of the mesenchymal and epithelial components is benign, and preliminary clinical data suggest that the tumor has a benevolent course. Two cases, however, contained small, well-circumscribed papillary lesions near the renal pelvis that resembled low-grade collecting duct carcinoma. The clinical implications of the latter finding are unclear.
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PMID:Nephrogenic adenofibroma. A novel kidney tumor of young people. 137 78

The effect of increased red blood cell aggregation on uteroplacental blood flow was studied in 11 awake, late-pregnant guinea pigs. The aggregation of the red cells was increased by administering high molecular weight dextran (HMWD) to the previously hemoconcentrated animal. The purpose of the hemoconcentration before HMWD was 1) to use a preeclampsia model in which the hemorheology may be impaired because of the combined effect of polycythemia, an increased red cell aggregation, and an increased plasma viscosity and 2) to potentiate the aggregation-increasing effect of HMWD. Relative to the pre-HMWD condition, arterial blood pressure and systemic vascular resistance increased by 10 and 26%, respectively. The cardiac output fraction shunted across the systemic circulation and the arterial hematocrit decreased by 30 and 4%, respectively. Neither cardiac output nor the weighted organ flows, including those to the placentas, changed in response to the rise in red cell aggregation. We conclude that an imposed increase in red cell aggregation has no appreciable effect on uteroplacental blood flow in the awake and healthy late-pregnant guinea pig. These data do not exclude the possibility that increased red blood cell aggregation potentiates the negative effects on uteroplacental blood flow, e.g. in pregnancy-induced hypertension or preeclampsia, where the placenta is not only marginally perfused but also frequently damaged histologically.
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PMID:Increased red cell aggregation does not reduce uteroplacental blood flow in the awake, hemoconcentrated, late-pregnant guinea pig. 137 30

An awakening has taken place over the last 25 years to the science of sleep disorders. Foremost amongst these, both in the medical world and the public eye, has been Sleep Apnoea Syndrome (SAS). The prevalence is thought to be the order of 1-2%. Males are eight times more commonly affected than females, although after the menopause the gap narrows considerably. Sleep apnoea occurs in children, usually in relation to large tonsils and adenoids, but in adult life patients usually present between the age of 40 and 60 and the prevalence increases with age. Numerous apnoeas or hypopnoeas during the night's sleep result in disordered sleep architecture and unrefreshing sleep. This is usually accompanied by night-long snoring which may lead to marital discord and even complaints from neighbours. Symptoms on waking may be a headache and a feeling of not being refreshed by sleep. Sleepiness during the day can interfere with work and social activities and may produce risks to the patient and others if it occurs while operating dangerous machinery or driving. Over a longer time scale SAS results in intellectual and memory deterioration, a higher incidence of ischaemic heart disease, hypertension, polycythemia and pulmonary hypertension. Right heart failure is particularly likely if there is chronic airflow obstruction contributing to a low arterial oxygen level. Asystolic periods and tachyarrhythmias may occur during apnoeic periods. The increased mortality of SAS relates to coronary and cerebrovascular disease and arrhythmias. Sudden death occurs with greater frequency in patients with SAS, mainly at night.
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PMID:Sleep apnoea: causes, consequences and treatment. 141 52


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