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)

Benign intracranial hypertension is a rare complication of systemic lupus erythematosus often attributed to cerebral sinus thrombosis which impairs venous drainage and cerebrospinal fluid outflow. We report the case of a woman with a primary antiphospholipid syndrome who developed benign intracranial hypertension with no actual evidence of venous cerebral thrombosis and with no other possible cause for this clinical manifestation than high titres of anticardiolipin antibodies and a lupus anticoagulant.
 ...
PMID:Benign intracranial hypertension: a non-thrombotic complication of the primary antiphospholipid syndrome? 852 33

This study was done to clarify relationships between the degree of periventricular lucency (PVL), and lesions in the carotid arteries and the legs as detected with B-mode ultrasonography and the ankle pressure index, respectively. According to the distribution of PVL on computed tomography, 45 patients were divided into 2 groups: 22 patients with diffuse PVL (from the periventricular white matter to the subcortical area, DPVL group) and 23 patients with PVL localized in the frontal deep white matter (LPVL group). Plaque, defined as a thickened intima-media complex of 2.1 mm or more, was divided into two types; mural plaque and nodular plaque. Hypertension was more common in the DPVL group than in control groups, which consisted of 70 age-matched patients with cerebral thrombosis without PVL (CTH group) and 50 controls with neither PVL nor cerebrovascular lesions (NCT group). All patients in the DPVL group met the diagnostic criteria for Binswanger's disease proposed by Bennett DA. The incidence of low API indices (< 0.9) in the DPVL group (45%) was significantly higher than that in the NCT group, and it was slightly higher than that in the LPVL group. Carotid lesions, mainly nodular plaques, were seen in 82% of patients in the DPVL group and in 74% of those in the LPVL group; these percentages were significantly higher than those in the CTH (49%) and NCT (40%) groups. In particular, bilateral carotid lesions were more common in the DPVL group than in the other three groups. The degree of PVL correlated with lesions in the carotid arteries and the legs. These correlations suggest that the arterial lesions not only resulted from a risk factor (hypertension) for PVL, but also promoted PVL by causing extra- and intra-cranial arterial lesions. Furthermore, they imply that LPVL is a precusor to DPVL.
 ...
PMID:[Correlation between periventricular lucency and extracranial arterial lesions]. 874 69

584 kidney transplantations (208 from cadaveric donors, 376 from living relative donors) were performed in Medical Faculties of the Istambul University in 1986-1997. Thrombosis of the renal artery was observed in 2 patients (0.35%). One of them had diffused arterial atherosclerosis 4 months after the kidney transplantation. In spite of two successful thrombectomies, the patient died 3 months after the last surgical procedure from cerebral thrombosis. The other patient underwent nephrectomy. Hypertension was observed in 63 patients. In 5 of them about 50% stenosis of the anastomotic area was detected by doppler duplex scan and selective angiogram. Transluminal angioplasty was performed in one patient, open surgical correction in one case. Renal vein thrombosis took place in 1 (0.2%) patient. In 2 cases (0.35%) 5 and 12 years after the transplantation aortic aneurysmal dissection was observed.
 ...
PMID:[Vascular complications of kidney transplantation]. 964 87

To clarify the relationship between long-term prognosis of patients with stroke and their MRI findings, 103 patients with initial cerebral thrombosis, who survived more than three months after the ictus, were studied for five years. The mean age of 98 patients (T group), who were followed up completely, was 73.1 years-old and 65 were men. The age-matched controls consisted of two groups: 65 subjects, who had hypertension and/or diabetes without a history of stroke (R group), and 85 subjects, who had any hypertension, diabetes and stroke (N group). MRI findings were divided into six categories: 1) types of causative lesion, 2) grades of periventricular hyperintensity (none, rims/caps, patchy, diffuse PVH), 3) number of spotty lesions, 4) presence of silent infarction. 5) ventricular dilatation, and 6) extents of brain atrophy. Types of causative lesion were subdivided into 3 subtypes; infarction of the perforating artery territory (P type), infarction of the cortical artery territory (C type), and brainstem infarction (B type). The presence of vascular risks and dementia, and the extent of activity of daily living (ADL) were assessed. The P, C, and B types were identified by MRI in 46, 36, and 16 of the T group, respectively. Motor impairment, dementia, and an ADL status of complete dependence at discharge were also seen in 84, 44, and 22, respectively. In the T group, 33 patients died during five years, which resulted in a cumulative mortality rate of 33.7% and an annual mortality rate of 8.2%. Based on log-rank analysis, the survival rate of the T group revealed was significantly lower than those of the R and N groups. The recurrent rate in the T group (annual stroke recurrence rate was 4.0%) was higher than in the R and N groups, but stroke recurrence was not the cause of death and two thirds of deaths were due to aspiration pneumonia and/or asphyxia. Cox hazard regression analysis for death due to respiratory diseases showed that the hazard ratios of infarction, patchy PVH, and more than 4 spotty lesions were 8.87 (p < .001), 0.31 (p = .058), and 0.44 (p = .098), respectively. Compared to the survival group, rates of complete dependence in ADL, dementia, and brain atrophy were significantly higher in the death group with low incidences of the P type and patchy PVH, which indicated small vessel disease. These findings suggested that in patients with cerebral thrombosis, even in the chronic phase, care should be taken to prevent pneumonia and/or asphyxia due to bulbar palsy. Furthermore, no MRI findings were distinct predictors of long-term prognosis, although infarction based on the small vessel disease had rather good outcome in terms of respiratory disease.
 ...
PMID:[Long-term prognosis of patients with initial cerebral thrombosis and the MRI findings]. 1036 31

