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

Platelet-activating factor (PAF) induces platelet aggregation and hypotension. It has been implicated in embryonic implantation, fetal lung maturation, and parturition. Alcohol abuse is associated with platelet dysfunction, chronic hypertension, and alcohol-related birth defects. We hypothesized that alcohol may cause, in part, these effects by increasing the activity of PAF-acetylhydrolase (PAF-AH), thereby decreasing PAF concentration. Pregnant mice were given 3.5 g/kg of alcohol orally twice daily from gestation days 7-17. PAF-AH was measured on gestation days 5, 14, and 19 in pregnant females. Nonpregnant females were treated and sampled at parallel time intervals. Pair-fed and untreated control groups were also used. The maternal plasma PAF-AH decreased with gestational age in the untreated controls. Alcohol significantly increased PAF-AH levels in both the pregnant and nonpregnant animals. PAF deficiency might contribute to the tocolytic action of alcohol, as well as some alcohol-related pregnancy complications.
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PMID:Effect of alcohol on platelet-activating factor acetylhydrolase activity in pregnant and nonpregnant mice. 797 79

Angiotensin converting enzyme plays a key role in the regulation of blood pressure and inhibitors of the enzyme are effective antihypertensive agents. An association between hypertension and alcohol abuse has long been recognized and manipulations of the renin-angiotensin system in laboratory animals has been shown to alter their consumption of ethanol. Procedures that decrease the renin-angiotensin system increase ethanol consumption. Paradoxically, inhibitors of angiotensin converting enzyme also diminish drinking. Several possible explanations for this observation have been proposed. However, observations on the relationship between stress-induced drinking and the antidipsogenic action of a fragment of adrenocorticotropic hormone suggest another possibility: angiotensin converting enzyme may be involved in the metabolism of this peptide and thereby exert an influence on drinking behavior.
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PMID:Angiotensin converting enzyme inhibitors and alcohol abuse. 803 63

Based on the results of a many-year dynamic follow-up of 151 patients with dyscirculatory encephalopathy (DE), the authors distinguish six variants of its clinical course: stable, slowly progressing without paroxysms or transient disorders of brain circulation (TDBC), slowly progressing with paroxysms, that with TDBC, intermittent, rapidly progressing. The two former variants are referred to the favorable type of DE course, the rest are considered unfavorable. The major risk factors in the patients with the favorable and unfavorable patterns of DE were studied, as well as the contribution of these factors to the development of DE. In male patients the factors conductive to the development of an unfavorable DE course were psychoemotional stress, hypokinesia, alcohol abuse, the presence of two or more concomitant somatic diseases and the absence of regular therapy; in women such factors were psychoemotional stress, excessive body mass, arterial hypertension, the presence of two or more concomitant somatic diseases, and a family history of cardiovascular diseases. A method for predicting the DE course, based on a discriminant analysis of the risk factors, has been developed, that will essentially improve the efficacy of therapeutic and prophylactic measures in such patients.
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PMID:[Variants of the clinical course of circulatory encephalopathy and the significance of certain risk factors]. 804 83

Cerebrovascular accidents are responsible for killing or disabling half a million Americans every year and are the third leading cause of death in this country. Finding cost-effective means of decreasing stroke mortality and morbidity is of great humanitarian and economic importance. Panoramic dental radiography was done on 19 white men who had a recent cerebrovascular accident and who were hospitalized at a Department of Veteran Affairs medical center. Inclusion criteria included clinical suspicion or imaging study evidence that the stroke arose from atheroembolic disease of the carotid artery bifurcation. Women were omitted from the study because of their paucity in the patient pool, and African-Americans and Asian-Americans were omitted because strokes in those groups usually develop as a result of disease of intracranial vessels. Carotid arterial calcifications appearing as a radiopaque nodular mass adjacent to the cervical vertebrae at or below intervertebral space C3-4 were noted in seven persons (37%). These patients had an average age of 65 years and demonstrated multiple risk factors (prior transient ischemic attacks, prior stroke, hypertension, obesity, tobacco and alcohol abuse, hyperlipidemia) associated with occurrence of a stroke. We concluded that some white men at risk for a cerebrovascular accident may be identified in the dentist's office by appropriate review of the panoramic dental radiograph and medical history. The presence of carotid artery calcifications demands an expeditious referral to an appropriate practitioner who can assist in the control of risk factors and arrange prophylactic surgical removal of the carotid arterial plaque, which are both safe and reliable methods of reducing the incidence of stroke.
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PMID:Prevalence of detectable carotid artery calcifications on panoramic radiographs of recent stroke victims. 806 36

Cerebrovascular accidents (CVAs) are the third commonest cause of death in France. Approximately 15% of them are due to stenosis of the extracranial internal carotid. The fact that a third of CVAs are followed by death and another third by major handicaps leads to the need for careful prevention. This has three aspects: 1) Correction of risk factors: hypertension, smoking, hyperglycemia, hyperlipidemia, obesity, alcohol abuse, hematological abnormalities and oral contraception; 2) the prescription of one of two platelet anti-aggregants, the efficacy of which has been proved: acetylsalicylic acid or ticlopidine; 3) surgical elimination of tight carotid stenoses. The following require surgery: 1) more than 70% stenosis following cerebral or ocular TIA or minor CVA; 2) more than 75% stenosis in asymptomatic patients or with episodes of VBI as well as 70% in case of thrombosis of the contralateral internal carotid; 3) following a CVA leaving serious sequelae: tight stenosis when it is reasonable to assume that a further CVA could lead to clinical worsening or to a loss of independence; 4) symptomatic and/or more than 80% restenosis. The decision should be made only after confirmation of the diagnosis and of the degree of stenosis and verification of the absence of any local or systemic contra-indication. The surgical team must have a low cumulative mortality and perioperative CVA rate. These patients require ongoing medical monitoring, particularly from a cardiological standpoint.
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PMID:[Treatment of patients with atherosclerotic carotid stenosis in 1993. Indications and long-term results of surgery]. 807 24

