Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The relation between poor glycemic control and the development of diabetic microangiopathy has long been recognized. However hyperglycemia alone cannot account for the striking heterogeneity of diabetic patients regarding the presence or absence of microangiopathic lesions. This study was therefore designed to determine the prevalence of retinopathy, nephropathy, and neuropathy, and to identify the factors respectively associated with these lesions. In 157 patients with type I (insulin-dependent) diabetes, the following parameters were recorded: sex, age, duration of diabetes, body mass index, fasting plasma glucose, HbA1c, blood pressure, antihypertensive treatment, tobacco consumption, urinary albumin excretion, plasma creatinine, and presence of retinopathy and neuropathy. One-half of these patients had retinopathy, 32% neuropathy, and 29% nephropathy. Patients with nephropathy exhibited concomitantly high prevalences of retinopathy (69%) and neuropathy (49%). Among patients with retinopathy, 39% had nephropathy; 79% of those with neuropathy had concomitant retinopathy. For each microangiopathic localization, patients with the disease had significantly higher values (p less than 0.05) than those without for duration of diabetes, prevalence of hypertension, and systolic blood pressure. Stepwise logistic regression analysis showed that the following were independent predictive factors of each localization: for nephropathy, systolic blood pressure; for retinopathy, duration of diabetes; and for neuropathy, duration of diabetes, age, and HbA1c.
 ...
PMID:Factors associated with diabetic microangiopathy: a study of 157 type I (insulin-dependent) diabetic patients. 177 19

Recent reports of risk factors for and survival of patients with diabetic retinopathy do not include exudative maculopathy as a separate entity. We therefore studied a group of hypertensive Type II diabetic subjects with exudative maculopathy (n = 26) compared to a carefully matched hypertensive diabetic comparison group without retinopathy (n = 26) over seven years. Diabetic maculopathy patients had higher mean diastolic blood pressure (101.6 +/- 14 versus 94.8 +/- 10 mmHg, p less than 0.05), serum cholesterol (6.65 +/- 2.2 versus 5.9 +/- 1.31 mmol/l), HDL2 subfraction levels (0.46 +/- 0.23 versus 0.32 +/- 0.18 mmol/l) and a higher prevalence of hyperlipidaemia (54% versus 35%) compared to the comparison group. After seven years, the maculopathy group showed a strikingly higher prevalence of renal failure and nephrotic syndrome (42% versus 8%, p less than 0.05) and of macroproteinuria (58% versus 15%, p less than 0.01) compared to the comparison group. Mortality and cardiovascular disease event rate was 12% and 38% in the maculopathy and 15% and 31% respectively in the comparison group. We conclude that although mortality is not significantly higher in diabetics with exudative maculopathy, proteinuria, renal failure and nephrotic syndrome may be associated features on long term follow-up. Hypertension and hypercholesterolaemia may also be risk factors in the development of diabetic maculopathy.
 ...
PMID:Long-term follow-up of and underlying medical conditions in patients with diabetic exudative maculopathy. 180 Jan 69

There is a need for greater educational emphasis, both at undergraduate and postgraduate level, on the detection of diabetic eye disease, in particular diabetic retinopathy. The early diagnosis of the sight-threatening lesions of proliferative retinopathy and maculopathy is a prerequisite for the prevention or reduction of the visual loss and blindness associated with this diabetic complication. It is also essential that patients are aware that diabetes can result in visual loss due to diabetic retinopathy. Patients should understand that diabetic retinopathy may be present without ophthalmic or diabetic symptoms and that its incidence increases with duration of diabetes, poor diabetes control, and hypertension. They must also be aware that, if detected early, retinopathy can be treated successfully and vision preserved. Early detection depends on regular eye examination involving both visual acuity assessment and ophthalmoscopy through dilated pupils by experienced personnel. A comprehensive programme of screening followed by prompt and adequate treatment would made a significant contribution to eradicating diabetic retinopathy as a cause of blindness.
 ...
PMID:Screening for diabetic retinopathy. 182 56

