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

Takayasu's arteritis in a pregnant white patient is described. This case highlights the fact that, irrespective of race, any patient who presents for the first time in pregnancy with pulseless hypertensive disease or other features suggestive of Takayasu's arteritis, should have their management in labour determined by the number of complications that are present. These are retinopathy, arterial aneurysms, hypertension and aortic regurgitation. These prognostic criteria will result in a classification of patients that will lead to appropriate management.
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PMID:Takayasu's arteritis in a pregnant woman. A case report. 168 80

In 1978, an epidemiological survey for adult diabetes was conducted in Taipei City. A total of 219 Chinese non-insulin-dependent diabetic patients were discovered and 217 of them were examined for retinopathy, neuropathy and nephropathy. Among the 110 men and 107 women studied, 63.1% were free of complications and the prevalences for retinopathy, nephropathy and neuropathy were 24.0%, 12.9% and 23.5%, respectively. The clinical and biochemical data of the patients were compared. For those with and those without complications, the diabetic duration (8.2 +/- 6.7 vs 4.1 +/- 2.7, years), percentage of insulin treatment (8.8% +/- 0.7%), percentage of hypertension (42.5% vs 26.3%), and the fasting plasma glucose (182.8 +/- 63.6 vs 135.0 +/- 44.6, mg/dl) were significantly different. Diabetic duration and glycemic control consistently correlated with retinopathy, nephropathy and neuropathy. Hypertension and insulin treatment were also associated positively with the complications. The more complications the diabetic patients had, the poorer the glycemic control, the longer the diabetic duration, a higher percentage of insulin treatment and hypertension were found.
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PMID:Retinopathy, neuropathy and nephropathy in non-insulin-dependent diabetic patients. 168 73

Diabetes mellitus is associated with significant morbidity and mortality caused by the micro- and macro-vascular complications that all too frequently develop during the lifetime of the diabetic patient. In attempts to treat the complications of diabetes, several different treatment strategies have been investigated. The role of tight blood glucose control in the treatment of diabetic vascular complications has recently been challenged, as the existing data in support of this mode of therapy are currently inconclusive. Perhaps more effective in preventing many of the vascular complications is the rigorous treatment of hypertension that frequently accompanies diabetes mellitus. Epidemiological studies have demonstrated that the presence of hypertension significantly contributes to the development and progression of diabetic nephropathy, retinopathy, cardiovascular disease, and possibly neuropathy. Preliminary clinical studies demonstrate that the progression of diabetic renal disease can be slowed by vigorous antihypertensive therapy. Among the various antihypertensive agents used to treat the hypertension associated with diabetes mellitus, calcium channel blockers are emerging as one of the agents of first choice. This is because of their very low side effect profile and their absence of detrimental effects on serum lipid levels and glucose tolerance. Calcium channel blockers may be of additional potential benefit to the diabetic patient by slowing the progression of atherosclerosis, reversing the intracellular calcium defects that may contribute to the pathogenesis of diabetic cardiomyopathy, and protecting against the progression of chronic renal disease.
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PMID:The future of calcium channel blocker therapy in diabetes mellitus. 172 50

Four patients with isolated acute ocular ischemic syndromes also had circulating antiphospholipid antibodies. Two patients had vaso-occlusive retinopathy and two, anterior ischemic optic neuropathy (which was successive in one). Extensive clinical laboratory evaluation identified vascular risk factors in two patients. One patient had essential thrombocytosis, confirmed by bone marrow biopsy; the other had stable hypertension and a history of coronary artery disease. These cases suggest that small vessel thrombosis in situ may be a mechanism for antiphospholipid-associated ocular and cerebral ischemia.
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PMID:Ocular thrombosis associated with antiphospholipid antibodies. 174 13

