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

In this summary, the authors have attempted to examine reports of associations between various dietary habits and practices on one hand, and serum lipids or clinical disease on the other hand. There seems to be little doubt that both hypertension and ischemic heart disease have a nutritional background, but in all likelihood, there are other factors such as hereditary traits, occupational hazards, and perhaps personal habits including cigarette smoking, alcohol abuse and prolonged ingestion of medicinal drugs. One of the strongest correlates seems to be the role of complex carbohydrates in regulating blood lipid concentrations. Carbohydrates not only have an effect on the endocrine system that regulates blood volume, but they also influence absorption of fat soluble substances from the digestive tract and if natural fiber is included, it has an effect on fecal bulk, transit time of the fecal stream, and reabsorption of bile acids and neutral sterols. Epidemiologically, there is some evidence that the changes that occurred in the American diet in the years between 1914-1944 may well have played a permissive role in the genesis of a portion of the coronary heart disease, high blood pressure and stroke that occurred in the United States. It is not too farfetched to suggest that had the American servicemen been given more cereal food products including bread and other baked food items, instead of excessive amounts of meat and fats, the dietary pattern of America might well have been substantially different. Furthermore, this difference could easily have influenced the pattern of atherosclerosis and hypertension. A great deal more work is needed to confirm or refute these suggestions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Dietary changes and their possible effect on blood pressure. 298 49

Dietary alteration or intervention is an ideal method of preventing or treating hypertension. Medication may be eliminated or reduced in many cases. Correction of obesity and alcohol abuse are confirmed methods of treating hypertension. Reduction of sodium intake is effective in that portion of the population which is salt-sensitive. Probably, the ratio of sodium to potassium is of importance and increasing potassium intake while reducing sodium intake is effective in many situations. Evidence is being reported which indicates that adequate intake of calcium, and perhaps magnesium, is effective in preventing hypertension. Limited information indicates that a sufficiency of dietary essential fatty acids and fibre are effective in hypertension prevention. The role of dietary protein, carbohydrates, fat, cholesterol, vitamins, and essential elements (other than those mentioned above) in the pathogenesis has not been fully elucidated at this time, but there are indications that adequate intakes are beneficial in hypertension. Water hardness may have some effect in reducing hypertension incidence, and any effectiveness would probably result from calcium and magnesium in the drinking water. Animal studies and limited human studies indicate some detrimental effects of heavy metals, such as lead and cadmium, upon the pathogenesis of hypertension. Information regarding caffeine intake is inconclusive.
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PMID:Dietary factors in essential hypertension. 300 94

Various morbidity parameters in Mamre, a village of 4,623 residents in the western Cape, are described. Acute morbidity (either injury or illness) occurring in the 2 weeks before the survey was reported by 4% of respondents. Investigation of several chronic conditions for which people said that they were receiving treatment yielded rates of 57/1,000 for hypertension, 29/1,000 for 'nerves', 13/1,000 for diabetes and 19/1,000 for tuberculosis; 9.9% of respondents reported disability. Reported morbidity increased with age, was commoner in women than in men, and agreed with perceptions of individuals' health. Tuberculosis, inadequate sewerage and water facilities, alcohol abuse and dusty roads were perceived to be the main health problems by the community. The morbidity profile and the relatively high rate of pscyhosocial problems found are consistent with a process of urbanisation in a predominantly working-class community.
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PMID:Morbidity profile of the Mamre community. 326 40

Patients with heart failure should stop smoking, maintain an optimal weight and limit their intake of salt. Alcohol abuse should be avoided. The detection and early treatment of hypertension appears to have had a major impact in preventing heart failure. Diuretics revolutionized the treatment of congestive heart failure and their proper and appropriate use can alleviate peripheral and pulmonary oedema. Diuretics should not be overused and care should be taken to avoid hypokalaemia. Controversy surrounds the use of digoxin in patients in sinus rhythm; the drug should be used in patients in atrial fibrillation. The use of an inotropic drug may be harmful in the presence of coronary artery disease. A reduction in the current use of digoxin might be of benefit to many patients with heart failure. When the drug is prescribed it should be used in a therapeutic and not homeopathic dose. Recent interest has been directed toward the use of vasodilators and the angiotensin-converting enzyme inhibitors in patients with heart failure. In my opinion, these drugs should be used after patients have been treated with thiazide and loop diuretics. Vasodilators are particularly beneficial in acute heart failure or in patients with chronic heart failure when the symptoms are related to fluid overload and volume expansion. The cause of symptoms in patients with chronic heart failure optimally treated with diuretics is controversial. Shortness of breath may not be simply related to the left atrial pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Changing ideas in the treatment of heart failure--an overview. 330 Sep 78

