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

Information on whether a woman had ever had any children was recorded for all deaths registered to ever-married women in England and Wales between 1938 and 1960. Analysis of the relation between parity and cause of death for 1.2 million women aged 45-74 years revealed that parous women had lower mortality from breast, ovarian, and endometrial cancer than did nulliparous women but a higher mortality from diabetes mellitus, gallbladder disease, cancer of the uterine cervix, nephritis and nephrosis, hypertension, ischaemic and degenerative heart disease, cerebrovascular disease, and all causes of death. There is a parallel between the long term effects of pregnancy and of oral contraceptives on health.
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PMID:Long term effects of childbearing on health. 408 66

This is a general review of the types of steroid contraceptives, their mode of action and efficacy, and major complications, including thromboembolism, cancer, jaundice, diabetes and hypertension. Tables show combined and sequential pills available in Belgium, by brand name, manufacturer, and composition. About 300,000 Belgian women use the pill. Since endometrial cancer is probably, and cervical cancer certainly, not enhanced by the pill, the maternal death rate among pill users is about 5% of the rate among unprotected sexually active women.
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PMID:[Hormonal contraception]. 472 79

This prospective study determines the presence of a consistent endocrine disturbance in patients with endometrial carcinoma. A major requirement of the study was an unbiased control group matched as to age, race, economic status, and primary reason for referral. All patients with untreated endometrial carcinoma or postmenopausal bleeding were studied and grouped into: 1) endometrial carcinoma (n=56), and 2) atrophic endometrium (n=83), or the "bleeding" controls. Average age of patients with carcinoma was 63.9 years and that of controls, 61.3 years. Factors studied were glucose metabolism, estrogenic activity, gonadotropin excretion, obesity, hypertension, time of climacteric, fertility, and menstrual history. By averaging deviations from ideal weight, cancer patients were found to be 13.1 pounds heavier than the control group (49.8 pounds vs. 36.7 for the controls). Analysis of fertility data showed that age at time of marriage in patients who were parous compared with those who were nulliparous was 20.1 and 26.8 years respectively for the carcinoma group, and 20.4 and 27.5 years for the bleeding controls. Of parous cancer patients, 6.3% used contraception vs. 13% of the controls. These data do not suggest that pregnancy prevention by late marriage or contraception plays a significant role in the later development of endometrial carcinoma. Hypertension, time of menopause, diabetes, estrogenic activity, and gonadotropin excretion did not exhibit significant effects in the development of carcinoma. The findings support those of Corscaden, Fertig, and Gusberg that obesity and infertility are statistical concomitants with endometrial carcinoma but contradict current belief that there is direct evidence of abnormal endocrine state (e.g., glucose metabolism, estrogen stimulation, or anterior pituitary activity).
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PMID:Endocrine factors in endometrial carcinoma. A preliminary report. 601 48

Epidemiological data on 1017 cases of primary cancer of endometrium in Israel diagnosed over a 7-year period are presented. Incidence of corpus cancer in Israel has not changed in the last decade; the mean incidence for the current study is 18.73/100,000 women above the age of 25. Eight percent of patients were above the age of 51, with a steep increase of incidence being found above the age of 35. Endometrial carcinoma was four to five times more prevalent in Jewish women of European-American origin than in those of Asian-African background. In 85% of the patients diagnosis was made while the disease was in Stage I. A strong correlation was found between endometrial cancer and infertility, but no correlation was found with diabetes and hypertension. The five-year survival rate in the present survey was 65.0%. Factors affecting prognosis and clinical stage of the disease at diagnosis, degree of myometrial invasion, tumor differentiation, age of the patient and type of treatment are discussed.
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PMID:Endometrial cancer in Israel, 1969-1975. 613 Sep 92

Patients with endometrial carcinoma (N = 1113) were treated by conventional therapy, using surgery and radiotherapy, complemented by daily administration of 100 mg oral medroxyprogesterone acetate (MPA) for a 2-year period. Only 7.3% of the malignancies were at an advanced clinical stage (III or IV), whereas 75.9 and 16.8% of the carcinomas were detected at clinical stages I and II, respectively. The 5-year survival rate was 71.0% overall, and 77.8%, 61.0, 29.0, and 5.3 for clinical stages I, II, III, and IV, respectively. Patients with anaplastic carcinoma (grade 3) at all clinical stages had significantly lower survival rates than had patients with well-differentiated (grade 1) and moderately differentiated (grade 2) adenocarcinomas. Death of grade 1, grade 2 and grade 3 endometrial carcinoma during the first 2 years occurred in 4.7, 6.8, and 18.2% of cases, respectively, in stage II, indicating that adjuvant MPA cannot totally prevent the progression of endometrial malignancy. The incidence of anaplastic endometrial carcinoma increased with the spread of the disease. It often appeared in patients with low body weight or a second invasive malignancy, but seldom occurred in young patients or patients with diabetes, uterine myoma, or a history of previous estrogen use. The worsened prognosis associated with old age, low body weight, and presence of a second invasive malignancy thus seems at lest partly due to the increased incidence of anaplastic carcinoma, which, on the other hand, did not contribute to the decreased 5-year survival rate of patients with diabetes or severe hypertension.
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PMID:Clinical outcome in endometrial cancer. 621 34

