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

An extensive review of the literature, supplemented by experimentation on progestagen-only minipills taken continuously finds the 4 most effective progestagens. They were tested for 4358 cycles in 483 women. In general lynestrenol and norethisterone acetate give fairly regular cycles with a longer menstrual period. Intermenstrual bleeding is frequent at the beginning but tends to regulate itself. D-norgestrel seems to give shorter cycles with less intermenstrual bleeding. NOrgestrienone gives longer cycles with less bleeding. Problems include spotting or amenorrhea which are often worrisome for the patient. The advantage of the minidose progestagen-only pill is that it has no estrogen and therefore can be used when estrogen is contraindicated: in the case of tumors, history of thromboembolism, disorders of lipid metabolism, fibromatosis, mastitis, prediabetes, and arterial hypertension.
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PMID:[Oral contraception by means of progestagen-only micropills taken continuously in the light of four recent trials (author's transl)]. 102 28

Modern oral contraceptive pills are safe for the majority of American women. The most important contraindications to oral contraceptive pill use are a history of thrombophlebitis or thromboembolism while on the pill or during pregnancy, smoking over 15 cigarettes daily if over 35 years of age, active liver disease, hypertension, diabetes, a lipid disorder, or breast cancer. A history of gestational diabetes is not an absolute contraindication to oral contraceptive pill use, but women with such a history must be encouraged to exercise and eat properly to reduce the high risk of developing overt diabetes. Couples should be encouraged to use condoms to reduce the risk of sexually transmitted diseases. Most antibiotics do not decrease the effectiveness of the pill. Nonuse of contraception among adolescents and older couples is the most common reason for failure. Postcoital contraceptive pills are available but are not completely effective. The use of modern contraceptives is almost always safer than nonuse.
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PMID:Update on oral contraceptive pills and postcoital contraception. 150 69

Hemodynamic changes of lesser circulation were investigated in 108 patients with diabetic nephroangiopathy. They were also given vitamin E therapy (8 micrograms/kg of body mass) for 2 weeks to correct metabolic derangements and indices of pulmonary hemodynamics. Partial renal function was determined with 131I-hippuran and 99mTc-DTPA renoscintigraphy. Pulmonary hemodynamics was assessed with pulmonary scintigraphy (MAA 99mTc). The results have shown that vascular renal lesions in diabetes mellitus cause hypertension of lesser circulation and disorders in pulmonary microcirculation, and disorders of lipid metabolism and activation of lipid peroxidation (LPO) progress with augmentation of severity of disease. Vitamin E therapy improves pulmonary hemodynamics, lipid metabolism and LPO. Antioxidant correction was most effective at the initial stages of diabetic nephroangiopathy.
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PMID:[Disorders of pulmonary hemodynamics in patients with diabetic nephroangiopathy and its correction with antioxidants]. 151 66

To understand the content of ambulatory family practice and find effective ways to improve clinical service, education and research in the Department of Family Medicine of Kaohsiung Medical College Hospital, we surveyed 14,064 patients from Jan. 1984 to Feb. 1991 and analysed (a) their basic demographic data including sex, age, insurance type, source and residential district and (b) clinical health problems covering 25,679 diagnoses and 148,994 diagnostic visits. Clinical health problems were recorded by the ICHPPC-2 code system. Results of basic demographic survey were as follow: 49.1% of patients was male and 50.9% female; 58.9% fell in the age group of 16-40 years and 22.4%, 12.0% and 6.7% of patients fell into the age groups of 41-65, under 16 and over 65 years respectively; 62.8% was insured usually by labor insurance and 26.9% had no insurance; the commonest referrals were other patients, colleagues, company personnel, doctors, media ... etc.; 58.8% lived in Kaohsiung City and 19.6% in Kaohsiung county. As for clinical health problems, the data showed that the commonest thirty diagnoses encountered at our clinic accounted for 69.3% of 25,679 diagnoses and the commonest ten diagnoses in descending order were medical health examination, acute URI, abdominal pain, uncomplicated hypertension, prophylactic immunization, hepatitis B carrier, back pain, anxiety disorder, viral hepatitis and irritable bowel syndrome. By calculating the average value of each diagnosis in a sample of 148,994 diagnostic visits to evaluate the habits of practice, we found that the commonest ten diagnostic visits at clinic in descending order were diabetes mellitus, hypertension involving target organ, uncomplicated hypertension, gout, hyperthyroidism, duodenal ulcer, tuberculosis, lipid metabolism disorder, other peptic ulcer and depressive disorders; all were chronic diseases. We concluded it was very important and helpful for the development of family medicine program and primary care unit to understand the content of their own ambulatory practice.
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PMID:[The content of ambulatory family practice in Kaohsiung Medical College Hospital]. 156 Apr 75

