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

The growing size of world cities and ever more competitive working conditions are thought to cause subjective stress, anxiety and depression, with a resulting decrease in the quality of life, sleep disturbances, drug and alcohol abuse and poor productivity. Acute stress may suppress immune function, leading to an increased incidence of infections, and chronic stress may predispose to a number of ailments, including digestive disturbances, hypertension, ischaemic heart disease and neoplasia; jointly, these factors cause a substantial shortening of life expectancy. The control of stress thus makes an important contribution to health. Stress levels can be reduced by anxiolytic drugs, or by a variety of psychological techniques; however, an appropriate programme of physical activity may be the preferred option, since exercise has many positive effects on health that are unrelated to stress. If exercise is to be effective in inducing relaxation, it must be noncompetitive, moderate in intensity, and pursued in pleasant surroundings.
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PMID:Exercise and relaxation in health promotion. 916 Apr 78

There is now strong evidence from animal studies and, in humans, from epidemiological studies as well as from retrospective and prospective intervention studies, that obstructive sleep apnea (OSA) can cause persistent hypertension not only during sleep but during waking hours as well. There is also some evidence that habitual snoring alone, even without OSA, can do the same. Many of the hitherto unexplained epidemiological, clinical, biochemical, hematological, and physiological abnormalities seen in essential hypertension (EH) could be explained by the accompanying sleep related breathing disorders (SRBD). Many cases of resistant hypertension are probably due to SRBD. Recent studies show that SRBD are extremely common in EH but that the vast majority of patients with these sleep disorders are being missed by physicians who are treating the accompanying hypertension, even when the patients already have blatant symptoms of OSA. Recent investigations have shown that the probable reason for this underdiagnosis of OSA is lack of physician knowledge about the condition. This lack of knowledge is prevalent not only among family physicians, but among hypertension specialists and researchers in the field of hypertension as well. OSA is a common, easily diagnosed, and eminently treatable condition that is associated not only with disturbed sleep, loud snoring and excessive daytime sleepiness (which greatly increases the risk of traffic accidents), but also with hypertension, especially resistant hypertension, a broad range of cardiovascular problems, decreased sexual functioning, memory deficits, difficulty concentrating, and changes in personality and mood. It deserves much more attention by physicians treating hypertension than it is currently getting.
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PMID:Sleep related breathing disorders are common contributing factors to the production of essential hypertension but are neglected, underdiagnosed, and undertreated. 944 66

In many cross-sectional studies an association has been found between snoring and hypertension. However, differing results have been obtained when confounding factors have been taken into account. To establish whether snoring is a risk factor for developing hypertension, a population-based, prospective survey was performed. In 1984 and 1994, 2,668 males, aged 30-69 yrs at baseline, answered questionnaires concerning sleep disturbances and somatic disease. Of the habitual snorers in 1984, 12.5% reported that they had developed hypertension during the period, compared with 7.4% of the remaining subjects (p<0.001). In a multiple logistic regression model persistent snoring, i.e., reported habitual snoring in both 1984 and 1994, was found to be an independent predictor for the development of hypertension among males aged 30-49 yrs (odds ratio 2.6, 95% confidence interval 1.5-4.5) after adjustments for age, body mass index (BMI), weight gain, smoking, alcohol dependence, and physical inactivity. Among the subjects aged 50-69 yrs in 1984, no association between snoring and development of hypertension was found. Although based only on reported data, the results indicate that persistent snoring is an independent risk factor for the development of hypertension among males aged <50 yrs. Prospective surveys, including whole-night sleep recordings, are needed to establish whether this is due to a higher prevalence of obstructive sleep apnoea syndrome among snorers or whether nonapnoeic snorers with increased upper airway resistance also have an increased risk of developing hypertension.
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PMID:Snoring and hypertension: a 10 year follow-up. 962 92

