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

The prevalence of hypertension is particularly high in people of black African descent throughout the world, and the consequences of hypertension, such as hypertensive heart and renal disease and stroke, are also more common. But there is little consensus on whether hypertensive retinopathy follows a similar pattern. We determined the prevalence of hypertensive retinopathy and its relationships with resting and ambulatory blood pressure in a population study of Afro-Caribbeans and Europeans aged 40 to 64 years in London, UK. Retinal photographs of 651 participants were graded for hypertensive retinopathy. Age- and sex-standardized prevalence of retinopathy was 11% (95% confidence interval, 8% to 14%) in Europeans and 21% (95% confidence interval, 16% to 26%) in Afro-Caribbeans (P < .001), respectively. This ethnic difference in prevalence was greatest in normotensive women (8% in Europeans versus 20% in Afro-Caribbeans, P < .001). Resting systolic pressure was 8 mm Hg higher in normotensive Afro-Carribean compared with European women, but this could not fully account for the ethnic difference in the prevalence of retinopathy. Examination of the different relationships of age and resting and ambulatory blood pressures with hypertensive retinopathy showed that these relationships were strongest in European women and weakest in Afro-Caribbean women. We conclude that hypertensive retinopathy is more common in Afro-Caribbeans, particularly women, and that ethnic differences in resting blood pressure cannot fully account for this. The relatively weak relationship between resting and ambulatory blood pressures and retinopathy in Afro-Caribbeans suggests that factors other than blood pressure determine the high rates of hypertensive retinopathy in this group.
Hypertension 1995 Jun
PMID:Hypertensive retinopathy in Afro-Caribbeans and Europeans. Prevalence and risk factor relationships. 776 81

Twenty-seven patients (ages 13-55 years) with Takayasu's arteritis (TA) underwent a detailed ophthalmological examination which included a history of visual symptoms, recording of visual acuity, slit-lamp examination, examination of retina (direct fundoscopy and rapid sequence fluorescein angiography) and estimation of retinal haemodynamics. Arterial hypertension was the commonest (77%) presentation of TA. Sixty-six percent of the patients had one or more ocular change. Sixteen (33%) of the 54 eyes tested had Takayasu's retinopathy (TR), 20 eyes (37%) had hypertensive retinopathy (HR) and the retina was normal (NR) in 18 eyes (33%). Two patients with advanced TR had bilateral cataract. The arm-to-retina circulation time in eyes with TR (16.4 +/- 2.66 seconds) was prolonged as compared to the eyes with HR (10.9 +/- 1.63 seconds, P < 0.01) and NR (9.6 +/- 2.37 seconds, P < 0.01). The arteriovenous filling time in eyes with TR was also significantly prolonged. The intraocular pressure (mmHg) in eyes with TR (9.3 +/- 3.6) was lower (P < 0.001) than that in eyes with HR (14.4 +/- 4.1 mmHg) and NR (14.2 +/- 2.6). Central retinal artery pressure recorded in 8 eyes with TR was less than 35 mmHg in spite of the systemic hypertension. The retinal haemodynamics suggest that the carotid artery involvement leading to diminished retinal blood flow is the pathogenetic mechanism of TR.
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PMID:Ocular changes in Takayasu's arteritis in India. 793 5

Lacrimal fluid local fibrinolytic activity was measured in 101 patients with different variants of arterial hypertension. The studied parameter was found reduced in patients developing hypertensive retinopathy on the respective eye. A correlation was revealed between progress of hypertensive changes in the fundus oculi and reduction of lacrimal fluid local fibrinolytic activity. The results indicate that reduction of this parameter may be regarded as one of the prerequisites for the development of hypertensive retinopathy.
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PMID:[Local fibrinolytic activity of the lacrimal fluid in patients with arterial hypertension]. 819 54

Arterial hypertension is a risk factor for the development of retinal, cerebral and renal microangiopathy. Therefore, a prospective study was started to investigate the progression of retinal microangiopathy in hypertensive patients. Initially, 254 patients were examined in a cross-sectional study. Following an ophthalmological examination, retinal hemodynamics were quantified by means of video-fluorescence angiography. Moreover, blood fluidity (hematocrit, plasma viscosity and erythrocyte aggregation) was analyzed. The severity of the retinal changes was defined according to the Neubauer classification. One hundred (40%) patients showed retinal changes corresponding to stage I; 133 (52%) were classified as stage II. Hypertensive retinopathy (stage III and IV) was encountered in 20 (8%) patients. Arm-retina time was significant prolonged among the hypertensive patients compared with a control group. Arteriovenous passage time showed no significant differences between hypertensive patients and reference values. Plasma viscosity was significantly increased in hypertensive patients and showed a significant increase with progression of the retinal changes. Hematocrit and erythrocyte aggregation were normal among the patients studied. The present findings show an alteration in blood fluidity among hypertensive patients, whereas retinal microcirculation showed no significant disturbances. Follow-up studies are planned to assess the development of retinal microcirculatory changes among hypertensive patients.
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PMID:[Retinal hemodynamics in patients with arterial hypertension]. 821 36

