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

Drug usage was studied in a geriatric hypertension-screening program. A questionnaire was used to collect the required information from patients visiting the clinic during three successive years. The study included 1,711 patients, of whom 76.6 percent were regularly using a drug preparation. A consistent increase was noted in the average number of drug categories used with increasing age, from 1.6 in patients under 70 to 2.6 in patients over 84 years old. The most common drug categories involved were antihypertensive agents, cardiovascular drugs, vitamins, and internal analgesics.
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PMID:Drug use in a geriatric population. 45 91

The clinical features of congestive heart failure in the elderly were investigated in 104 patients (57 males, 47 females, mean age of 79.2). Patients were divided into two subgroups, the readmission group, 33 patients who were readmitted within 6 months after discharge, and the non-readmission group. Chief complaints were dyspnea, edema, chest pain, loss of appetite, chest compression, and palpitation. Heart failure was caused by infection, myocardial ischemia, arrhythmia, inappropriate drug usage including poor drug compliance, the use of beta-blockers, excessive intake of sodium, and anemia. Careful use of drug was essential especially in the readmission group. Major underlying heart disease were ischemic heart disease (39.4%), valvular disease (26.9%), hypertensive heart disease (9.6%), with cardiomyopathy, congenital heart disease seen in the minority. There was no statistically significant difference in underlying heart diseases between the two groups. Supraventricular arrhythmias such as atrial fibrillations, paroxysmal atrial fibrillations, paroxysmal supraventricular tachycardias, and premature atrial contractions were noted in 85.3% of the cases. Drugs for treatment were diuretics, digitalis, isosorbide dinitrate, calcium antagonists. ACE inhibitors and alpha-blockers were also used, showing that vasodilators were more extensively used than before. The major complications were hypertension (39.4%), renal dysfunction (27.9%), cerebrovascular disease (26.9%), diabetes mellitus (16.5%), arteriosclerosis obliterans (7.7%). Renal dysfunction, arteriosclerosis obliterans was seen significantly more frequently in the readmission group. The prognosis at one year after admission was significantly worse in the readmission group. In summary, the major underlying diseases were ischemic heart disease, valvular disease, and hypertensive heart disease. Ischemic heart disease was seen more frequently than in previous investigations at our hospital.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Congestive heart failure in elderly readmitted patients]. 152 7

While the evidence for a clustering of health habits is not particularly strong, there are both pedagogic and economic arguments in favour of a multifaceted approach to health education. The present review thus examines the impact of regular physical exercise upon other forms of health behaviour, testing the extent to which an activity programme can be a catalyst of improved lifestyle in both primary and secondary preventive therapy. The conceptual framework of health promotion is examined with particular reference to the models of Skinner, Becker, Fishbein, Triandis and Rokeach. Certain differences are noted between the decision to exercise and the marketing decisions for which Fishbein's model was originally designed. Nevertheless, in its later modifications, it provides a basic framework for understanding how human lifestyle is shaped. Theoretical mechanisms are suggested whereby exercise could influence such behaviours as cigarette smoking, alcohol consumption and drug usage, seat-belt usage, hypertension, body mass, lipid profile, promiscuous sexual behaviour, the carrying of lethal weapons, and acceptance of regular preventive medical examinations. The empirical evidence from both cross-sectional and longitudinal experiments shows a relatively weak association between exercise habits and other desirable forms of health behaviour. Moreover, it is arguable that other forms of health intervention such as smoking withdrawal or dieting might be equally effective as a primary change agent, and much of the observed association between exercise and other health habits could be attributable to a common dependence on demographic and socio-economic factors. On the other hand, the apparent weakness of associations may arise in part from difficulties in measuring both habitual physical activity and other forms of health behaviour, with a resultant attenuation of correlations. Possibly, a stronger association between exercise participation and other favourable health habits would be uncovered if attention were focused upon those forms of endurance exercise currently thought to enhance cardiac health. Given that moderate endurance exercise is also positive and pleasant advice, further examination of the potential of multifaceted but exercise-centered health promotion programmes appears warranted.
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PMID:Adolphe Abrahams memorial lecture, 1988. Exercise and lifestyle change. 265 29

