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

AGAPE (Computer-based Outpatients' Clinic Programme) is a programme for IBM-compatible microcomputers realised by physicians for the management of hypertensive patients. The programme is planned to make the operators' work complete and expeditious while, at the same time, respecting the standard formulation of the clinical approach to the patient. The collection, organisation, recording and communication of data are handled on line by the programme under the operator's control. Special attention has been given to the control of the quality of the data collected as well as to their easy use for clinical, research and statistical purposes. This programme was used for 52 months in a hypertension clinic where physicians and nurses work jointly. Up to April 1989, 1924 new patient visits and 10,639 control visits together with 3,375 groups of lab tests were inserted. The mean training time for new operators was 3.2 hours; the mean data insertion time was 12.5 minutes for the first visit, 3 minutes for the subsequent visits and 2.5 minutes for lab tests. The drop-outs, evaluated at one-year follow-up on each 250 patients before and after the introduction of the computerized system, were 84/250 and 64/250 respectively (p less than 0.05), with a trend to wards the better control of hypertension (diastolic blood pressure less than 90 mmHg, 128/250 vs 143/250, n.s.).
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PMID:[A computerized support system for the ambulatory treatment of patients with arterial hypertension]. 219 59

The prevalence of hypertension among the elderly is high. Recent multicenter studies have shown hypertension, especially isolated systolic hypertension, to be a risk factor and treatment to be effective, if individualized. In addition, the presence of multiple complicating conditions and the need for multiple medications in the elderly increases the required medical knowledge base necessary to appropriately determine antihypertensive therapy. To assist the primary provider, an expert system has been developed that provides advice on therapeutic decisions for elderly patients (greater than 65 years old and less than 85 years old). It takes into account such factors as age, sex, lifestyle, site of care, nutritional status, physiologic and pathophysiologic changes, co-existing diseases, multiple drug use, and prior antihypertensive drug exposure and response. The system user enters patient characteristics, disease states, risk factors, relevant laboratory values, and prior drug therapy. The system responds with a set of recommendations of appropriate therapy individualized for the specific patient. To further assist the process, relative costs of therapy are also included. The system, consisting of over 200 rules, is currently undergoing validation by a panel of cardiologists. It is implemented in IBM's Expert System Environment (ESE) on the IBM 4341. The authors wish to acknowledge the contribution of the ESE software by the IBM Corporation.
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PMID:Antihypertensive therapy for the elderly: an expert system to assist therapeutic decisions. 246 92

A survey of the personality types of 85 patients with cerebrovascular disease (CVD) was made in comparison with those of 100 healthy persons. A personality behaviour scale in the form of questionnaires was used. The result showed that not only the total scores (TH + CH) of the patients, group were much higher than those of the healthy subject group (P less than 0.01), but the scores of TH and CH were also higher than those of the control group respectively. This group of CVD patients have similar personality types as the group of patients "A" type of personality being dominant in both groups. Using the method of multiple steps and regression analytical procedures with the help of an IBM PC/XT microcomputer, fourteen independent variables (X1-14) and six dependent variables (Y1-6) were analysed individually. The results revealed that the usual, conventional risk factors such as elderly age, history of hypertension, obesity, alcoholism, and etc. Would be the most important pathogenic elements. Although the "A" type of personality ranked behind the above mentioned factors, yet its importance should not be neglected.
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PMID:[A study of personality type and its pathogenetic effect on patients with cerebrovascular disease]. 262 May 86

In order to examine the electrocardiographic (ECG) changes which occur with advancing age we defined an apparently healthy reference population derived from prospectively followed subjects of the Framingham Heart Study. Healthy subjects were clinically free of hypertension, coronary artery disease, congestive heart failure and valve disease and were not taking antihypertensive or other cardiac medications. ECG tracings were analyzed by the IBM Bonner (V2) program. Mean values and correlations with age for PR duration, QRS duration and axis, S wave voltage V1 and R wave voltage V5 are presented. With advancing age in men there is a narrowing of QRS, a leftward QRS axis shift, and a loss of S V1 and R V5 amplitude. In women only a leftward QRS axis shift is associated with advancing age. These changes should be considered in defining normal age- and sex-specific reference values. These findings underscore theoretical limitations of commonly-used criteria for the ECG diagnosis of conditions such as left ventricular hypertrophy.
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PMID:Electrocardiographic changes with advancing age. A cross-sectional study of the association of age with QRS axis, duration and voltage. 350 Sep 94

