Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case control study of transient global amnesia (TGA), transient ischaemic attacks (TIA) and normal controls is described. Each of the 51 TGA patients, selected between January 1985 and March 1990, was compared with four controls (two TIAs and two normals) for the presence of vascular risk factors (hypertension, diabetes, smoking habits, cholesterol, triglycerides and haematocrit levels, heart disease, previous stroke), previous TGA, migraine, psychiatric illness and recent head trauma. Patients with TGA had less diabetes, hypercholesterolaemia and hypertriglyceridaemia than TIA. TGA subjects had significantly more hypertension (odds ratio = 3.31) and migraine (odds ratio = 8.67) than normal controls. During a mean of 17.4 mths of follow-up (range 1-96 mths), three subjects had recurrent TGA, one sustained a TIA and a minor stroke, but none had seizures. Thrombo-embolism and epilepsy are unlikely to be the cause of this benign disorder. The role is stressed of appropriate precipitants, including haemodynamic changes, and of individual susceptibility (of which migraine is probably a marker) in the genesis of TGA.
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PMID:Transient global amnesia. A case control study. 155 58

We assessed the lifetime prevalences of headache disorders in a cross-sectional epidemiologic survey of a representative 25- to 64-year-old general population. We classified the headaches on the basis of a clinical interview and a physical and neurologic examination using the operational diagnostic criteria of the International Headache Society. Lifetime prevalence of idiopathic stabbing headache was 2%, of external compression headache 4%, and of cold stimulus headache 15%. Benign cough headache, benign exertional headache, and headache associated with sexual activity each occurred in 1%. Lifetime prevalence of hangover headache was 72%, of fever headache 63%, and of headache associated with disorders of nose or sinuses 15%. Headaches associated with severe structural lesions were rare. External compression headache, fever headache, headache associated with metabolic disorders, and headache associated with disorders of nose or sinuses all showed significant female preponderance. The symptomatic headaches and headaches unassociated with structural lesions were more prevalent among migraineurs. In subjects with tension-type headache, only hangover headache was overrepresented. There was no association between the headache disorders and abnormal routine blood chemistry or arterial hypertension. In women with migraine, however, diastolic blood pressure was significantly higher than in women without migraine.
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PMID:Symptomatic and nonsymptomatic headaches in a general population. 160 51

In a questionnaire-based study we compared the clinical features of migraine with aura (classical migraine) and migraine without aura (common migraine) in 354 and 397 patients, respectively, attending The Princess Margaret Migraine Clinic. Other than those related to the aura, no significant differences were seen in any clinical features of the attack (e.g. frequency or duration of attacks, time of day at onset, location of headache at onset, severity of headache, or nausea and vomiting). Common migraine attacks were significantly more likely to occur at weekends (p = 0.002). Dietary triggers tended to be more troublesome in classical migraineurs while pregnancy and the menstrual cycle affected both migraine types equally. Classical migraine patients were twice as likely to have a history of hypertension (p less than 0.05) and showed a slightly but not significantly greater tendency to depression. Family histories of migraine were similar in each migraine type. We conclude that classical and common migraine are fundamentally similar in their clinical characteristics and that the occurrence of focal neurological symptoms during a migraine attack has little influence on the rest of the attack.
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PMID:Some clinical comparisons between common and classical migraine: a questionnaire-based study. 177 36

Ca antagonists of the dihydropyridine class (DHPs) are a heterogeneous group of drugs that interfere with Ca entry into vascular smooth muscle cells of resistance arterioles through type-L calcium channels producing arteriolar vasodilation. This leads to a reduction of vascular tone and, therefore, they have been successfully used in the treatment of systemic hypertension, myocardial ischemia (stable, variant, and unstable angina and silent ischemia), and Raynaud's phenomenon. Furthermore, recent clinical trials have indicated that DHPs may induce regression or slowing the progression of atheroma in coronary arteries. The results obtained with DHPs in the prophylaxis of migraine headache and in treating ischemic stroke and cerebral artery vasospasm are encouraging. However, more carefully designed, double-blind, large-scale, long-term studies are needed to better define the therapeutic value of DHPs in these disorders, the severity of adverse effects, and the mechanism responsible for their therapeutic effects.
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PMID:Dihydropyridines and vascular diseases. 179 15

During 1989-90 there were a total of 3,475,862 prescriptions of oral contraceptives (OCs) made in Australia by general practitioners. A 2- sided insert to facilitate deciding on the proper dosage for patients with various conditions was developed containing the estrogen- progestogen doses of OC preparations, management of minor side effects (nausea, vomiting, weight gain, chloasma, breakthrough bleeding, breast tenderness, or acne), and the relative contraindications to OC use. The simple, user-friendly, and flexible flow chart contains relative contraindications: age over 35 in heavy smokers, migraine or severe vascular headache, age over 45, previous cholestasis during pregnancy, hypertension, smoking, diabetes mellitus, long term immobilization, abnormal vaginal bleeding, gallbladder disease, impaired liver function, acute infectious mononucleosis, and use of rifampin or anticonvulsants.
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PMID:Prescribing oral contraceptives and the medical record. 179 98

