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

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

The purpose of this study was to determine which factors were associated with an increased risk of thrombo-hemorrhagic complications in a historical cohort of 100 consecutive and unselected patients with essential thrombocythemia (ET) in whom busulfan treatment was given when platelets were more than 1,000 x 10(9)/L and/or a major thrombotic or hemorrhagic event occurred. The incidence of major hemorrhagic complications was very low (0.33%/person-time at risk [pt-yr]) in comparison with that of thrombotic episodes (6.6%/pt-yr). In an adequate and appropriate control historical group of 200 patients, no severe hemorrhages were recorded and the incidence of thrombotic events was 1.2% pt-yr. Thus, the analysis of risk factors was restricted to this latter group of events. Age, a previous thrombotic event, and long duration of thrombocytosis were identified as major risk factors for thrombosis, while smoking, diabetes mellitus, hyperlipidemia, and hypertension did not influence the rate of thrombotic episodes.
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PMID:Incidence and risk factors for thrombotic complications in a historical cohort of 100 patients with essential thrombocythemia. 230 91

Primary thrombocythemia may cause vascular thrombosis; it has been rarely involved in coronary atherosclerosis with myocardial infarction. We report three cases of renal arteries atherosclerosis occurring in association with primary thrombocythemia. These cases are three young women (20, 40 and 42 years old) with severe hypertension secondary to atherosclerosis with stenosis of renal arteries, one or both sided, and in association in one case with diffuse arterial stenosis. Systematic investigation revealed thrombocytosis with latent myeloproliferative syndrome of megacaryocytic colony. Thrombocytosis was previously present as attested by a blood count one year before (in one case) and by long-term peripheral vasomotor troubles, electively improved by aspirin (in two cases). In none of these three cases, vascular risk factors, nor hereditary vascular diseases were present. So we assume that platelets high levels are responsible for this early atherosclerosis, in keeping with the well-know role of platelets in atherosclerosis pathogenesis. Platelets investigations must be done in case of renovascular hypertension, occurring without any classical vascular risk factors.
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PMID:[Essential thrombocythemia and hypertension as a result of stenosis of the renal artery]. 309 94

Essential thrombocythemia (ET) is a myeloproliferative disorder characterized by marked thrombocytosis with associated hemorrhagic, thrombotic and embolic complications caused by platelet dysfunction. In this report we describe two cases of ET and moderate to severe hypertension associated with renal artery stenosis and renal microvascular lesions. In both cases treatment of the hematologic disorder resulted in reduction of blood pressure and improvement of clinical symptoms.
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PMID:Hypertension complicating essential thrombocythemia. 337 89

The authors report the case of a 60-year-old white man with a previous history of pulmonary tuberculosis, smoking habits, hypertension, intermittent claudication and erythromelalgia, admitted to our ward with an ischemic cerebral event. Initial laboratory evaluation documented thrombocytosis (platelet-950000/mm3) and discrete anemia. Additional studies confirmed the diagnosis of essential thrombocythemia, meeting all the criteria proposed by the Polycythemia Vera Study Group in 1986, after exclusion of the possible causes of reactive thrombocytosis. Therapy was initiated with alpha-2b interferon (3 MU/m2 subcutaneously three times a week) and aspirin. Platelet count control was obtained and the patient remained asymptomatic. Nine months later cutaneous toxicity obliged the discontinuance of alpha-interferon. Due to a continuous increase of platelet count, hydroxyurea was introduced. The patient is asymptomatic, with platelet counts < 500000/mm3, without toxicity manifestations, two years after diagnosis. The contribution of cardiovascular risk factors versus thrombocythemia in the pathogenesis of the ischemic cerebral event and the benefit of platelet count control are discussed.
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PMID:[Essential thrombocythemia. Apropos a case of cerebrovascular stroke]. 828 17

A 36-year-old male was evaluated for treatment-resistant hypertension. A high platelet count 828 x 10(9).l-1, led to the diagnosis of essential thrombocythemia (ET). Aorto-renal angiography revealed critical bilateral renal artery stenosis and coronary angiography showed three-vessel disease. Percutaneous transluminal renal angioplasty was only partially successful. The patient received a 12-week course of busulphan and subsequently the thrombocyte count decreased to 200 x 10(9).l-1. Renal angiography 12 months later showed bilateral regression of the renal artery stenosis with lowering of the blood pressure to normal levels.
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PMID:Renovascular hypertension and coronary heart disease complicating essential thrombocythemia. 847 24

