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

Intracranial hypertension is caused by various pathologic processes. From oncologic point of view, they are 1) intracranial space-occupying lesions, especially malignant tumors, 2) leptomeningeal tumors, 3) hemorrhage in the brain tumors, 4) intracranial hemorrhage due to hemorrhagic diathesis related to the malignant tumors, and 5) cerebral thrombosis or embolism due to increased blood coagulability secondary to malignancy. In the increase of intracranial pressure, brain edema or disturbance of cerebrospinal fluid (CSF) circulation due to the presence of brain tumors play more important role than the tumor bulk itself. CT scan is useful for demonstrating the process causing the intracranial hypertension. Therapeutic measures in all patients with increased intracranial pressure are initiated promptly to restore the cardiopulmonary dysfunction if any. Hyperventilation and intravenous infusion of hyperosmolar agents such as mannitol and glycerol have an immediate effect in reducing intracranial pressure when brain edema plays role in increasing it. Steroids are also very effective in reducing brain edema; the effect is less immediate but long lasting. CSF drainage or shunt operation is necessary when dilated ventricular system plays role in the intracranial hypertension. The radical treatment of the intracranial hypertension is a removal of the tumor causing it; however, if not indicated, the second choice is the internal or external decompressions. Postoperative radiotherapy and chemotherapy are also indicated for the malignant brain tumors.
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PMID:[Intracranial hypertension]. 688 68

OC (oral contraception) can cause hypertension in a small minority, about 5%, of users. There does not seem to be a relationship between estrogen dosage and hypertension, while a relationship between progesterone and hypertension seems more possible. Hypertensive reaction to OC has been primarily seen in patients over 30; length of use is another important factor; the incidence after the 5th year of use is reputed to be 2.5-3 times higher than for the first year. Almost all women who develop hypertension with OC use will return to normal levels after OC termination. Several studies indicate a 4-fold to 6-fold increase in the risk of thrombosis and of thrombophlebitis among OC users and especially among woman over 35. OCs containing 50 mcg or less of estrogen can decrease the incidence of thromboembolic diseases by as much as 25%. It has also been reported that OC use before a surgical procedure increases the risk of postsurgical thromboembolism. Frequency of cerebral thrombosis, however rare, also seems to be higher in OC users, especially smokers. Risk of myocardial infarction is also higher among OC users especially in relation to age and smoking. A British study found that mortality rates among smokers were 10.2/100,000 pill users, versus 2.6 in nonusers in the age group 30-39; rates were 62.0 and 15.9 respectively in women over 40; duration of OC use is also a relevant factor. Absolute contraindications to OC use include any precedent of history of cardiovascular or cerebrovascular disease, impaired liver functions, any known or suspected form of neoplasia, genital bleeding, congenital hyperlipidemia, and obviously pregnancy. Relative contraindications include hypertension, migraine, epilepsy, varicose veins, diabetes, uterine leiomyomas, age over 35, and elective surgery. Potential OC users should be carefully screened to minimize possible risks. Age, health history, and smoking are extremely important. Starting OC with a dose lower than 50 mcg of estrogen is also advisable. A woman on OC should be seen every 6 months. Despite side effects and complications, OCs are the most effective and safest method of contraception a physician can offer.
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PMID:Complications and contraindications of oral contraception. 702 10

The universal prevalence of arterial hypertension among Blacks is no longer disputed, although there still remain unanswered questions. Hypertension among Blacks is nearly always primary (85% of cases), while the secondary form is synonymous with some type of renal disorder. A few 'associations' of hypertension exist. Diet may be significant, especially potassium deficiency as a result of high starch intake, low intake of potassium and other practices. Enigmatic clinical aspects include: (i) the absence of symptoms generally, especially in the presence of established severe clinical disease with and without target organ damage; (ii) the clinically apparent selective target organ damage; (iii) labile blood pressure readings at any stage; (iv) cerebral thrombosis and frequent blood pressure normalization; (v) cardiomyopathy in relation to hypertension; (vi) the discordance of morbid events; (vii) dramatic isolated morbid events, which suggest special vulnerability.
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PMID:Aspects of hypertension among blacks. 708 58