OBJECTIVE: To establish the acceptability and tolerance of ambulatory blood pressure monitoring (ABPM). METHODS: A two-part questionnaire was completed by the doctor; one part before ABPM and the second after the recording. The pre-recording data concern the demographic data of the patient: previous illness, symptoms, reaction of the patient, anthropometric data, treatment details and the reason for ABPM. The second part of the questionnaire records the type of monitor used, the conditions of the recording and any difficulties for, or adverse effects on, the patient. SUBJECTS: Six hundred and seventy-two patients considered hypertension by World Health Organization criteria (diastolic blood blood pressure >/=90 mmHg, systolic blood pressure >/=140 mmHg), were considered for the first descriptive part of the study; a total of 654 patients were considered for the second part related to tolerance; 18 patients refused to reply to the questions concerning the second questionnaire. The general characteristics of the population were as follows: 345 men (51.5%), 327 women (48.5%) and mean age 54+/- 15 years. RESULTS: The devices used were SpaceLabs (63%), Novacor (19.3%), Nippon Collin (6.3%) and other machines (11.2%). The difficulties caused by the machine were classified as 'nul', 'moderate' or 'important'. The levels of difficulty defined as 'important' were 32% related to the cuff, 14% to the awkwardness of the machine and 6% to the noise of the monitor. Difficulty in driving was reported in 9% of cases and difficulty related to comments by colleagues in 6%. Analysis during sleep hindered sleep in 55%, with a very disturbed sleep pattern (more than three reported awakenings) in 14% of cases. Regression analysis allowed examination of the links among the different variables, taking into account the type of machine or the profile of the subject. Thus, it was possible to differentiate among the elements that could influence or predict intolerance. CONCLUSION: Recording-related problems are not negligible but can be reduced by an approach oriented towards each individual patients, taking into account specific information for particular circumstances.
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PMID:Acceptability and tolerance of ambulatory blood pressure measurement in the hypertensive patient. 1022 26

Noise is an unwanted sound and/or a potential health hazard. Apart from noise-induced hearing loss noise causes numerous psychosocial and unspecific vegetative effects. Disturbances of communication are most frequently complained, and sleep disturbances ar regarded as most deleterious. These reactions may then cause performance decrements, annoyance and behavioral alterations. The permanent influence of noise may contribute to the multifactorial genesis of cardiovascular diseases, particularly of hypertension.
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PMID:[Noise effects not only the ears. But can damage to health be objectively evaluated?]. 1082 54

Narcolepsy is a disabling, chronic sleep-wake disorder that typically starts in a patient's second or third decade of life. Its key features are hypersomnia and cataplexy. Sleep paralysis, hallucinations, and disrupted sleep are nonspecific symptoms and are not always present. Disability relates primarily to sleepiness- related cognitive impairment, accidents, and psychosocial problems. Treatment, which includes counseling, scheduled napping, and pharmacologic intervention, is effective for most patients. Hypersomnia is best treated with such indirect sympathomimetics as mazindol, pemoline, methylphenidate, and amphetamine. Modafinil may become the drug of choice because it has fewer side effects. Cataplexy, sleep paralysis, and hallucinations may be ameliorated by compounds, including clomipramine and imipramine, that suppress rapid eye movement (REM) sleep. Regular follow-up visits enable the clinician to recognize uncommon but serious side effects (tolerance, substance abuse, psychosis, and hypertension) and additional sleep disturbances (sleep apnea, periodic limb movements in sleep, REM sleep behavior disorder), which can be specifically treated.
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PMID:Narcolepsy. 1109 16

A cross-sectional study was carried to find out the lifestyle pattern and morbidity profile of geriatrics residing in urban community of Vikram Nagar, Delhi. Women constituted 56.25% and men 43.75% of a total of 128 study subjects. Hindus were 89.06% and Sikhs 10.93%. Age group of 60-75 years accounted for most of the study population. 85% of the subjects complained of one or more health problems. 90.62% of them suffered from dental problems. A significantly higher proportion of women suffered from problems of locomotion/joints and anemia as compared to men whereas genitourinary problems were higher in men as compared to women. 42.55 of the women and 30.76% of the men were obese. Current smokers constituted 15.62% of the women and 30.76% of the men were obese. Current smokers constituted 15.62% of the population whereas 30.35% of the men were current consumers of alcohol. 12.5% used tobacco. As low as 10.15% of the population engaged in regular physical activity. 55.46% of the subjects were vegetarian. 22.65% suffered from disturbed sleep pattern. Smoking showed statistically significant association with hypertension and respiratory tract diseases. Physical activity showed association with obesity and disorder of locomotion. Behavior and lifestyle modification in the form of primordial prevention and counseling of the high risk groups should be carried to improve the quality of life of the aged.
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PMID:Life style and morbidity profile of geriatric population in an urbans community of Delhi. 1250 34

