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)

Although it is well known that diabetics have high mortality rates due to ischemic heart disease (IHD), controversies still exist about the severity of coronary artery disease in diabetics compared to nondiabetics. We compared coronary arteriographies of 50 diabetics with IHD to those of 50 nondiabetics with IHD. In regard to coronary risk factors, incidence of obesity was significantly higher in diabetics. Incidence of hypertension, hypercholesteremia, hyperuricemia was higher, although not significant, in diabetics. Incidence of smoking was significantly higher in nondiabetics. The diabetic group showed a significantly higher incidence of patients with more than two or three diseased vessels, and a significantly higher number of diseased coronaries with more than 50% stenosis per patient compared to nondiabetics (5.6 +/- 3.7 vs 3.7 +/- 3.2). The distribution of diseased coronaries with more than 75% stenosis showed no difference between diabetics and nondiabetics. The incidence of coronary spasm was significantly lower in diabetics (12% vs 28%). The high incidence of multiple vessel disease in diabetics was thought to be due to other complicated coronary risk factors, especially hypertension and hypercholesteremia.
 ...
PMID:[Coronary artery disease in diabetic patients]. 157 50

Fifty-four patients hospitalized in Niger for complications from hypertension between September 1988 and October 1989 were studied. The following complications were observed: left ventricular hypertrophy (56%), coronary vascular defect (35%), left heart deficiency (26%), cardiac failure (32%), retinopathy (56%), renal insufficiency (35%), and stroke (24%). The most frequent risk factor was Type A personality (76%), followed by stress (48%), excess weight (37%), tobacco use (35%), hyperuricemia (35%), hypercholesteremia (17%), and diabetes (15%). Complications from hypertension may well become a major problem for African countries as they develop.
 ...
PMID:Hospitalizations in Niger (West Africa) for complications from arterial hypertension. 158 Oct 14

The influence of obesity on the development of ischemic heart disease (IHD) was studied in 103 diabetic patients over 65 years of age. The patients were divided into three groups on the basis of their body mass index: lean, less than 20; normal, 20-25; obese, greater than 25. The incidence of IHD was significantly (p less than 0.01) higher in the obese group than in the other groups (43.2 vs. 18.8 and 16.3%). The age, sex distribution, duration and control of diabetes mellitus, methods of diabetic therapy, and prevalence of hypertension, hyperuricemia and smoking were not significantly different in the three groups. The level of serum triglyceride was higher and that of high-density lipoprotein cholesterol (HDL-C) was lower in the obese group than in the other groups, but the prevalence of IHD was significantly higher in the obese patients without hypertriglyceridemia and/or low HDL-C than in the normal group (p less than 0.05). These results suggest that obesity is a risk factor for development of IHD in elderly diabetic patients independently of other known risk factors.
 ...
PMID:Role of obesity in development of ischemic heart disease in elderly diabetic patients. 162 45

The objective of treating patients with hypertension is not simply to reduce blood pressure but rather to prevent the associated morbidity and mortality. Recent assessments of clinical trials have shown that while the risk of stroke is consistently lower with antihypertensive therapy, the same degree of success has not been demonstrated for coronary artery disease (CAD). Although there are many explanations of why we have not done as well in preventing CAD, one possibility is that the therapy used in clinical trials, primarily thiazide diuretics and beta-adrenoreceptor blockers, has increased the patient's risk of developing coronary atherosclerosis or lethal arrhythmias. Four classes of antihypertensive agents are recommended for initial therapy--thiazide diuretics, beta-adrenoreceptor blockers, angiotensin-converting enzyme (ACE) inhibitors, and calcium entry blockers. The metabolic effects of thiazide diuretics include electrolyte disturbances (hypokalemia, hypomagnesemia, and hyponatremia), dyslipidemia (increased triglycerides), abnormalities of glucose metabolism (hyperglycemia, hyperinsulinemia, and peripheral insulin resistance), and hyperuricemia. beta-Adrenoreceptor blockers have many of the same metabolic adverse reactions. beta-Adrenoreceptor blockers without intrinsic sympathomimetic activity (ISA) also cause dyslipidemias (lowered high-density lipoprotein cholesterol and increased triglycerides) and abnormalities of glucose metabolism (hyperglycemia, hyperinsulinemia, and peripheral insulin resistance). beta-Adrenoreceptor blockers with ISA and third-generation beta-blockers with selective partial agonist activity (celiprolol and dilevalol) do not cause dyslipidemia and to date do not appear to induce abnormalities in glucose metabolism. ACE inhibitors may decrease triglycerides and increase high-density lipoprotein cholesterol, and captopril may improve insulin sensitivity. Calcium entry blockers are metabolically neutral.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Metabolic considerations in the choice of therapy for the patient with hypertension. 167 Nov 90