On the basis of the data from the registry of cerebral stroke (CS) cases in Novosibirsk (covering 937 patients and 314 healthy control subjects) the authors have made a mathematical analysis of 19 factors of the risk of disease development. Nine factors have been isolated whose varying combinations were most contributory to the risk of the development of CS in the studied population: cardiac diseases, transient disorder of the cerebral circulation, arterial hypertension, atherosclerosis, aggravated heredity for cardiovascular diseases, intermittent claudication, diabetes mellitus, systematic alcohol abuse, and hypodynamia. The authors have developed a practicable and reliable system for predicting the development of cerebral stroke in apparently healthy subjects (the accuracy of prediction is 86%).
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PMID:[Experience of prognosis and the risk factors of stroke in Novosibirsk]. 336 95

This study addresses the underlying causes responsible for the severity and persistence of active, refractory epistaxis. Seventy-five patients referred because of treatment failure by primary care physicians showed hypertension and aspirin and alcohol abuse to be major factors in the refractory nature of their epistaxis. The majority of bleeding was located near the posterior floor of the nasal cavity and just posterior to Kiesselbach's plexus and was only associated with septal deviation, spurring, or mucosal abnormalities in 16 of the 75 patients. Seventeen of 67 outpatients required hospitalization. Standard laboratory tests were often inadequate determinants of etiology. Intractable epistaxis should be a signal for a thorough investigation of factors that influence clotting.
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PMID:Factors associated with active, refractory epistaxis. 339 Mar 29

Anxiety is the fifth most common clinical diagnosis in the primary care setting. Panic disorder, a severe episodic form of anxiety, has been found to occur in approximately 6% of primary care patients. These patients often selectively focus on one of the frightening autonomic symptoms and are frequently misdiagnosed. The three most common presentations of panic disorder in the medical setting are cardiac symptoms (chest pain, tachycardia), neurologic symptoms (headache, dizziness/vertigo, syncope), and gastrointestinal symptoms, especially epigastric distress. The presentation of cardiac symptoms by patients with panic disorder is especially likely to lead to expensive and potentially iatrogenic medical testing. Hypertension and peptic ulcer are the most commonly associated medical diagnoses in patients with panic disorder. Major depression, alcohol abuse, simple phobias, and posttraumatic stress disorder are the most frequently associated psychiatric diagnoses. Psychopharmacologic treatment of panic disorder has been demonstrated to be highly effective in double-blind, placebo-controlled studies. Effective psychopharmacologic agents include the tricyclic antidepressants (notably imipramine and desipramine), the monoamine oxidase inhibitors (phenelzine), and the high-potency benzodiazepines (alprazolam).
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PMID:Panic disorder: epidemiology, diagnosis, and treatment in primary care. 353 Nov 89

We aspirated synovial fluid from the knees of 50 patients with asymptomatic, nontophaceous gout, in whom synovial fluid monosodium urate (MSU) crystals had previously been documented in the knees or other joints. Fifty-eight percent of these asymptomatic patients had MSU crystals in their knee joints. Serum uric acid levels, serum creatinine levels, volume of synovial fluid aspirated, and cell counts of the aspirated fluid did not differentiate the MSU crystal-positive group from the group without MSU crystals. Clinical factors such as alcohol abuse, coronary heart disease, hypertension, duration of gout, duration of the intercritical period, and drug therapy did not differentiate the 2 groups. Nineteen patients consented to aspiration of their other knee. Seven of these patients (37%) had MSU crystals bilaterally, and 6 patients (32%) had them unilaterally. The implications of the persistence of MSU crystals (including those in intracellular locations) in many patients, despite normalization of serum uric acid levels, should be determined. Knee joint aspiration is a sensitive method for the demonstration of MSU crystals in asymptomatic patients. The procedure might also be useful in documenting these crystals in patients who have had attacks of arthritis with features consistent with a diagnosis of gout, but in whom MSU crystals have not been documented.
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PMID:Monosodium urate crystals in the knee joints of patients with asymptomatic nontophaceous gout. 380 Oct 71

Alcohol abuse and hypertension are two important health concerns for the general US population. A review of the literature indicates, however, that black Americans are at greater risk of experiencing primary and secondary health and behavioral problems associated with these two concerns. Empirical evidence exists suggesting a relationship between alcohol consumption and hypertension and its related sequelae. Although the correlation is not of a dose-effect nature, the results of numerous longitudinal and other studies have suggested a positive relationship. Various implications exist in the treatment, control, and prevention of hypertension for highrisk groups. For example, existing health-care protocols may be modified for regular screening and monitoring of "excessive" alcohol consumption patterns, especially of hypertensive and borderline hypertensive patients. Whenever possible, health-care counseling and education should be a necessary adjunct to treatment and prevention efforts to better control hypertension in the black community.
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PMID:Alcohol consumption and hypertension: a review with suggested implications. 398 47

Alcohol abuse is a frequent contributor to elevated blood pressure and may be the most common cause of secondary hypertension. The mechanism of this association is unknown. In most cases, the blood pressure elevations are reversible and return to normal upon discontinuation of alcohol use. Even though transitory, such hypertension cannot be considered benign, or inconsequential, since it may be contributory to the increased prevalence of cardiovascular disease observed in problem drinkers.
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PMID:Alcohol-induced hypertension: mechanisms, complications, and clinical implications. 399 53


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