Patients with mild to moderate hypertension require only a simple schedule of investigations, especially if there is a history of stroke or hypertension in first degree relatives. Tests are necessary to profile other cardiovascular risk factors and to detect target organ damage with only limited screening for secondary hypertension. Careful history, physical examination, repeated blood pressure measurements over months and measurements of body mass index, random cholesterol, routine blood chemistry and urinalysis using impregnated paper strips are all that are required. More detailed investigations can be reserved for special groups such as those with peripheral vascular disease or abnormal renal function before or after treatment with angiotensin converting enzyme inhibitors or significant proteinuria or hypokalaemia. Patients with essential hypertension who are smokers with lipid abnormalities may go on to develop superimposed renovascular disease. Severe hypertension at any age and especially if there is a reliable negative family history also merits special consideration. Resistance to antihypertensive treatment is more often due to non-compliance or non-steroidal anti-inflammatory drug use or alcohol abuse than to underlying secondary causes.
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PMID:Hypertension: investigation, assessment and diagnosis. 820 68

In order to assess left ventricular structure and diastolic function, 50 hypertensive male subjects, 25 with and 25 without a history of alcohol abuse, and 20 normotensive male controls underwent Doppler echocardiographic examination followed by ambulatory blood pressure monitoring for 24 hours. Left ventricular mass was significantly higher in alcoholic hypertensives in relation to non-alcoholic hypertensives (p < 0.05) and normotensive controls (p < 0.001). Moreover, Doppler parameters expressing left ventricular filling pattern were significantly worse in alcoholic than in non-alcoholic hypertensives (p < 0.01). Clinic and ambulatory blood pressure were similar in alcoholic and non-alcoholic hypertensives, while mean day-time heart rate was significantly higher in alcoholics (p < 0.01). Collected data suggest that non-hemodynamic factors are probably involved in the development of cardiovascular abnormalities in hypertensive alcoholics, and that echocardiography should be employed for risk-profile definition in alcohol-associated hypertension.
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PMID:Left ventricular hypertrophy and diastolic dysfunction in alcohol-associated hypertension. 823 10

Individuals who experience repeated stressful events are at risk for developing physical and psychological illnesses. African Americans are an ethnic group that is exposed to a range of stressors over time, including racism which leads to discrimination. African Americans also suffer disproportionately from hypertension, cardiac disease, obesity, and drug and alcohol abuse--all illnesses that have been linked to stress. This paper describes a model to guide nursing practice, research, and education about the influence of racism on the cognitive appraisal, stress, and coping of African Americans. Lazarus and Folkman's (1984) phenomenological approach to cognitive appraisal, stress, and coping is the theoretical framework on which the model is based.
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PMID:Stress and coping: the influence of racism on the cognitive appraisal processing of African Americans. 824 90

Population aging is continuously increasing in Italy and in the World. Individuals aged 60 years or more are currently 10,500,000 and will be 13,000,000 in 2015. Life quality in geriatric ages includes the maintenance of sexual power: according to recent data (Carrol et al., 1992), 80% of impotence cases are due to organic causes. In addition, the use of drugs can cause impotence. Among them tiazidic diuretics may cause an increase of sexual disturbances. Other drugs with this potential are digitalis, antihypertensive drugs (particularly beta blockers), major and minor tranquillizers, antidepressant, H2 receptor antagonists, antiparkinsonian cholinergic drugs and estrogens employed in the treatment of prostate tumors. Diseases of geriatric age that can alter sexual power are diabetes mellitus, ischemic heart disease for the accompanying depression and for the use of antidepressants; severe hypertension is complicated by impotence in 15% of cases. Among neurological diseases Parkinson's disease and multiple sclerosis can be causes of sexual dysfunctions. Patients on hemodialysis can be impotent, with recent data (Soloh et al 1992) showing that erythropoietin treatment of anemia also improve sexual dysfunctions. Prevention from a geriatric standpoint should be base on action on known risk factor as smoking, alcohol abuse and dislipidemias and with the activation of a close drug vigilance.
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PMID:[Andrologic problems and internal pathology in the elderly]. 825 79

This paper is about the effort to measure the assistance load at the first level of attention given by arterial hypertension and care risk factors. It is been worked as a demonstration project to initiate activities within the setting of a Health Center. The risk factors are explored from the proportions of patients with the problems of obesity, smoking, hyperlipidemia, diabetes mellitus and alcoholism. The information was obtained from 395 consecutive cases out of 1100 persons who came to the center in a month period. They were 325 women (82.2%) and 70 men (17.2%) with a range of 18 to 85 years, average 40 +/- 17 and a median of 36. Obesity was encountered in 35.7% in men and 48.8% in women. Diabetes was found in 9.1% both sexes. Hypercholesterolemia > 200 mg/dl in 30.4% and > 240 mg/dl in 19.6%. Alcohol abuse was encountered in 14%, 9.2% in women and 37.7% in men. Smoking was present in 22.3% of them, 16.3% in women and 50% in men. High blood pressure > 140/90 mm Hg or hypertension history was present in 21% of the cases. Controlled cases were 6.6%. In the whole group 34% showed at least one risk factor, 57% showed two factors and 66% showed three factors. Therefore, the best estimate of assistance load, on the fight of risk factors associated to hypertension should not consider less than 70% among the regular subjects coming to this health center.
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PMID:[Arterial hypertension and other coronary risk factors in primary care]. 829 29


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