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)

The effect of residual C-peptide secretion in longer standing IDDM on glycaemic control and the prevalence and evolution of complications over 2 years was evaluated. Thirty-one subjects with IDDM of 15.4 (1.5) years duration (mean SEM)) and residual C-peptide secretion, were matched for age, duration of diabetes and body mass index with 31 subjects without detectable C-peptide secretion. At trial entry and over 2 years, levels of HbA1, fructosamine and mean blood glucose were essentially similar in both groups. Levels of glycated albumin (GSA) were significantly higher in the C-peptide negative group after 3 and 9 months (P less than 0.05). An increased prevalence of proliferative retinopathy in the C-peptide negative group and of peripheral vascular disease in the C-peptide secretor group was apparent at entry to the study (both P less than 0.05), although no significant differences were observed after 1 or 2 years. There was no difference in the prevalence of peripheral or autonomic neuropathy, hypertension, nephropathy or ischaemic heart disease. Subjects with C-peptide concentrations greater than 0.100 pmol/ml at entry to this study had lower daily insulin requirements after 1 and 2 years, but behaved like the larger group with any detectable C-peptide secretion in all other respects. Residual C-peptide secretion was lost after 1 year in 7 patients, in whom glycaemic control during the year had been particularly poor. Insulin antibody titres were no different in the 2 groups at any time point. This study suggests that residual C-peptide secretion in longer standing IDDM confers the potential for limited improvements in glycaemic control. This effect appears to be insufficient to prevent the evolution of microvascular complications over a 2-year period. Residual C-peptide secretion and relative hyperinsulinaemia may be associated with an excess of peripheral vascular disease.
 ...
PMID:The relevance of persistent C-peptide secretion in type 1 (insulin-dependent) diabetes mellitus to glycaemic control and diabetic complications. 235 Oct 37

Calcium-channel blockers may well be the drugs of choice for treating angina, hypertension, and supraventricular arrhythmia in the elderly. They are effective, have no serious side effects, and when wisely matched to the patient, are very well tolerated. Most calcium-channel blockers can be administered once or twice daily. A choice of four is available; only verapamil and diltiazem hydrochloride are useful for supraventricular arrhythmia. All four, however, are effective for the treatment of hypertension and angina. Expanding uses of calcium-channel blockers include peripheral vascular disease and migraine. There may be a theoretical advantage in humans from the point of view of the anti-atherosclerosis demonstrated in animals.
 ...
PMID:Calcium-channel blockers and the elderly. 237 3

Serotonin is a vasoactive substance that acts on blood vessels and platelets but whose primary action lies in its role as an amplifier for other agents. The aim of this work was to study the effects on blood platelets and erythrocytes of the S2-serotonergic receptor antagonist ketanserin. Twenty-seven patients with untreated hypertension and/or intermittent claudication received a bolus intravenous (i.v.) injection of 10 mg ketanserin followed by 2 mg/h during 3 h i.v. infusion. Platelet function and erythrocyte filterability were studied before and 30 min, 3 h, and 24 h after the bolus injection. The results showed decreases of plasma beta-thromboglobulin and platelet factor 4 levels (p less than 0.001) and platelet aggregation induced by epinephrine plus serotonin (p less than 0.001), whereas ADP-induced aggregation remained unchanged 30 min and 3 h after ketanserin administration. Red cell filterability was decreased (p less than 0.01). There was a tendency toward lower mean arterial blood pressure but heart rate remained unchanged. The dual effect of ketanserin on platelet function and erythrocyte filterability might be of great clinical value in hypertension and peripheral vascular disease in which microcirculatory flow is altered.
 ...
PMID:Effects of ketanserin on platelet function and red cell filterability in hypertension and peripheral vascular disease. 241 53

