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

Concerning 150 patients suffering from acute cerebrovascular insufficiency we asked the following questions: 1. How often did cardiac decompensation occur, 2. How often did hypertension and hypertrophic symptoms occur in the electrocardiogram, and 3. How often did arteriosclerosis of the cerebral and coronary vessels occur together in deceased patients? Among the patients examined were 47.3% who showed symptoms of cardiac decompensation. Hypertension was found in 60.7% of the patients. The combination of symptoms of hypertrophy in the electrocardiogram and cardiac dysrhythmia was registered 39 times (26.0%). Arteriosclerosis was found in 68.2% of the post-mortem examinations. A high correlation was found between the sclerosis of the intracranial cerebral vessels (65.9%) and the sclerosis of the coronaries (75.0%). The possibilities of the prevention and deceleration, resp., of cerebrovascular insufficiency by early therapy of hypertension and of cardiac decompensation are pointed out.
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PMID:[Hypertension and heart failure in patients with cerebrovascular insufficiency]. 261 95

Twenty-one patients with high aortic occlusion treated at our institution from 1967 to 1986 were reviewed. There were seventeen men aged from 39 to 78 (mean age: 61.0) underwent surgical intervention. All patients presented clinical manifestations of vascular insufficiency of the lower limbs; rest pain in eleven patients, intermittent claudication in nine and the others. Sexual impotence was present in eight patients. Renal artery involvement was seen in one case, and renovascular hypertension was observed in this patient. Hypertension and ischemic heart disease were present in twelve cases, cerebrovascular insufficiency in one case, diabetes mellitus in three cases. The following surgical treatments were performed; end-to-end Y-shaped Dacron graft implantations from the infrarenal abdominal aorta to the common femoral arteries in six patients, onlay V-shaped Dacron graft implantations in three patients, axillofemoral extra-anatomic bypass in four patients, and amputation only in one. The hospital mortality was 18% (3/17). Twelve patients discharged from the hospital are followed up (average period was 118 months), but the follow up was lost in two patients. There were two late deaths, which course was not related to operations. The prognosis of high aortic occlusion after anatomic bypass is good, thus it was concluded that anatomic bypass with Y-shaped or V-shaped Dacron graft was recommended and extra-anatomic bypass might be performed only in a high risk patient.
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PMID:[Surgical treatment and result of high aortic occlusion]. 296 80

This paper presents a 51 year old black female with known hypertension and an acute illness characterized by aortic regurgitation, cerebrovascular insufficiency, renal insufficiency, aortic valvular insufficiency, mediastinal widening and other features characteristic of acute Type I aortic dissection. An unusual feature in this individual is dissection extending into the membranous septum of the heart and into the aorto-atrial space with large hematoma, which partially disrupted the conduction system as well as dislodging the tricuspid septal leaflet in such fashion that major tricuspid regurgitation was present and interfered with termination of cardiopulmonary bypass. This patient presents a very unusual complication of which we wish to inform the readers.
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PMID:Tricuspid incompetence resulting from retrograde aortic dissection. 365 43

Cerebral insufficiency with or without neurological deficits (n.d.) may be treated effectively surgically by carotid artery reconstruction or by extra-intracranial anastomoses. The low mortality of these operations and the favourable results including prevention of new n.d. and amelioration of long standing n.d. suggest consideration of operation in geriatric patients. Noninvasive screening methods for cranial artery pathology such as neck auscultation, direct and indirect Doppler ultrasonic investigations and dynamic and static cerebral scan therefore should be performed not only in all patients with overt cerebrovascular insufficiency whatever degree but also in patients with hypertension, diabetes mellitus, ischemic heart disease and occlusive disease of the extremities on account of the high incidence of multivascular disease in these patients. We compared 60 consecutive patients before and beyond the age of 70 respectively, treated surgically for cerebrovascular insufficiency. The only significant differences apart from age were a higher rate of pathologic findings of the heart on x-ray and on the ecg in the aged. Despite this mortality, major complications and favourable results were not different for both age groups. These results favour an active approach to diagnosis and indication to surgical treatment not only in young patients but also in the symptomatic geriatric patient.
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PMID:[Internal medicine aspects in patients with operable carotid lesions]. 613 62