Eighty-four consecutive black patients who had confirmed but untreated hypertension participated in a double-blind randomized clinical trial involving potassium supplement (64 mmol/day) versus bendrofluazide (10 mg/day). Diastolic blood pressure (DBP) of the 42 patients receiving potassium supplementation (group A) decreased from a mean (+/- SD) of 108 +/- 3 to 88 +/- 4 mm Hg (p less than 0.001; paired t test) after 28 weeks of medication. DBP of the 42 patients receiving bendrofluazide (group B) decreased from a mean of 108 +/- 2 to 84 +/- 4 mm Hg (p less than 0.001; paired t test). There was no statistically significant difference between the magnitude of decrease in DBP in group A and B patients (unpaired t test). No clinical, biochemical, or ECG abnormalities occurred in group A patients. Eight group B patients showed hyperuricemia; 4 patients in the same group had hyperglycemia and 3 other patients had hypokalemia. The results support the notion that potassium supplementation may be an effective therapeutic approach to mildly hypertensive blacks.
 ...
PMID:Potassium supplementation versus bendrofluazide in mildly to moderately hypertensive Kenyans. 171 14

Exogenous obesity is characterized hemodynamically by expanded intravascular (plasma) volume associated with an increased cardiopulmonary volume and cardiac output. In contrast, essential hypertension is related to an increased total peripheral resistance that is more or less uniformly distributed throughout the component organ circulations associated with a contracted plasma volume in proportion to the height of arterial pressure. Thus, both cardiac output and total peripheral resistance are elevated in obesity hypertension, and both impose a load on the left ventricle, resulting in both a volume and a pressure overload left ventricular hypertrophy. Although renal vascular resistance is not as increased as it is in lean hypertensive patients, these patients are subjected to hyperfiltration and proteinuria. Additionally, these hemodynamic alterations coexist with carbohydrate intolerance, hyperinsulinemia, hyperlipidemia, and hyperuricemia. With weight reduction and associated pressure reduction, the hemodynamic and metabolic changes reverse toward normal. However, should this not be achievable, the angiotensin converting enzyme inhibitors and calcium antagonists provide rational physiological approaches to drug therapy. With these agents pressure reduction is achieved through a fall in vascular resistance without intravascular volume expansion, and this is associated with reduced left ventricular mass and preserved cardiac and renal function, and without exacerbation of preexisting metabolic perturbations. Hence, these two classes of antihypertensive agents may provide a rational and physiological means for reversing the pathophysiological alterations of hypertensive disease in those obese patients in whom weight control is not possible.
Hypertension 1992 Jan
PMID:Obesity hypertension. Converting enzyme inhibitors and calcium antagonists. 173 Apr 48

