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

Average systolic blood pressure levels from epidemiological studies conducted on black populations in sub-Sahara Africa were pooled and compared with pooled systolic blood pressure levels from black populations in the northern portion of the Western hemisphere (the West Indies and the United States). Studies published in English that listed systolic blood pressure means and standard deviations and sample sizes in 40-49-year-old men and women were included. Overall, systolic blood pressure levels were higher (p less than 0.05) in blacks from the northern Western hemisphere than in blacks from sub-Sahara Africa for both men (12 mm Hg higher) and women (13 mm Hg higher). The analysis was also conducted on regions within sub-Sahara Africa and in rural and urban subgroups. Systolic blood pressure was lower (p less than 0.05) in East Africa than in the other three regions within Africa for both sexes. Overall, urban blacks within Africa had higher systolic blood pressures (p less than 0.05) than rural blacks for both sexes. In the northern Western hemisphere, rural blacks had higher systolic blood pressures (p less than 0.05) than urban blacks for both sexes. Studies should be designed with standardized methods to unravel these intraracial differences in blood pressure levels.
Hypertension 1991 Sep
PMID:Systolic blood pressure levels in black populations in sub-Sahara Africa, the West Indies, and the United States: a meta-analysis. 183 16

In an attempt to study and prevent the development of hypertension, there is a growing interest in measuring blood pressure in children. The aim of this is to detect and monitor those with a relatively high level of blood pressure. Until now, reference values on blood pressure in children are based on data from North-American youngsters. The present study provides percentile charts based on pooled data from studies on blood pressure conducted in six North-West European countries among 28,043 children. These blood pressure centiles are presented as age-, height- and gender-specific. Brief guidelines for blood pressure measurements in childhood and for detection of children with a relatively high blood pressure are included.
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PMID:Blood pressure in childhood: pooled findings of six European studies. 184 24

The failure of up to half of all patients in developing countries to adhere to recommended drug regimens may reflect inadequate physician- provider communication rather than resistance to treatment. There is substantial evidence that patients are more likely to conform to treatment regimens when they are fully informed about their medical condition and the medication prescribed. To investigate the extent to which patients in Zimbabwe received this type of information, household heads in 910 households in the Mashonaland West Province were interviewed. The sample included equal numbers of respondents from urban, rural, and commercial farming areas. Diseases most commonly reported by rural residents and farmers were diarrhea, influenza, cough, hypertension, and malaria. Most of the illnesses were attributed to natural or supernatural causes, and 80% of respondents in these subsamples claimed to distrust their health care provider and never asked questions about medications prescribed. The rural residents perceived health care personnel as too busy to answer questions and did not believe they would understand any information offered. On the other hand, these respondents indicated they would like to have information on the cause of their illness, its duration and treatment, the best way to take prescribed drugs, actions to take when drugs produce side effects, and storage of medication. Physicians who treat semi-literate rural residents with indigenous health beliefs are urged to provide information about medication tailored to match the individual perceptions and needs of the patient. This need is less urgent in urban areas, where 60% of respondents had general knowledge about the action of various medicines and were able to obtain information from pharmacists.
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PMID:Drug information for patients in the community. 185 94

A 7 months-old child affected of West syndrome presented a cardiac hypertrophy with subaortic obstruction induced by adrenocorticotropic hormone treatment. The administration of this hormone may induce a Cushing syndrome; at high doses has chronotropic and inotropic positive effects and may produce arterial hypertension and cardiac hypertrophy. We pointed out the importance of the echocardiography-Doppler in the diagnosis and follow-up of the cardiac hypertrophy with subaortic obstruction as well as the reversibility of the cardiac involvement when the drug is suppressed.
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PMID:[Cardiac hypertrophy associated with subaortic obstruction induced by adrenocorticotropic hormone treatment]. 196 92

The development of novel DA receptor agonists, with various receptor selectivities, has confirmed the therapeutic utility of modulationing the peripheral dopaminergic system as Goldberg proposed 30 years ago. In addition to the acute therapy of heart failure, circulatory shock, and renal dysfunction, for which low dose DA has been standard therapy for many years, there is substantial evidence that DA receptor modulation will make a significant contribution to the chronic therapy of hypertension and congestive heart failure. However, development of drugs with adequate oral bioavailability remains a priority if we are to exploit fully these therapeutic possibilities.
Proc West Pharmacol Soc 1990
PMID:Clinical use of dopamine receptor agonists. 198 Mar 63

German physicians are increasingly adopting national and international recommendations on the promotion of non-pharmacological treatment of elevated blood pressure. This reflects a greater sensibility to the advantages and disadvantages of antihypertensive drugs versus dietary means. Furthermore, the rapid growth of health expenditure is a central issue in many policy decisions. Increasingly, the use of cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA) is being advocated as a possible means of making the medical care system more efficient. We report an analysis of the value of treating hypertension in Germany-West.
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PMID:Antihypertensive treatment in Germany, subjected to a cost-effectiveness analysis. 212 67

