Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The author submits a review on the combined prevalence of diabetes and hypertension which increases with age and is a basic risk factor of vascular cardiac and cerebral complications. It is associated with a higher incidence of obesity, hypertriglyceridaemia and reduced HDL-cholesterol. It is part of the metabolic syndrome X, the syndrome of insulin resistance. Hypertension is found in 60-80% type 2 diabetics and in 40% type 1 diabetics. Obesity is found on average in 40% type 1 diabetics and 85% type 2 diabetics. Macroangiopathy leads to ischaemic heart disease, cerebrovascular episodes and ischaemia of the lower extremities. British investigations revealed that long-term intensive control of the blood sugar level and hypertension reduced in particular the incidence of microvascular complications. A marked decline of the morbidity and mortality of diabetics was recorded after effective treatment of hypertension maintaining blood pressure readings below 130/80 mm Hg. The author discusses also contemporary views on the etiopathogenesis of hypertension in diabetic subjects who may suffer from different types of hypertension. The combination of diabetes and hypertension has obviously a multifactorial etiology--genetic predisposition and several external mechanisms. In the pathogenesis of hypertension an important part is played by insulin resistance and enhanced activity of the sympathetic nervous system. Reaven's hypothesis of metabolic syndrome X was supplemented in recent years by the role of the sympathoadrenal system. From the therapeutic aspect effective reduction of hypertension by correct selection of antihypertensives is most important.
 ...
PMID:[Hypertension and diabetes mellitus--pathophysiology and risk]. 1095 57

Multiple metabolic syndrome (MMS) implies a frequent coincidence of four basic serious metabolic risk factors for subsequent manifestation of cardiovascular disease. The latter include: central type obesity, arterial hypertension, dyslipoproteinaemia and diabetes mellitus type II (non-insulin-dependent diabetes mellitus--NIDDM). MMS is also described as syndrome X, Reaven's syndrome, insulin resistance syndrome, metabolic syndrome or as the "deadly quartet". NIDDM in humans is conceived as a syndrome the pathogenesis of which is multifactorial and it is not an unequivocal nosological unit. It many epidemiological studies reliable evidence was provided that in the aetiology of NIDDM a marked genetic influence is involved. Its genetic predisposition is conditioned by the interaction of candidate genes and a complex of influences of the external environment. Evidence was provided that MMS phenotypes cumulate only in members of some families. The mode of genetic transmission of NIDDM remains obscure.
 ...
PMID:[Genetic predisposition for multiple metabolic syndrome. Part 1. Diabetes mellitus type 2--incidence and prevalence]. 1095 28

Risk factors contributing to the potential inter-relationship between obesity and hypertension include insulin, fatty acids, and angiotensin II. All of these mediators are either produced by or act on adipocytes, influence fat cell metabolism, and have effects on the cardiovascular system. Moreover, these three mediators have several potential sites for positive feedback interaction, thus exacerbating the influence of any single risk factor. The purpose of this review is to highlight recent advances in our understanding of the influence of insulin, fatty acids, and angiotensin II on fat cell metabolism. Special emphasis is placed on potential adipose-related mechanisms of these factors, which would predictably elevate blood pressure. Given the prevalence of obesity and hypertension in the American population, delineation of potential pharmacologic targets that would influence both of these disease states is of primary importance to the successful treatment of these diseases of the metabolic syndrome X.
 ...
PMID:Fat cell metabolism: insulin, fatty acids, and renin. 1098 Nov 39

Metabolic syndrome X includes glucose intolerance or type 2 diabetes, dyslipidemia and arterial hypertension which are classical cardiovascular (CV) risk factors. In course of time, other CV risk factors have been added to the syndrome: rheological alterations, endothelial dysfunction, anomalies in the coagulation/fibrinolysis system, microalbuminuria and so on.... Insulin resistance is the cornerstone of metabolic syndrome X, with secondary hyperinsulinism. Upper body obesity is associated with metabolic syndrome X. Simple waist measurements can detect the subjects (10-15% of the population) at increased CV risk with a sensitivity of 70%. This is invaluable for such a simple and cheap test. Diet is the first step in treating these patients and reducing caloric intake is necessary in most of them. Saturated fats will be replaced by polyunsaturated and mono-unsaturated ones. Long-chain carbohydrates with low glycemic index will be suggested. Regular physical activity will be promoted. If these life style modifications fail, drugs can be added: biguanide and glitazone are good candidates. Orlistat has improved metabolic syndrome X on a long-term basis. Drugs that could increase insulin resistance are to be avoided.
 ...
PMID:[The importance of syndrome X in daily practice]. 1119 91

