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

A community based epidemiological study of hypertension was carried out on a random urban sample of young persons (15-24 yr) of Delhi. Hypertension was defined as systolic blood pressure greater than 140 mmHg and/or a diastolic blood pressure greater than 85 mm Hg or a history of current antihypertensive therapy. Of the 6543 subjects examined, 202 were found to be hypertensive. The overall prevalence rate was 30.9/1000 (male 41.2/1000, female 21.7/1000). Secondary hypertension was present in 4 of the 202 patients. Only 16 patients were aware of the presence of hypertension; of these 6 were on medication. Family history of hypertension was present in 87 subjects (43.1%). Of the 202 hypertensives, 67 were obese and 16 were smokers. The degree of physical activity was identical in the hypertensive and non-hypertensive subjects. Blood samples of 129 of the 202 patients were analysed for lipid levels. High values of total cholesterol were observed in nine.
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PMID:Epidemiological study of hypertension in young (15-24 yr) Delhi urban population. 816 99

A follow-up study of coronary heart disease (CHD) was carried out among adults in Delhi 3 years after an initial community-based epidemiological survey of the same population. A total of 575 of the 814 cases of CHD detected clinically and by electrocardiogram (ECG) in the initial survey took part. On re-examination of the original cohort of 4151 adults who were free of CHD both clinically and by ECG in the initial survey, 245 new cases of CHD were detected - 73 on a clinical basis (21 with myocardial infarction and 52 with angina pectoris) and 172 by ECG (13 with myocardial infarction and 159 with probable CHD based on ST and T changes). The overall incidence of CHD was 19.7 per 1000 (males, 17.3 per 1000; females, 21.0 per 1000). The incidence on a clinical basis was 5.9 per 1000 (males, 6.5 per 1000; females, 5.5 per 1000) compared with 13.8 per 1000 by ECG (males, 10.8 per 1000; females, 15.5 per 1000). Although the incidence of myocardial infarction was higher in men (3.6 per 1000) than women (2.2 per 1000), the incidence of angina pectoris was 36.5% higher in women (18.7 per 1000) than in men (13.7 per 1000). Hypercholesterolaemia and systemic hypertension were the commonest risk factors in the 245 new cases.
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PMID:A 3-year follow-up study of coronary heart disease in Delhi. 844 40

The author had the opportunity to plan and carry out a community based epidemiological survey of Delhi urban population and rural areas of Gurgaon (Haryana) for estimation of prevalence rates and risk factors for the coronary heart disease and hypertension. Based on the experience of conducting this largest population based epidemiological study in India for coronary heart disease and hypertension, problems in conducting these studies were identified. These are discussed in this paper so that other workers may benefit from this experience.
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PMID:Problems of population based epidemiological surveys. 886 94

A community-based epidemiological survey of coronary heart disease and its risk factors was carried out over the period 1984-87 on a random sample of adults aged 25-64 years: 13,723 adults living in Delhi and 3375 in adjoining rural areas. ECG examination and analysis of fasting blood samples for lipids were performed on subjects with the disease and asymptomatic adults free of clinical manifestations. The overall prevalence of coronary heart disease among adults based on clinical and ECG criteria was estimated at 96.7 per 1000 and 27.1 per 1000 in the urban and rural populations, respectively. Prevalences of a family history of coronary heart disease, hypertension, obesity and diabetes mellitus were significantly higher in the urban than in the rural population, and smoking was commoner among rural men and women. Mean levels of total serum cholesterol and low density lipoprotein cholesterol were higher among urban subjects; the mean level of triglycerides was higher in rural subjects. The proportions with total cholesterol levels > 190 mg/dl were 44.1% and 23.0% in urban and rural men, respectively, and 50.1% and 23.9% among urban and rural women, respectively. High density lipoprotein cholesterol levels < 35 mg/dl were found in 2.2% of urban men and 8.0% of rural men compared with 1.6% and 3.5% among urban and rural women, respectively. An abnormal ECG pattern (Q wave or ST-T changes) in asymptomatic individuals is also considered to be a risk factor for coronary heart disease. In asymptomatic adults, 1.7% of urban men and 1.2% of urban women showed abnormal Q waves compared with 0.3% of rural men and 0.4% of rural women. A higher proportion of asymptomatic women showed ST-T changes in both populations. Rural men and women had higher total calorie and saturated fat intakes than urban subjects. Differences in dietary cholesterol intake were marginal. Sodium intake was greater in urban adults. Average daily consumption of alcohol by urban men was 12.7 ml ethanol compared with 2.4 ml in rural men.
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PMID:Urban-rural differences in the prevalence of coronary heart disease and its risk factors in Delhi. 914 48

