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

1. The diagnosis of isolated systolic hypertension, diastolic hypertension and normotension in elderly subjects, as defined by casual office blood pressure measurement, was compared with 24 h ambulatory blood pressure monitoring using an Accutracker II. 2. Mean day-time ambulatory blood pressure monitoring underestimated the casual systolic blood pressure in all three clinical groups. Diastolic pressure was not underestimated to the same extent. 3. Ambulatory blood pressure monitoring best reflected casual blood pressure determination for normotensive subjects. In subjects with isolated systolic hypertension ambulatory blood pressures were only consistent with that diagnosis for 8% of the day time period. For 34% of the day time, their ambulatory blood pressures were consistent with diastolic/mixed hypertension. 4. It is concluded that isolated systolic hypertension may not be a sustained condition, but rather an isolated response to office measurement of blood pressure.
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PMID:Isolated systolic hypertension: does it really exist on ambulatory blood pressure monitoring? 234 Jun 42

We studied the blood pressure in 1,635 workers in 12 companies of Guadalajara City. We observed direct relationship of age with systolic and diastolic values. The prevalence of high blood pressure for 1,000 workers was: for systolic hypertension 158.71; for sisto-diastolic hypertension 99.42 and for the diastolic hypertension 27.02. We found that for the systo-diastolic hypertensives their life expectancy was 11.5 years shorter and the economic impact was calculated in 2,954.10 million of pesos for each 100 workers.
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PMID:[Several aspects of arterial pressure in urban workers]. 234 30

To quantify the association of abnormal glucose tolerance with hypertension and postural hypotension, 2480 men and women aged 50-89 yr from a defined population were evaluated by oral glucose tolerance and measurements of supine, seated, and standing blood pressure. In both sexes, adults with impaired glucose tolerance or non-insulin-dependent diabetes mellitus (NIDDM) had increased mean blood pressure compared with those with normal glucose tolerance. These differences were both statistically (P less than 0.05) and clinically (3-12 mmHg) significant and were independent of age, obesity, and the use of antihypertensive medication. Age-adjusted rates of systolic hypertension and isolated systolic hypertension were also higher in subjects with impaired glucose tolerance or NIDDM compared with those with normal glucose tolerance. Diastolic blood pressures and rates of diastolic hypertension were minimally higher in adults with impaired glucose tolerance and NIDDM. In both sexes, systolic blood pressure correlated significantly with fasting plasma glucose and 2-h postchallenge plasma glucose even after adjustment for age and obesity. Postural hypotension occurred in 7% of all subjects and did not vary significantly according to glucose tolerance.
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PMID:Abnormal glucose tolerance and hypertension. 235 Oct 10

A group of 89 apparently healthy subjects and 175 patients with essential hypertension (EH) and systolic (atherosclerotic) hypertension aged 25 to 74 years were surveyed. The healthy subjects were found to have changes in prostaglandin (PG) synthesis and metabolism: a reduction in blood plasma concentration of PGE2 and its urinary excretion, a rise in plasma PGF2 level, and, generally, increase in the pressor and decrease in depressor potentials of the PG system. In the EH patients, changes in the PG synthesis and metabolism were unidirectional and had quantitative variations. The differences in the PG levels of healthy and EH-afflicted individuals were found to become less marked with age. The patients with systolic hypertension exhibited higher plasma prostacyclin concentrations as compared to the age-matching control, which is evidence of a lower pressor potential of the PG system than that of the EH patients. The nature and magnitude of changes in the PG system play a certain role in blood pressure formation and in development of the hemodynamic variant of arterial hypertension.
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PMID:[Age-related characteristics of the prostaglandin system in healthy subjects and in patients with arterial hypertension: hypertonic disease and systolic (atherosclerotic) hypertension]. 235 36

Fifty-two surgical patients with isolated aortic valve stenosis were studied preoperatively and postoperatively to determine the incidence of pulmonary hypertension and its response to surgical intervention. Pulmonary artery systolic hypertension was classified as absent (group 1, less than 30 mm Hg), mild (group 2, 30 to 39 mm Hg), moderate (group 3, 40 to 59 mm Hg), and severe (group 4, greater than 60 mm Hg). Thirty-seven of our patients (71%) had preoperative pulmonary hypertension. There was a positive correlation between left ventricular end-diastolic pressure and both systolic and diastolic pulmonary artery pressures preoperatively (p less than 0.001). After operation we found a decrease in mean systolic pulmonary pressure in group 4, from 85.8 +/- 23 mm Hg to 41.2 +/- 10.4 mm Hg (a 52% decrease, p less than 0.001), and in group 3, from 48.9 +/- 5.9 mm Hg to 32.1 +/- 7.1 mm Hg (a 34% decrease, p less than 0.001). A significant decrease in the mean diastolic pressure was found only in group 4, in which the pressure decreased from 33.7 +/- 8.7 mm Hg to 26.0 +/- 7.6 mm Hg (p less than 0.05). The operative mortality was 1.9%. Our data indicate that pulmonary artery hypertension in aortic stenosis is common, is related to end-diastolic pressure, and can be expected to improve in the early postoperative period.
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PMID:Reversibility of pulmonary artery hypertension in aortic stenosis after aortic valve replacement. 236 33