The aim of the study was to evaluate the direct influence of lipid parameters (total and HDL-cholesterol, triglycerides and total lipids) on the rheologic-coagulative pattern. We studied blood rheological properties--blood (BV), plasmatic (PV), and seric (SV) viscosity, whole blood (WBF) and red cell (RCF) filterability--and some coagulative factors--fibrinogen (Fib), levels of clotting factor VII (fVIIc) and VIII (fVIIIc) activity--in 156 men aged 40-54 years; 87 patients had type II hyperlipoproteinemia (46 type IIa and 41 type IIb) and 69 were normolipemic controls. Smokers, patients with arterial hypertension, diabetes mellitus or cardiovascular clinical manifestations were excluded. Type IIb hyperlipoproteinemic patients had increased blood viscosity (shear rate 225 sec-1, p. less than 0.01), which was positively correlated with triglycerides and fibrinogen concentration. Levels of fibrinogen, fVIIc and fVIIIc activity did not differ significantly in hyperlipemic patients and controls, although fVIIc activity and fibrinogen were both positively related with lipid parameters. These data suggest that, in absence of other major risk factors, the alterations of the rheologic-coagulative pattern are mainly dependent on the severity of the lipid disorder.
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PMID:[The relationships between the lipoprotein profile and rheological-coagulation parameters in patients with hyperlipoproteinemia type II]. 162 10

1. Childhood obesity has been increasing for the last ten years in Tateyama City. Obesity in boys between the ages of 11 to 13 years was especially prominent. 2. Childhood obesity hardly improved especially in middle and morbid obesity. Eighty-five percent of light obesity in children lead to adult obesity. 3. Complications such as hypertension, serum lipid disorder and fatty liver were also observed in childhood obesity. Considering that Tateyama City is a typical Japanese country city, the above results could be representative of Japanese childhood obesity. Recent increases in childhood obesity might be due to the westernized dietary habit.
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PMID:Incidence of childhood obesity over the last 10 years in Japan. 228 54

Hypertension and hyperlipidemia are cardiovascular risk factors that commonly coexist. Studies have indicated that it is important to control both risk factors to achieve significant reductions in morbidity and mortality. Recent debate has focused upon whether traditional step I antihypertensive agents can substantially lower these risks because of their effects on plasma lipids. This debate continues to be unresolved. However, for the patient with elevated lipid levels, diuretics and beta-blockers may make the management of the lipid disorder more difficult. Therefore it may be desirable to select alternative step I antihypertensive agents that will not interfere with the therapy for hyperlipidemia. Alternative step I agents include alpha 1-blockers, ACE inhibitors, and calcium channel blockers. These agents either have no effect on plasma lipids or they improve the lipid profile. Generally, these drugs are well tolerated and provide good alternatives for patients with hyperlipidemias. The initial drug of choice can be chosen depending upon other patient variables such as age, race, or concomitant diseases.
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PMID:Initial drug therapy for hypertensive patients with hyperlipidemia. 257 62