Inhibitors of angiotensin converting enzyme (ACE) have been developed recently for therapeutic purposes in hypertension and ischemic cardiovascular diseases. Ogiku et al. reported that one such inhibitor, imidapril, significantly prolonged survival in stroke-prone spontaneously hypertensive rats (SHRSP). The present study was designed to investigate the effect of imidapril on cerebral blood vessels in SHRSP to clarify role of the ACE inhibitor in mechanisms of cerebral thrombosis and stroke. Imidapril was administered orally at 1.0 and 5.0 mg/kg/day for 3 weeks from the age of 7 weeks, and was shown to prevent the usual increase in blood pressure seen in these animals. It also delayed He-Ne laser-induced cerebral thrombosis and increased significantly the plasma concentration of nitric oxide metabolites (NO2/NO3). To confirm the association between nitric oxide (NO) and these effects of imidapril, an inhibitor of nitric oxide synthase, N(G)-nitro-L-arginine methyl ester hydrochloride (L-NAME) was dissolved in drinking water and administered to the animals for 3 weeks. Four of six rats died from stroke when L-NAME was given alone. When imidapril (5.0 mg/kg/day) was administered with L-NAME, however, the animals showed no signs or symptoms of stroke. In these instances, therefore, the concurrent administration of L-NAME with imidapril reversed significantly the effects of imidapril. Intravenous injection of imidaprilat (100 microg/kg), an active metabolite of imidapril, also decreased blood pressure significantly and increased the plasma levels of NO2/NO3 after 5 min. Moreover, imidaprilat enlarged arteriolar diameters and caused an increase in red cell velocity and mean blood flow in pial arterioles after 15 min. The results strongly suggested that imidapril protects cerebral vessels in SHRSP by elevating the release of NO, thereby improving the cerebral circulation and reducing the tendency to thrombosis and stroke.
 ...
PMID:Protective effects of imidapril on He-Ne laser-induced thrombosis in cerebral blood vessels of stroke-prone spontaneously hypertensive rats. 1082 69

The results of 3 British and 1 American investigation of the risk of thromboembolism among women using oral contraceptives are reviewed. 1 British study conducted among general practitioners found the risk of developing superficial thrombophlebitis about 3 times greater among pill users. Neither of 2 other studies, in which hospital admissions and fatalities were analyzed, found any significant link between oral contraceptives and coronary thrombosis, but both indicated a 6 to 8-fold increase in risks of venous thromboembolism and of cerebral thrombosis. The findings of the American study were similar. None of the 4 studies discovered any evidence that the thromboembolic risk is greater early in the course of medication or, that it increases with duration of use. The American study obtained some evidence that sequential preparations might be more harmful than combined ones. The British Committee on Safety of Drugs has since determined, on the basis of analysis of routinely submitted reports of suspected adverse reactions, that the thromboembolic risk is higher with pills containing 75 mcg or more of estrogen than among those containing only 50 mcg. For the woman, who for any reason finds oral contraception to be the only satisfactory method of birth control, the risks may be considered acceptable provided medical supervision is adequate. Use of the pill entails other known major hazards (jaundice, hypertension) and knowledge of the longterm effects is very incomplete. Substantial evidence suggests that the estrogenic component of combined and sequential pills is responsible for the thromboembolic risks. The greater risks of pregnancy and menstrual disturbances accompanying progestogen-only oral contraceptives may limit their advantages.
 ...
PMID:Thrombosis and the Pill. 1225 86

The estrogen and progestin in most oral contraceptives, regardless of amounts, can produce undesirable side effects in any woman. The convenience and effectiveness, however, make oral contraceptives an excellent birth control method for the correctly screened patient. The use of relatively small doses of estrogen combined with a progestin complementary to the estrogenic, progestogenic, and androgenic needs of the patient will reduce the risk of side effects. Above the 50 ug estrogen level there is significantly higher risk of pulmonary embolism, venous thrombosis, and cerebral thrombosis. Hypertension, depression and hepatic disorders are other potential side effects. Less serious complications are breakthrough bleeding, likely caused by low level estrogen dosage and amenorrhea. Progestogenic effects include sustained noncyclic weight gain and amenorrhea. Prescribing these agents necessitates adequate follow-up and willingness to alter the prescription.
 ...
PMID:Choosing the appropriate oral contraceptive. 1226 Jun 96