Hypertension has a high prevalence in most countries, so it is to be expected that hypertension will be found together with other common diseases in many patients. The association between the hypertension and the concomitant disease may be causal or casual. The presence of some other disease in the hypertensive patient often places severe restraints on the choice of antihypertensive therapy. Indoramin, an alpha adrenoreceptor antagonist may be used without ill-effect in the therapy of hypertension in patients who also have chronic obstructive airways disease, congestive heart failure, mild renal failure, peripheral vascular disease, angina pectoris, and diabetes mellitus. In at least some of these patients, the use of beta adrenoreceptor blocking drugs or thiazide diuretics would be contraindicated. We do not know whether these advantages of indoramin are unique or whether they are a general property of all alpha-adrenoreceptor antagonists.
 ...
PMID:Indoramin in the hypertensive patient with concomitant disease: clinical experience. 242 8

Since beta-adrenoceptor blocking drugs were originally discovered and shown to be important therapeutic agents in the management of both angina pectoris and hypertension, many other similar drugs have become available. These share the common property of beta-adrenoceptor antagonism, though they may vary in terms of potency. However, they differ from one another in terms of their additional pharmacological properties--cardioselectivity, partial agonist activity, and membrane stabilizing activity. Cardioselectivity refers to the ability of some drugs, notably atenolol and metoprolol, to block beta 1 receptors without blocking beta 2 receptors. This has been considered to be of potential importance in patients with obstructive airways disease, patients with peripheral vascular disease, and patients with insulin-dependent diabetes during hypoglycemic crisis. Partial agonist activity is the intrinsic activity that some drugs have to stimulate the beta adrenoceptor while they are competitively antagonizing catecholamines. In consequence, they may have less effect on resting heart rate, cardiac output, peripheral vascular blood flow, and resting respiratory function. However, there is no good evidence that major adverse effects of beta-adrenoceptor blocking drugs such as congestive heart failure, bronchospasm, or symptoms of peripheral vascular disease are prevented by drugs with partial agonist activity: bradycardia may be improved, but its importance has probably been overemphasized. Membrane-stabilizing activity appears to be unimportant. As far as pharmacokinetic differences between drugs are concerned, lipid solubility is seen to be of increasing importance. The more water-soluble drugs have longer elimination half-lives, produce less interindividual variation in steady-state plasma concentrations, and penetrate the central nervous system less readily.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Pharmacological characteristics of beta blockers and their role in clinical practice. 243 20

The present article deals with the pathophysiological role of serotonin in cardiovascular disease and in other disorders that are accompanied by cardiovascular pathophysiological events. The distribution of serotonin over various organs and tissues and the presence of several types of 5-HT receptors would suggest a rather important physiological role of serotonin. However, a modest serotonergic role could only be shown for the microcirculation and for the regional circulation of the brain and the intestinal wall. An important pathological role of serotonin in the carcinoid syndrome, in migraine, and in peripheral vascular disease is beyond debate, although many details remain to be established. The possibility that serotonergic mechanisms contribute to Raynaud's phenomenon and other vasospastic disorders is the subject of present discussions, although firm evidence for this view is not widely available. An involvement of peripheral serotonin in the genesis and maintenance of essential hypertension seems very unlikely, although vascular damage due to hypertension is probably enhanced by serotonin released from aggregating platelets. This ancillary process is, in particular, to be anticipated in older patients, with vascular walls predamaged by atherosclerosis. For this reason, pharmacological blockade of 5-HT2 receptors may be of potential therapeutic benefit in this category of patient. Finally, the involvement of central serotonergic mechanisms in hypertensive disease cannot be ruled out.
 ...
PMID:Pathophysiological relevance of serotonin. 244 63

Although there have been few direct observations, the etiology of spontaneous hyphema in patients with retinal or ocular hypoxia is assumed to be hemorrhage from a neovascular iris vessel. This paper reports observed hemorrhage from such a rubeotic iris in a patient with central retinal vein occlusion, diabetes, hypertension, peripheral vascular disease and chronic open-angle glaucoma. Bleeding was spontaneous with dilation, but stopped within 24 hours without treatment, leaving only traces of inferior angle blood staining. The two types of central retinal vein occlusion, and suggestions for their management, are also discussed.
 ...
PMID:Central retinal vein occlusion and iris neovascularization hemorrhage. 246 May 14

