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

A long-standing hypothesis is that feelings of anger and anxiety increase the risk for essential hypertension. Most studies examining this hypothesis have been cross-sectional in design or undertaken with men only. We tested this hypothesis along with determination of the other behavioral and biological predictors of increases in systolic (SBP) and diastolic (DBP) blood pressure from baseline to a follow-up examination 3 years later in a prospective study of 468 middle-aged women whose blood pressure at the baseline examination was less than 140/90 mmHg. Analyses showed that increases in the Spielberger Trait Anger Scale between the baseline and 3-year follow-up examination, as well as Framingham Tension scores (a measure of anxiety) at baseline, independently predicted an increase in SBP (P less than 0.01). Other factors that independently predicted an increase in SBP were baseline fasting insulin, parental history of hypertension and increases in body mass index and in alcohol intake across the 3 years of follow-up. Increases in the Spielberger Trait Anger Scores independently predicted increases in DBP (P less than 0.02), as did black race, increases in body mass index and hematocrit and decreases in potassium intake. Although menopausal status and hormone replacement therapy were unrelated to changes in blood pressure, postmenopausal women on hormone replacement therapy did show significant increases in DBP in the univariate analysis. Anxiety at baseline, along with parental history of hypertension, baseline fasting insulin and baseline body mass index, predicted a later onset of hypertension, i.e. on pharmacologic treatment for hypertension, in the univariate analysis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Psychological, biological and health behavior predictors of blood pressure changes in middle-aged women. 164 59

Tension development in arterial smooth muscle is regulated by variations of calcium concentration in the submicromolar range. The receptor for Ca2+ is calmodulin, which through stimulation of myosin light chain kinase can activate sequentially two apparently different contractile states. A third possible contractile state may be related to C-kinase activation. These contractile states are thought to have different Ca2+ sensitivities. Ca2+ is supplied from two major sources: the sarcoplasmic reticulum and the extracellular space. The release of sarcoplasmic reticulum Ca2+ is mediated by the intracellular messenger inositol-1,4,5-trisphosphate (IP3) and perhaps by Ca2+ itself. These two messengers have the potential for amplification; for example, IP3 may release some Ca2+ that may subsequently cause Ca2+-induced Ca2+ release. The entry of Ca2+ from the extracellular space into the cytoplasm is mediated by a Ca2+ leak and by excitable Ca2+ channels and is modulated by a Ca2+ buffer barrier consisting of the superficial sarcoplasmic reticulum. Two types of adenosine 5'-triphosphate-driven Ca2+ pumps in the sarcoplasmic reticulum and plasmalemma are responsible for returning the cytoplasmic Ca2+ concentration to resting level after contraction and for maintaining Ca2+ homeostasis during the life of the cells.
Hypertension 1986 Jun
PMID:Calcium activation of vascular smooth muscle. State of the art lecture. 242 35

To assess the hemodynamic effects of Clonidine in hypertensive patients (pts) with an acute myocardial infarction (AMI), we administered the drug to 12 such patients either in a single bolus (75--150 micrograms in 5 min - 8 pts) or by continuous infusion (0.4--5 micrograms/min - 4 pts). Hemodynamic measurements were obtained by means of a Swan-Ganz thermodilution catheter, before and 60 min after the administration of the drug. Clonidine did not significantly affected Heart Rate (from 80.5 +/- 3.9 to 78.4 +/- 5.9 beats/min), Mean Pulmonary Arterial Pressure (from 18.6 +/- 1.7 to 15.1 +/- 1 mmHg), Mean Pulmonary Wedge Pressure (from 12.5 +/- 1.1 to 10.6 +/- 0.7 mmHg), central Venous Pressure (from 4 +/- 0.8 to 3 +/- 0.9 mmHg), Cardiac Index (from 2.6 +/- 0.07 to 2.6 +/- 0.7 L/min/m2), Stroke Volume (from 65.2 +/- 2.8 to 68.5 +/- 5.5 ml/b). Conversely Mean Arterial Pressure fell significantly from 127 +/- 3.1 to 96.2 +/- 7.2 mmHg (P less than 0.001). Left Ventricular Systolic Work Index was reduced from 62.3 +/- 3.3 to 50.4 +/- 4.4 gm/beats/m2 (P less than 0.025), Total Systemic Resistances from 1888 +/- 50 to 1412 +/- 117 dyne sec cm-5 (P less than 0.005) and Tension Time Index from 3536 +/- 495 to 2389 +/- 385 x 10(3) mmHg x sec/min (p less than 0.05). Clonidine is a safe and useful drug to obtain a fall of high blood pressure often complicating AMI, without depressing left ventricular performance, as suggested by no significant changes of CI, WP and LVSWI. The reduction of TTI suggests a beneficial effect on the balance between myocardial oxygen delivery and demand. Clonidine is a hypotensive drug which can be safely used in patients with AMI, without depressing the left ventricular performance.
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PMID:[Hemodynamic effects of intravenous clonidine in patients with acute myocardial infarction]. 676 71