To assess the role of hypertension in asymptomatic cerebral lacunae, we evaluated cranial computed tomography in 76 untreated hypertensive patients, 173 hypertensive patients treated with antihypertensive drugs, and 69 age-matched normotensive control subjects who were more than 60 years of age and without a history of stroke. Cerebral lacunae were diagnosed by computed tomography as a hypodense lesion less than 15 mm in diameter seen on a single 10-mm scan section. The factors contributing to lacunae were determined by stepwise discriminant analysis. Single or multiple cerebral lacunae were revealed in 27.6% (21 of 76) of untreated hypertensive patients, 17.3% (30 of 173) of treated hypertensive patients, and 7.2% (5 of 69) of normotensive control subjects. Incidence of lacunae was significantly higher in hypertensive patients than normotensive control subjects. Stepwise discriminant analysis showed that the most strongly contributing factor for lacunae was the grade of hypertensive retinopathy in untreated hypertensive patients and mean blood pressure in treated hypertensive patients. Asymptomatic cerebral lacunae were frequently detected by computed tomography in elderly patients with essential hypertension. The severity and duration of hypertension correlate positively with this type of vascular complication in hypertension.
Hypertension 1994 Jan
PMID:Role of hypertension in asymptomatic cerebral lacunae in the elderly. 828 71

Four patients with exudative retinopathy due to hypertension were observed for periods ranging from 12 to 35 months. Despite multiple drug therapy in high dosage and some clinic attendance, blood pressure was not controlled and remained severely elevated. Even though severe hypertension persisted, however, exudative phenomena disappeared and renal function remained stable during the follow-up period. Neither the pathogenesis nor the natural course of hypertensive retinopathy is yet fully understood. It is accepted that antihypertensive therapy causes gradual regression of the retinal changes of hypertensive retinopathy. There are no data concerning the natural course and progress of hypertensive retinopathy in patients with severe untreated hypertension. It is unclear why the patients in our study had complete regression of hypertensive retinopathy.
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PMID:Resolution of hypertensive retinopathy despite persistent high diastolic pressure. 843 91

A cohort of 227 untreated essential hypertensive patients from north-western Italy was studied in order to evaluate the prevalence of micro- and macroalbuminuria and their relationship with other cardiovascular risk factors. Albuminuria was evaluated as the albumin to creatinine ratio (Alb/Cr) in three non-consecutive first morning samples. The prevalence of microalbuminuria and macroalbuminuria was 10% and 2.2%, respectively. Albuminuric patients showed higher blood pressure, serum creatinine, triglycerides and uric acid as well as a greater prevalence of retinopathy. Stepwise multiple regression analysis demonstrated that only a small part of variations in albuminuria was explained by changes in blood pressure. Duration of disease did not seem to influence microalbuminuria. The presence of hypertensive retinopathy was associated with greater albuminuria, longer duration of hypertension, and higher prevalence of major ECG changes, but not with higher blood pressure levels. Microalbuminuria, rather than a consequence of elevated blood pressure levels, seems to be a marker of a syndrome featuring, among other characteristics, essential hypertension. Furthermore, microalbuminuria must be considered as an independent cardiovascular risk factor.
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PMID:Prevalence of micro- and macroalbuminuria and their relationship with other cardiovascular risk factors in essential hypertension. 852 98

The development of hypertension is associated with the presence of cardiovascular structural alterations. The principal target organs of hypertensive disease are the heart, brain, kidney and eye. Although left ventricular hypertrophy is an initially useful and well tolerated adaptive mechanism because it tends to reduce wall stress, it may subsequently lead to impaired cardiac function and even heart failure. Vascular structural alterations include reduced compliance, the appearance of atheromatous lesions in the large arteries, and hypertrophy or remodelling of small artery walls, and may be involved in the onset of retinal, renal and brain lesions. Technological progress now enables us to evaluate cardiovascular structural alterations early on as well as to monitor their natural history and the modifications induced by antihypertensive therapy. There is no question as to capacity of antihypertensive therapy to reduce the incidence of stroke, heart failure, renal failure and severe hypertensive retinopathy. Although a number of drugs are able to lower blood pressure, ACE-inhibitors and calcium entry blockers more effectively bring about the regression of left ventricular hypertrophy and, probably, also the retrocession of structural alterations in small resistance arteries; they seem to have a beneficial effect on structural alterations in large arteries as well. Although the regression of left ventricular hypertrophy could be associated with an improved prognosis, no data are available yet on the prognostic significance of the presence and regression of vascular structural alterations.
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PMID:[The organ damage in arterial hypertension]. 856 78

An exceptional case of tetralogy of Fallot is reported; the patient survived without severe symptoms or surgical treatment. The diagnosis was made by echocardiography at the age of 61 years when the patient experienced hypertensive retinopathy. Death occurred at 63 from myocardial infarction. It is thought that longstanding hypertension had contributed to a diminished right-to-left shunting, thus reducing cyanosis and hypoxic damage to the myocardium, which enabled prolonged survival.
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PMID:[A 63-year-old man with uncorrected tetralogy of Fallot]. 857 88

To evaluate the hemorheological influence on oxygen release after a period of 4 months of suspension from smoking and of antihypertensive treatment with amlodipine 10 mg o.d. and defibrotide 400 mg o.d. we have studied 14 smokers with II moderate hypertension (according to the World Health Organization) with hypertensive retinopathy II and slight left ventricular hypertrophy and II stage type a peripheral arterial disease according to Leriche-Fontaine classification. The total suspension for a period of 4 months from smoking associated with a Ca-antagonist such as amlodipine and an hemorheological, antithrombotic drug such as defibrotide together could bring about an improvement on the treatment of hypertension and a notable reduction in the risks linked to the complications found in hypertensives with PAOD II type a.
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PMID:[Transcutaneous oximetry in smokers with moderate hypertension and peripheral arterial disease treated with amlodipine and defibrotide, also with total smoking cessation]. 881 9


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