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)

Atrasentan is a selective endothelin ET(A) receptor antagonist under development by Abbott for the potential treatment of cancer, particularly prostate cancer, for which it is in phase III trials [413197]. In July 2002, phase II trials for renal, ovarian, lung, colorectal, breast and brain cancers were being initiated [457800]. Atrasentan has been granted Fast Track status, allowing for a rolling NDA [414666], [443479]; the company was planning to begin filing for prostate cancer in late 2003. Atrasentan has also been in phase I trials for hypertension [319405], [326268], but development for this indication had been halted by 2001 [407049].
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PMID:Atrasentan Abbott. 1221 23

Since the last in a series of childbirth education classes discusses contraception, educators must know about various family planning methods. Oral contraceptives (OCs) comprise combined OCs, phasic OCs, and minipills. Combined OCs inhibit secretion of gonadotropin-releasing hormone, which in turn keeps the follicle-stimulating hormone from inducing the ovarian follicle to grow and keeps luteinizing hormones from activating ovulation. They also thicken cervical mucus. Minipills also thicken cervical mucus and render the endometrium unreceptive to fertilized egg implantation. They do not always inhibit ovulation, however. OCs can induce side effects, such as nausea, hypertension, increased risk of atherosclerosis, and fatigue. The IUD prevents pregnancy either by inhibiting implantation of a fertilized egg or by an inflammatory reaction of the endometrium resulting in a release of macrophages which may destroy sperm. The no-longer-produced Dalkon Shield IUD increased the risk of pelvic inflammatory disease and damaged the reputation of other IUDs. Rare IUD complications are uterine perforation, salpingitis, tubal scarring, pelvic inflammatory disease, and infertility. Diaphragms, cervical film, and condoms serve as barriers between the egg and sperm. The main problem with barrier methods is the increased risk of developing toxic shock syndrome. Spermicide increase the effectiveness of diaphragms, cervical caps, and condoms. Vasectomy keeps sperm from arriving at storage sites. Shortterm side effects are swelling, discomfort, and occasional rejoining of the cut ends of the vas. Research hints at a link between vasectomy and prostate cancer. Some complications of tubal ligation are urinary tract infections, accidental electrical burns, and pelvic infections. Natural family planning methods include withdrawal, the rhythm method, and the sypto-thermal method. Controversial injectable contraceptives are Depo-Provera (medroxyprogesterone acetate) and Noristerate (norethisterone enanthate).
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PMID:Birth control update for childbirth educators. 1234 29

A growing body of evidence supports preventive interventions in asymptomatic adults. Primary prevention, which includes counselling (in particular for smoking cessation) and review of immunisation status, has been shown to be more cost-effective than secondary prevention. Evidence supports screening for hypertension, hyperlipidaemia, cervical cancer, colorectal cancer, breast cancer and obesity. Screening for lung, pancreatic and ovarian cancer has no effect on outcome and should not be performed. Controversial preventive interventions include general screening for diabetes mellitus, thyroid disorders and prostate cancer. Physicians should be aware of a possible hidden agenda in patients presenting for a checkup.
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PMID:Evidence for prevention and screening: recommendations in adults. 1242 90

The purpose of the present study was to perform a BPH risk factor analysis in men, relating the prostate gland volume to components of the metabolic syndrome and to identify clues to the etiology of BPH. Our material comprised a consecutive series of 158 patients with lower urinary tract symptoms with or without manifestations of the metabolic syndrome. In this group, the measured volume of the prostate was related consecutively to potential risk factors. The diagnoses atherosclerosis, non-insulin-dependent diabetes mellitus (NIDDM) and treated hypertension were obtained from the patient's medical history. Data on blood pressure, waist and hip measure, body height and weight were collected and body mass index (BMI) and waist/hip ratio (WHR) were calculated. Blood samples were drawn from fasting patients to determine insulin, cholesterol, triglycerides, HDL and LDL-cholesterol, uric acid and ALAT. The prostate gland volume was determined using ultrasound. Our results show that there was a larger prostate gland in men with NIDDM (P=0.0058), treated hypertension (P=0.0317), obesity (P<0.0001), low HDL-cholesterol levels (P=0.0132) and high insulin levels (P<0.0001) than in men without these conditions. The prostate gland volume correlated positively with the systolic blood pressure (r(s)=0.17; P=0.03), obesity (r(s)=0.34; P<0.0001) and fasting insulin (r(s)=0.38; P<0.0001) and negatively with HDL-cholesterol (r(s)=-0.22; P=0.009). On the basis of our findings, we concluded that NIDDM, treated hypertension, obesity, low HDL-cholesterol levels and high insulin levels constitute risk factors for the development of BPH. The results suggest that BPH is a facet of the metabolic syndrome and that BPH patients may share the same metabolic abnormality of a defective insulin-mediated glucose uptake and secondary hyperinsulinemia as patients with the metabolic syndrome. The findings generate a hypothesis of a causal relationship between high insulin levels and the development of BPH. In a clinical setting, the findings of the present report suggest that, in any patient presenting with BPH, the possible presence of NIDDM, hypertension, obesity, high insulin and low HDL-cholesterol levels should be considered. Conversely, in patients suffering from these conditions, the possibility of a clinically important BPH should be kept in mind.
Prostate Cancer Prostatic Dis 1998 Mar
PMID:Components of the metabolic syndrome-risk factors for the development of benign prostatic hyperplasia. 1249 10

