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)

This paper analyzes the short-term results of 463 consecutive primary reconstructive operations on the carotid bifurcation based on the standards of "quality". In 383 (82.7%) cases, the patients were operated on for stenosis of the internal carotid artery (ICA); 60 (13%) patients had combination of stenosis and kingking of the ICA and 20 (4.3%) presented with isolated kinking of the ICA. Classic open carotid endarterectomy (CEAE) was performed in 240 cases, eversion CEAE in 144, resection with ICA redressment in 45, and ICA grafting in 28 cases. The perioperative lethality accounted for 1.54% (7 cases), per 463 operations, with the standard of "quality" being equal to 2%. Myocardial infarction was the cause of death in 5 cases, one patient developed homolateral stroke which eventuated in lethal outcome, and one more patient developed lethal stroke in the contralateral hemisphere. The incidence of homolateral strokes which did not eventuate in lethal outcome accounted for 1.94% (9 cases). The indicator "stroke plus lethality from stroke" in the general patient group was 2.38% which is even lower versus the standard of "quality" for asymptomatic patients and constitutes 3%. Among asymptomatic patients proper, the indicator "stroke plus lethality from stroke" was equal to 0, among TIA patients to 0 at a 5% standard, and in patients with initial stroke, initial stroke, it amounted to 3.19% at a 7% standard. Perioperative strokes were not recorded in patients with ICA kingking or at ICA grafting. The basic factor of the risk of perioperative neurologic deficit was a history of stroke. Patients with different stages of cerebrovascular insufficiency did not significantly differ as regards age, sex distribution, the presence of CAD, arterial hypertension, diabetes mellitus, the degree of stenosis of the operated ICA and the time of its clamping at operation. Patients with a history of strokes differed significantly from the general group only in the incidence of lesion of the contralateral ICA and in the frequency of the use of internal shunt. Analysis of the risk factors of perioperative stroke in patients with a history of strokes has shown that they were diabetes mellitus and the use of internal shunt. The development of perioperative stroke among patients with a history of stroke was not influenced by the incidence of contralateral ICA lesion, the standing of cerebral circulatory distress or the size of an ischemic focus. The initial character of ICA lesion and the type of reconstruction did not affect the origin of perioperative focal deficits or lethality.
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PMID:What influences the standards of "quality" of carotid endarterectomy? 1465 36

The purpose of the study was to examine cerebral microcirculatory and structural changes in 32 patients (20 males and 12 females whose age varied from 37 to 63 years) with moderate arterial hypertension (AH). All the patients underwent single-photon emission computed tomography of the brain, using (99m)Tc-hexamethylpropyleneaminoxylfor the evaluation of perfusion, as well as magnetic resonance imaging for the examination of cerebral structures. Cerebral structural changes and perfusion impairments were detected in patients with AH, even if they had no clinical signs of cerebrovascular insufficiency. Inadequate blood flow most frequently occurred in the parietal and temporal regions of the brain. There was a reduction in the cerebrovascular reserve in the frontal lobes in AH.
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PMID:[Cerebral microcirculation and structural changes in the brain in essential hypertension]. 1573 12

Teveten (eprosartan mesilate) was used as a monotherapy or in combination with hypotiazide (12,5 mg/day) in dosage 600 mg once a day for treatment of 20 patients with cerebrovascular pathology (chronic cerebrovascular insufficiency, consequences of brain ischemica in the presence of arterial hypertension stage I-II, or higher borderline levels of normal blood pressure (BP). Treatment duration was 12 weeks, 24-h monitoring of BP was made some indices of cerebral blood flow, hemodynamics and peripheral vessels reaction were registered. Modulating antihypertensive effect of Teveten was found, statistically significant reduction of systolic BP did not result in worsening of cerebral hemodynamics. Moreover, there was an improvement of endothelial function. Therefore, teveten may be recommended for treatment of patients with cerebrovascular pathology both with arterial hypertension and higher borderline BP.
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PMID:[Cerebral hemodynamics and endothelium function in patients with cerebrovascular pathology treated by teveten]. 1598 21

Angiotensin II is a key mediator in the mechanism of hypertension and plays a pathophysiological role for the development of ischemic stroke. Activation of AT1 receptors by angiotensin II initiates a complex signaling cascade via in part reactive oxygen species produced by the enzyme NADPH oxidase in blood vessels and induces vasoconstriction, vascular proliferation, and inflammation leading to cerebrovascular insufficiency. On the other hand, AT2 receptors are potentially protective. Recently, many clinical trials showed inhibition of renin-angiotensin system(AT1 receptor blockers and ACE inhibitors) has beneficial effect on stroke prevention independent of blood pressure lowering. Inhibition of renin-angiotensin system is a new promising strategy for stroke prevention.
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PMID:[Stroke and renin-angiotensin system]. 1676 30

Using cyclosporine as an immunosuppressive drug allowed increasing survival of grafts as well as patients. Despite this drug is being safely used for many years, it can cause complications. The most often complications are nefrotoxicity, hepatotoxicity, diabetes mellitus, arterial hypertension and neurotoxicity. The most often manifestation of neurotoxicity are tremor, leucoencephalopathia, headache and even seizures. Among risk factors we can enumerate arterial hypertetension, low cholesterol level, hypomagnesemia and previous cerebrovascular insufficiency.
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PMID:[Neurotoxicity of cyclosporine]. 1720 51