The author exposes the present concept of metabolic syndrome X, which is a complex of Type II diabetes, obesity, hypertension and vascular problems. This syndrome has been known for many years, but it has been individualized as such only recently. This is due to the huge importance that obesity is reaching in developed countries, especially in the U.S.A. Today this is a very important health problem. In this work, in addition to the description of the syndrome, which is purely an internal medicine issue, its relation to some women-specific problems is also explained, especially to the so-called polycystic ovary.
 ...
PMID:[Metabolic syndrome X in women]. 1120 48

Hypertension and diabetes are the basic risk factors of atherosclerosis and its complications. At present new associations are sought which will enable us to describe more satisfactorily the mutual relationship of hypertension, metabolic disorders and cardiovascular disease. One of the systems involved in all substantial physiological processes is the autonomic nervous system. Stimulation of the sympathetic nervous system by chronic stress causes in addition to an elevated pulse rate and cardiac minute output also activation of another important pressor mechanism--the renin-angiotensin-aldosterone system. Increased activity of the sympathetic nervous system plays a part also in the development of impaired glucose and lipid metabolism, which are very frequent in hypertonic subjects. Hyperinsulinaemia, hypertriglyceridaemia and reduced HDL-cholesterol concentration are associated with a decline of the insulin capacity to take up glucose and deposit glycogen and together with a raised blood pressure create the so-called metabolic syndrome of insulin resistance (syndrome X, Reaven's syndrome).
 ...
PMID:[Stress-induced hypertension and diabetes mellitus]. 1139 76

The discovery of a link between in utero experience and later metabolic and cardiovascular disease is one of the most important advances in epidemiology research of recent years. There is increasing evidence that alterations in the fetal environment may have long-term consequences on cardiovascular, metabolic, and endocrine pathophysiology in adult life. This process has been termed programming, and we have shown that undernutrition of the mother during gestation leads to programming of hyperphagia, obesity, hypertension, hyperinsulinemia, and hyperleptinemia in the offspring. Using this model of maternal undernutrition throughout pregnancy combined with postnatal hypercaloric nutrition of the offspring, we examined the effects of IGF-I therapy. Virgin Wistar rats (age 75 +/- 5 d, n = 20 per group) were time mated and randomly assigned to receive food either ad libitum or 30% of ad libitum intake (UN) throughout pregnancy. At weaning, female offspring were assigned to one of two diets (control or hypercaloric [30% fat]). Systolic blood pressure was measured at day 175 and following infusion with 3 microg/g per day recombinant human IGF-1 (rh-IGF-I) by minipump for 14 d. Before treatment, UN offspring were hyperinsulinemic, hyperleptinemic, hyperphagic, obese, and hypertensive on both diets, compared with ad libitum offspring and this was exacerbated by hypercaloric nutrition. IGF-I treatment increased body weight in all treated animals. However, systolic blood pressure, food intake, retroperitoneal and gonadal fat pad weights, and plasma leptin and insulin concentrations were markedly reduced with IGF-I treatment. IGF-I treatment resulted in a 3- to 5-fold increase in 38--44 kDa and 28--30 kDa IGF binding proteins, although in UN animals, there was an impaired and differential up-regulation of these insulin-like growth factor binding proteins following IGF-I treatment. The 24-kDa IGF binding protein representing IGF binding protein-4 was down-regulated in all IGF-I-treated animals, but the decrease was more marked in UN animals. Our data suggest that IGF-I treatment alleviates hyperphagia, obesity, hyperinsulinemia, hyperleptinemia, and hypertension in rats programmed to develop the metabolic syndrome X.
 ...
PMID:IGF-I treatment reduces hyperphagia, obesity, and hypertension in metabolic disorders induced by fetal programming. 1151 75