Individual illness belief systems form a cognitive structure which lies beneath the cultural and social aspect of health care in a community. Popular belief systems are different from, yet linked to, expert belief systems. Popular illness terms often help support a stable cultural milieu by linking concepts of causes and significance of types of illness problems with a set of health care seeking choices; as well as linking typical physical and psychological symptoms with associated social problems. This study presents an example of how illness beliefs perform these functions in urban, mainstream America. One hundred and seventeen people with biomedically defined hypertension were interviewed following the Explanatory Models format. The belief held by 72% of this sample was that they had 'Hyper-Tension,' a physical illness characterized by excessive nervousness caused by untoward social stress. The data are used to derive a composite diagram of the cognitive domain of 'Hyper-Tension' in American which demonstrates the various options people have for interpreting their experiences and choosing appropriate therapeutic actions. They use this illness belief system to justify otherwise unwarranted social behavior and to assume various aspects of the sick role. This popular model is compared and contrasted with the professional model of the disease 'hypertension' and with other less frequent models which were observed in this sample.
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PMID:Hyper-tension: a folk illness with a medical name. 740 22

1. Comparative measurements of the Tension-Time-Index during ergometric work and of the Physical Working Capacity 170 were carried out in patients with borderline (n = 24) and stable hypertension (n = 51) in comparison with normals (n = 47), aged 20-60 years. 2. The Tension-Time-Index which is generally accepted as an indirect estimation of the myocardial oxygen consumption was significantly (p < 0.001) higher in the borderline hypertensives (30.5%) and in the hypertensives (41.7%) already at the low work load of 50 watt. 3. The PWC170 which has been shown to be a reliable ergometric method for determination of the physical performance was 21.2% lower (p < 0.001) in the hypertensives with 2.71 +/- 0.74 W/kg body weight in comparison with 3.44 +/- 0.8 W/kg body weight of the normals. Already the borderline hypertensives had a reduced PWC170 of 2.93 +/- 0.7 W/kg body weight. 4. Therefore hypertensives should perform a dosed endurance training of middle intensity, which results in a reduction of heart rate, systolic blood pressure and consequently of the Tension-Time-Index and which improves the Physical Working Capacity. These favourable effects of training are of great benefit especially for those patients also suffering from ischemic heart disease because the myocardial oxygen consumption is the limiting factor of physical performance. 5. In order to prevent acute and chronic vascular complications caused by excessive blood pressure increases during physical activity in hypertensives, ergometric tests for dosage of training and if necessary an antihypertensive treatment should be applied before starting the training program.
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PMID:[Ergometric investigations of the tension-time-index and of the PWC 170 in patients with borderline and stable hypertension in comparison with normals (author's transl)]. 744 61

We investigated mechanisms by which hypoxia produces relaxation of the aorta and tested the hypothesis that these mechanisms are altered during chronic hypertension. Tension of thoracic aortae from normotensive Wistar-Kyoto (WKY) rats and stroke-prone spontaneously hypertensive rats (SHRSP) was measured in an organ bath under control conditions and at two levels of hypoxia. In WKY rats, mild and severe hypoxia produced relaxation of the aortae (precontracted with phenylephrine) by 33 +/- 4% and 82 +/- 3%, respectively (mean +/- SEM). Removal of endothelium or administration of NG-nitro-L-arginine (10(-4) mol/L), an inhibitor of nitric oxide synthase, abolished relaxation of the aortae in response to mild hypoxia but did not affect relaxation during severe hypoxia. Glibenclamide (10(-6) mol/L), an inhibitor of potassium channels, attenuated relaxation of the aortae during mild and severe hypoxia by 49 +/- 16% and 74 +/- 4%, respectively. In SHRSP, mild hypoxia produced little relaxation of the aortae (3 +/- 4%, P < .05 compared with WKY). Indomethacin did not increase relaxation to mild hypoxia in SHRSP, which suggests that a cyclooxygenase-derived contracting factor does not contribute to impaired relaxation. Severe hypoxia relaxed the aortae by 86 +/- 4% in SHRSP, and glibenclamide inhibited this response by 60 +/- 9%. These findings suggest that relaxation of the aorta in response to mild hypoxia in WKY rats is mediated primarily by endothelium-derived relaxing factor, and the response to mild hypoxia is markedly impaired in SHRSP.(ABSTRACT TRUNCATED AT 250 WORDS)
Hypertension 1995 Apr
PMID:Relaxation of the aorta during hypoxia is impaired in chronically hypertensive rats. 753 13