Endometrial cancer is the cause of considerable morbidity among women, but the disease has been underrated and its management more casual than its virulence warrants. Endometrial carcinoma is the most frequently diagnosed invasive neoplasm of the female genital tract in the US, and is third in incidence after breast and colonic cancer. The white population of the US has the highest age standardized incidence of endometrial cancer in the world, India and Japan have the lowest, and the European countries occupy intermediate positions. Between 75% and 80% of women diagnosed with endometrial cancer are postmenopausal, and the mean age at diagnosis is about 60 years. In many cases endometrial hyperplasia is misdiagnosed as frank malignancy. The predisposing factors for endometrial cancer seem to be obesity, hypertension, diabetes mellitus or an abnormal glucose tolerance curve, and prolonged or unopposed estrogen stimulation. Raised estrogen levels may occur in the following situations: 1) women with functioning ovarian tumors that produce estrogen; 2) women with polycystic ovarian disease; 3) women with ovarian dysgensis (Turner's syndrome) managed with estrogen replacement therapy; 4) women taking high estrogen sequential oral contraceptives (OCs); and 5) women undergoing estrogen replacement therapy. There is an increased risk of endometrial carcinoma associated with nulliparity. Carcinoma of the endometrium occurs in a variety of subtypes, the most frequent being adenocarcinoma, followed by adenocanthoma, adenosquamous carcinoma, clear cell carcinoma, papillary adenocarcinoma, and secretory carcinoma. Overall 5-year survival rates are 72% for adenocarcinoma, 68% for adenocanthoma, and 26% for adenosquamous carcinoma. The true extent of endometrial cancer can be ascertained only after exploratory laparotomy and then various therapies may be used according to the stage of the disease.
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PMID:Carcinoma of the endometrium. 637 16

In a population-based study 923 asymptomatic women with diabetes aged 40 to 70 years were investigated by aspiration curettage. The samples were evaluated histologically. During the initial screening 4 histologically proved endometrial cancers were diagnosed. All cancer patients were additionally obese and had hypertension, with one exception they were also nulliparous. During the same period the expected number of cases for all investigated women was estimated to 0,74. The expected number of cases limited to those with diabetes, obesity and hypertension was 0,31; and limited to those with diabetes, obesity, hypertension and nulliparity was 0,1, respectively. Additionally 4 cases of adenomatous hyperplasia of the endometrium were identified. The long-term impact on morbidity and mortality of endometrial cancer within the investigated population at risk cannot be assessed as yet.
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PMID:[Screening for endometrial carcinoma in a group at risk]. 649 87

This article summarizes the major risks and benefits of oral contraceptive (OC) use for specific categories of users. Major risks associated with OC use include vascular and circulatory disorders, hypertension, cancer, and other conditions such as gallbladder disease. There are also numerous minor side effects, e.g., breast tenderness, weight changes, yeast infections. Most of these side effects are attributed either to estrogen or progestin, which mimic excesses or deficiencies in the natural hormonal balance. These symptoms can often be reversed through alterations in the hormonal content of the OC. There have been numerous recent reports regarding the protective effect of OC use against conditions such as benign breast disease, ovarian and endometrial cancer, pelvic inflammatory disease, ectopic pregnancy, and rheumatoid disease. The risks and benefits for potential users can only be evaluated through reference to data from the relevant population group, taking into account factors such as age, race, heredity, potential predisposition for disease, and social habits. Information about the risk of medical problems in specific population groups must be weighed against the risk for those problems in the same population when combined with OC treatment. The benefits of the drug must also be weighed against the number and degree of risks found for the specific user. The convenience and efficacy associated with OCs can far outweigh the risks, inconveniences, and less impressive efficacy of other contraceptive methods in many cases. However, women over age 35 years, especially smokers, should use alternative methods of contraception. New hormonal contraceptive formulations and different modes of drug delivery are currently under development. However, several years of scientific investigation will be required to evaluate the longterm advantages or disadvantages of the newer experimental drugs compared with present OCs.
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PMID:The pill: a closer look. 655 6

A cohort of 23 233 women who had received estrogen prescriptions was recruited for a prospective study of estrogen therapy and the associated risk of endometrial cancer. For a detailed study, a comprehensive questionnaire was mailed to 735 randomly sampled cohort members, and 89 per cent of them responded. Estrogen exposure and its implications were described in a preceding paper (part I). The present paper reports the distribution in the cohort sample of personal features known to be risk factors for endometrial cancer. A comparison with results from various materials derived from population-based surveys and case-control studies implied that the cohort members might have a lower proportion of nulliparity (infertility) and a somewhat higher prevalence of hypertension. Differences in the distributions of age at menarche or menopause, weight, height and prevalence of diabetes were according to these comparisons slight and probably without clinical significance. It was concluded that the prevalence of risk factors for endometrial cancer other than estrogen exposure was not higher in the cohort than in the background population. Moreover, approximately one-fifth of the estrogen takers had been freed of their risk through hysterectomies.
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PMID:Characteristics of estrogen-treated women. A descriptive epidemiological study of a Swedish population. Part II. 663 3

The incidence of endometrial cancer has been on the increase in Japan. To clarify the risk factors for endometrial cancer in Japanese women, we and our collaborators conducted a strictly controlled case study. A total of 19 Japanese medical centers participated in the study. Sexual abstinence, sterility, postmenopausal status and menstrual irregularity after the age of 30 years appear to be factors which significantly raise the relative risk for endometrial cancer. Conventionally, hypertension, diabetes, obesity and dietary habits have been emphasized as risk factors, however, these factors did not make a significant difference in our study. Accordingly, we suggest that examination for endometrial cancer should be performed on postmenopausal Japanese women and on women with menstrual irregularity who develop abnormal genital bleeding.
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PMID:[Case controlled study of endometrial cancer--high risk factors in Japanese women]. 666 73


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