In the beginning of the 21st century, a need for a different medical approach arises among the medical systems in the world. This new attitude, beyond laboratory tests, imaging procedures, and pharmacological treatment, emphasizes the significance of the role of the patient, and transfers the control to the patient himself and his/her family. This is the biopsychosocial medical approach. In such a system the medical staff considers not only the traditional biological factors, but also the mental and environmental factors, when it plans the treatment course. The lack of consideration of the real medical and psychological needs of the patient can result in misuse of essential resources. It can also lead to the frustration of the patient and the medical personnel. Clinical psychophysiology is a treatment implementation of the biopsychosocial approach, and it is supposed to meet the biological and psychological needs of the patient. The biopsychosocial method integrates physiological treatments and behavior-cognitive care. The article describes in detail various processes of the clinical psychophysiology, according to the current professional literature. We conclude that the clinical psychophysiology might be useful in treating many problems in primary medicine, such as chronic pain, hypertension, sleep disturbances, and attention disorders. The primary care system is the optimal place to practice the biopsychosocial method, and the challenge is to develop the appropriate doctrines, which would enable the medical staff to help the patients in need. In the article we discuss in details five strategies which allow broader use of the instruments of the clinical psychophysiology: 1) Expansion of doctors education; 2) Allied health professionals involvement; 3) Integration of behavioral medical treatment in primary care; 4) Causing effective modification with minimal medical staff contiguity; 5) Referral for follow-up treatment. The clinical psychophysiology, in the framework of primary care, is a powerful integration of the biomedical and bio-social models.
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PMID:[Clinical psychophysiology in the primary care system]. 1269 73

Chronic daily headache (CDH) is an important problem for clinicians. It is frequent in tertiary care structures, although at present there is no clear consensus about definitions and operational criteria. In fact, CDH is a group of headache disorders that includes chronic migraine (CM). CDH usually evolves from an episodic headache form, which was migraine in most cases. Several psychopathological factors (e.g. psychiatric comorbidity, personality traits or stressful life events) and some somatic disorders (e.g. like arterial hypertension, allergic condition, sleep disturbances) are frequent in CM patients. Caffeine consumption, alcohol overuse and medication overuse (abortive drugs for migraine) could favour chronicity. The possible role of these factors remains poorly understood. Prospective studies and research about the pathophysiology of chronic pain will lead to a better understanding of CM.
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PMID:Neurobiology of chronic migraine. 1281 2

Epidemiological studies have shown a strong association between sleep-disordered breathing (SDB) and cerebrovascular diseases. A total of 114 male patients, aged 40-65 years, referred to sleep laboratory for the evaluation of snoring and disturbed sleep were studied. Subjects were divided into three groups: habitual snoring, mild-moderate and severe obstructive sleep apnea syndrome (OSAS), respectively, determined by using three respiratory disturbance index (RDI) cut points (</=5, 5 < RDI < 30 and >/=30). Measurement of intima-media thickness (IMT) and the presence of plaque were determined by ultrasonographic evaluation. Major vascular risk factors such as hypertension, diabetes, smoking, hyperlipidemia, and obesity were determined. The OSA groups had significantly higher IMT values compared with the habitual snoring group. Three groups were significantly different with regard to the presence of plaque. Age and body mass index were found to be significantly associated with IMT while age and RDI were found to be most probably predictive for plaque. There were no significant differences amongst the three groups with respect to age, prevalence of hypertension and diabetes, smoking, total cholesterol and total triglyceride levels. These findings suggested that SDB is a predisposing factor for the atherosclerotic process and precipitate plaque particularly when associated with higher RDI.
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PMID:Is there a link between the severity of sleep-disordered breathing and atherosclerotic disease of the carotid arteries? 1294 Aug 27


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