Hypertension is an established risk factor for retinopathy. Whether it is an independent risk factor or acts only by association with nephropathy is not known. Therefore, we studied 273 Type 1 diabetic patients. They were divided into four groups. Group 1 (n = 55) were normotensive and normoalbuminuric, group 2 (n = 51) had hypertension but were normoalbuminuric, group 3 (n = 33) had nephropathy but were normotensive, and group 4 (n = 134) had nephropathy and hypertension. Hypertensive patients with normoalbuminuria (blood pressure 146 +/- 19 (+/-SD)/87 +/- 12 mmHg) had the same prevalence of retinopathy as normoalbuminuric normotensive patients (123 +/- 12/75 +/- 5 mmHg). Hypertensive nephropathic patients (blood pressure 147 +/- 18/87 +/- 8 mmHg) had more retinopathy than hypertensive normoalbuminuric patients despite similar blood pressure (normal retina/advanced retinopathy: 3%/73% vs 46%/17%, p less than 0.001). Nephropathic normotensive patients had worse retinal changes than hypertensive normoalbuminuric patients (19%/49%, p less than 0.001) but fewer than the nephropathic hypertensive patients p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Is hypertension a major independent risk factor for retinopathy in type 1 diabetes? 183 Feb 56

Albumin concentration in a morning urine sample was analyzed in a cross-sectional study in 476 insulin-dependent diabetic patients. The following groups of patients were defined: A) normal urinary albumin (urine albumin less than 12.5 mg/L); B) high normal albuminuria (12.5-30 mg/L); C) microalbuminuria, ie, incipient nephropathy (31-299 mg/L); and D) clinical nephropathy (greater than or equal to 300 mg/L). The prevalences of incipient and clinical diabetic nephropathy were 24.8 and 14.4%, respectively. There were no differences in clinical parameters such as age, age at onset or duration of diabetes, blood pressure, serum creatinine, or HbA1c levels between groups A and B. The frequency of retinopathy in these groups was 55 and 50%, respectively. In group C, there were increases in age, duration of diabetes, blood pressure, serum creatinine, and HbA1c levels. The frequency of retinopathy was higher (80%), and more patients had severe forms (47%). In group D, there were further increases in all parameters and, in addition, younger age at onset of diabetes. The frequency of retinopathy was 97%, and severe forms of retinopathy were more common (86%). Seventeen percent of the patients were treated for hypertension. These patients were older, had longer duration of diabetes, and had higher levels of blood pressure, serum creatinine, and urinary albumin, as well as a younger age at onset of diabetes than patients not requiring antihypertensive treatment.
 ...
PMID:Albuminuria and associated medical risk factors: a cross-sectional study in 476 type I (insulin-dependent) diabetic patients. Part 1. 183 Mar 15

The association between urinary albumin concentration (UAC) in a morning urine sample and medical risk factors was evaluated in a cross-sectional study of 451 type II (noninsulin-dependent) diabetic patients. The following four groups of patients were created according to their urinary albumin levels: A) normal (less than 12.5 mg/L); B) high normal (12.5-30 mg/L); C) microalbuminuria, ie, incipient nephropathy (31-299 mg/L); and D) clinical nephropathy (greater than or equal to 300 mg/L). The patients with high normal levels had higher HbA1c and systolic blood pressure levels than patients with values within normal limits. The prevalence of incipient and clinical diabetic nephropathy was 20 and 7%, respectively. Incipient nephropathy was associated with higher blood pressures and body weights. Patients with clinical nephropathy had even further increases in these parameters, were older, and had longer duration of diabetes. In both groups of nephropathy, men were preponderant. Thirty six percent of all patients and 73% of patients with clinical nephropathy were treated for hypertension; 55% were treated with insulin. The insulin-treated patients had poorer metabolic control, but there were no differences in blood pressure or serum creatinine levels as compared with those of patients not receiving insulin treatment. The proportion of patients with severe retinopathy increased with the degree of albuminuria, although 22% of the patients with clinical nephropathy continued to be nonretinopathic.
 ...
PMID:Albuminuria and associated medical risk factors: a cross-sectional study in 451 type II (noninsulin-dependent) diabetic patients. Part 2. 183 Mar 16