The present investigation, regarding a population of 6,600 persons living in the health-district of U.S.L. 31 (Ferrara), shows an incidence of hypertension (6.8%) a little lower than in larger epidemiologic studies. "Mild Hypertension" is the most important kind of hypertension (45.9%), on the basis of either anamnestic or current data. The systolic hypertension is prevailing in the classes of older ages, allowing to underline physiopathology of elderly (passive arteriosclerotic mechanism), in comparison with juvenile kind (cardiovascular hyperkinetic mechanism). In 40.9% the therapeutic results are satisfactory with normalization of blood pressure, whereas in 27.1%, are only passable. In a few cases (5.6%) severe hypertension persists.
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PMID:[Distribution and characteristics of arterial hypertension in a sample of the population of Ferrara]. 239 38

Successful long-term treatment of hypertension must include consideration of individual patients' life-style interfaced with the potential for adverse drug events. In a postmarketing surveillance study, 30,515 patients received captopril monotherapy and were evaluated by 7792 physicians. Mean systolic and diastolic blood pressures were reduced 17 and 11 mm Hg, respectively. Mean diastolic blood pressure was reduced 10% for patients with mild hypertension; larger mean reductions were noted for patients with moderate (16.5%) and severe (21.5%) hypertension. Captopril therapy was equally effective in all races (white, Hispanic, and black patients), age groups, and in isolated instances of systolic hypertension. Only 4.9% of patients reporting an adverse event required discontinuation of therapy. Headache (1.8%) and dizziness (1.6%) were the most frequently reported adverse events. Quality-of-life measures improved.
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PMID:Efficacy, safety, and quality-of-life assessment of captopril antihypertensive therapy in clinical practice. 240 3

Hypertension is common in the elderly, up to half of the population over the age of 65 years can be so classified. Raised systolic and diastolic blood pressure levels increase the risk of cardiovascular morbidity and mortality in those aged up to 80 years. Recent intervention studies have shown that antihypertensive treatment reduces death from stroke and myocardial infarction, without producing intolerable side-effects. The benefits of treating isolated systolic hypertension and hypertension following stroke are, as yet, unproven. The therapeutic goals for treating hypertension in the elderly should be to lower blood pressure while keeping adverse reactions to a minimum and thereby not impairing the patient's quality of life. Non-pharmacological methods should be tried initially before resorting to drug therapy. Both thiazide diuretics and beta-adrenoceptor antagonists are of proven value as first line hypotensive agents in the elderly. Drug therapy should be tailored to the individual patient and increased slowly to reduce the incidence of side-effects.
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PMID:Benefits of anti-hypertensive therapy in the elderly. 240 49

Using noninvasive measurements of arterial diameter, compliance, and distensibility permits the mechanisms of increased systolic pressure in hypertensive humans to be better understood. Reduced arterial compliance causing a disproportionate increase in systolic pressure is a characteristic feature not only of pure systolic hypertension in the elderly but also of sustained essential systolodiastolic hypertension, mainly in persons aged over 50 years. Antihypertensive drugs should improve the status of large vessels through an active effect on the tone of the vascular smooth muscle of large arteries, a field as yet poorly investigated in hypertensive humans.
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PMID:Hemodynamic mechanisms of and therapeutic approach to systolic hypertension. 240 64

This study was initiated to assess the efficacy and safety of celiprolol in a large number of hypertensive patients. Patients received a once-daily dose of 200 mg celiprolol for the first 3 weeks. If blood pressure was not lowered satisfactorily, the investigator was asked to raise the dose to 300 mg celiprolol or add a diuretic for the next 3 weeks. The study included 2,694 patients, 2,311 of whom were evaluable over a period of 3 weeks, 1,876 over 6 weeks. On admission 10% had isolated systolic hypertension, 38% mild diastolic hypertension, 35% moderate diastolic hypertension, and 17% severe diastolic hypertension. Concomitant diseases were diabetes mellitus, chronic obstructive airway disease, and peripheral arterial disease. BP was lowered in patients with hypertension of all degrees of severity. There was no obvious relation between efficacy and age or with duration of disease. Only 229 patients received 300 mg celiprolol; 223 patients additionally received a diuretic. Heart rate decreased by a mean of 8 beats/min and was lowered mostly in patients with tachycardia. In no case did heart rate fall below 50. Side effects were rare and in most cases not serious. Treatment was discontinued owing to suspected adverse effects in 58 patients (2.15%). In conclusion, celiprolol administered for up to 6 weeks appeared to be safe in the management of hypertension.
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PMID:Results of the Austrian celiprolol postmarketing surveillance study. 242 58


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