The risk factors for myocardial infarction and cerebral apoplexy were retrospectively studies on residents in a city with the population of 100,000. The average age of the deceased subjects was relatively high in myocardial infarction compared with other diseases studied in this report. Hypercholesterolemia was also found in case of the deceased myocardial infarction. The most important risk factor for cerebral hemorrhage and subarachnoid hemorrhage was hypertension. Serum cholesterol in the deceased subjects with cerebral hemorrhage and cerebral thrombosis was elevated 10% during the last decade of the study whereas in myocardial infarction it remained unchanged.
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PMID:Epidemiological study of myocardial infarction and cerebral apoplexy in survival and deceased subjects. 722 34

One hundred and one patients below 45 years and showing objective signs of cerebral ischemia were studied retrospectively for pathogenic factors. Twelve were below 15 years; the male to female ratio was 1:1. Factors known as predisposing (heart disease, hypertension, hyperlipemia, diabetes mellitus or infectious diseases) and other possible factors (e.g. trauma, abuse) were found in 41 patients. Among women using contraceptive pills there might be an increased risk of development of cerebral thrombosis, but the material was not large enough to warrant statistical analysis. In 64 patients one or more abnormal coagulation values were found, the most frequent being a deficient vessel wall fibrinolysis, which was noted in 38%. We therefore consider it worthwhile to investigate the fibrinolytic defence mechanism of the vessel wall in patients with cerebral thrombosis, since it is possible to treat this condition with specific fibrinolytic stimulating agents.
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PMID:Coagulation studies in children and young adults with cerebral ischemic episodes. 732 67

It is well known that there exists a significant correlation between cardiovascular mortality and pathology and estrogen therapy. Arterial hypertension and cerebral thrombosis can be added complications. It is estimated that of over a million OC (oral contraception) users, 100 are susceptible of vascular accidents, and 5 of death. If the absolute value of such risk can be considered small, it augments signfiicantly in connection with such factors as hypertension, diabetes, hyperlipidemia, and especially, smoking. The physiopathology of alterations caused by OCs is still under discussion, but it is possible that synthetic estrogen and ethinyl estradiol are mainly responsible for side effects, while estradiol-17 beta seems to limit the development of vascular risk. Reducing the dosage of ethinyl estradiol, as in the minipill, does not solve the metabolic problem.
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PMID:[Estrogen therapy and vascular risk]. 738 69

Platelets are deeply involved in the onset of thrombosis, such as cerebral thrombosis and myocardial infarction. In large-sized platelets, the enzyme activity is increased, and adhesion and release potential as well as coagulability are also increased, resulting in particularly active involvement in thrombogenesis. This indicates that changes in the platelet count (PLT) and mean platelet volume (MPV) reflect the state of thrombogenesis. However, there have been only a relatively few reports on PLT and MPV in the elderly, although thrombosis frequently occurs in this population. Therefore, we measured platelet parameters in men without thrombotic diseases, hematological diseases, hepatic diseases, or malignant tumors, in order to determine changes in PLT and MPV in aged men and the effects of various factors (hypertension, hyperlipidemia, diabetes, obesity, and smoking/drinking) on these changes. A total of 2,061 men, aged 30-83 (264 cases in their 30s, 810 cases in their 40s, 742 cases in their 50s, 209 cases in their 60s, 32 cases in their 70s and 3 cases in their 80s), were used as subjects. In addition, 36 men aged 30-34 (mean age 32.6 +/- 1.2 years) and 35 men aged over 70 (mean age 73.0 +/- 3.5 years) were designated as the young and aged groups, respectively. Compared with the young group, the frequency of hypertension and that of diabetes were significantly higher or tended to be higher in the aged group, whereas the frequency of smoking tended to be smaller in the aged group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Changes in the number and volume of platelets in male elderly persons, and effects of various factors on them]. 761 79