Blood pressure signals recorded continuously in ambulatory patients were analyzed by an IBM 370 computer and the systolic and diastolic values of each pressure cycle presented in form of a histogram. The results of pressure recordings in patients with 'borderline or labile' and 'established' hypertension are presented and discussed.
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PMID:Computer analysis of continuous blood pressure recordings in essential hypertension. 729 15

A cross-sectional study of 2650 male and 751 female employees of the IBM company in the Milan area was conducted in 1987 to compare risk profiles for coronary heart disease between men and women and to analyse the awareness of risk status of people at risk. After age adjustment, the rate of cigarette smoking was higher in women (35%) than in men (25%). Other coronary heart disease risk factors were more common in men than in women. After controlling for age, 38% of the men and 19% of the women met the study criteria for hypertension, and 22% of the men and 17% of the women had high blood cholesterol. However, an analysis by age groups showed that, although in the younger age groups women had lower levels of cardiovascular risk factors, except smoking, compared to men, in the age brackets 50 or older women had similar or more adverse risk factor profiles than men. Of the people with hypertension, only 22% of the men and 19% of the women were aware of their hypertension, and only 2% of the men and 4% of the women had successful control by drugs. Even when subjects with mild hypertension were excluded, high proportions of undiagnosed and uncontrolled hypertension were found in both sexes. Of the individuals with serum cholesterol > or = 240 mg.dl-1, less than half of the men and less than 20% of the women were aware of their high blood cholesterol levels. Multiple risk factors were frequently present in the same individuals, especially among males and older women.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prevalence of coronary heart disease risk factors in northern-Italian male and female employees. 758 19

Altogether 90.2 thousand workers of 33 enterprises of the cities and villages were examined. Of these, men (mean age 41.1 +/- 1.1 years) accounted for 39.2%. Use was made of an automated system for mass cardiological screening and dispensary observation made over time of the workers and employees of the organized bodies by computer EC, CM and IBM PC XT/AT. Different cardiological diseases were revealed in 38.4% of the examined. Out of the total number of the patients, 44.5% were diagnosed to have arterial hypertension (AH) whereas 18.6% coronary heart disease (CHD). CHD was widely prevalent in the working middle-aged and elderly men and women. Angina pectoris of effort appeared to be most frequently occurring form of CHD, accounting for 70.4% of the total number of CHD patients. Myocardial infarction was discovered in 0.9% of men and 0.3% of women. AH was identified in 40.8% of CHD patients, whereas 38% demonstrated borderline AH. Therefore, associated CHD and elevated blood pressure was recorded in 78.8% of the patients. A relationship was established between the prevalence and incidence of cardiovascular diseases and sex and age.
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PMID:[The prevalence of cardiovascular diseases among the workers and employees of organized collectives based on cardiological screening data]. 799 4

