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

Clinical and coronary arteriographic findings were evaluated in patients with angina pectoris who were considered not to have diabetes mellitus or to have chemical or clinical diabetes. Each of the three groups consisted of 100 consecutive referred patients. Neither the age of the patients nor duration of symptoms differed significantly among the groups. Hypertension, gout, and peripheral vascular disease were more frequent in the patients with clinical diabetes. There was no difference in serum cholesterol concentration among the groups, but plasma triglyceride levels and the frequency of type 4 hyperlipoproteinemia were significantly higher (p less than 0.01) in the chemical and clinical diabetic groups than in the nondiabetic patients. Coronary arteriographic observations indicated that the severity of the coronary arterial disease was greater in both diabetic groups than in nondiabetic patients. The difference in the coronary scores among the three groups of patients interacts to some extent with the triglyceride level, since a high score in the diabetic groups was noted only in the presence of an elevated tryglyceride concentration. The results indicate that the increased severity of coronary arterial disease in diabetic patients is not attributable to age, duration of symptoms, hypertension, type -4 hyperlipoproteinemia, or apparent severity of the glucose intolerance.
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PMID:Reappraisal of the role of the diabetic state in coronary artery disease. 18 Dec 12

Lipids and lipoproteins were analysed in forty-one survivors of stroke, aged less than 65 years, and the same number of age and sex matched controls without vascular disease. The stroke subjects had no evidence of coronary artery or peripheral vascular disease. High density lipoprotein cholesterol was significantly lower (1.19 +/- 0.06 mmol/l) in the stroke subjects than the controls (1.47 +/- 0.07 mmol/l). Triglyceride was also elevated in the stroke subjects, but this was confined to those who were taking antihypertensive treatment which included beta-blockers and/or thiazides. The low levels of high density lipoprotein in stroke were independent of hypertension or its treatment. Thus low levels of high density lipoprotein appear to be associated with cerebrovascular disease, while elevated triglyceride is a complication of anti-hypertensive therapy.
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PMID:Reduced high density lipoprotein in stroke: relationship with elevated triglyceride and hypertension. 22 76

Atherosclerosis is one of the most common causes of peripheral vascular disease. Complications result from arteries compromised because of focal accumulations of lipids and other materials within and between cells in the vessel walls. Factors including hyperlipidemia, hypertension, diabetes mellitus, obesity, physical inactivity, smoking, social stress, and genetic background have been implicated as promoting a higher risk of atherosclerosis and its consequences.
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PMID:Atherosclerosis: a major cause of peripheral vascular disease. 58 6

One hundred and twelve South Indian males with non-diabetic peripheral vascular disease of the lower limb were classified clinically into three groups according to the level of obstruction (aorto-iliac, 26 patients; femoropopliteal, 46 patients; distal, 40 patients). Arteriography was done in 65 patients and serum lipid estimations in 69. In the aorto-iliac group the mean age was 45 years (+/- 11.6 s.d.); 23 per cent had hypertension, 28 per cent polycythaemia and 55 per cent hyperlipidaemia. Aortography suggested atheroma in most. In the femoropopliteal group the mean age was 39 years (+/- 12.8); 22 per cent had hypertension, 11 per cent polycythaemia and 21 per cent hyperlipidaemia. Arteriography showed lesions typical of atheroma in many and was consistent with thrombo-angiitis obliterans in some. In the distal group the mean age was 37 years (+/- 9.8); 8 per cent had hypertension, 20 per cent polycythaemia, 25 per cent hyperlipidaemia and 20 per cent had distal arterial disease of the upper limb. Arteriography was consistent with thrombo-angiitis obliterans in most cases. Atheroma seemed to be implicated in 96 per cent of the aorto-iliac group and in 64 per cent of the femoropopliteal group.
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PMID:The pattern of non-diabetic peripheral vascular disease in South India. 62 67

Measurement of the sinus node recovery time has been proposed as a diagnostic tool for recognition of the sick sinus syndrome. The latter is most frequently encountered in elderly patients with hypertension, coronary heart disease, and atherosclerosis. In order to provide normal values for the sinus node recovery time in this particular population group, atrial pacing studies were carried out in 30 subjects over 50 years of age, all with peripheral vascular disease and some with angina pectoris (10), residua of infarction (6), or hypertension (7). On stimulation, 7 patients maintained a I:I atrioventricular conduction up to the rate of 180/min. Second degree atrioventricular block developed in all other cases. On six occasions, Wenckebach's periods appeared at the relatively slow pacing rate of 120/min. The maximum postoverdrive pause ranged from 680 to 1600 ms with an average of 1100 ms plus or minus 190 (10). For each pacing speed, a correlation was found between the duration of the pause and the control intrinsic cardiac rate, longer pauses being associated with longer resting PP intervals. Beyond 120/min, the duration of the pause was seen to shorten progressively as the driving rate was increased. Finally, the behavior of the sinus node pacemaker following interruption of pacing showed individual variations. After pacing at relatively slow rates, a prompt return to near control values was consistently observed, whereas, after fast rates of driving, a phase of secondary depression developed in about one-half of the studied cases.
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PMID:Sinus node recovery time in the elderly. 112 18