In this study we hypothesized that reduced renal mass (RRM) hypertension, which is associated with a chronic reduction in vessel density, could reduce steady-state muscle performance. Vessel density and isometric tetanic force from the in situ gastrocnemius-plantaris-soleus muscle group were studied in age-matched normotensive sham-operated control (HSS) and hypertensive RRM rats on a high-salt (4.0% NaCl) diet (HSRRM) and a low-salt (0.4% NaCl) diet (LSS and LSRRM, respectively). The Achilles tendon was isolated and connected to a force transducer. Peak isometric tension elicited by sciatic nerve stimulation (1/s for 10 min, 50 impulses/s for 330 ms) was not different between the groups. In the LSS, HSS, and LSRRM groups, tension decreased similarly at 3 min to 375 +/- 22, 447 +/- 26, and 424 +/- 21 g/g, respectively. Tension was significantly reduced in the HSRRM group (203 +/- 45 g/g) relative to the LSS, HSS, and LSRRM groups by 3 min. These differences in steady-state tension persisted throughout the remainder of the experiment. Microvessel density, measured by the lectin fluorescence technique, was reduced significantly only in the soleus, plantaris, and medial gastrocnemius of the HSRRM rats. We conclude that RRM hypertension results in reductions in vessel density (rarefaction) that are associated with decreased steady-state muscle performance.
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PMID:Decreases in steady-state muscle performance and vessel density in reduced renal mass hypertensive rats. 877 43

The sensitivity of the myofilaments to Ca2+ is increased during agonist-induced contraction of vascular smooth muscle. Given the important contribution of vascular tone to the elevation of peripheral resistance observed in genetic hypertension, we have investigated whether alterations in myofilament Ca2+ sensitivity occur in small arteries from spontaneously hypertensive rats (SHR) and age-matched Wistar-Kyoto (WKY) controls during the developmental and established phases of hypertension. Segments of mesenteric, renal, and femoral artery with an average lumen diameter <300 microm from 5- or 20-week-old rats were mounted in a wire myograph. Morphological measurements were made and the vessels permeabilized with Staphylococcus aureus alpha-toxin. Dose-response curves to increasing concentrations of Ca2+ were obtained and the ability of 100 nmol/L endothelin-1 (ET-1) or 10 micromol/L norepinephrine (NE) in the presence of 10 micromol/L GTP to enhance tension in response to low Ca2+ (pCa6.7) was determined. Systolic, diastolic, and mean blood pressures were higher in SHR than in WKY at 5 and 20 weeks. The media thickness:lumen diameter ratio was increased in mesenteric and femoral arteries from SHR compared with WKY at 5 and 20 weeks. There was no difference in media thickness:lumen diameter ratio in renal arteries or between 5- and 20-week animals in any vascular bed. The pCa curves were not different in mesenteric, renal, or femoral arteries from hypertensive compared with normotensive rats or between age groups, except in femoral arteries at 20 weeks, which exhibited a greater sensitivity to Ca2+ in SHR. Tension developed in response to maximal Ca2+ (pCa5.0) was greater in permeabilized mesenteric arteries from SHR compared with WKY at 20 weeks of age only; media stress was again similar in both strains but increased in older animals compared with younger animals in mesenteric arteries from WKY. The submaximal contraction induced by pCa6.7 was greater in femoral and renal than mesenteric arteries. GTP (10 micromol/L) augmented the tension developed to pCa6.7 in mesenteric arteries at 5 and 20 weeks and in renal arteries at 20 weeks. Addition of 100 nmol/L ET-1 or 10 micromol/L NE in the continued presence of GTP markedly increased tension in mesenteric arteries at 5 and 20 weeks. In renal arteries, 10 micromol/L NE enhanced Ca2+ sensitivity in the presence of GTP in SHR at 5 and 20 weeks and WKY at 5 weeks. In femoral arteries, there was a tendency for ET-1 and NE to increase Ca2+ sensitivity, but this increase was significant in WKY at 20 weeks (ET-1) and SHR at 5 weeks (NE) only. We have demonstrated that the sensitivity of the myofilaments to Ca2+ and ET-1- or NE-induced Ca2+ sensitization is not different in permeabilized small mesenteric, renal, or femoral arteries from SHR compared with WKY controls. Only in SHR mesenteric arteries at 20 weeks of age was there evidence of increased active tension in response to maximal Ca2+, despite structural differences, consistent with increased muscle mass in femoral arteries from SHR. We conclude that it is unlikely that a ubiquitous abnormality of the sensitivity of the contractile apparatus to Ca2+ or agonist-induced Ca2+ sensitization in vascular smooth muscle underlies the elevated total peripheral resistance associated with hypertension.
Hypertension 1997 Sep
PMID:Calcium sensitivity and agonist-induced calcium sensitization in small arteries of young and adult spontaneously hypertensive rats. 931 30