In order to obtain more information on the quality of metabolic control and presence of secondary complications in type 2 diabetic patients treated in a hospital outpatient-clinic, we studied 124 of our diabetic patients (56 males, 68 females, age 65 (SD 11) years, duration of diabetes 9, range 1-32 years). HbA1c levels were 7.9% in patients on oral hypoglycaemic agents (n = 56), and 8.2% in insulin-treated patients (n = 59). Cholesterol and triglyceride levels tended to be lower in the insulin-treated patients. The prevalence of vascular abnormalities was high: in comparison with a population of general practice patients more patients had hypertension (56% vs 38%), coronary artery disease (48% vs 40%), and cerebrovascular disease (15% vs 6%). In addition, 35% of our diabetics had signs of peripheral artery disease. Retinopathy was present in 35 patients, microalbuminuria was found in 31 patients, proteinuria in 18 patients. The presence of microalbuminuria and proteinuria was a strong indicator for cardiovascular disease, polyneuropathy and retinopathy. The use of cardiovascular medication was high: 57 patients used antihypertensive therapy, 37 used diuretics, and 26 long-acting nitrates. Only 25 patients took no medication apart from to their diabetes therapy.
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PMID:[Regulation of diabetes and late complications in the ambulatory treatment of patients with Type II diabetes mellitus]. 174 45

The article presents an evaluation of an anti-influenza vaccination programme in a population at risk, with a special study of the general characteristics of the group of non-complying patients, and the possible relation of these characteristics with their conduct. Moreover, a study was made of the possible motives for not complying with the vaccination programme by means of a survey carried out by post and telephone in a representative sample of 108 individuals. A 34.77% of the registered population did not receive the anti-influenza vaccine, corresponding largely with the youngest age group (15 to 44 years) and there were no significant differences determined by sex or risk factor or doctor. A positive response was received from 75% of those surveyed, and the basic conclusions drawn were a low proportion of information error attributable to the programme (2.94%), and patient refusal as the principal cause of non-compliance (54.41%), followed by "other reasons" (hospitalisation, absence from home, etc.) (32.35%). The strategies that may be followed in the face of this problem require definition of the group of non-compliers, further understanding of the motives for their conduct, and educational measures to change their attitude. 95.9%). Incidence of hypertension and hyperlipemia was 56.2% and 47.3%. Late vascular events varied between 2.6% (nephropathy) and 19.5% (retinopathy). A total of 101 patients (44.6%) were unaware of the existence of diabetic health education programmes. Moreover, 68 (30.3%) declared that they had never received any previous information about their diabetes. Practical skills were evaluated on an individual basis.
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PMID:[The evaluation of noncompliance in an anti-influenza vaccination program]. 175 43

The prevalences and risk factors of micro- and macroalbuminuria were surveyed in all 927 patients with diabetes mellitus who visited outpatient clinics in 27 hospitals in the Fukuoka prefecture on a designated day. The urinary albumin-creatinine ratio (UAI; mg/g Cr) of spot urine was determined in all patients except those with persistent macroproteinuria. The results were as follows: (1) The prevalences of microalbuminuria (UAI 30-299) and macroalbuminuria (UAI greater than or equal to 300) were 26% and 15%, respectively. (2) Hyperglycemia and high blood pressure synergistically increased the prevalences. (3) The independent risk factors of microalbuminuria were severities of retinopathy and neuropathy, duration of diabetes, blood pressure, and HbA1c, as determined by logistic regression analysis, although the explanation rate was low.
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PMID:One-day survey of albuminuria in diabetic outpatients in Fukuoka Prefecture, Japan. Fukuoka Diabetic Clinic Group. 177 29

At the Kiel University Department of Gynaecology, 21 patients between the 21th and 39th week of gestation were treated in 1987 and 1988 following diagnosis of HELLP syndrome. At the time of diagnosis all patients presented an advanced gestosis/eclampsia. 9 patients developed the classical signs and symptoms, while hospitalised. The typical signs of gestosis, hypertension, proteinurea, oedema and hypoproteinaemia preceded the changes in laboratory values caused by the HELLP syndrome. Upper abdominal pain and increase in transaminase values occurred on the average 3.4 or 2.7 days prior to the decrease of, thrombocyte count. In 19 of the 21 cases, pregnancy was terminated by caesarean section. Severe peripartal complications occurred in 7 cases e.g. foetal death in utero (n = 3), eclampsia (n = 5), renal failure (n = 2), cerebral oedema (n = 1), intracerebral haemorrhage (n = 1), disseminated intravascular coagulation (n = 1), abdominal wall haematoma (n = 1). 6 of these patients were admitted after complications had occurred prior to admittance. All 18 infants born alive survived the neonatal period. The average birth weight was 1,571 g. 11 infants were discharged clinically normal. The remaining infants included 5 cases pointing to retinopathy and 3 cases of cerebral palsy. One infant developed post-haemorrhagic hydrocephalus.
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PMID:[Development of symptoms and perinatal complications in HELLP syndrome]. 177 22