A series of 58 patients of aortitis syndrome were analyzed from the standpoint of the pathogenesis and surgical treatment. Investigations of HLA revealed a high incidence of HLA-A9, BW52, MT1 and DR2 antigens with statistically significant differences in the chi-square test. These data indicate that a haplotype composed of A9, BW52, MT1 and DR2 is common in patients with aortitis syndrome and suggest that a genetic factor plays an important role on the pathogenesis of the disease. Experiences with the surgical treatment of various types of aortitis syndrome, such as operation for cerebrovascular insufficiency (7 cases), for hypertension produced by coarctation or renovascular stenosis (14 cases), for aortic regurgitation (2 cases), and for aneurysm (7 cases) were analyzed. Reconstructive surgery is difficult in many of them because of the complicated lesion produced by inflammatory changes. Attention should be paid to the selection of the most suitable time for operation, application of special surgical technique, and prevention of the complications to obtain favorable results.
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PMID:Pathogenesis and surgical treatment of aortitis syndrome. 617 99

A prospective study was undertaken in March 1980, at the Vascular Surgery Department of the Padua University, Medical School, to establish whether patch graft angioplasty is useful in preventing restenosis after carotid endarterectomy (CE). Seventy-four patients underwent 86 CE (bilateral in 12 cases) for atherosclerotic disease involving the carotid bifurcation. Thirty-eight (51.4%) patients presented TIA's or non hemispheric symptoms of cerebrovascular insufficiency; 30 (40.5%) were asymptomatic and 6 (8.1%) had partial nonprogressing or fixed strokes. All operations were performed under general anesthesia, with pharmacologic hypertension and systemic heparinization; in all cases, continuous EEG monitoring and 'stump pressure' measurement were employed. The operation was performed without a temporary intraluminal shunt in the patients showing tolerance to carotid clamping. The protection of the shunt was required only in patients with EEG monitoring changes (17). All carotid arteriotomies were extended into the internal carotid artery to overpass the end of the endarterectomy. Overpass was also used in the proximal edge of the arteriotomy, in the common carotid artery. The distal intima was never fixed with stitches and the arteriotomy was routinely closed with a PTFE patch graft angioplasty. Early results of cerebral protection were excellent. No patient presented permanent or transient postoperative neurological problems and no patient died in the postoperative period for causes related to the operation. This is substantiated by results we achieved during the period 1970-1979 in 192 patients, when all carotid endarterectomies were routinely performed without a shunt, with figures of 2.5% of postoperative stroke and 1.5% of mortality. Longterm follow-up (from 6 to 36 months) was completed in 51 patients (60 operations).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The rationale for patch-graft angioplasty after carotid endarterectomy: early and long-term follow-up. 639 Jul 93

The feasibility of discontinuing digitalis-glycoside treatment was tested in 200 patients with various cardiovascular diseases who, on admission to hospital, were on maintenance digitalis. Among those with the main diagnosis of hypertension digitalis administration was discontinued without ill effect in 73%; among those with peripheral arterial obstructive disease in 64%; and among those with coronary heart disease in 33%. Discontinuing digitalis was less often justified in patients with valvar defects, cardiomyopathies, myocardial infarction or cerebrovascular insufficiency. Indications for digitalis-glycoside treatment should be more rigorously applied.
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PMID:[Prescription habits in the long-term treatment with digitalis glycosides]. 662 53