Thromboembolic disease remains the most frequent cause of perinatal mortality in the Western world. Much has been written about the management of patients with underlying inherited thrombophilic disorders during pregnancy. However, a number of factors, such as age over 35 years, multiparity, and cesarean section are strong predictors of an increased risk of venous thrombosis and pulmonary embolus. Poorly controlled hypertension, especially in the setting of preeclampsia and eclampsia, is a risk factor for stroke. Appropriate preventive guidelines in these settings must be developed. In addition, various acquired preexisting conditions are associated with thromboembolic disease during pregnancy. In this article, the acquired syndromes of ovarian vein thrombosis, essential thrombocythemia, antiphospholipid syndrome, and cardiac valvular disease during pregnancy will be discussed, and the appropriate preventive and therapeutic interventions for these conditions will be reviewed. Proper management of acquired thrombophilia during pregnancy requires vigilance and a thorough understanding of the risks associated with the condition and its therapy.
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PMID:Acquired thrombophilia in pregnancy. 984 Jun 91

A total of 187 consecutive patients with essential thrombocythemia (ET) were diagnosed and followed by our Hematology Department in the period October 1980-November 1994. The overall follow-up was 773 patient-years. Thrombosis-free survival and overall survival were calculated for the whole cohort; the same parameters were then calculated after arbitrary division of the cohort into two groups, according to the median age at diagnosis (55 years). Fifty percent of the patients had at least one thrombotic episode within 9 years after diagnosis. The thrombosis-free survival curves calculated for patients younger or older than 55 years at diagnosis were comparable. About 85% of the patients were alive 10 years after diagnosis. The survival curves for patients younger and older than 55 years at diagnosis were not significantly different in the observation period, and the observed mortality (seven patients) among patients younger than 55 years at diagnosis was significantly higher than expected (1.68 cases). The relative risk of death was four times greater (SMR = 4.17, 95% C.I. 1.6-8.6, p<0.01) than for healthy, age-matched people living in the same area. Age at diagnosis, smoking, sex, hypercholesterolemia, peak number of platelets, hypertension, and diabetes were not significant prognostic cardiovascular risk factors in our cohort. In conclusion, our data show that ET has to be considered a serious disease that significantly decreases both quality of life (expected life without thrombosis) and life expectancy for younger patients.
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PMID:Thrombosis-free survival and life expectancy in 187 consecutive patients with essential thrombocythemia. 1064 77

The impact of the cardiovascular risk factors smoking, hypertension, hypercholesterolemia, and diabetes mellitus on the risk of thrombotic complications was evaluated retrospectively in 132 patients with essential thrombocythemia (ET). The median age at diagnosis was 51 years, and the median follow-up time was 65 months. Sixty-three out of 132 patients (48%) had one or more vascular risk factors, whereas 69 patients (52%) had no risk factors. Thirty-two patients were smokers, 27 had hypertension, 21 hypercholesterolemia, and four diabetes mellitus. During the follow-up, 53 patients (40%) had 98 arterial thrombotic events, half of which were disturbances of cerebral circulation. Fifteen patients (11%) experienced 27 venous thrombotic events. The presence of one or more vascular risk factors increased the risk of arterial thrombotic complications. Of the patients, 52% with one or more vascular risk factors and 29% of those without any risk factors had arterial thrombosis (P = 0.01). In multivariate analysis the only independent risk factor was smoking (P = 0.01). Male gender increased the risk of arterial thrombosis significantly. Thirty-six out of 62 men (58%) but only 17 out of 70 women (24%) had an arterial complication (P < 0.001). Smoking had a strong predictive value for the development of arterial complications in women but not in men. Among women 9/15 (60%) of the smokers and 12/82 (15%) of the non-smokers experienced arterial thrombosis (P = 0.002), whereas among men no difference between smokers and non-smokers could be found. According to the present findings, the male gender should be regarded as a risk factor when deciding about the indication for treatment. Smoking should be discouraged especially among women with ET.
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PMID:The predictive value of vascular risk factors and gender for the development of thrombotic complications in essential thrombocythemia. 1126 28

A 67-year-old woman with previously untreated essential thrombocythemia developed bilateral adrenal hemorrhage. She had no known vascular risk factors including smoking, diabetes mellitus, hypertension, and hypercholesterolemia. Her platelet count was 921 x 10(9)/l. She received preemptive steroid therapy to prevent the occurrence of adrenal crisis, but 5 weeks later the replacement therapy was discontinued because the patient fully recovered with a normal adrenocorticotropic hormone stimulation test. Thereafter, she remained well for more than 4 years with a platelet count ranging from 600 to 800 x 10(9)/l. Although adrenal hemorrhage is very rare, it can occur as a hemorrhagic complication of essential thrombocythemia.
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PMID:Bilateral adrenal hemorrhage in essential thrombocythemia. 1210 69


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