To evaluate the present role of fundal examination in the assessment of the hypertensive patient, 348 hypertensive subjects, mostly with borderline or mild hypertension, were studied with direct ophthalmoscopy. The exam was always performed by the same observer. The degree of left ventricular hypertrophy was also evaluated with ECG and echocardiography. Blood pressure was measured with 24-hour ambulatory monitoring, using either the Del Mar Avionics Pressurometer II and IV, the Spacelabs 5200 or the A & D TM-2420. Signs of hypertensive retinopathy were found in 51% of the subjects. The degree of retinopathy, defined according to a modified Keith-Wagener grading system, was highly correlated with average 24-hour mean blood pressure (r = 0.31; p less than 0.0001). Based on ECG, 16% of the subjects had left ventricular hypertrophy, while 23% showed an echocardiographic left ventricular mass, indexed by body surface area, above the normal limits. Left ventricular mass index was correlated with ambulatory blood pressure levels, but at a lower level of statistical significance (r = 0.19; p less than 0.001) compared to the degree of retinopathy. No correlation was found between 24-hour blood pressure and ECG findings. Ophthalmoscopy proved to be more sensitive than echocardiography and ECG in indexing 24-hour blood pressure load, while the specificity of the 3 exams was similar. The present data indicate that fundal examination is a sensitive indicator of the vascular consequences of increased blood pressure and is therefore useful in the assessment of the hypertensive patient, while the more expensive echocardiography is not of great clinical value in borderline and mild hypertension.
 ...
PMID:[Role of ophthalmoscopy in arterial hypertension: a problem revisited]. 183 70

We made serial measurements of the platelet intracellular free calcium concentration in 167 patients with non-insulin-dependent diabetes mellitus (77 males and 90 females) over a two-year period, and investigated the relationship between this parameter and diabetic angiopathy. We measured both the basal and thrombin-stimulated platelet free calcium concentrations using fura-2/AM as a fluorescent indicator. The patients were grouped according to the severity of nephropathy, retinopathy, and hypertension and their hemoglobin A1c levels. The basal platelet calcium level of the diabetic patients was higher than that of a healthy control group. There were high levels in the patients with mild nephropathy and retinopathy, but low levels in those with severe disease, and the platelet calcium level reflected the degree of progression of diabetic angiopathy. Stimulated platelet calcium varied with the progression of nephropathy, being highest in early nephropathy and lowest after proteinuria developed. Our findings suggested that abnormalities of calcium handling may be related to the onset of diabetic vascular complications, especially diabetic nephropathy.
 ...
PMID:Platelet free Ca2+ concentration in non-insulin-dependent diabetes mellitus. 184 17

We examined the physical, sociodemographic, and psychosocial health status of diabetic Mexican Americans aged 45 to 74 years using data from the Hispanic Health and Nutrition Examination Survey. Diabetic Mexican-American women had lower education levels and lower employment rates in comparison with nondiabetics. Glaucoma, retinopathy, and activity limitation were more prevalent in diabetic than in nondiabetic men and women. Diabetic women also had a higher prevalence of hypertension, kidney problems, and cataracts. No significant differences were found in depression levels between diabetic and nondiabetic Mexican Americans of either sex. Among diabetics, duration of diabetes was associated with increased prevalence of stroke and activity limitation. These findings on the health status of diabetic Mexican Americans furthers our understanding of the health service needs of this population.
 ...
PMID:Health status of diabetic Mexican Americans: results from the Hispanic HANES. 184 40

The clinical presentation of hypertension was studied prospectively in 328 hypertensives referred to Soba Hospital, Khartoum, Sudan. The mean age of the patients was 48 years, and the major symptoms were cardiac and neurological. Only about a third of these patients were on regular medications at the initial visit. Secondary hypertension was detected in only 5% of patients. The prevalence of smoking and alcohol consumption was very low. Renal and cardiac complications were commonly encountered as part of the presentation, while retinopathy was infrequent. These findings are similar to those reported in black hypertensives in Africa but are distinct from the presentation of hypertension in US blacks.
 ...
PMID:The clinical presentation of hypertension in Sudan. 184 42


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>