The prerequisites for analyses of the medical, social and economic consequences of drug usage are in part available in Sweden. Hard data, though, are still fragmentary. Examples are given where various data sources and methods have been applied. It is suggested that feedback of drug utilization data should increase to create a more questioning attitude among prescribers. The concept of medical audit has to be better explained including the fact that individual-based registers are necessary tools in trying to assess the rationality of drug treatment. In the future such analyses should focus on everyday treatment of common disease entities such as hypertension, diabetes, dyspepsia and asthma. Long term medical and economical consequences of optimized pharmacological versus non-pharmacological treatment should be studied.
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PMID:Approaches to assessing the rationality of drug usage in a developed country. 316 31

We report an autopsy case of methamphetamine-related intracranial hemorrhage and vasculitis. The possible relationship between drug usage and the occurrence of intracranial bleeding and cerebral vasculitis in such patients is discussed. A 22-year-old woman died after an intravenous injection of unknown dose of methamphetamine. A computed tomography head scan demonstrated massive subarachnoid hemorrhage and hematoma in corpus callosum. Cerebral angiography revealed nonfilling of bilateral intracranial carotid arteries and extravasation of contrast medium from right pericallosal artery which was visualized retrogradely via vertebral artery. Postmortem studies showed cerebral edema, subarachnoid and intracerebral hemorrhage, and intracranial vasculitis in the absence of aneurysm, arteriovenous malformation or chronic hypertension. Histological findings of necrosis of blood vessel walls with destruction of the elastica and smooth muscle layer, and without leukocytotic infiltration of the blood vessel walls were observed in order of anterior cerebral, middle cerebral, vertebral, posterior cerebral and basilar arteries. These angiographic and histological evidence suggests that such hemorrhage results from the development of fibrinonecrosis in the large intracerebral vessels, in addition to a sudden rise in blood pressure.
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PMID:[An autopsy case of subarachnoid and intracerebral hemorrhage and necrotizing angitis associated with methamphetamine abuse]. 321 43

We prospectively identified predictors of future antihypertensive use in untreated persons age 18-65 years who had elevated diastolic blood pressures of 90-104 mm Hg or systolic blood pressures of at least 140 mm Hg. Data were derived from two independent cohorts completing household surveys conducted in 1981-1984 and 8 years later, as part of the Pawtucket Heart Health Program. Demographics, self-reported health behaviors and beliefs, and physiologic measurements were obtained. Drug use was determined through structured interviews. Analysis of covariance and logistic regression were performed. In the 492 subjects, independent baseline predictors of future antihypertensive use (p < 0.05) included female gender, older age, diastolic blood pressure elevation, self-perceived high blood pressure, and self-reported salt limitation. Antihypertensive use for previously untreated mild hypertension is diverse. Older women with diastolic elevations who are health conscious are most likely to be treated.
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PMID:Predictors of future antihypertensive use in patients with mildly elevated blood pressure. 766 62

Until recently neither the extent of antihypertensive drug usage in Iceland nor its distribution among drug classes was known. Of the 1,145 men aged 70-84 years alive in 1991, 834 participated in a study carried out by Hjartnavernd, the Heart Association. A history of hypertension or the presence of high blood pressure when measured at the Associations institute were found in 429 men, of whom 157 were on medication for hypertension alone: 95 on single drug treatment, 49 on two drugs, and five on three drugs, no information being available for the remaining eight. The most widely used drugs were diuretics or beta-blockers, of which diuretics apparently yielded better results. Of combined regiments, that of beta-blockers and diuretics was by far the most common, followed by ACE- (angiotensin converting enzyme) inhibitors and diuretics, and beta-blockers and calcium channel blockers. Thus, both medical and economic factors suggest that diuretics should be used in this age group.
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PMID:[[Hypertension treatment of elderly men in Iceland]. 772 55