The authors examine the clinical connotations of arterial hypertension in a geographical population of 1002 patients attending the Cardiological Outpatient Clinic of Unit no.2 in the Isonzo area (Monfalcone) using the most appropriate statistical methods, such as SPSS (Statistical Package for the Social Sciences) implemented on PC IBM AT 286, for multiple linear regression using a stepwise method. 1) Arterial hypertension was the result of a phenomenon which was striking owing to its mean value of 184.7 +/- 20.915 mmHg with equal mode and median of 180 mmHg. In the subgroup of 720 elderly patients this mean value differed slightly, 186.9 +/- 20.648 mmHg, with the same mode and median, whereas in the group of 282 adults the mean was 170.0 +/- 20.540 mmHg with a mode and median of 160 and 175 mmHg respectively. In the overall population 154 cases (15.4%) were affected by slight arterial hypertension with a mean of 158.9 mmHg, and 848 cases (84.8%) presented moderate-severe arterial hypertension with mean values of 189.4 mmHg. In elderly patients the mean rose to 190.4 mmHg whereas it was 186.3 mmHg in adults. 2) Mean age was 65.3 +/- 11.093 years: 70.7 +/- 7.396 years in older patients and 51.7 +/- 6.106 years in adults. Surface ECG showed signs of left ventricular hypertrophy in 292 elderly patients (40.5%) and 85 adults (30.0%), signs of ischemic cardiopathy due to T wave alteration in 246 elderly patients (34.1%) and 101 adults (35.7%), and due to ST tract in 340 (47.2%) and 102 (36.2%) respectively, with equal involvement of the free surface of the left ventricle. The radiographic enlargement of the cardiac shadow in elderly patients was observed in slight form in 153 cases (21.3%) and in moderate and marked form in 222 cases (30.8%), and in adults in 36 (12.8%) and 43 (15.2%) cases respectively. 3) Body weight was normal on average and equivalent to 77.3 +/- 13.578 kg, but of this series 713 cases were overweight and 237 were obese; 504 of elderly patients (70%) were pathological with 346 (48.1%) overweight and 158 (21.9%) obese, and of 209 pathological adults (74.1%), 130 (46.1%) and 79 (28.0%) were respectively overweight and obese. BMI oscillated from 1.70 to 5.60 with a mean of 2.80 +/- 0.409: from 1.70 to 4.21 in elderly patients with a mean of 2.70 +/- 0.379 and in adults from 2.00 to 5.60 with a mean of 2.90 +/- 0.460. 4) Mean cholesterolemia was 237 +/- 48.029 mg% and levels were normal in 203 cases and high in 799 subjects. Elderly patients showed the same mean level with a total of 580 pathological cases (80.5%) divided into 305 (42.3%) cases of slight hypercholesterolemia with a mean of 227.2 mg% and 275 (38.2%) severe cases with levels of 283.7 mg%. Adults presented a mean serum level of 236 +/- 47.588 mg%: 63 (22.3%) cases of normocholesterolemia, 117 (41.5%) cases of slight cholesterolemia with mean serum level of 224.8 mg%, and 102 (36.2%) severe cases with a mean level of 286.2 mg%, resulting in a total of 219 pathological cases (77.7%).
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PMID:[Arterial hypertension in an ambulatory population of elderly subjects. Epidemiologic and clinical study in Isonzo]. 897 80

We have developed a computer model of cerebrovascular hemodynamics that interacts with a pharmacokinetic drug model. We used this model to examine the effects of various stimuli occurring during anesthesia on cerebral blood flow (CBF) and intracranial pressure (ICP). The model is a seven-compartment constant-volume system. A series of resistances and compliances relate blood and cerebrovascular fluid fluxes to pressure gradients between compartments. Variable arterial-arteriolar resistance (Ra-ar) and arteriolar-capillary resistance (Rar-c) simulate autoregulation and drug effects, respectively. Rar-c is also used to account for the effect of CO2 on the cerebral circulation. A three-compartment pharmacokinetic model predicts concentration-time profiles of intravenous induction agents. The effect-site compartment is included to account for disequilibrium between drug plasma and biophase concentrations. The simulation program is written in VisSim dynamic simulation language for an IBM-compatible personal computer. Using the model, we have predicted ICP responses during induction of anesthesia for a simulated patient with normal as well as elevated ICP. Simulation shows that the induction dose of intravenous anesthetic reduces ICP up to 30% (propofol > thiopental > etomidate). The duration of this effect is limited to less than 5 minutes by rapid drug redistribution and cerebral autoregulation. Subsequent laryngoscopy causes acute intracranial hypertension, exceeding the initial ICP. ICP elevation is more pronounced in a nonautoregulated cerebral circulation. Simulation results are in good agreement with the available experimental data. The presented model allows comparison of various drug administration schedules to control ICP.
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PMID:Computer simulation of intracranial pressure changes during induction of anesthesia: comparison of thiopental, propofol, and etomidate. 1021 32

The blood pressure of 495 normal children aged nine to fourteen years were measured. The body height, weight, blood lipid profile, fasting blood glucosum(FBS) were also measured. The children's family history of hypertension and their dietary status and physical exercise status were investigated. The results showed that the older the child, the higher the blood pressure. On single factor analysis, systolic blood pressure (SBP) was positively correlated with age, family history of hypertension, intake of whole lipid milk, body height, weight, BMI, blood TC, LDL-C and FBS, whereas it was negatively correlated with the time of physical exercises and blood HDL-C/TC. Diastolic blood pressure(DBP) was positively correlated with age, body height, weight, IBM, FBS, blood TC and LDL-C, whereas it was negatively correlated with blood HDL-C/TC. Multifactor regression analysis showed that weight, age, blood TC and FBS had significant effects on SBP, while weight, age, blood TC and LDL-C had significant effect on DBP. Therefore, avoiding obesity, improving dietary status, taking more physical exercises and suitably lowering blood lipid and FBS should be carried out in children.
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PMID:[Study of the risk factors of blood pressure in children]. 1221 52


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