The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) was designed to see if the effects of doxazosin, amlodipine and lisinopril were superior to those of chlorthalidone on the incidence of cardiovascular disease in high-risk patients with hypertension. Earlier this year, following an interim analysis of 24,335 patients, the doxazosin treatment arm was stopped amid reports of an increased incidence of secondary cardiovascular endpoints relative to chlorthalidone. This paper will offer some insight into the interpretation of the ALLHAT interim data, and clarify any issues around the use of alpha-1 adrenoceptor antagonists, such as doxazosin, in the management of patients with benign prostatic hyperplasia. Prostate Cancer and Prostatic Diseases (2000) 3, 152-156
Prostate Cancer Prostatic Dis 2000 Nov
PMID:Interpretation of the ALLHAT interim analysis and implications for the treatment of patients with BPH. 1249 91

The purpose of this study was to obtain objective information on the necessity of invasive anesthetic monitoring during radical prostatectomy. We reviewed retrospectively the charts of 257 patients undergoing radical prostatectomy on an established pathway which did not include the intraoperative use of an arterial line or central venous catheter. Outcome measures including intraoperative vital signs, cardiac arrhythmias, blood loss and fluid management were assessed. In particular, we sought to determine situations in which insertion of monitoring devices was required because of an unanticipated intraoperative event. The patient ages ranged from 40 to 75 y with a mean of 60.3 y. The mean estimated blood loss was 546.9 cm(3) (median 500 cm(3)). Thirty-eight patients had a measured intraoperative systolic blood pressure of <90 mmHg, but no hypotensive episodes required any treatment other than fluid administration. A single patient required pharmacologic therapy for hypertension. One patient received intravenous lidocaine because of premature ventricular contractions, but no other arrhythmias were observed. No patient required intraoperative insertion of an arterial line or central venous catheter. These data provide objective evidence for the abandonment of routine use of central venous catheters or arterial lines during radical prostatectomy. This avoids not only the expense of these maneuvers, but also the potential morbidity of unnecessary invasive medical procedures.
Prostate Cancer Prostatic Dis 1999 Dec
PMID:Is invasive anesthetic monitoring necessary during radical prostatectomy? 1249 75

Health disparities are of continuing concern to the community of public health professionals. Despite concerted efforts on a number of fronts, little progress seems to have been made towards eliminating these disparities. This is due in part to a frame of reference that focuses on race and racism. While racism plays a role, continued focus on socially constructed racial groups will not lead to solutions to the problem. Humans are biological organisms and the presence of disease indicates a maladaptation between the individual human organism and its environment. Lumping together into a 'racial' group large numbers of individuals who share little in terms of phenotype, culture, and/or behavior inhibits reaching appropriate solutions. Progress will only be made when the issue of health disparities is reframed as one of phenotype/environmental mismatch. Such a frame crosscuts current racial groups. Health disparities such as hypertension, prostate cancer, low-birth-weight (LBW) infants, infant mortality, rickets, and melanoma are affected by the interactions of degree of pigmentation, amount of exposure to ultraviolet B (UVB) radiation, and levels of serum vitamin D. Reframing the problem of health disparities from one of race and racism to one of phenotype/environmental mismatch permits a solution to an otherwise intractable problem.
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PMID:Health disparities: reframing the problem. 1285 93