In 1986, 110,660 of 281,589 residents aged 25-74 years in Da Qing, Hei Long Jiang Province of China, were surveyed. Based on the results of a 75-g oral glucose tolerance test, 630 subjects were found to have previously undiagnosed diabetes according to 1985 WHO criteria. Among them, 600 diabetics aged 35-74 years (288 men, 312 women) and 410 non-diabetics of similar age with normal glucose tolerance (207 men, 203 women) were examined to determine the prevalence of retinopathy and coronary heart disease (CHD) and to evaluate associated characteristics. Retinal examinations of 423 newly diagnosed diabetics showed that 15.4% had several microaneurysms and/or small intraretinal haemorrhage, 5.5% soft exudates, 7.1% hard exudates, and 2.3% proliferative retinopathy. Among 220 non-diabetics, 13.6% had one or two microaneurysms and/or small intraretinal haemorrhage, and only 1.4% had a few soft exudates; half of the non-diabetics with retinopathy had hypertension. CHD, according to Minnesota coding (1.1-1.3, 5.1-5.3 and 7.1) of resting electrocardiograms, was ten times more frequent in the diabetics (3.59%) than in the controls (0.32%), after adjusting for age and sex. Multiple regression analysis showed that plasma glucose concentration was a risk factor for retinopathy after adjusting for age, sex, body mass index (BMI), smoking and blood pressure. Two-hour plasma glucose concentration (after adjusting for age, sex, BMI, smoking and blood pressure) and blood pressure (after adjusting for age, sex BMI, smoking and 1-h or 2-h plasma glucose level) were associated with CHD among the diabetics and non-diabetics and among the diabetics alone. Thus, both micro- and macrovascular complications occur frequently in previously undiagnosed Chinese diabetics and the frequency of CHD is markedly increased compared to the low frequency among Chinese non-diabetics.
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PMID:Coronary heart disease and diabetic retinopathy in newly diagnosed diabetes in Da Qing, China: the Da Qing IGT and Diabetes Study. 177 54

907 consecutive patients, (456 Asian and 451 Caucasian) were assessed, employing a similar methodology to the multi-centre WHO study. The Asians were older at diagnosis (46.5 years compared with 40.6 years, P less than 0.01); they had a shorter duration of diabetes (6.3 years versus 11.4 years, P less than 0.1), a higher rate of diabetes in the first degree relatives (29.5% compared with 16%, P less than 0.1), less ketonuria at presentation (85.3% compared with 47.8%, P less than 0.1), and fewer were treated with insulin (31.4% compared with 68.7%). Comparing the prevalence of complications between Asians and Caucasians, the ischaemic heart disease rate was similar; peripheral vascular disease was less (3.7% Asian, 9.3% Caucasian, P less than 0.05); retinopathy was less (11.6% Asian, 32.3% Caucasian, P less than 0.01) but renal disease was more (22.3% Asian, 12.6% Caucasian, P less than 0.01). After adjusting for age, sex, duration of diabetes, age at diagnosis, hypertension, smoking and treatment with or without insulin, these differences remained significant. Multivariate logistic regression failed to reveal a significant contribution due to any of the above variables, or due to body mass index (BMI), haemoglobin A (HbA1), or physical activity in the prevalence of complications in Asians compared with Caucasians. Marked heterogeneity in the complications of diabetes in the two ethnic groups studied was found, but must be confirmed from population-based studies.
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PMID:A comparison of the clinical features and vascular complications of diabetes between migrant Asians and Caucasians in Leicester, U.K. 177 13


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