Forty-two women with pregnancies complicated by pre-eclampsia and heavy proteinuria greater than or equal to 5 g/24 h were referred for conservative management to the high-risk obstetric unit in the John Radcliffe Hospital, Oxford, over a period of 5 years. Hyperuricaemia preceded the onset of heavy proteinuria in all 42 women. Most of the women had severe hypertension, but none developed eclampsia and there were no major maternal complications. Delivery was necessary within 2 weeks of onset of severe proteinuria in 88.1% of cases, although in some very preterm pregnancies delivery could be deferred for 3 or more weeks. Thirty-five women (83%) were delivered by caesarean section, 91% of whom were delivered urgently before the onset of labour. The high rate of urgent preterm operative delivery underlines the uncertainty of advanced pre-eclampsia and the need for close monitoring if delivery is to be deferred. Perinatal mortality was high; all the perinatal deaths occurred in babies of less than 29 weeks gestation. Despite heavy proteinuria, postpartum recovery was good. Three months after delivery, all but one patient had no significant proteinuria. There was no evidence of residual renal dysfunction. Although the outlook for pre-eclampsia with heavy proteinuria is limited, in a few cases pregnancy can be prolonged for significant periods of time without apparently prejudicing maternal safety and permitting enhancement of maturity at birth. The observations justify cautious conservative management even when heavy proteinuria is present.
 ...
PMID:Prognosis for pre-eclampsia complicated by 5 g or more of proteinuria in 24 hours. 173 13

The hypertensive disorders of pregnancy are a frequent cause of neonatal morbidity and mortality. 259 newborns of hypertensive women were study to establish the relationship between some maternal findings and the subsequent neonatal complications. The severity, early onset of hypertension, proteinuria and the gestation of 32 week or less, are related with special risk of small-for-date, anoxia, seizures and neutropenia. Preeclampsia was related with foetus more compromised. Also hyperuricemia, thrombocytopenia and cesarean section were light predictors of neonatal trouble. These findings can orientate the neonatologist to select the newborns prone to complications, watching them closely to start the treatment, if necessary, as soon as possible.
 ...
PMID:[Prediction of complications in children of hypertensive mothers]. 176 48

Between December 15, 1988 and November 30, 1990, the application of Rome and New York criteria enabled the diagnosis of 60 cases of gout among patients with arthritis or hyperuricemia seen as out-patients or hospitalised in the Department of Rheumatology of the Brazzavile T.H.G. There were 57 men and 3 women, with a mean age of 51. Gout is the primary form of inflammatory arthropathy in adults in the Congo. Affecting all socio-professional groups, it is diversely associated with obesity, alcoholism, hypertension and diabetes. Initial involvement affects the big toe. Oligo and polyarticular forms predominate because of the absence or delay in specific treatment. This series included 30 per cent of cases of chronic gout. Evidence of renal impairment was found in one third of patients. However, urate lithiasis was absent. Tophi were found preferentially over the elbows. Sickle cell disease was responsible for one case of tophaceous gout. In contrast with the results of studies undertaken before the 1980s, gout is seen to be a common condition in equatorial Africa.
 ...
PMID:[Epidemiological and clinical aspects of gout in equatorial Africa. Apropos of 60 cases followed in the Department of Rheumatology of the Teaching Hospital Center in Brazzaville]. 178 Jun 67

A retrospective study of 194 patients is carried out. Patients were divided into two groups: 154 patients with acute cerebrovascular accident (ACA) and 40 patients without vascular pathology, hospitalized for other causes. A descriptive analysis of these patients is made with respect to age, sex, type of ACA, previous ACA and potential relationship between the type of this first ACA and the one motivating current hospitalization. In addition, ACA is related to risk factors (hypertension, dyslipemia, diabetes, cardiopathy). In our series, variables that can be considered as risk factors, with significant differences between both groups, are: HTA, tobacco consumption, cardiopathy, dyslipemia (hypercholesterolemia and hypertriglycemia, hyperuricemia and diabetes. Alcoholism, anticoagulation, antiaggregation or polyglobulia were not risk factors. In 33.2% of patients with current ACAs, there were antecedent of clinically documented cerebrovascular pathology; one thing of them were transitory cerebral ischemias and more than half of them, cerebral infarcts. In conclusion, we stressed the role of primary and secondary prevention acting against risk factors, given the recurrence of this pathology and the irreversibility of the injuries once happened.
 ...
PMID:[Cerebrovascular accident: study of risk factors and development in 154 cases]. 179 Feb 78


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>