As a basis for chronobiologic analyses and thereby for screening deviant blood pressure, measurements are advocated, preferably with ambulatorily functional instrumentation at half-hour intervals around-the-clock for an initial span of 7 days. When only manual instrumentation is available, 3-hourly measurements during waking and one measurement, preferably by a companion, around mid-sleep is recommended to detect a blood pressure disorder. Such screening is warranted for a reasonably reliable diagnosis, particularly in order to recognize circadian blood pressure overswinging (Circadian Hyper-Amplitude-Tension, CHAT) and to separate this new disease risk syndrome from an elevation of the time structure (chronome)-adjusted average (MESOR), that is MESOR-hypertension, and from the coexistence of the two foregoing conditions.
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PMID:Blood pressure variability assessed by semiautomatic and ambulatorily functional devices for home use. 1042 96

From January 1997 to December 2001, patients with subarachnoid hemorrhage (SAH) among 14,008 residents in an isolated mountainous area; Oguni and Minamioguni towns in Kumamoto Prefecture, were evaluated. The subjects were patients being treated at Oguni Municipal Hospital. Over a period of 5 years, 19 patients were found to be suffering from SAH in this area, 3 of whom were visitors (residing outside this area). The annual incidence rate of SAH in this area was calculated as 22.9 per 100,000. The sex ratio (men:women) was 4:12. The average age was 67.9 years; 65.0 years for men and 68.8 years for women. Eleven patients were older than 65, and constituted 68.8% of the subjects. The risk factors of SAH were recognized, and both hypertension and smoking constituted 31.6%. Alcohol was 21.1% and hyperlipemia was 15.8%. In 13 clipping operated cases excluding 1 test craniotomy, Hunt & Kosnik's Grades at admission were G.I: 2, G.II: 5, G.III: 3, G.IV: 2 and G.V: 1, and Fisher's Groups were G.I: 0, G.II: 8, G.III: 3 and G.IV: 2. The sites of 16 operated aneurysms were internal carotid-posterior communicating artery (IC-PC): 2, anterior communicating artery (A Co.A): 4, middle cerebral artery (MCA): 10 and vertebral artery-basilan artery (VA-BA): 0. The aneurysmal size were < 5 mm: 5, 6-10 mm: 9 and 11 mm < :2 (average 7.6 mm, 2-15 mm). The results were evaluated at discharge, excluding 1 SAH of unknown etiology. 9 were good, 2 were dependent and 7 including 5 non-operative cases had died. We were satisfied with these results, because we were treating older patients. Although we attempted the clipping operation using only a three dimensional computed tomographic angiograply (3D-CTA; X-Vision GX (TOSHIBA) & X-Tension), we had no problem, except for 1 test craniotomy. 3D-CTA was useful during the clipping operation in the small hospital, especially, in regard to cost.
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PMID:[Treatment of subarachnoid hemorrhages in an isolated mountainous area]. 1266 29


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