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

Transient hypertension occurred in 3 patients shortly after blunt injury to the abdomen. Renal trauma was suspected in all 3 patients and radiological evidence for renal injury was present in 2. Plasma renin activity definitely was elevated in 1 patient and probably was elevated in another. There was a decrease in blood pressure in all 3 patients during infusion of the angiotensin II analogue--saralasin--showing that the hypertension in these patients was angiotensin-mediated. Renal function as reflected by the blood urea nitrogen, creatinine and electrolytes was not impaired significantly. Thus, acute hypertension after blunt abdominal trauma may be angiotensinogenic and is not necessarily sustained.
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PMID:Renin angiotensin involvement in transient hypertension after renal injury. 65 Jul 71

A cohort of patients with peripartum cardiac failure (PPCF) was followed for 10 years after the initial illness. The follow up rate was 78%. Fifty two per cent of patients improved without further episodes of heart failure. PPCF recurred in 26 per cent. Heart failure unrelated to pregnancy was seen in 13%, and 9% of the patients progressed to dilated cardiomyopathy. Transient hypertension was seen in 87% of patients on admission, and later hypertension was found in 45%. Late hypertension influenced heart size more when recurrent PPCF or progressive heart failure was present. Anaemia on admission had no effect on subsequent heart size. The electrocardiogram may continue to be abnormal for up to 10 years in normotensive patients who had no heart failure. The abnormal electrocardiogram in patients with persistent cardiomegaly may represent progressive myocardial damage. Mortality rate was highest (11%) in the first year and declined thereafter. Cardiac deaths were common in patients with recurrent PPCF or progressive heart failure.
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PMID:Peripartum cardiac failure. A ten year follow-up study. 259 96

Clonidine hydrochloride (CH) is an antihypertensive drug with complex pharmacologic activity including central and peripheral alpha-adrenergic stimulation and CNS depression. We reviewed the records of 5 children admitted to our Pediatric Intensive Care Unit following accidental ingestion of CH. All patients presented with lethargy or stupor, beginning 20-60 minutes after ingestion. Respiratory depression or apnea occurred in 4, requiring endotracheal intubation in 2 and mechanical ventilation in 1. All 5 developed mild to moderate hypertension, and 3 developed asymptomatic bradycardia. The dose of CH ingested was estimated to be 0.2-0.4 mg in 4 out of 5 patients. Treatment consisted of efforts to prevent absorption of CH from the GI tract and supportive care. All signs of CH toxicity resolved within 6-14 hours. Four patients were transferred from ICU within 24 hours and discharged home the following day. One patient developed post-extubation stridor and atelectasis. Significant toxicity occurred even though the amount of CH ingested was relatively small in at least 4 or 5 patients. Transient hypertension occurred early in the hospital course of all patients and resolved without treatment. Hypotension and symptomatic bradycardia were not observed. Apnea was the most serious abnormality observed. All patients recovered without significant morbidity.
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PMID:Hypertension associated with clonidine ingestion. 652 27

Decerebrate rat was used to study the discharge pattern of barosensitive neurons. This preparation avoids general anesthesia and suppresses painful sensations of the animal. Twenty-eight spontaneously active units were recorded in the rostral ventrolateral region of the medulla (RVLM). Six units had projections to the spinal cord (bulbospinal) and 22 were not antidromically activated by spinal cord stimulation (NAA). Transient hypertension induced by intravenous injection of noradrenaline depressed the activity of 21 units, and increased activity of 7, regardless of axonal destination. Unlike anesthetized rat, the decerebrate rat possesses spontaneously active neurons with excitatory response to hypertension.
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PMID:The medullary rostral ventrolateral pressor region: an electrophysiological study in decerebrate rat. 804 81