More than half of elderly men and women have hypertension, leading to a significant risk of increased morbidity and mortality. The cause of hypertension in this age group is unknown. Left ventricular hypertrophy is frequently present, often associated with diastolic dysfunction. Systolic hypertension in the elderly increases the risk of cardiovascular disease, but there are no good data to show that the treatment of isolated systolic hypertension reduces the morbidity or mortality. Good evidence indicates that antihypertensive treatment in this group decreases cardiovascular morbidity and mortality up to age 80, so most elderly hypertensive patients should be treated. An empiric trial of nonpharmacologic therapy can be initiated in those with mild hypertension and no cardiovascular disease, but most patients will require drug therapy. Most elderly hypertensive patients have accompanying illnesses for which they may or may not be taking medications. Some antihypertensive drugs exacerbate coexisting diseases while others augment treatment regimens. Similarly, drugs may interact in a beneficial or adverse way. Finally, drug metabolism is altered by age, leading to problems with toxicity or diminished efficacy. The choice of medication should be based on all such considerations, including the cost and convenience of the drugs available.
West J Med 1990 Apr
PMID:Perspective on hypertension in the elderly. 219 Apr 14

Extracorporeal shock wave lithotripsy (ESWL) for the treatment of upper urinary tract stone disease is held in high regard by the public and the profession. Although the efficacy is good (77.4% to 100%) for the treatment of 1- to 2-cm stones in select patients, ESWL may require the assistance of adjuvant procedures in as many as 26% of patients and may need repeating in as many as 32% of patients. These represent more difficult situations in which larger, more numerous, or harder stones may be present and in which ureteral stones are manipulated before treatment. The predominant adverse effect of ESWL treatment is the microvascular disruption of the tissues through which the shock waves pass. In addition, the procedure is painful, with many patients requiring narcotic analgesia. Long-term complications such as the new onset of hypertension have occurred in as many as 8% of treated patients, but much speculation about the long-term effects remains.
West J Med 1990 Jul
PMID:Extracorporeal shock wave lithotripsy of urinary calculi. Theory, efficacy, and adverse effects. 220 60

Between 1984 and 1989, orthotopic cardiac transplantations were done in 90 patients from 10 to 65 years of age for end-stage, refractory congestive cardiomyopathy. Two patients had had ischemic strokes 5 months and 18 years, respectively, before transplantation. Six patients (7%) suffered acute neurologic events perioperatively. Three patients suffered cerebral infarctions. In 1 case this occurred 10 days before transplantation--probably as a result of systemic hypoperfusion--with the placement of ventricular assist devices. Two others suffered infarctions 5 and 21 days, respectively, after transplantation, each of probable embolic origin. Two patients had an acute intracerebral hemorrhage 21 and 36 days, respectively, after transplantation; both were located within the basal ganglia and subcortical regions. Both patients had moderate to severe hypertension, and in 1, renal failure and a coagulopathy developed before hemorrhage. Tremor, seizures, and an altered level of consciousness developed in 1 patient as an apparent toxic reaction to cyclosporine treatment. Only 1 patient died as a result of the neurologic complication--of an acute intracerebral hemorrhage. Three patients recovered fully, 2 partially. Only the case of drug toxicity could be directly attributed to the transplantation procedure itself. We conclude that the risk of an acute neurologic insult with orthotopic cardiac transplantation is low but may result from drug toxicity, cerebral ischemia, or hemorrhagic mechanisms.
West J Med 1990 Aug
PMID:Neurologic complications of cardiac transplantation. 221 70

Prostaglandins are part of the family of oxygenated metabolites of arachidonic acid known collectively as eicosanoids. While they are formed, act, and are inactivated locally and rarely circulate in plasma, they can affect blood flow in some tissues and so might contribute to the control of peripheral vascular resistance. Few studies have shown any derangement of total body prostaglandin synthesis or metabolism in hypertension, but increased renal synthesis of one prostanoid, thromboxane A2, has been noted in spontaneously hypertensive rats and some hypertensive humans. This potent vasoconstrictor may account for the increased renal vascular resistance and suppressed plasma renin activity seen in many patients with hypertension. Increased renal vascular resistance could increase the blood pressure directly as a component of total peripheral resistance or indirectly by increasing glomerular filtration fraction and tubular sodium reabsorption. Specific thromboxane synthesis inhibitors not only decrease renal thromboxane production but also increase renal vasodilator prostaglandin synthesis when prostaglandin synthesis is stimulated. This redirection of renal prostaglandin synthesis toward prostacyclin might be of benefit in correcting a fundamental renal defect in patients with hypertension.
West J Med 1990 Aug
PMID:Prostaglandins, the kidney, and hypertension. 214 99


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