This paper outlines the pattern of drug utilisation in the elderly inpatient population in the nursing homes, Bumhudzo and BS Leon Trust and the two central hospitals, Harare and Parirenyatwa, in urban Harare, during the period, February to September 1990. The total population of elderly patients in the four institutions was calculated at 324 (52 pc) 170 of which were males and 48 pc were females. Of these patients 273 (84 pc) were Black, 44 (14 pc) were White and seven (2 pc) were Asians. Drug use pattern was estimated using the defined daily dose (DDD) system. The pattern of drug use was matched with the disease pattern to detect any discrepancies in drug utilisation. Of the 324 patients interviewed 114 (35 pc) were not on medication. The total number of drug formulations taken by the studied population was 1,117 with a mean of 3.45 drugs per individual at any one moment. Polypharmacology seems rife. The study indicated irrational and over utilisation of centrally acting drugs and vitamins and minerals. The most utilised group of drugs are the cardiovasculars (22 pc of the total) The most common disease conditions encountered in the elderly were hypertension, 7 pc, congestive heart failure, 7 pc, epigastric pain, 6 pc, senile dementia, 5 pc and pneumonia, 5 pc. The responses on sources of drug information available for the elderly revealed that pharmacists are totally unknown to the elderly in this respect. Measures that could be taken to improve elderly drug use are suggested.
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PMID:Drug utilisation in the geriatric population in the nursing homes and central hospitals of urban Harare. 795 24

The authors compared self-reported medical history and medication use in a cataract case-control study of 1,380 persons (1985-1989) in Boston, Massachusetts, with information from the participants' physicians. Under- and overreporting varied by condition and type of medication. A self-reported history of hypertension had the highest sensitivity (91%), and diabetes history had the highest specificity (97%). Among different medications investigated, self-reported antihypertensive medication use was the most sensitive (88%), while self-reported use of insulin was the most specific (99%). Differences between patient- and physician-reported frequencies were very small, except for arthritis (15%) and regular aspirin use (21%). Results suggest an accurate recall of medical and drug usage history in well-defined chronic conditions.
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PMID:Comparing self-reported and physician-reported medical history. 817 94

Epidemiology of stroke in the elderly in Thailand was conducted from August 1994 to October 1996. The total of 3,036 Thai elderly were included in this study. They represented the elderly population from four regions; Central Region (615 elderly, Nakhon Pathom Province), Northern Region (840 elderly, Lampang Province), North-Eastern Region (706 elderly, Sakon Nakhon Province), and Southern Region (857 elderly, Ranong Province). All elderly in these selected areas received general physical examinations and complete neurological examinations from neurologists. Demographic data concerning each individual was recorded by specially trained nurses. Data included age, sex, occupation, education, drug usage, alcohol, smoking and pre-existing diseases. Blood was taken from each subject for complete blood count, fasting blood sugar, cholesterol, triglyceride, high density lipoprotein cholesterol and VDRL. Data on physical examinations were recorded with particular attention to blood pressure, carotid bruit, cardiac murmurs, cardiac arrhythmia, speech, posture, gait, frontal lobe releasing signs, Babinski sign and focal neurological deficit. Thirty-four stroke patients were identified from 3,036 elderly (prevalence rate of 1.12 per cent). There were 12 stroke patients from Central Region (prevalence rate of 1.99 per cent), 5 from Northern Region (0.6 per cent), 4 from North-Eastern Region (0.6 per cent) and 13 from Southern Region (1.5 per cent). Hypertension was the main risk factor for stroke in this study whereas diabetes mellitus, smoking, alcohol consumption, hyperlipidemia and underlying heart diseases were insignificant risk factors. The prevalence of hypertension in Thai elderly was ranging from 16.7 to 47.2 per cent (criteria over 140/90 mmHg) or 6.1 to 24.8 per cent (criteria over 160/90 mmHg). Prevalence of smoking and alcohol consumption in Thai elderly ranged from 19.5 per cent (Sakon Nakhon) to 62.1 (Lampang) and 16.75 per cent (Nakhon Pathom) to 33.70 per cent (Lampang) respectively. Data from physical examinations revealed that dysarthria, hemiplegic gait and Babinski sign were the significant signs for diagnosis of stroke in the community setting. The prevalence of carotid bruit, cardiac murmur and cardiac arrhythmia were ranging from 1.3 to 1.8 per cent, 3.1-7.1 per cent and 0.8-1.4 per cent respectively. From this study, it can be concluded that stroke prevention is the best policy for stroke management. Stroke prevention measures should thus be aimed at the high risk elderly group. This is best achieved by identifying risk factors among them and then controlling these risk factors properly.
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PMID:Epidemiology of stroke in the elderly in Thailand. 967 86


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