During a prospective cohort-study of several year's duration the results of a survey regarding prevalence of arterial occlusive disease, as well as classical risk factors and rheological profile of patients suffering from vascular disease were examined. 364 patients out of a total of 2,498 individuals suffered from vascular disease. 168 (6.7%) had cardiovascular, 151 (6.0%) cerebrovascular and 109 (4.4%) peripheral vascular disease. Compared to to healthy individuals, the patients showed a significant accumulation of classical risk factors (elevated cholesterol and triglyceride values, decreased HDL-cholesterol concentration, obesity, smoking, high blood pressure, gout or diabetes mellitus). Only 30.2% of the healthy controls presented two or more risk factors, whereas the angiological patients showed two or more risk factors in 71.9%. Rheological parameters measured in the survey were: Plasma viscosity, erythrocyte and platelet aggregation, erythrocyte rigidity and hematocrit. Only 14.2% of the healthy individuals had two or more rheological parameters exceeding the 1-s range, whereas 56.6% of the patients showed two or more elevated rheological parameters.
 ...
PMID:Prevalence, risk factors and rheological profile of arterial vascular disease; first results of the Aachen study. 246 78

Calcium antagonists have a spectrum of actions that opposes many of the pathophysiological abnormalities found in hypertension in old age. There is good evidence that these drugs reduce blood pressure effectively in the elderly. There is no evidence from controlled studies to indicate that they are more effective in elderly than in young subjects. There is equally no convincing evidence that age is an independent predictor of hypotensive efficacy of calcium channel antagonists, after the effect of pretreatment blood pressure and random variation have been taken into account. There have been no studies comparing the efficacy of calcium antagonists with other classes of antihypertensive drugs in old age, and there is no evidence that any one group of calcium antagonists is superior in this age group. There have been no studies demonstrating that calcium antagonists have a beneficial effect on the morbidity and mortality associated with hypertension in the elderly, or indeed in any age group. Side effects are equally common in old and young subjects and are usually mild. Overall, calcium antagonists are valuable and appropriate drugs for the treatment of hypertension in the elderly. They may be particularly useful for treating hypertension associated with conditions that occur with increased frequency in the elderly such as peripheral vascular disease, ischemic heart disease, cardiac arrhythmias, and obstructive airways disease. Since plasma concentrations of these drugs may be elevated in elderly patients due to altered pharmacokinetics, therapy should be started with low doses and increased gradually.
 ...
PMID:Hypertension in the elderly: the role of calcium antagonists. 246 96

The primary goals in the management of hypertension, angina pectoris, and postinfarction cases are to prevent further damage to the cardiovascular system and to reduce the risk of subsequent myocardial infarction. Of all the drugs currently available, the beta-blockers seem the most likely to achieve this aim. The search for new beta-blockers centers around the need for agents that offer the advantages of beta 1-adrenoceptor antagonism without the unwanted beta 2 effects, which may be dangerous in asthmatic patients and may make bronchitis, diabetes, and arteriopathy worse or more difficult to control. One solution is to use a selective beta 1-adrenoceptor antagonist. Another is to develop a molecule that acts as an antagonist at beta 1-adrenoceptors and as an agonist at beta 2-adrenoceptors. celiprolol is such a "third-generation" beta-blocker in that it combines both attributes, and thereby offers a clinically relevant advance. It does not seem to disrupt glucose homeostasis or exacerbate peripheral vascular disease, the lipid profile appears to be positively altered, and the risk of bronchospasm is reduced. Celiprolol is therefore both clinically and biochemically well tolerated.
 ...
PMID:Pharmacology of third-generation beta-blockers: greater benefits, fewer risks. 248 89


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>