Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of pseudoxanthoma elasticum with multisystem involvement is described. Neurological complications, as reported in the literature, are reviewed. These include cerebrovascular insufficiency, multiple lacunar infarcts, aneurysms, subarachnoid and intracerebral hemorrhages, progressive intellectual deterioration, and psychic and mental disturbance which may be due to cortical atrophy. Seizures occur more frequently than in the general population. Hypertension and alteration of cerebral vessels are the two basic pathophysiological mechanisms responsible for the neurological complications of this disease.
 ...
PMID:Pseudoxanthoma elasticum: a review of neurological complications. 69 22

The role of surgery in the treatment of extracranial cerebrovascular disease is essentially a prophylactic one but it should be borne in mind that apart from preventing stroke, such procedures will or should eliminate symptoms. The authors believe that every patient suffering from cerebrovascular insufficiency should be thoroughly evaluated for extracranial cerebrovascular occlusive disease and that arteriograms should be performed on all patients who could be expected to be candidates for surgery. The various indications for surgery have been discussed. The authors believe that people who have severe bilateral disease and who are of an advanced age are probably in a higher risk group. They also believe that surgery should not be offered to people who have a complete stroke and who are in semi-coma or coma, no matter how rapidly they may be transferred to the operating theatre. The authors firmly believe that intra-operative E.E.G. monitoring is an important adjunct to the safe surgical treatment of lesions of the carotid bifurcation, not only to indicate when shunting is necessary but also to indicate how well that shunt is functioning. In spite of the frequent presence of associated heart disease, hypertension and other vascular lesions, operation can be offered with confidence to suitable candidates. Elimination of symptoms can be expected in over 90% of cases. Only one patient has suffered a stroke since leaving hospital and this occurred because of occlusion in his internal carotid artery which was not operated on. Apart from patient selection, the factors which have contributed to the authors' low morbidity and mortality have been the use of intra-operative E.E.G. monitoring, intra-operative heparinisation and the availability of excellent angiographic studies.
 ...
PMID:The surgical management of extracranial cerebrovascular occlusive disease: a review of 200 consecutive surgical cases. 76 4

One hundred and twenty-six patients (71 non-diabetics and 55 diabetics) suffering from mild hypertension (Diastolic BP 90-110) have been reviewed. Hypertension was idiopathic in 123 and possible renal causes were considered in 3 cases. Evidence of target organ involvement, either singly or in combination in the form of electrocardiographic evidence of left ventricular hypertrophy and ischaemic changes, cardiac enlargement on radiology, cerebrovascular insufficiency, retinopathy and albuminuria in the absence of other pre-disposing causes was present in 28.5% of the patients. The prevalence rate of these complications was higher in the diabetics (34.5%) as compared to non-diabetics (23.9%). These complications occurred in the 4th and 5th decades of life in nearly 80% of these patients. Serum cholesterol was higher in diabetic patients with complications than non-diabetics. Mild hypertension may not be an entirely benign condition and the need for controlled studies to assess the efficacy of anti-hypertensive drugs in this category is stressed.
 ...
PMID:Mild hypertension--a review of 126 cases. 81 74

Because of the multiplicity of disease conditions and diminished tolerance for drugs in the aged, it is necessary to know concomitant pathologic conditions to determine which antihypertensive drug to use. In the Philadelphia Geriatric Center, there are about 1,000 residents, between 70 and 100 years of age. About 40% have hypertension; almost 50% have or once had depression; there are many cases of hiatal hernia and/or peptic ulcer; in one subdivision of residents, almost 40% have renal disease with BUN above 30 mg/100 ml. In antihypertensive treatment, some individuals respond fairly well to reassurance and weight reduction, when obese, even without drugs. All are given a low-salt diet. A diuretic is first used--thiazide in cases of good renal function, furosemide with impaired renal function. Liquid potassium supplements are given. If there is but little reduction in blood pressure in several weeks, methyldopa is added in ascending doses, in cases with or without renal impairment. In hypertension with impaired renal function, furosemide and/or methyldopa were especially valuable. Furosemide as an antihypertensive drug was also noted to delay the onset of congestive heart failure. Since reserpine can aggravate peptic ulcer and can precipitate or aggravate depression, it should seldom be used to treat hypertension in the aged. Guanethidine is rarely used, since it can cause cerebrovascular insufficiency and marked weakness. High blood pressure should be reduced slowly in the aged, to avoid untoward effects.
 ...
PMID:An approach to the treatment of hypertension in the aged. 105 27

In general the anamnesis meets all requirements which are put to a screening method; however, special problems arise when the anamnesis is made by means of a questionnaire. The team which gives the report had projected a questionnaire for 8 cardiovascular groups of diagnosis (ischaemic heart disease, hypertension, functional, inflammatory and pulmonary heart disease, disturbances of the peripheral arterial blood supply, cerebrovascular insufficiency and venous diseases). This questionnaire was reduced and qualified and tested on test persons of a Berlin enterprise. A final judgment concerning the use of the anamnesis as screening method cannot be given at present. However, it limns oneself already that it is possible with its help to establish many endangered persons and patients and to subject them to the primary and secondary prevention.
 ...
PMID:[Anamnesis as a screening method for cardiovascular diseases]. 121 Apr 56