Hypertensive conditions encountered during pregnancy are classified as preeclampsia, transient hypertension and chronic hypertension. The pathophysiology, consequences and management of these disorders differ, but their clinical presentations overlap substantially. Preeclampsia is a syndrome of the second half of pregnancy, characterized by hypertension, edema and proteinuria, but all three findings are not required to make the diagnosis. Preeclampsia can progress unpredictably to a variety of crises, including eclamptic seizures, and contributes significantly to maternal and perinatal mortality. Management consists of prompt delivery for a mature fetus. Management of preeclampsia at earlier stages of gestation requires balancing the risks of immediate delivery of an immature fetus against the risks to both mother and child of a complication of preeclampsia. Transient hypertension is a clinically benign condition characterized by isolated high blood pressure in late pregnancy; its significance lies in the difficulty of distinguishing it from early preeclampsia. Chronic hypertension is a risk factor for intrauterine growth restriction and intrauterine fetal demise, as well as for preeclampsia. The management strategy consists of control of maternal blood pressure, ongoing antepartum assessment of fetal well-being and surveillance for superimposed preeclampsia.
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PMID:Preeclampsia and hypertensive disorders of pregnancy. 862 88

Cyclosporine (CsA) is frequently used for nontransplant indications such as autoimmune diseases. Unfortunately, side effects such as renal dysfunction and hypertension are frequently described in spite of close monitoring with CsA trough levels. The purpose of the present prospective cohort study was to use the CsA level obtained 6 h after the morning dose (T6) for CsA dose adjustment and its impact on observed side effects in 11 patients (44+/-17 years) treated with CsA for autoimmune diseases. Patients were monitored for CsA-related side effects at each outpatient visit, including blood pressure measurement, CsA trough and T6 levels and routine laboratory tests. Changes in blood pressure and biochemical parameters were compared to the previous visit (n = 244) and a change >30% was considered significant. Significant changes in monitored variables were observed in the following percentage of visits: increases in systolic/diastolic blood pressure (1.2), serum creatinine (6.1), potassium (0.8), and uric acid (6.3), and a decrease in magnesium (0.5). At the end of follow-up (20+/-12.5 months), CsA dose was reduced from 4.8+/-1.1 to 3.5+/-1 mg/kg/day (p = 0.004); serum creatinine, potassium, uric acid, hemoglobin, total cholesterol, effective renal plasma flow and glomerular filtration rate did not differ from baseline. Alkaline phosphatase increased from 63+/-19 to 82+/-21 U/l(p = 0.04) and magnesium decreased from 0.85+/-0.1 to 0.75+/-0.1 mmol/l (p = 0.02). Transient hypertension and reversible renal dysfunction was seen in 2 patients, respectively. In conclusion, CsA monitoring according to T6 levels may allow a lower CsA dose than the one usually recommended and reduce the incidence of side effects in patients with autoimmune diseases.
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PMID:Cyclosporine dose adjustment using levels obtained six hours after the morning dose: effect on side effects in patients with autoimmune diseases. 938 65

