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

The content of IgA, IgM, IgG and IgE was measured in 55 male patients with uncomplicated essential hypertension (EH) running a labile course (25 patients) and a stable course (30 patients). Analyzing the material, account was taken of aggravated heredity factor as regards arterial hypertension, established according to the anamnesis in relatives of the first degree kinship. A group of patients with the aggravated familial anamnesis as regards arterial hypertension were distinguished. They suffered from labile hypertension with a tendency to hyperreninemia and IgE overproduction, which may be unfavourable in terms of EH progression and development of cardiovascular complications.
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PMID:[The correlation of the indices of humoral immunity and of the activity of the renin-angiotensin-aldosterone system in hypertensive patients]. 206 80

Studies using ambulatory monitoring of blood pressure have indicated that patients with persistently elevated clinic pressures may be subdivided into two groups, those in whom ambulatory pressure is also elevated (persistent hypertension), and those in whom it is normal (white coat hypertension). The role of behavioral factors in contributing to these two types is discussed. Studies of white coat hypertension suggest that it is not characterized by any generalized physiological abnormality, and that target-organ damage is mild and the prognosis relatively benign. It may represent a conditioned response to the physician. Behavioral factors can significantly influence the diurnal profile of blood pressure, as shown by a comparison of ambulatory pressures recorded on working and non-working days, and in women who experience varying levels of occupational and domestic stress. The role of behavioral factors in the development of sustained hypertension (defined as an upward resetting of the diurnal profile), however, is much less clear. A cross-sectional study of normotensive and hypertensive men has shown that men employed in high-strain jobs are more likely to show a sustained elevation of blood pressure.
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PMID:The role of behavioral factors in white coat and sustained hypertension. 209 82

There is not increasing evidence that, from an epidemiological stand-point, treatment of diastolic hypertension in the elderly leads to a significant cardiovascular risk reduction; however, for the individual patient, the magnitude of absolute risk reduction is relatively small. More widespread use of ambulatory blood pressure recording is suggested in order to improve patient selection - i.e. to avoid antihypertensive treatment in patients with white coat hypertension - and to prevent overtreatment in patients with established hypertension. This strategy should result in a selection of elderly, hypertensive patients who are more likely to benefit from pharmacological treatment and thus restrict the number of patients needing treatment for prevention of a cardiovascular complication. Furthermore, by decreasing the risk of overtreatment, this strategy is likely to result in a decrease in the number of medication-related side effects such as coronary morbidity and mortality.
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PMID:[Treatment of arterial hypertension in the elderly person: unresolved problems]. 221 20

In a birth cohort of children in the Dunedin Multidisciplinary Health and Development Study in New Zealand, resting blood pressures were recorded biennially five times from age 7 to 15 years. Using previously described methods, we examined the level, trend, and variability of blood pressures in those children with at least three readings. The level, trend, and variability of height, weight, and body mass index were compared among six separate groups of children. Two groups were categorized on the basis of high systolic pressure levels, one with low variability and the other with high variability, which was thought to resemble adult labile hypertension. Two additional groups were categorized on the basis of increasing and decreasing blood pressure trends; the fifth group had consistently low blood pressures, and the sixth group consisted of the remaining children. There were significant differences among the groups for the level of all the physical measurements and for the trend of body mass index. No significant differences were found among the groups for gender or socioeconomic status. A parental history of high blood pressure, stroke, or heart attack was significantly more common in the first two groups.
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PMID:Blood pressure level, trend, and variability in Dunedin children. An 8-year study of a single birth cohort. 222 85

During a survey of young subjects not receiving treatment for hypertension in Tecumseh, Michigan, clinic and self-monitored blood pressures taken at home (14 readings in 7 days) were obtained in 737 subjects (387 men, 350 women, average age 31.5 years). Hypertension in the clinic was diagnosed if the clinic blood pressure exceeded 140 mm Hg systolic or 90 mm Hg diastolic. In the absence of firm criteria for what constitutes hypertension at home, subjects whose average home blood pressure was in the upper decile of the whole population were considered to have hypertension at home. By these criteria, 7.1% of the whole population had "white coat" hypertension (i.e., high clinic but not elevated home readings). The prevalence of "sustained" hypertension (i.e., high readings in the clinic and at home) was 5.1%. Subjects with white coat and sustained borderline hypertension in Tecumseh were very similar. Both groups showed, at previous examinations (at ages 5, 8, 21, and 23 years), significantly higher blood pressure readings than the normotensive subjects. As young adults (average age 33.3 years), the parents of both hypertensive groups had significantly higher blood pressure readings than the parents of normotensive subjects. Both hypertensive groups had faster heart rates, higher systemic vascular resistance, and higher minimal forearm vascular resistance. Both hypertensive groups were more overweight, had higher plasma triglycerides, insulin, and insulin/glucose ratios than normotensive subjects. The white coat hypertensive group also had lower values of high density lipoprotein than the normotensive group. White coat hypertension is a frequent condition.(ABSTRACT TRUNCATED AT 250 WORDS)
Hypertension 1990 Dec
PMID:"White coat" versus "sustained" borderline hypertension in Tecumseh, Michigan. 224 30