Relationships between cardiovascular risk and disease, and dementia have been identified, and the term vascular cognitive impairment (VCI) is used to describe individuals with significant cognitive impairments produced by cerebrovascular disease (CVD). VCI is the second most prevalent form of dementia and is composed of a heterogeneous pathology. Risk factors for VCI are similar to those of the most prevalent form of dementia, Alzheimer's disease (AD). In addition, recent data suggest that VCI can contribute significantly to the progression of AD, and AD can contribute to VCI. Translational animal models of VCI are necessary to further understand CVD mechanisms contributing to impaired cognition. This review describes animal models of cerebrovascular insufficiency (ie, chronic hypoperfusion and hypertension) that produce experimental VCI, including their relationships to human VCI and, when appropriate, to AD. The use of these models is expected to help discover biomarkers and disease mechanism-linked targets for diagnostic and therapeutic purposes, thus facilitating early identification and intervention in VCI.
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PMID:Vascular cognitive impairment: dementia biology and translational animal models. 1957 68

The authors carried out carotid angioplasty and stenting (CAS) in forty-six patients (with a total of 48 interventions performed). Of these, forty-two (91.3%) patients were found to belong to a high-surgical-risk group; The patients years (mean age - 62.1 +/- 8.2 years). Thirty-six patients were found to have symptomatic lesions of the internal carotid arteries (ICAs) >70%, and ten had asymptomatic stenoses >80%. Twenty-three (50%) patients were diagnosed with grade II cerebrovascular insufficiency (CVI) (transitory ischaemic attacks). Amongst the most frequently encountered accompanying pathologies were various-severity CADs in forty (95.2%) patients, and arterial hypertension in thirty-eight (90.4%). The cerebral blood flow state during CAS interventions was controlled by means of transcranial Doppler ultrasonography in sixteen patients. In twelve patients, the main stage of the intervention was performed under control of ultrasonographic duplex scanning (USDS). The technical success of the operation was achieved in forty-four (95.7%) cases. Failures were primarily caused by impossibility of passing the guidewire catheter in type 3 aortic arch in two patients. Twenty-six (56.5%) patients developed bradycardia and hypotension after CAS. No haemodynamically significant restenoses following CAS within the follow-up terms from 2 to 12 months were observed in twenty-two patients. The article also contains a brief comparative analysis of multicenter randomized studies on the CAS-related problem. In conclusion, the authors note safety and high efficiency of CAS, considering this intervention an alternative to carotid endarterectomy in patients with elevated surgical risk. A USDS-controlled operation significantly broadens the possibilities of the method concerned.
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PMID:[Angioplasty and stenting of carotid arteries in patients with high surgical risk]. 1979 57

The multicenter clinical-epidemioilogical program "CALIPSO" included 4865 patients with chronic cerebrovascular insufficiency associated with arterial hypertension. Patients received cavinton in intravenous infusions in drops during one week in dosage (25 mg in the 1-4 days, 50 mg in the 5-7 days) and then perorally in dose 30 mg/day during 90 days. The data analysis of the first 1011 individual medical records revealed the significant decrease of patient's complaints (p<0,001) and severity of neurological symptoms (p<0,05) as well as the improvement in scores on the Tinnetti scale (p<0,001) and the MMSE (p<0,001). The safety profile of the drug was confirmed.
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PMID:[Efficacy of cavinton in the treatment of patients with chronic blood flow insufficiency. Russian multicenter clinical-epidemiological program "CALIPSO"]. 2131 88

Chronic cerebrovascular insufficiency is the most common manifestation of chronic diseases of the nervous system. Its main causes are hypertension and atherosclerosis. Diseases debut mainly on 5-6th decade of life. The condition prohreiyentnyy, but the degree of progression can be varied--from slow to galloping. Therefore, when studying the effectiveness of treatment programs, in our opinion, it is important to include the medical complex of different methods of reflexology.
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PMID:[Complex treatment of patients with chronic cerebrovascular insufficiency]. 2335 Jan 45

This review presents the data of assessing antihypertensive efficacy and tolerability vasoselective high-lipophilic the 3d generations calcium channel blocker lercanidpine. The inhibition of the calcium ions flow through the membranes of smooth muscle cells of blood vessels causes peripheral, cerebral, renal and coronary vasodilation decreasing total peripheral vascular resistance and, consequently, blood pressure (BP) lowering and improve regional circulation. During reception of lercanidipine the level of norepinephrine remains the same even when using high doses of the drug. Negative inotropic effect does not occur therefore, lercanidipine can be used in the treatment of myocardial ischemia. Renal protection properties slow down the development and progression ofchronic renalfailure (CRF). The drug can be successfully used in patients with arterial hypertension, chronic renalfailure, diabetic and non-diabetic nephropathy. Lercanidpine also may be effectively used in the treatment of hypertension with associated clinical conditions: bronchial asthma, chronic obstructive pulmonary disease, bradiarrythmias, atrioventricular blockade 2-3 degree, sinus node dysfunction, peripheral arteries deseases with symptoms of the extremities ischemia, sleep disturbance, depression, dystonia, asthenic and cephalgic syndme in the frame of the cerebrovascular insufficiency manifestations. Therapy with lercanidpine, in addition to lowering blood pressure, can help to nephroprotection, neuroprotection, antianginal effect, the regression of left ventricular hypertrophy, improvement of lipid metabolism and glucose tolerance. With over 30 years experience in the application and modification of the molecular structure, slow the onset of action and superior long-lasting effect reception of letranidipine well-tolerated and provides a high adherence ofpatients to the treatment of hypertension.
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PMID:[THE ROLE PLEIOTROPIC EFFECTS OF CALCIUM CHANNEL BLOCKER LERCANIDIPINE IN PERIOPERATIVE THERAPY OF ARTERIAL HYPERTENSION.] 2948 11


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