Chronic elevation of systemic levels of acute phase reactants and inflammatory cytokines found in patients with diabetes and the often-associated metabolic syndrome X (hypertriglyceridemia, low serum high density lipoprotein cholesterol, hypertension, and accelerated atherosclerosis) may be responsible for the increased incidence of cardiovascular problems in this population. Here we examine the contribution of adipose tissue to the systemic elevation of acute phase reactants associated with chronic hyperglycemia. We demonstrate that adipose tissue expresses a number of acute phase reactants at high levels, including serum amyloid A3 (SAA3), alphal-acid glycoprotein, the lipocalin 24p3 as well as plasminogen activator inhibitor-1 (PAI-1). Additionally, we show SAA3 is expressed at low levels under normal conditions but in the diabetic state is dramatically up-regulated in adipose tissue while down-regulated in liver. Furthermore, pro-inflammatory stimuli and high glucose can lead to the induction of SAA3 in adipose tissue in vivo as well as in the 3T3-L1 adipocyte cell line. Adipose tissue may therefore play a major role in the pathogenic sequelae of Type II diabetes, in particular the cardiovascular problems associated with prolonged hyperglycemia.
 ...
PMID:Hyperglycemia-induced production of acute phase reactants in adipose tissue. 1154 17

Overweight and obesity are recognised as responsible for an increase in vascular risk and in excess mortality due to cardio-vascular diseases. This is especially true in presence of increased visceral (central) fat distribution, a key factor for insulin-resistance, the main component of the metabolic syndrome X. Cardio-vascular risk in overweight and obese subjects appears strongly correlated with the common risk factors, more frequently present in these patients: type 2 diabetes, hypertension, lipid abnormalities. Weight reduction improves all risk factors and decreases the patient's global vascular risk. The improvement in the various risk factors is significant with a moderate weight loss (10% of the initial weight). Weight reduction should been obtained always with nutritional-hygienic means (physical activity, weight-reducing diet...) maintained for several months. Only when these approaches appear to be insufficient, the need for an associated pharmacological treatment has to be considered. Amongst the weight-reducing drugs currently available or close to be, orlistat has demonstrated its interest in the glycemic control of type 2 diabetic patients, and its favourable effect in hypertensive patients. Available clinical studies have clearly shown the more marked effect of orlistat in comparison to placebo in reducing the various risk factors. So far, few studies have been conducted to assess the effects of the specific drug therapy on the control of metabolic abnormalities and risk factors in overweight or obese patients, except in type 2 diabetic patients for whom, most of the oral anti-diabetic agents have been tested in overweight or obese diabetic population.
 ...
PMID:[Obesity and cardiovascular risk]. 1178 68

The underlying determinants of cardiovascular risk are governed by both genetic and lifestyle factors. One of the major adverse outcomes of unhealthy lifestyles is obesity, the genesis of which begins in childhood. Obesity, an important risk factor for atherosclerotic cardiovascular disease, type 2 diabetes, and hypertension, persists (tracks) strongly from adolescent years to adulthood. Secular trends toward increased obesity in the past 25 years have occurred in children and adults alike. Of interest, baseline adiposity precedes hyperinsulinemia in all age groups, independently of race, sex, and baseline insulin levels. Adiposity is an independent predictor of the risk of developing the cluster of risk variables of the metabolic syndrome X, beginning in childhood. Exposure to a multiple risk factor burden over time enhances the development of coronary atherosclerosis and hypertensive cardiovascular disease. In fact, autopsy studies in youths have shown that the extent of fibrotic atherosclerotic plaques in coronary arteries, measured antemortem, increases markedly with the presence of syndrome X risk variables. Further, in overweight children, insulin levels are associated with left ventricular mass. In young people, overnutrition, coupled with physical inactivity, leads to weight gain. Since obesity, unhealthy dietary habits, and a sedentary lifestyle are interrelated and modifiable, prevention and intervention must begin in early life. (c)2001 CHF, Inc.
 ...
PMID:Emergence of obesity and cardiovascular risk for coronary artery disease: the Bogalusa Heart Study. 1182 87


<< Previous 1 2 3 4 5 6 Next >>