The use of ABPM allows an improved assessment of blood pressure (BP) and therefore of the individual cardiovascular risk. It is able to identify patients who truly need therapy more exactly. Mostly patients with white coat hypertension who don't need therapy are identified. Furthermore, ABPM correlates more closely to target organ damage and to cardiovascular morbidity and mortality. This may be helpful to treat especially those patients who truly need therapy. BP exhibits a typical circadian rhythm with the highest values during the early morning hours and a decline during the night. A change of the day/night rhythm during shift work leads to an adaptation of BP rhythm. The early morning rise of BP and heart rate is accompanied by hemodynamic, rheological and biochemical alterations, which together may contribute to the increased frequency of vascular complications during the morning hours. The nightly decline of BP is often absent in patients with secondary hypertension and cardiac or renal organ damage. A lack of the nocturnal BP decline should therefore lead to further patients' evaluation. Elevated nocturnal BP seems to worsen the prognosis. ABPM offers better individual control of BP in patients on treatment and therefore is helpful to optimize the treatment. A more exact individual BP control during the awakening and sleeping period is possible as well as an avoidance of overtreatment. Patients could be protected both from prescription of too many drugs and from lowering BP too much. A further advantage lies in an improved control of patients with nocturnal hypertension.
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PMID:[The significance of 24-hour blood pressure monitoring in the diagnosis and therapy of arterial hypertension]. 228 May 76

Authors reported a case of recurrent intracerebral hemorrhage accompanied by severe orthostatic hypotension. A 51-year-old women had recurrent intracerebral hemorrhage 3 times during a period of 2 years. The first and third hemorrhages were located in the right putaminal region, and the second hemorrhage in the left thalamic region. Cerebral angiography revealed neither evidence of vascular malformation nor that of tumor vessels. At the third admission, she became unconscious for three hours after admission, and emergent fronto-temporal craniotomy was performed. Light microscopic histological investigation with congo-red stain demonstrated the absence of cerebral amyloid angiopathy. Laboratory examination revealed no hemorrhagic diathesis. During hospitalization, She complained of dizziness in the standing position. When systolic blood pressure fell from 140 mmHg in the supine position to less than 80 mmHg in the standing position, she became unconscious. Her blood pressure was very labile with orthostatic changes and her systolic blood pressure was also very labile without orthostatic changes, changing from 108 mmHg to 218 mmHg. Severe orthostatic hypotension and labile hypertension made the medical control of hypertension difficult. In conclusion, both severe orthostatic hypotension and labile hypertension were risk factors of recurrence of intracerebral hemorrhage.
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PMID:[Hypertensive recurrent intracerebral hemorrhage accompanied with orthostatic hypotension and labile hypertension]. 236 32

Patients with hypertension in the clinic but not during daily activities ("white coat" hypertension) may be at lower risk of hypertensive morbidity and mortality than patients with hypertension in both settings ("persistent" hypertension). We hypothesized that the white coat phenomenon was due to greater blood pressure reactivity to the stress of a clinic visit and that, as a consequence, white coat hypertensive patients would display greater blood pressure reactivity to exercise and mental stress, as well as increased emotional reactivity and higher levels of anger, anxiety, or depression. We studied 89 patients with essential hypertension between 29 and 59 years old with ambulatory blood pressure monitoring, treadmill exercise testing with oxygen consumption measurement, mental stress testing (including mental arithmetic, public speaking, and video game tasks), and psychological testing (State-Trait Anxiety Scale, Cook-Medley Hostility Scale, Center for Epidemiologic Studies Depression Scale, emotional reactivity scale). We defined white coat hypertension as a mean ambulatory systolic blood pressure of 135 mm Hg or less and diastolic 85 mm Hg or less and persistent hypertension as a mean ambulatory systolic blood pressure of 140 mm Hg or more or diastolic 90 mm Hg or more. Forty-nine patients were classified as persistent hypertensives and 20 as white coat hypertensives. No significant differences were seen in demographic or clinical characteristics, fitness level, blood pressure response to exercise or mental stress, or psychological characteristics, except that white coat hypertensive patients had lower systolic blood pressures in the clinic and during exercise and greater variability of clinic diastolic blood pressures.(ABSTRACT TRUNCATED AT 250 WORDS)
Hypertension 1990 Aug
PMID:Physiological, psychological, and behavioral factors and white coat hypertension. 237 47

Echocardiography represents an innovative diagnostic method in patients with mild hypertension because it allows evaluation of target organ involvement and, thus, potentially may be of value in determining which patients might most benefit from treatment. In large-scale observations of mild to moderate hypertension, the electrocardiogram and the chest x-ray film each identified approximately 5% of patients as having left ventricular hypertrophy (LVH), whereas echocardiography demonstrated this finding in almost 50%. This high sensitivity also was found in a study of young hypertensive patients (average age 28 years) among whom over 30% had left ventricular muscle wall thicknesses greater than the highest value found in age-matched normotensive controls; additionally, evidence for LVH was documented in a subgroup of young patients with labile hypertension whose blood pressure actually were normal at the time of the echocardiographic procedure. Blood pressure is not the only cause of LVH. Other factors, including heightened activity of the sympathetic nervous system and the renin axis, may be important. Thus, treatment of hypertension with agents such as diuretics or vasodilators that fail to decrease sympathetic activity, or which might even increase it, often fails to produce regression of LVH. In contrast, agents with sympatholytic properties may exhibit beneficial effects on left ventricular muscle mass that are independent of their actions on blood pressure.
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PMID:Echocardiographic evaluation of left ventricular hypertrophy. 242 16

Different odontology publications have stressed how important it is for every D.D.S. to be familiar with the fundamentals of detection and treatment to be considered in all cases of patients who suffer from hypertension. This condition has of late been occurring at increasingly early ages, and it is now known that children of hypertensive parents have higher blood pressures than those of parents with normal readings, all ages considered. The state of stress in which individuals currently live, conditions young persons with labile hypertension to develop essential hypertension, which becomes fixed within briefer periods.
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PMID:[Dental care for the pregnant hypertensive patient]. 253 50


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