The risk factors for perinatal asphyxia were investigated in a cohort study of all 2371 deliveries at Maulana Azad Medical College in New Delhi, India, in the study period. There were 86 cases of asphyxia (35 fetal deaths and 51 live births), for an overall asphyxia rate of 36.3/1000 births. Asphyxia prevalence was 2.2% among live births compared with 63.6% among still births. Multivariate analysis identified the following significant risk factors for asphyxia: prolonged second stage labor (odds ratio (OR), 9.4), vaginal breech delivery (OR, 6.6), elective Cesarean delivery (OR, 4.6), pregnancy-induced hypertension (OR, 2.7), and fetal growth retardation (OR, 2.4). These findings indicate that most perinatal asphyxia is associated with pregnancy-related complications such as hypertension and preventable intrapartum problems. Decreases in the incidence of perinatal asphyxia require the identification of pregnant women at risk for institutional delivery and training of medical personnel to manage complicated labor and delivery.
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PMID:Perinatal asphyxia: multivariate analysis of risk factors in hospital births. 928 87

Socio-economic changes are taking place all over the world, especially in developing countries, and these influence all aspects of life an all age periods. Resultant disparities have brought about alarming and increasing manifestations of malnutrition and non-communicable disease. Illiteracy, poor health facilities have damaging effects on children. Raising the literacy of girls and adolescents will reduce the leading cause of malnutrition in children, since these future, better educated mothers will be responsible for the children's welfare: child care status with mother care. Protein calorie sufficiency is only present in approximately 60% of the rural population of India: the remainder has differing degrees of malnutrition. When they move into better socio-economic status people are at increased risk from coronary heart disease and diabetes mellitus, for which several theoretical explanations have been proposed. There is a difference in the patterns of these diseases in urban and rural populations, the exact basis for which is not yet clear. For example, in the 25-64 years age group, coronary heart disease prevalence in Delhi is 97/1,000 while in a rural area it is 27/1,000, while the respective figures for hypertension are 127/1,000 and 29/1,000. The patterns in both groups have changed within 3-5 years. The geriatric age group has its own, changing features, due to increasing longevity of life, and to break up of social customs and family structure.
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PMID:Nutrition and chronic diseases--Indian experience. 956 45

The effect of hypertension on maternal and fetal outcome was investigated in a case-control study of 250 pregnant women with hypertension (average age, 23.8 years) and 400 pregnant women without this complication (average age, 22.1 years) who presented to Safdarjang Hospital in New Delhi, India. 200 cases (80%) and 372 controls (93%) were primigravidae. 240 cases (96%) had pregnancy-induced hypertension, while 10 (4%) had chronic hypertension. Hypertension was mild and nonproteinuric in 142 cases (56.8%), and was severe and proteinuric in 108 (43.2%). As expected, the prevalence of adverse outcomes was significantly higher in cases than controls: preterm delivery, 28.8% vs. 3%; need for labor induction, 52.8% vs. 3.25%; cesarean section delivery, 14.8% vs. 3.5%; and need for special nursery care, 40% vs. 6.75%. 4.8% of infants of mothers with hypertension were stillborn, compared with 0.25% of infants of controls; overall perinatal mortality rates were 14.8% and 1%, respectively. All neonatal complications occurred in proteinuric, pregnancy-related hypertension cases and there was a strong association between perinatal loss and both prematurity and low birth weight. Maternal hypertension contributes to an estimated 22% of all perinatal deaths. This risk could be reduced by optimum antenatal care and timely increased use of obstetric interventions.
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PMID:Hypertensive disorders of pregnancy and maternal and foetal outcome: a case controlled study. 956