Hypertension in pregnancy is defined by a systolic blood pressure > or = 140 mm Hg and a diastolic blood pressure of > or = 90 mm Hg or by a rise in blood pressure of systolic > or = 30 mm Hg and diastolic > or = 15 mm Hg. High blood pressures are found in 5-10% of all pregnancies. The outcome of pregnancy is influenced by the fact whether there occurs a proteinuria in addition to hypertension. While the prognosis of an isolated hypotension is good, the combination of hypertension and proteinuria leading to preeclampsia is the primary cause of maternal death in many countries and is responsible for 20-25% of perinatal mortality. A simple classification divides between chronic hypertension, preeclampsia, preeclampsia superimposed on chronic hypertension and transient hypertension. With chronic hypertension pregnancy outcome is determined by a preexisting nephropathy and the occurrence of a superimposed preeclampsia. Preeclampsia and superimposed preeclampsia are pregnancy induced multiorganic diseases, endangering both the mother and the fetus. Transient hypertension is a benign pathology, which occurs toward the end of pregnancy usually on the basis of a latent essential hypertension, which is laid open through pregnancy. While a severe chronic hypertension in pregnancy must be treated to prevent a hypertensive maternal encephalopathy, a less severe chronic hypertension should not be treated as the risk of a superimposed preeclampsia and the maternal and fetal outcome cannot be influenced by antihypertensive therapy. The incidence of preeclampsia is 3-5% in nulliparae and 0.5% in multiparae. Preeclampsia is a severe and dangerous pathology with an unknown etiology. Pregnancy termination is the only causal therapy. At present it is still recommended to terminate a severe preeclampsia after stabilizing the mother, irrespective of gestational age. In less severe preeclampsia occurring before 32 weeks of gestation, termination of pregnancy can be postponed under intensive monitoring and a prophylaxis with magnesium sulfate in order to accelerate the fetal lung maturation with glucocorticoids. A conservative management in the case of a HELLP-syndrome (Haemolyis, Elevated Liver enzymes, Low Platelets), which is a very severe form of preeclampsia, is not recommended because it hasn't been validated in prospective controlled studies. The most dangerous complication of preeclampsia is eclampsia, which is defined by general tonic-clonic convulsions before or after birth. The most effective prophylaxis of eclamptic attacks is the intravenous therapy with magnesium sulfate. A primary prohylaxis for preeclampsia doesn't exist. Treatment with low-dose aspirin in high-risk patients, i.e. after a severe preeclampsia, in cases of chronic hypertension, in cases of nephropathy and in cases with antiphospholipid-syndrome++ can be recommended. The prophylactic use of low-dose heparin, which has lead to a significant decreased incidence of preeclampsia in retrospective analysis, is now the object of a randomized, controlled trial in our hospital. All women who suffered from a preeclampsia should have a check-up after 3-6 months. Preexisting pathologies are found in up to 40% of patients, mostly in multiparae, i.e. chronic hypertension, nephropathy, endocrine pathologies, anomalies of blood coagulation and antiphospolipid-syndrome.
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PMID:[Hypertensive disorders in pregnancy]. 1054 28

Association between mild to moderate hypertension and headache is probably coincidental. Severe sustained hypertension, malignant hypertension and paroxysmal hypertension (sudden rise) are associated with severe headache. Transient hypertension can occur during an attack of migraine or cluster headache. Hypertension may increase the frequency and severity of migraine in migraineurs and may transform an episodic migraine into chronic daily headache. Concomitant treatment of hypertension is important in these patients.
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PMID:Migraine and hypertension. 1066 13

The objective of this study is to describe the incidence of transient hypertension and to evaluate if transient hypertension is associated with increased maternal or fetal morbidity as compared to other hypertensive disorders of pregnancy and normotensive controls. Data were collected from all deliveries at the University of Mississippi Medical Center from July 1, 1996 through January 1, 1997. Patients were grouped according to ACOG criteria for pregnancy induced hypertension. Specific maternal and fetal morbidities were compared among the groups and controls. There were 1489 deliveries during the study period. Nearly 30% of patients met the criteria for transient hypertension. There were no significant differences between patients with transient hypertension and controls in regard to maternal and fetal outcomes. Transient hypertension occurs more often than expected, however, it appears to be of limited clinical significance.
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PMID:The myth of transient hypertension: descriptor or disease process? 1138 3

Surgical removal of phaeochromocytoma may be accompanied by acute cardiovascular changes. We report the haemodynamic changes in seven patients with retroperitoneal laparoscopic adrenalectomy for phaeochromocytoma. Transient hypertension (systolic pressure (SBP) > 160 mm Hg) was observed in all patients during manipulation of the tumour, in two patients during pneumoretroperitoneum insufflation, and in one patient during intubation. Small doses of nicardipine were sufficient to control these episodes of hypertension. Transient hypotension (SBP < 100 mm Hg) was observed in two patients during exsufflation and in one patient during repositioning to the lateral position. Our observations suggest that this approach provides relative haemodynamic stability, especially during pneumoretroperitoneum insufflation.
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PMID:Haemodynamic changes during retroperitoneoscopic adrenalectomy for phaeochromocytoma. 1217 37


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