The current trends in favor of androgen deprivation therapy (ADT) for nonmetastatic prostate cancer at the stage of biochemical recurrence or increasing prostate-specific antigen (PSA) raises the issue of exposing otherwise asymptomatic patients to potential side effects over the longer term. Some of these side effects can have deleterious effects on quality of life, and others may contribute to increased risks for serious health concerns associated with aging. Sexual side effects are the most well-recognized adverse effects from ADT and include loss of libido, erectile dysfunction (ED), and hot flashes. Loss of libido is distressing to many men, and they may not pursue treatments for ED. However, for those who do maintain sexual interest, various remedies are available. The incidence of hot flashes, which may not abate over the course of ADT, is close to 80%. Estrogens, progestin megestrol acetate, medroxyprogesterone acetate, venlafaxine, and cyproterone acetate have been shown to alleviate hot flashes and associated symptoms. Physiologic effects, including gynecomastia, changes in body composition (weight gain, reduced muscle mass, increase in body fat), and changes in lipids, are less commonly recognized as side effects of ADT. These may lead to an exacerbation of potentially more serious conditions, such as hypertension, diabetes, and coronary artery disease. Loss of bone mineral density, anemia, and hair changes also may occur. Additionally, both the diagnosis of prostate cancer and the hormonal therapy can cause psychological distress. These side effects need more systematic study in clinical trials. Physicians should be aware of far-reaching consequences of ADT and should incorporate strategies for preventing and managing toxicities into routine practice.
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PMID:Side effects of androgen deprivation therapy: monitoring and minimizing toxicity. 1266 85

Previous epidemiologic studies evaluating risk factors for lower urinary tract symptoms (LUTS) have focused on White populations. Between September 1996 and January 1998, in a population-based sample of African-American men aged 40-79 years in Flint, Michigan, the authors assessed the role of putative sociodemographic, lifestyle, and medical history risk factors in moderate to severe LUTS, including the subcategories of obstructive and irritative symptoms. After the exclusion of men with prostate cancer or prior prostate surgery and men who were taking alpha-blockers for urinary tract symptoms, 708 participants provided responses to a structured interviewer-administered questionnaire. After multivariable adjustment, current and former smokers were at increased risk of moderate to severe LUTS, including obstructive symptoms. Heavy alcohol consumption and a history of hypertension or diabetes were positively associated with LUTS, and high income (>/=$30,000) was inversely associated with LUTS and with obstructive and irritative symptoms. A history of heart disease was positively associated with LUTS and with irritative symptoms. To the authors' knowledge, this was the first population-based study undertaken in African-American men to evaluate putative risk factors for moderate to severe LUTS, including subcategories of obstructive and irritative urinary symptoms. These results describe associations with specific lifestyle and medical history risk factors.
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PMID:Risk factors for lower urinary tract symptoms in a population-based sample of African-American men. 1274 43

Endothelins (ET-1, ET-2 and ET-3) are 21-amino-acid peptides with two disulfide bonds that belong to the sarafotoxin family. ET-1, ET-2 and ET-3 are produced endogenously from preproendothelin to give big endothelins, which are cleaved by endothelin-converting enzyme (ECE) to yield the active protein. Endothelin has been shown to play important physiological and pathological roles by interacting with its G-protein-coupled receptors. There are two cloned ET receptors: the ET(A) receptor, which is selective for ET-1, and the ET(B) receptor, which binds ET-1, ET-2 and ET-3 with similar affinities. Since the discovery of endothelin, and especially since the availability of peptide ET antagonists such as BQ-123 and BQ-788, and nonpeptide compounds such as bosentan, considerable effort has been spent on better understanding the role of endothelin and its receptor antagonists. As a result, endothelin has been implicated in a variety of serious diseases, such as congestive heart failure, hypertension, pulmonary hypertension and prostate cancer. Research in pharmaceutical and biotechnology laboratories has generated many endothelin antagonists with either sulfonamide or triaryl carboxylic acid scaffolds, and a number of ET(A)-selective or nonselective ET(A)/ET(B) endothelin antagonists have entered clinical trials. This article will review the small-molecule ET(A)-selective and nonselective ET(A)/ET(B) antagonists that are under clinical evaluation, and highlight a member of this group of compounds, sitaxsentan. A summary of the medicinal chemistry that led to the identification of sitaxsentan will be presented, followed by selected animal and human clinical trial data. (c) 2001 Prous Science. All rights reserved.
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PMID:Nonpeptide endothelin antagonists in clinical development. 1275 Jul 62


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