The association between coagulation abnormalities and pregnancy outcome was investigated in a case-control study conducted at Lady Hardings Medical College and Associated Hospitals in New Delhi, India, in 1991-92. Enrolled were 30 neonates born to mothers with pregnancy-induced hypertension (PIH) and 30 infants of normotensive mothers. Compared with control infants, infants of mothers with PIH had significantly elevated levels of prothrombin time (PT), partial thromboplastin time with kaolin (PTTK), thrombin time (TT), and fibrinogen and fibrinogen degradation products (FDP) and significantly reduced platelet counts and fibrinogen. PTTK and TT were significantly higher in neonates born to mothers with hypertension of more than 1 month's duration, but the difference in PT, fibrinogen, and platelet count was not significant. Also observed was a significant correlation between decreasing gestational age and derangement in all coagulation parameters and between decreasing birth weight and an increase in FDP level. The incidence of disseminated intravascular coagulation was higher in preterm than term neonates. 43.3% of neonates required admission to the neonatal intensive care unit and the perinatal mortality rate was 3.3%.
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PMID:Correlation of coagulation abnormalities with clinical outcome in neonates of mothers with pregnancy induced hypertension. 983 64

Distribution patterns of blood pressure were studied in a randomised sample of 10,215 school children (5,709 boys 4,506 girls) in the age group 5-14 years in Delhi. The mean values of systolic and diastolic blood pressure (SBP and DBP) increased with age in both sexes. The cut-off points for high blood pressure were based on average SBP and/or DBP values of 95th percentile or greater for each age. The values for SBP ranged from 70 mm Hg to 140 mm Hg and for DBP from 36 mm Hg to 100 mm Hg for the age group 5-9 years. In the age group 10-14 years, the values for SBP and DBP ranged from 72 mm Hg to 160 mm Hg and from 46 mm Hg to 120 mm Hg, respectively. The prevalence of hypertension (systolic, diastolic or both) was 11.9 percent in boys and 11.4 percent in girls, an insignificant difference. Anthropometric variables like height, weight and body mass index showed positive correlation with systolic as well as diastolic blood pressure but the waist-hip ratio showed negative correlation coefficient with blood pressure. Family history of hypertension in one or both the parents was present in 20.4 percent children with high blood pressure compared to 6.8 percent in normotensives. Family history or diabetes was also significantly higher in hypertensive children (5.4%) than in normotensives (3.1%).
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PMID:An epidemiological study of blood pressure in school children (5-14 years) in Delhi. 1040 46

Epidemic dropsy results from the consumption of edible oils adulterated with Argemone mexicana oil by unscrupulous traders. Twenty consecutive 'in-door' patients of dropsy were intensively studied during the recent Delhi epidemic. Samples of edible oil used by them, their urine and their serum samples tested positive for sanguinarine on thin layer chromatography. The illness starts as a gastro-enteric illness followed by oliguria and pedal oedema. The following are often observed: cutaneous erythema with blanching and tenderness on pressure; violacious pigmentation of the skin; shortness of breath with orthopnoea; right-sided heart failure with normal left ventricle (LV) functions; as well as severe anaemia and hypoalbuminaemia. Renal function tests showed: bland urinary sediments; decreased glomerular filtration rate (GFR); mild to moderate azotaemia; acute tubular necrosis; patchy pneumonitis; moderate hypoxia with respiratory alkalosis; and restrictive ventilatory defects on blood gas analysis; and spirometry suggestive of interstitial pulmonary oedema of non-cardiogenic origin. 99mTc colloid sulphur liver scans showed colloid shift. There was marked dilatation and proliferation of dermal capillaries in the absence of significant inflammation in the biopsy specimens. Toxic alkaloids of Argemone mexicana oil induce widespread capillary dilatation and permeability causing leakage of protein rich plasma into the interstitial tissues of various organs. A hypovolaemic state is thus induced producing renal hypoperfusion which may progress to acute tubular necrosis. Interstitial fluid in alveoli causes restrictive ventilatory dysfunction with hypertension and right-sided failure with well-preserved LV function. The hepatic venous congestion induces Kupffer's cell dysfunction, which results in colloid shift on a radionuclide liver scan.
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PMID:Epidemic dropsy: observations on pathophysiology and clinical features during the Delhi epidemic of 1998. 1193 Dec 4


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