This article examines the issue of safe, effective contraception for women with cardiac disease. Although barrier methods do not complicate chronic illness, they are not as effective as oral contraception (OC) and the IUD. Effeciveness is an especially important criterion among such women because of the risks posed to their health by pregnancy. Clinicians must balance the decreased side effects of parrier methods with their failure rates. Specific side effects of OCs may worsen organic heart disease by increasing risks of embolic disease, hypertensive repsonse, fluid and water retention, and hyperlipidemia. Epidemiologic research has noted a 6-fold increase in the risk of deep venous thrombosis or pulmonary empolism and a 2-fold increase in risk of cerebral thrombosis in healthy OC users. The risk of myocardial infarction is greatest in women 35-44 years of age (54/100,000 users) and may be higher in patients already predisposed to empolic disease. These findings suggest that women with histories of coronary artery disease, thromboembolic disease, and cerebrovascular disease should avoid OC use. OC is also contraindicated for women with hypertension, although low-dose progestin-only pills can be prescribed.
 ...
PMID:Contraception and chronic illnesses: cardiac disease. 1226 9

Results of different studies conducted over the past 2 decades on the relationship between oral contraceptive (OC) use and venous thromboembolism, stroke, and myocardial infarct are summarized. The possibility that OCs would increase the risk of venous thrombosis was 1st raised by a case reported in 1961, and has been confirmed by at least 9 retrospective and 4 prospective studies in the UK, US, and Scandinavia. An increased risk of venous thrombosis has been confirmed only among women currently using OCs and possibly among those stopping use within 1-2 weeks. The risk is unrelated to duration of use, although few data are available on women using OCs continuously for more than 3 years. The proof of a relationship between risk of venous thrombosis and estrogen content is convincing, although an association with progestin content has also been suggested. Evidence is beginning to accumulate for an association between smoking and venous thrombosis in OC users and nonusers alike. British prospective studies have indicated a risk of death from venous thrombosis in OC users of 2-3/100,000 users/year during the 1970s, but modern low-dose formulations, better patient selection, and better surveillance have probably reduced the risk further. The evidence of a relationship between OC use and cerebral hemorrhage is only moderately convincing, with any increased risk unlikely to be more than 2-fold. The data regarding cerebral thrombosis are more consistent and convincing; they demonstrate a positive association of risk of cerebral thrombosis with both the estrogen and progestin content of OCs. Past as well as current users may be at increased risk, but data on the effect of duration of use are lacking. At least 9 retrospective and 2 prospective studies have established the significance of the risk of myocardial infarct in OC users. Risk of myocardial infarct may be related to both estrogen and progestin content, and appears to be limited to current users. Little evidence has been found of a relationship to duration of use. Strong evidence exists of a relationship between OC use and other risk factors for myocardial infarct, including smoking and hypertension. Very few deaths were observed from this cause in women under 35 in the 1970s. As with venous thrombosis, the mortality risks of stroke and myocardial infarct have probably declined appreciably in the past few years. OCs have been implicated in blood pressure elevations as well as a series of cardiovascular problems such as Budd-Chiari syndrome, occlusion of arteries in the intestines and extremities, and hemolytic uremic syndrome. The few available published studies suggest that administration of estrogens to peri- or postmenopausal women does not entail a cardiovascular risk.
 ...
PMID:[Vascular disease and hormonal treatment--epidemiology]. 1228 Jan 97

Every Dane has an identity number, allowing one to follow persons despite name and/or address changes. Every Dane discharged from a hospital has at least one diagnosis that is stored in the national patient register. This allows researchers to find women in a specific age group who have had a cerebral thrombosis, regardless of residence. Dr. Ojvind Lidegaard, a Danish gynecologist, has conducted a retrospective case control study to clarify the relationship between oral contraceptives (OCs) and the risk of cerebral thrombosis. He analyzed data on all Danish women aged 15-44 who had experienced a cerebral thrombosis between 1985 and 1989. After conducting a multivariate analysis, he found that OCs with 50 mcg estrogen had an odds ratio of 2.9 for cerebral thromboembolic attack, those with 30-40 mcg estrogen had an odds ratio of 1.8, and progestogen-only OCs had an odds ratio of 0.9. He concluded that the lower the content of estrogen in OCs, the lower the risk of cerebral thrombosis. He estimated the relative risk for the new 20 mcg OCs to be 1.2-1.3. His study found that the most significant contributor to risk of cerebral thrombosis is age. The odds increase by about 10 times between age 20 and age 40. Cigarette smoking alone increases the risk by 50%. At the University of Pisa in Italy, women using OCs with 30 mcg estrogen had higher levels of fibrinogen and fibrinopeptide A (blood coagulating factors) than did those using OCs with 20 mcg estrogen. Neither OC affected the anticoagulant antithrombin III, however. In fact, the 20 mcg OC induced no changes in hemostatic parameters. These studies show that estrogen contents of OCs determine the risk of cerebral thrombosis. Dr. Lidegaard claims that women can use low-dose OCs until age 50, assuming they do not smoke. He believes these OCs can be safely used by smokers until they reach age 35-40. Women who should not use OCs include those who have had a thrombosis or have high blood pressure or coagulation disorders.
 ...
PMID:The case for a lower dose pill. Assessing the impact of estrogen dose. 1231 51


<< Previous 1 2 3 4 5 Next >>