The role of surgical therapy for Takayasu arteritis remains controversial. From 1973-1991, 23 patients with Takayasu arteritis have been treated at the University of Southern California. Twelve patients have required 17 arterial reconstructions for symptomatic complications of arterial disease refractory to medical therapy. Indications for operation have included renovascular hypertension (7), extremity ischemia (5), cerebrovascular insufficiency (2), dilated ascended aorta with aortic insufficiency (1), thoracic aortic aneurysm (1), and abdominal aortic aneurysm (1). Long-term clinical follow-up has demonstrated uniform symptomatic improvement. Fifteen of seventeen arterial reconstructions are still patent. Surgical treatment of symptomatic Takayasu arteritis is highly effective. Excellent long-term graft patency can be expected following arterial reconstruction.
 ...
PMID:Surgical treatment of Takayasu arteritis. 136 Sep 62

Overall 1,104 persons exposed to industrial radiation were examined for the effect of minor doses of ionizing radiation on the development of the initial forms of cerebrovascular diseases (CVD). Use was made of an original method of five-factorial screening prediction of the development of CVD. As a result of the examination, 603 persons (54.6%) made up a group at greater risk for cerebrovascular insufficiency. Arterial hypertension was found to be the leading risk factor while the age 45-49 years turned out most dangerous from the standpoint of the onset of the diseases under consideration. No relationship was established between the total dose of external radiation and the risk of the development of cerebrovascular disorders. 96 persons at greater risk for CVD were subjected to a thorough clinical and instrumental examination. Of these, 79.2% appeared to have initial manifestations of brain circulatory insufficiency and stage I dyscirculatory encephalopathy.
 ...
PMID:[The effect of small doses of ionizing radiation on the development of vascular brain diseases]. 166 26

Takayasu's arteritis is an inflammatory arteriopathy that often progresses to obliteration of multiple large arteries. Variable results have been reported after medical and surgical management. Twenty female patients with Takayasu's arteritis were treated from 1973 to 1989. Eleven (55%) patients had hypertension. Upper or lower extremity ischemia was present in 12 (60%) patients and cerebrovascular insufficiency in seven (35%). Nine patients initially managed with corticosteroids had no improvement in signs or symptoms of arterial insufficiency. Eleven patients had 16 vascular procedures for the following indications: renovascular hypertension (6), extremity ischemia (5), cerebrovascular insufficiency (2), dilation ascending aorta with aortic insufficiency (1), thoracic aortic aneurysm (1), abdominal aortic aneurysm (1). Procedures included aortorenal bypass (5), carotid-subclavian, axillary, or brachial bypass (4), aorto-carotid bypass (2), aneurysm resection (2), supra-celiac aorto-femoral bypass (1), ascending aorta/aortic valve replacement (1), and nephrectomy (1). Clinical improvement occurred in all patients. There were no operative deaths. All are alive at a mean follow-up of 5.75 years (6 months to 16 years). Revision of the initial reconstruction has been required for recurrent renovascular hypertension in one patient and extremity ischemia in another. The other nine patients remain symptomatically improved. Symptomatic Takayasu's arteritis frequently requires arterial reconstruction. Symptomatic improvement and excellent long-term graft patency can be expected after arterial reconstruction.
 ...
PMID:Surgical procedures in the management of Takayasu's arteritis. 197 28

A generally accepted classification and documentation for cerebrovascular insufficiency are needed to eliminate controversies and misinterpretation in clinical studies on the spontaneous course of the disease and the outcome of patients receiving surgical or conservative treatment. The author proposes a clinical classification (stages I to IV) based on the affected vascular territory (A, B, C). The following findings should be included: 1. the number of diseased extracranial arteries (I to IV vessel disease), 2. the presence of ischemic brain lesions (CT, SPECT, RMI), 3. concomitant diseases or risk factors (hypertension, coronary heart disease etc.). Such morphological and functional staging makes possible the selection of comparable groups of patients for investigation.
 ...
PMID:[What does asymptomatic stenosis mean? Topics in clinical terminology and documentation]. 198 3

This report is concerned with presentation of overall experience with abdominal aneurysmectomy, carried out upon 500 consecutive cases during the last 20 years. Emphasis is placed upon substantially improved results of the last decade in terms of survival and late mortality thus, leading to an increased spectrum of operative indications together with justified surgical aggression in the overall management of abdominal aneurysm. Elective surgery was applied upon 385 cases whereas in the remaining 115, emergency undertaking was necessary. Mortality in elective surgery was 3%. From the group of 115 emergency operations, 70 represent formal rupture with a mortality of 32% and 35 exhibited symptomatology compatible with threatening rupture. Mortality in this particular group was 8%. There was an age ranging from 38 to 87 years, with a mean age of 62.2. A definite preponderance of the disease was noted in patients between 60 and 70 years of age (17%-29%). Risk factors including heart disease, hypertension and advanced age, were responsible for the majority of deaths occurred within 30 days. Subsequent decrease of mortality should be attributed to improvements of anesthesia, monitor equipments and other supportive measures during and immediately following the operation within modern intensive care unit. Cardiac cases were the predominant cause of late death (24%) with following cerebrovascular insufficiency (8.1%), cancer (5%) and chronic pulmonary disease (6%). No particular difference in mortality was noted among the three group of patients classified according to the 60, 70 and 80 decade of their age.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Twenty years experience with abdominal aneurysmectomy. Surgical considerations and analysis of late results. 259 92


1 2 3 4 Next >>