In 58 patients with progressive neurological deterioration from angiographically confirmed cerebral vasospasm after spontaneous subarachnoid hemorrhage, arterial hypertension was induced in an attempt to improve their deficits. The most effective regimen consisted of intravascular volume expansion, blockade of the vagal depressor response, and the administration of antidiuretics and vasopressor agents. With this protocol, arterial blood pressure could be sustained at high levels for prolonged periods. Neurological deterioration was reversed in 47 patients, transiently in 4; permanent improvement occurred in 43. Complications experienced during therapy included pulmonary edema, dilutional hyponatremia, aneurysmal rebleeding, coagulopathy, hemothorax, and myocardial infarction. Elevating systemic arterial pressure in states of cerebrovascular insufficiency resulting from vasospasm is safe if meticulous attention is paid to physiological, biochemical, and hematological parameters, with the exception that it may be hazardous in the presence of an untreated ruptured or intact aneurysm. Intravascular volume expansion and induced hypertension are effective in reversing ischemic deficits from vasospasm provided that treatment commences before cerebral infarction and that adequate pressures are maintained for a sufficient period. The production of a hypervolemic state by the use of colloid and crystalloid infusion accompanied by atropine blockade of the vagal depressor response and blunting of the diuresis with vasopressin enables arterial pressure to be elevated for longer than 1 week.
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PMID:Treatment of ischemic deficits from vasospasm with intravascular volume expansion and induced arterial hypertension. 713 49

CT examination in 100 patients affected by chronic cerebrovascular insufficiency showed a normal picture in 16 cases, while 84 subjects showed different degrees of atrophy, generalised and focal, controlateral or sometime omolateral to the infarct, with differing patterns. The mean age of subjects with normal CT was significantly lower in comparison with patients with definite atrophy. Besides the neurological picture and the time course, the patients' psychiatric status was also assessed: no definite relationship seems to exist between psychiatric disturbances and brain atrophy. Pseudobulbar syndrome was found in 46 cases and many of them showed cortical and mainly ventricular atrophy. This picture was very seldom found in patients with vertebro-basilar insufficiency. Localised cortical atrophy, on the contrary, was often associated with ischaemic stroke. The incidence of predisposing risk factors (hypertension, diabetes mellitus or high lipid levels) was greater in subjects with brain atrophy and older age than in patients with normal CT scan.
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PMID:[CT findings in chronic cerebrovascular insufficiency (author's transl)]. 729 86

Nicardipine is a second generation dihydropyridine-type Ca2+ antagonist with high vascular selectivity and strong cerebral and coronary vasodilatory activity. The compound is used in the treatment of hypertension, primarily in the elderly. In this review the main evidence of the cerebrovascular activity of nicardipine in preclinical studies using in vitro and in vivo models is detailed. A particular physico-chemical property of nicardipine is the almost complete protonation in acid environment. This allows its accumulation in ischemic brain regions and makes it a candidate for the treatment of cerebrovascular disorders characterised by impaired brain perfusion. The main clinical data on the use of nicardipine in cerebral ischemia and related disorders, subarachnoid haemorrhage and stroke, are also reviewed. These studies included 5940 patients affected by chronic cerebrovascular insufficiency (cerebral ischemia, cerebral atherosclerosis mainly associated with hypertension, transient ischemic attacks, sequelae of cerebral infarction, thrombosis or embolia, hypertensive encephalopathy), 1540 patients affected by sequelae of subarachnoid haemorrhage and 206 patients affected by stroke. Both preclinical studies and clinical trials have shown that nicardipine is a safe Ca2+ antagonist with powerful cerebrovascular activity. This suggests its possible use in cerebrovascular disorders in which blockade of Ca2+ channels of the L-type and/or selective cerebral vasodilatation is desirable. Further studies are necessary to establish if modulation of neuronal Ca2+ channels of the L-type by nicardipine may have a neuroprotective effect independent by the cerebrovascular activity of the compound.
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PMID:Nicardipine and treatment of cerebrovascular diseases with particular reference to hypertension-related disorders. 765 45


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