Based on four observations of cerebellar malacia in patients aged 40-45 years the authors describe the clinical picture of the disease, characterized by acute fierce occipital headache associated with nausea and vomiting. Focal cerebellar and stem symptoms develop frequently after a latency of several hours or days. None of the patients had signs of advanced arteriosclerosis or arterial hypertension:in two during the premorbid period arteriospastic manifestations were present--in one migraine, in the other angina pectoris. In three patients CT revealed bilateral malatic cerebellar affection, in one instance bilateral affection could be assumed from correlation of the clinical and CT finding. One patient died, necropsy revealed extensive malatic foci in both cerebellar hemispheres, while the finding on the entire vascular system was normal. Based on these observations and similar reports in the literature the authors discuss the possibility that arteriospasms are the decisive pathogenetic factor in the development of cerebellar malacia in young and middle age. The authors emphasize the importance of secondary oedematous changes for the prognosis and recommend for therapy a combination of common vasoactive substances with intensive antioedematous treatment and administration of calcium antagonists.
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PMID:[Cerebellar malacias in younger patients]. 180 19

Calcium channel blockers are effective antihypertensive agents, both as initial monotherapy and in combination with other antihypertensive agents. These drugs are also effective in the treatment of chronic, stable angina, variant angina and supraventricular arrhythmias. Drugs in this class have different affinities for calcium channels in vascular smooth muscle, cardiac muscle, cardiac sinus and atrioventricular node. They are all useful in hypertension and angina, but only verapamil and diltiazem are also useful in the control of heart rate and supraventricular arrhythmias. Nimodipine may control vascular spasm following subarachnoid hemorrhage. Calcium channel blockers have also been used in the treatment of migraine headache and Raynaud's phenomenon.
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PMID:Comparative clinical pharmacology of calcium channel blockers. 199 Jul 41

ION typically affects the older population with a sudden decrease in vision, altitudinal visual field loss, and a swollen optic nervehead. Systemic hypertension and diabetes mellitus are the most commonly associated medical problems. Occlusion of the posterior ciliary arterial blood supply to the retrolaminar optic nerve leads to axoplasmic stasis and further compromise of vessels in the nerve substance, which causes the typical funduscopic appearance. Although there is no recognized medical treatment that can reverse the visual loss, a recent report suggests optic nerve sheath decompression for a select group of patients with a gradual decline in vision due to ION may be beneficial. When ION occurs in persons less than 50 years of age, such etiologies as juvenile diabetes mellitus, antiphospholipid antibody-associated clotting disorders, collagen-vascular disease, and migraines should be considered. Rarely, complications of intraocular surgery or acute blood loss may cause an ischemic event in the optic nerve.
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PMID:Ischemic optic neuropathy. 201 Nov 5

The effects of 5-HT are varied and widely distributed throughout the human body. At this time, 5-HT research is a field ripe for "plucking." Not only is there a great demand for more selective agonists and antagonists, but there is more than enough work needed in receptor binding studies to keep pharmacologists employed for years to come. The clinical benefits of 5-HT receptor pharmacology are just starting to be developed and explored. Novel treatments for hypertension, migraine headaches, anxiety, and depression using 5-HT are just the beginning. It will be exciting to see what the future holds for 5-HT clinically.
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PMID:Serotonin receptor subtypes: functional, physiological, and clinical correlates. 202 90

To better understand and treat painful conditions, one needs to identify the cause, discover the source, and develop knowledge of peripheral and central pain transmission; headaches are no exception. The development of appropriate animal models is important. Accordingly, we have reviewed the anatomy, neurochemistry, electrophysiology, and pharmacology of the trigeminovascular system in experimental animals and emphasized whenever possible the relevance of this final common pathway to migraine, cluster, and other headache syndromes in humans. For example, based on recent anatomic dissections, the pericarotid cavernous sinus plexus was suggested as an important focus to investigate cluster headache pathophysiology. This plexus is an anatomic point of convergence for the nerves giving rise to the signs of sympathetic and parasympathetic activity and sensory symptoms that develop in cluster patients. As in other nociceptive systems, trigeminovascular axons assume at least two important roles. One concerns the transmission of nociceptive information. Electrophysiologic evidence supports the trigeminal nucleus caudalis as an important site for the convergence of visceral (vessel) and somatic (forehead) inputs to mediate the referral of vascular pain to superficial tissues. A second important role concerns the initiation of local increases in blood flow and enhanced protein permeability (sterile inflammation) via the axonal release of vasoactive neuropeptides. Plasma extravasation develops within the dura mater following trigeminal stimulation. Extravasation can be blocked by the administration of ergot alkaloids or sumatriptan, a new serotonin-like agonist, and a prejunctional (neuronal) mechanism of action for these drugs (such as blockade of release) was suggested based on experimental evidence. Whether vasoconstriction also relates to the therapeutic efficacy remains to be determined. As in other organ systems, real or threatened tissue injury provides an important stimulus for depolarizing sensory fibers. The stimulus may come from external conditions such as reduced blood flow or hypoglycemia. The brain may also possess intrinsic neuronal mechanisms by which nociceptors may be synthesized (e.g., glutamate-induced neurotoxicity, seizures). Molecules of relevance include bradykinin, prostaglandins, leukotrienes, and potassium. Experimental evidence was presented demonstrating that the trigeminal nerve mediates hyperemia within cortical gray matter by axon-reflex like mechanisms. An important role for this nerve was established during the hyperemic period of recirculation after ischemia or during severe hypertension above the limits of autoregulation.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Basic mechanisms in vascular headache. 217 82


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