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

The frequency of known causative factors of cerebral infarction was studied in 244 cases of first ever stroke due to cerebral infarction proved by computed tomography or at necropsy who were registered in the first two years of a prospective community based study. Risk factors for cerebral infarction were present in 196 (80%) cases; hypertension in 126 (52%); ischaemic heart disease in 92 (38%); peripheral vascular disease in 60 (25%); a cardiac lesion that was a major potential source of embolism to the brain in 50 (20%); transient ischaemic attacks in 35 (14%); cervical arterial bruit in 33 (14%); and diabetes mellitus in 24 (10%). Thirty one patients (13%) were in atrial fibrillation. Of the 48 patients who were free of risk factors or a major potential cardiac source of embolism at the time of the stroke, 18 were found to have hypertension after the stroke and 10 to have non-atheromatous non-embolic conditions (migrainous cerebral infarction (three), arteritis (two), inflammatory bowel disease (one), arterial trauma (one), autoimmune disease (one), carcinoma of the thyroid (one), and major operation (one). In 20 patients no causative factors could be identified. In this unselected series of patients with first ever stroke due to cerebral infarction most of the strokes were presumed to be due to either atheromatous arterial disease or embolism from the heart, and only 4% (95% confidence interval 2 to 7%) were probably due to non-atheromatous non-embolic causes. This has implications for research into strokes and allocation of public health expenditure.
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PMID:Predisposing factors for cerebral infarction: the Oxfordshire community stroke project. 249 1

In the treatment of hypertensive patients with peripheral vascular disease, alpha 1-adrenoceptor blockers may be considered first-choice drugs since they reduce the total peripheral resistance and do not decrease the plasma volume. As a preliminary step, we investigated the plethysmographic effects of doxazosin (1-8 mg for 6 weeks) on calf flow in 32 uncomplicated hypertensive patients. Despite the fall in sitting and standing blood pressure (from 163 +/- 18/101 +/- 6 to 147 +/- 19/94 +/- 8 mmHg and from 162 +/- 18/107 +/- 9 to 145 +/- 18/95 +/- 8 mmHg, respectively; both P less than 0.001) the calf flow was not decreased at rest and after ischaemia. Resting resistance was not significantly reduced (from 49.5 +/- 35 to 38.9 +/- 33 mmHg/100 ml per min) but its fall was significantly correlated with the fall in mean blood pressure (rs = 0.35, P less than 0.05). These findings confirm that doxazosin may be useful in the treatment of hypertension complicated by peripheral artery disease.
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PMID:Plethysmographic effects of doxazosin in essential hypertensive patients. 257 69

The first population-based incident case-control study of temporal arteritis (TA) in the US was conducted using the unique data resources of the Rochester Epidemiology Project. During the period 1950-1985, 88 newly diagnosed cases of biopsy-proven TA were identified among residents of Olmsted County, Minnesota. Cases were each matched to four Olmsted County community controls on age, sex and duration of community medical record. Odds ratios (OR) were calculated for marital status, education, Quetelet index, pregnancy, age at menopause, thyroid disease, diabetes, smoking, hypertension, angina, myocardial infarction, peripheral vascular disease, and stroke. Multivariable conditional logistic regression analysis identified statistically significant adjusted OR for smoking (2.3, 95% CI = 1.3-4.1). Elevated ORs which were not statistically significant were noted for angina, myocardial infarction, and peripheral vascular disease. These data suggest that TA and arteriosclerosis may share a common causal pathway. Alternatively, histopathological misclassification of temporal artery biopsies may have resulted in the observed association. Due to the limited power of this population-based study, multicentre collaboration should be encouraged to more precisely define the epidemiology of TA.
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PMID:A population-based case-control study of temporal arteritis: evidence for an association between temporal arteritis and degenerative vascular disease? 262 Oct 19

448 Sudanese diabetics were included in this study. 30% of patients were in the age group 40-50 years and only 6.3% had childhood diabetes. The predominant sex was female (64.5%). Obesity was found in 39% of patients, a positive family history in 66.5% and a history of diabetic ketoacidosis in 25.2%. 100 patients (below the age of 40) had a plain X-ray abdomen done but none had evidence of pancreatic calcification. Percentages of diabetic complications in this study were as follows: neuropathy 28.1%, retinopathy 18.5%, cataract 14.7%, hypertension 12.9%, nephropathy 11.6%, peripheral vascular disease 6.2%, coronary heart disease 4.2% and pulmonary tuberculosis 2.7%. The majority of our patients were uncontrolled, only 16.7% had normoglycaemia (FBG less than 140 mg%).
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PMID:Pattern of diabetes mellitus in the Sudan. 263 51

The clinical usefulness of calcium entry-blockers for the treatment of high blood pressure is related to their capacity to act upon the primary hemodynamic derangement in hypertension: the increased peripheral vascular resistance. They can be used alone or in combination with other antihypertensive agents for the treatment of various forms of hypertensive disease. The calcium entry-blockers appear to be the most useful agents for the treatment of hypertension in the elderly and for the treatment of hypertension associated with ischemic heart disease, pulmonary obstructive disease, peripheral vascular disease, and supraventricular arrhythmias. They are effective in reducing blood pressure in pregnancy-associated hypertension and must be considered as first-line therapy for the treatment of hypertensive crisis.
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PMID:Calcium channel antagonists in hypertension. 264 13