A group of 278 patients, over the age of 60 years, and representative of geriatric and general medical admissions to the District General Hospital in Banbury, Oxforshire, was studied to correlate the prevalence of systolic murmurs to age, sex, cardiac failure, ischaemic heart disease, dysrrhythmias, hypertension, peripherial vascular disease and anaemia. The object was to establish the clinical significance of these murmurs and test a postulate that they could not be dismissed as benign. Seventy-five per cent of the murmurs were judged to be aortic and 12 per cent mitral in origin. The prevalence of systolic murmurs increased with age from 32 per cent at 60-64 years to 57 per cent over 85 years, and was greater in females (44 per cent) than in males (34 per cent). The presence of systolic murmurs was related to the presence of cardiac failure, ischaemic heart disease, dysrrhythmias, hypertension, peripheral vascular disease and anemia. Only 8 per cent of patients with systolic murmurs had none of the above-mentioned six cardiovascular abnormalities compared with 36 per cent of patients without such a murmur, while multiple cardiovascular abnormalities were also commoner in the former group. The mortality rate in hospital was similar for patients with or without a systolic murmur.
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PMID:The clinical significance of systolic murmurs in the elderly. 114 71

In a controlled study on 121 patients with peripheral vascular disease (PVD) (75 patients with primary hyperlipoproteinemia, 15 diabetics, 31 patients without metabolic disease) the relationship between risk factors (hyperlipoproteinemia, obesity, hypertension, abnormal glucose tolerance, smoking) and the degree and localisation of sclerotic lesions was investigated by angiography. The degree was directly related in all patients to the number of risk factors, in Type IIa to cholesterol levels, in diabetics and Type IV with abnormal glucose tolerance to age. The latter patients were 5-10 years older than patients with Type IIa and showed 2 or more additional risk factors. The sclerotic lesions affected in Type IIa, less in Type IIb, predominately the pelvic vessels. Diabetics and Type IV patients showed a distal arterial involvement. The difference was significant. The degree of sclerotic lesions in arteries of the pelvis and the distal lower limb was positively correlated with the cholesterol-triglyceride ratio. Smoking aggravated the pelvic lesions in Type IV. Hypertension lead to more pronounced lesions of the distal lower limb in Type II. S-shaped tortuosities of the big vessels were shown to be typical, independent of localisation or degree.
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PMID:Primary hyperlipoproteinemias as risk factors in peripheral artery disease documented by arteriography. 119 76

To better evaluate the incidence of atherosclerosis in the internal mammary artery (IMA), 215 IMA segments from routine postmortem examinations were evaluated microscopically. Significant atherosclerotic narrowing was seen in 9 patients (4.2%). No patient had more than a 50% reduction in lumen diameter. The degree of incipient atherosclerosis correlated well with age, hypertension, diabetes, and peripheral vascular disease.
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PMID:Atherosclerosis of the internal mammary artery. 127 3

Changes in renal function caused by angiotensin-converting-enzyme (ACE) inhibitors can be detected on 99mTc-DTPA renography so that DTPA scanning before and after a single dose of captopril can be used to screen for renovascular disease. We have performed captopril-DTPA scans with renal arteriography on 104 patients, of whom 27 had renal artery stenosis, all due to atheroma. Using a 5% fall in divided function or a delay of greater than 15 min in time to peak activity on one side after captopril, or the finding of greater than 90% divided function on one side before captopril as criteria for a positive scan, a sensitivity of 93% and specificity of 70% was achieved. The negative predictive value of the test in our population was 93%. Bilateral improvement in renographic function after captopril was seen in patients with accelerated phase hypertension. The presence of bilateral renal artery disease did not reduce the sensitivity of the test, but sensitivity was reduced (75%) in patients with renal impairment. Clinical characteristics in our patients most strongly associated with renal artery stenosis were abdominal bruit, recurrent left ventricular failure, and peripheral vascular disease. In view of the well-publicized risks of ACE inhibitor therapy, care should be exercised in the use of these agents in such patients.
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PMID:Screening for renovascular disease with captopril-enhanced renography. 131 91

The results of renal transplantation in patients with juvenile-onset diabetes mellitus were compared to those of a well-matched control group of non-diabetic patients. All transplantations were performed between 1977 and 1988. In the diabetic group hypertension (72 versus 41%), coronary artery disease (17 versus 0%), and peripheral vascular disease (19 versus 0%) had been significantly more frequent pretransplantation. Fewer diabetic patients had previously been treated with dialysis therapy (69 versus 97%). Graft function measured by creatinine clearance after 1 year follow-up, and incidence of proteinuria were not significantly different. The overall graft survival was significantly worse in the diabetic group compared to the control group: 42 versus 69% after 60 months and 21 versus 62% after 90 months. This was caused by a significantly worse patient survival in the diabetic group after 105 months: 28 versus 78% in the control group. The graft survival following exclusion of the patients who died with a functioning graft did not differ significantly between the groups after 60 and 90 months: 62 and 31% in the diabetic group and 69 and 62% in the control group. The existence of any vascular disease before transplantation, especially pre-existing peripheral vascular disease, had a significant effect on mortality in diabetic patients (P = 0.0003). After transplantation, diabetic patients had significantly more cerebrovascular accidents (23 versus 3%), peripheral vascular disease (31 versus 3%), and number of infections (1.9 versus 1.2). Retransplantation was carried out in each group to the same extent, with the same success rate.
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PMID:Increased morbidity and mortality in patients with diabetes mellitus after kidney transplantation as compared with non-diabetic patients. 132 80


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