The majority of epidemiological studies on the benefits and risks of oral contraceptive (OC) use have been conducted during the late 1960s and early 1970s when OCs had 50 mcg of estrogen. Based on these studies, the risk of death due to OC use for nonsmokers 35-39 years old was lower than using no contraceptive at all (14.1 deaths/100,000 women/year vs. 25.7 deaths/100,000 women/year). In addition to smoking, other contraindications include women with a history of angina, myocardial infarction, blood clots or stroke, estrogen dependent cancer, hypertension, a known lipid disorder, and women with hepatitis or cirrhosis of the liver. Suitable 35 year old candidates for OC use would be nonsmokers with blood group O, at low risk for cardiovascular disease, and who might receive additional benefits, including those with severe dysmenorrhea or hypermenorrhea and possibly those who have a strong family history of osteoporosis, early menopause, or ovarian cancer. Practitioners should take a thorough history of these women and give a physical examination with a blood pressure check. They should also administer screening tests, such as a PAP test, mammograms, a lipoprotein profile, and a glucose test. After the practitioners have deemed these women to be healthy based on the examination and the results of the screening test, they then should prescribe only a low dose OC containing 50 mcg of estrogen. Today most estrogen based OCs contain 35 mcg and research on their effects have not yet begun. Scientists expect to find that the dose response effects for risks for thromboembolism, myocardial infarction, stroke, and gallbladder disease to be lower in users of the low dose preparations.
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PMID:Risks and benefits of oral contraceptive use in women over 35. 323 16

The first objective is to correct any existing coronary risk factors but this must be achieved with discrimination. Smoking should be strictly forbidden, hypertension reduced and a more active life style encouraged. However, a more nuanced approach should be adopted towards dietetic problems, obesity and disorders of lipid metabolism. It is also very important to teach the patient to use glyceryl trinitrate correctly in the double objective of relieving pain as quickly as possible and of preventing pain by using it in certain critical situations. Clinical practice shows that patients often use glyceryl trinitrate too sparingly. When these general measures have been settled, treatment must be adapted to each particular situation. The patient's age, the frequency of attacks, trigger factors, the repercussions of the disease on the patient's life all have to be considered before deciding on the individual's treatment. In younger patients, a controlled exercise ECG is essential for selecting patients for surgery. The drugs of choice for stable angina are the betablockers which have been shown to be effective and well tolerated. When this group of drugs cannot be used or is ineffective, other major anti-anginal drugs may be chosen according to the individual terrain and their known secondary effects.
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PMID:[Strategy of the medical treatment of angina pectoris]. 613 3

The influence of the efficacy of triglyceride and cholesterol correction on cardiovascular complications and mortality was analysed in a follow-up study with 260 patients with primary HLP (triglycerides before entry greater than 2.9 mmol/l and/or cholesterol greater than 7.8 mmol/l). The follow-up time was 67.4 +/- 27 months. It was hypothesised that reduction of elevated levels of triglycerides and/or cholesterol influenced favourably the incidence of angina pectoris, MI, stroke and total mortality. For ethical reasons, it was not possible to carry out the investigations with a control group. Therefore, we performed an internal comparison of 3 categories of lipid correction achieved during the trial (effective, moderate, insufficient). A substantial improvement of the lipid disorder was obtained by individualizing the therapy. Triglycerides and cholesterol decreased on average by 50% and 20%, respectively. The incidence of MI was 10 times higher than in the general population. With respect to the type of HLP, hypertriglyceridemia revealed a significantly higher incidence of MI compared with hypercholesterolemia and mixed HLP. The therapy variant was only of importance with respect to gallstone diseases accumulating in the CPIB-treated subgroups. We found a majority of cases with newly manifested angina pectoris and stroke in the group with moderate correction of both triglycerides and cholesterol. Patients with effective triglyceride and cholesterol correction suffered less frequently from MI than those with insufficient correction. This was also the case with secondary prevention in cases with MI prior to entry. There was no significant difference in the distribution of lipid categories at entry between those with and without recurrent infarction. In the group without reinfarction, however, the percentage with insufficient control diminished significantly. Associated risk factors such as hypertension, diabetes, smoking and obesity were of minor or no significance. In subjects with effective triglyceride correction, the total mortality was 0.97/1000 treatment months vs. 3.63 in insufficiently treated patients. The figures for MI mortality were 0.36 and 1.91, respectively.
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PMID:Reduced incidence of cardiovascular complications and mortality in hyperlipoproteinemia (HLP) with effective lipid correction. The Dresden HLP study. 649 44


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