The records of 18 consecutive patients referred to a Veterans Administration Hospital nuclear medicine service for renal scintigraphic tests to rule out renovascular hypertension were reviewed. The men were elderly (mean age, 62 years), and risk factors for untoward reactions, including long-standing hypertension, severe peripheral vascular disease, diabetes, chronic renal failure, and recent diuretic use were present. Despite these risks, there was no test morbidity, and the authors conclude that the renal scintigraphic test with captopril enhancement is well tolerated and deserves continued application and evaluation.
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PMID:Experience with the renal scintigraphic captopril test in an elderly population. 264 11

Animal and clinical studies have demonstrated the efficacy of calcium channel blockers in reducing blood pressure, especially in older patients whose hypertension is characterized by increased peripheral vascular resistance. Their chemical heterogeneity, which permits targeted therapy, as well as their minimal side effects, drug interactions, and clinical utility in numerous pathophysiologic states common to the elderly, enhance the suitability of calcium channel blockers in treating mild to moderate hypertension in this subgroup. This is particularly relevant for those patients who have concomitant conditions, such as diabetes, chronic obstructive pulmonary disease, or peripheral vascular disease, and for whom many of the more traditional antihypertensive drugs are either contraindicated or might cause a worsening of the disease.
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PMID:Antihypertensive therapy in the geriatric patient. I: A review of the role of calcium channel blockers. 265 72

We followed 19 men and 19 women with asymptomatic carotid stenosis up to 30 months to determine whether hematologic or lipid abnormalities could identify those individuals developing progressing carotid atherosclerosis (defined as an increase in mean percent stenosis greater than or equal to 19% or an increase in a single region of greater than or equal to 23%) on B-mode carotid ultrasonography performed at 2- to 6-month intervals. Our patients demonstrated increased beta-thromboglobulin, platelet factor 4, and fibrinogen compared with age-matched controls. Eight patients developed progression of carotid stenosis, and this group had higher baseline low-density lipoprotein (LDL) and fibrinogen than the 30 nonprogressing patients. Multiple regression analyses of age, sex, smoking, coronary artery disease, peripheral vascular disease, diabetes, hypertension, and baseline high-density lipoprotein (HDL), HDL2, HDL3, LDL, beta-thromboglobulin, platelet factor 4, and fibrinogen identified coronary artery disease and elevated LDL and fibrinogen as the only independent variables significantly associated with the progressing group. We conclude that, in patients with carotid atherosclerosis, a combination of coronary artery disease and elevated LDL and fibrinogen will predict with 88% accuracy whether the patient will have progressing carotid stenosis.
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PMID:Prediction of carotid stenosis progression by lipid and hematologic measurements. 218 78

Blood flow in a segment of the leg was determined by bioimpedance plethysmography in 47 diabetic patients and in 19 normal volunteers. The blood flow through the limb, expressed as stroke volume/m2 (SV/m2), was not significantly different in the two populations. SV/m2 showed significant negative correlation with the presence of peripheral vascular disease, fasting serum cholesterol concentration, glycosylated hemoglobin (HbA1c) concentration, and the duration of diabetes. The presence or absence of retinopathy (27.7% of cases) or nephropathy (4.3% of cases) did not show strong association with the SV/m2. Neither the duration of the hypertension nor the systolic or diastolic blood pressure correlated significantly with blood flow in the extremity. These data suggest that only some of the parameters used to assess "control" of diabetic patients can be useful predictors of macrovascular as well as microvascular disease in diabetic patients.
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PMID:Correlation between macrovascular disease as assessed by bioimpedance plethysmography and various parameters used to assess diabetic "control". 273 45

Peripheral arterial occlusive disease has been described frequently as a disease affecting predominantly men. There is only a few information available concerning peripheral vascular disease in the female. Therefore, the aim of the present study was to examine risk factors in relation to localisation and symptoms of peripheral arterial occlusive disease in female patients. A retrospective study has been performed in 48 female patients (52-82 years with a mean age 69.5 years). Finally 45 patients were witheld because they had all a doppler examination and an oscillography of the lower limbs. The majority of the patients, namely 22 patients (49%) had combined ileofemoral and distal lesions. There were 15 patients (33%) who had isolated distal lesions, while only 8 patients (18%) had isolated ileofemoral vascular lesions. With respect to the symptoms the population could be divided in three groups: 16 patients (36%) were asymptomatic, 19 patients (42%) had intermittent claudication and 10 patients (22%) had rest pain and necrosis. Smoking was not the predominant risk factor in this group. Diabetes mellitus seemed to enhance distal vascular lesions, while arterial hypertension, obesity and lipids were predictive risk factors in peripheral vascular disease in the female. A high incidence of cardiovascular disease (31 patients, 69%) and cerebrovascular disease (13 patients, 29%) was concomitant.
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PMID:Localisation and risk factors of peripheral arterial occlusive disease in the female. 276 56


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