To estimate the relationship between aging, dementia and changes observed on magnetic resonance imaging (MRI) seen in elderly patients with cerebral thrombosis, MRI findings in 103 patients with an initial stroke event (thrombosis group) were compared with those of 37 patients with hypertension/diabetes (high risk group) and 78 patients without those disorders (low risk group). In addition to the causative lesions in the thrombosis group, periventricular hyperintensities (PVH), spotty lesions (SL), silent infarctions (SI), ventricular dilatation (VD), and cortical atrophy (CA) were analyzed in these groups. Infarctions located in the internal capsule/corona radiata were the most frequent causative lesion. Compared to the low risk group, a high incidence of patchy/diffuse PVH, SI, and severe CA was seen in both the thrombosis group and the high risk group. Widespread PVH and multiple SL increased with age in the thrombosis group, while severe CA was seen in each group. SI and VD tended to increase after age 60, though they were not significant. Dementia, diagnosed in 40 out of 78 patients, increased with age. Multivariate analysis revealed the degree of the effects of MRI findings on dementia to be marked in PVH, brain atrophy, causative lesions, and SL, in that order. These results indicated that diffuse PVH and brain atrophy, developing with age, promoted dementia in the elderly with vascular lesions. Moreover, they suggested that a variety of silent brain lesions recognized on MRI other than infarction can affect symptoms in the elderly.
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PMID:[Brain MRI findings in patients with initial cerebral thrombosis and the relationship between incidental findings, aging and dementia]. 772 91

The incidence of cerebrovascular event during a period of 3 years in the geriatric society in Japan was examined along with the alternating pattern of cerebrovascular accidents in relation to aging and seasonal factors. The population of Tsuwano town was approximately 7000. The percentage of aged people over 65-year-old reached 23.1% in the 1990 national census. All cerebrovascular accident patients in our hospital and two outpatients clinic in this city were registered during the period from April, 1990 to March, 1993. The number of patients in the period was 95 cases, of which 19 were classified as transient ischemic attack (TIA), 30 as cerebral thrombosis, 16 as cerebral embolism, 10 as cerebral hemorrhage, 7 as subarachnoid hemorrhage, and 13 as unclassified cerebral infarction. The frequency of each type except TIA was 39.5% cerebral thrombosis, 21.1% cerebral embolism, 13.2% cerebral hemorrhage, and 9.2% subarachnoid hemorrhage. In all cases, hypertension was observed in 62.1%, and past history of cerebrovascular accident was observed in 29.5%. The cerebral embolism group was older than the other groups and one-half of this group had atrial fibrillation. Peak incidence differed by type of illness, TIA and cerebral embolism occurred uniformly throughout the year, but subarachnoid hemorrhage and cerebral thrombosis in the spring. The relationship of cerebrovascular accident to crisis, especially potentiation by cerebral thrombosis was evaluated in light of climatic factors.
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PMID:[An epidemiological study of stroke in a geriatric community--with special reference meteorological factors]. 773 43

To evaluate the cardiac dysfunction of the cerebral infarction (cerebral thrombosis) patients in the chronic period, non-invasive studies were performed on 45 cerebral infarction patients (CI group: 25 males and 16 females, mean age 64.1 y). Forty hospitalized patient without cerebral infarction served as controls (non-CI group: 23 males and 19 females, mean age 64.8 y). The CI and non-CI group were divided into two sub-groups: patients with a past history of hypertension (HT) and without (NT). In each sub-group, the cardiac functions were compared between CI and non-CI by M-mode and Doppler echocardiography. In echocardiography, research based on the premise that the function of the left ventricle can be divided into preload (EDVi), afterload (SVR), contractility (EF, mVcf, SBP/ESV) and distensibility (E/A). On results show that there were no significant differences in preload, afterload and contractility of the left ventricle between CI and non-CI group in each HT and NT sub group. However, a significant difference was demonstrated in the diastolic function the left ventricle between the two groups in the HT (p = 0.007) and NT (p = 0.04) sub-groups. In conclusion, left ventricle diastolic function was deteriorated in cerebral infarction patients although systolic function not deteriorated. Because diastolic dysfunction may be caused by existing latent heart failure and/or silent myocardial ischemia, echocardiographic study is useful for early detection of left ventricle impairments in cerebral infarction patients.
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PMID:[Study of left ventricular function in cerebral thrombosis with pulsed Doppler echocardiography]. 811 52


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