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

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

Birth weight is a popular topic, because it is precisely recorded, a major determinant of infant survival, associated with infant mortality, and health outcomes later in life. Low birth weight (LBW) is a predisposing factor for metabolic abnormalities such as atherosclerosis, renal disease, non-insulin diabetes mellitus, asthma, low IQ, hypertension, obesity, psychological distress. They have all been reported to be more common among those who were small at birth. Due to lack of studies suggesting a linkage between LBW and diseases of liver; evidences, which support the hypothesis on the creation of a link between LBW, an indicator of unfavourable intrauterine environment, and liver diseases emerging in the adult life, and possible direct associations of LBW with liver diseases, e.g., hepatitis, non-alcoholic fatty liver disease, cirrhosis, hepatoblastoma, or hepatocellular carcinoma were discussed. The associations between LBW and hepatitis vaccination as well as paediatric parental nutrition were also noted.
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PMID:Low birth weight: a possible risk factor also for liver diseases in adult life? 1367 7

To assess contexts of adherence with hypertension care among Hmong Americans, in-person interviews were conducted with a convenience sample of 323 adults using culturally adapted survey instruments. The mean age of participants was 58 years; 91% had no education, and 86% spoke no English. Although more than 90% had health insurance and were treated with medications, the rate of blood pressure control was low (27%). A majority (> 90%) suffered from psychological distress, and 46% lived with physical illness. Over 50% reported nonadherence with hypertension care. Respondents who were 50 years of age or older, had no physical illness, did not know that hypertension was preventable, or believed that American medicine was too strong, were more likely to report nonadherence with proper medication consumption. Findings suggest that adherence was not due to lack of health care coverage; instead, it may be due to gaps in health services.
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PMID:Adherence with hypertension care among Hmong Americans. 1608 2

In a retrospective study from the Dutch Mononitrate Quality of Life (DUMQOL) Study Group, the authors found that patients with angina with concomitant diabetes or hypercholesterolemia derived more benefit from changing over to a once-daily nitrate treatment regimen than did patients without angina. The aim of this study was to assess this issue prospectively. In an open-label study, patients with stable angina pectoris from facilities in Germany, Portugal, and me Czech Republic were treated for 3 months with multiple daily doses and subsequently for 3 more months with once-daily isosorbide mononitrate/dinitrate. After the first and second 3-month periods, they were assessed by a validated QOL battery including domains for mobility, side effects, life satisfaction, anginal pain, and psychological distress. In the 1045 patients who participated in the study, the mean summary domain scores varied from 5 to 16 points and score improvements from 1.6 to 4.3 points. In the patients without concomitant hypertension and smokers, domain scores improved less than they did in the patients without, with differences in domain score improvements up to 1.0 points (P<0.001), which is substantial considering the range of improvement was between 1.6 and 4.3 points. In the patients with diabetes mellitus or hypercholesterolemia, a reverse pattern was observed with differences in domain score improvements up to 0.4 points (P<0.05). Patients with angina with diabetes or hypercholesterolemia derived more benefit from an asymmetric regimen of isosorbide mononitrate/dinitrate than did patients without. Patients with angina with hypertension and smokers benefited less. Differences in endothelial function may be involved.
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PMID:Chronic nitrate therapy in patients with angina with comorbidity. 1677 58

Postpartum is a crucial period for a mother. During this period a mother is going through the physiological process of uterine involution and at the same time adapting to her new role in the family. Many postpartum complications occur during this period. Among the important obstetric morbidities are postpartum hemorrhage, pregnancy related hypertension, pulmonary embolism and puerperal sepsis. Common surgical complications are wound breakdown, breast abscess and urinary fecal incontinence. Medical conditions such as anemia, headache, backache, constipation and sexual problems may also be present. Unrecognized postpartum disorders can lead to physical discomfort, psychological distress and a poor quality of life for the mothers. Providing quality postnatal care including earlier identification of the problems (correction) and proper intervention will help the mother to achieve full recovery and restore her functional status back to the pre-pregnancy state sooner.
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PMID:"Postpartum morbidity--what we can do". 1762 74

From the 1990s, various studies have provided data on health-related quality of life (HRQOL) in patients with chronic kidney disease (CKD) in stages previous to the initiation of kidney replacement therapy (KRT). The characteristics of these patients (Strength of Recommendation C) are: Patients with CKD have a deterioration in their HRQOL when compared with the general population. This deterioration is associated with various sociodemographic variables: age, gender, marital status, educational level and income. The deterioration is partly explained by the diseases that cause CKD (hypertension and diabetes), associated comorbid conditions (especially cardiovascular) and complications of CKD (anemia and malnutrition-inflammation). The progressive decline in glomerular filtration rate (GFR) is associated with a progressive deterioration of HRQOL, as well as an increase in the frequency and severity of certain symptoms and the impact (psychological distress) they cause. Physical dimensions are more affected than mental or social dimensions. Mental disturbances in patients with CKD can be summarized as follows: - There is an association between high levels of anxiety and low levels of sense of coherence with a reduction in wellbeing that in turn affects functional capacity for activities of daily living. - Psychological impairment from symptoms increases as GFR worsens. - This is a high level of correlation between perception of disease, depression and satisfaction with life. - Impairment of mental dimensions is greater in male, young, divorced, unemployed, smoker, and obese patients and in those who take more medication and have greater comorbidity. - Impairment of mental dimensions is negatively associated with albumin levels and hemoglobin. The recommended questionnaire for measurement of HRQOL in this type of patients is the SF-36. The SF-12 can be used as a shorter alternative and is suitable for evaluation of groups of patients.
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PMID:[Psychological disturbances and deterioration of health-related quality of life of patients with stage 3-5 chronic kidney disease (not on dialysis)]. 1901 40

The intermediate processes through which the various unmarried states can increase the risk of subsequent cardiovascular disease mortality are incompletely understood. An understanding of these processes and how they may vary by gender is important for understanding why marital status is strongly and robustly associated with subsequent cardiovascular disease. In a prospective study of 13,889 Scottish men and women (mean age 52.3, Standard Deviation: 11.8 yrs, range 35-95, 56.1% female) without a history of clinically diagnosed cardiovascular disease, we examined the extent to which health behaviours (smoking, alcohol, physical activity), psychological distress (General Health Questionnaire-12 item) and metabolic dysregulation (obesity levels, and the presence of hypertension and diabetes) account for the association between marital status and cardiovascular mortality. There were 258 cardiovascular deaths over an average follow up of 7.1 (Standard Deviation=3.3) years. The risk of cardiovascular mortality was greatest in single, never married men and separated/divorced women compared with those that were married in gender stratified models that were adjusted for age and socio-economic group. In models that were separately adjusted, behavioural factors explained up to 33%, psychological distress explained up to 10% and metabolic dysregulation up to 16% of the relative change in the hazard ratios in the observed significant associations between marital status and cardiovascular mortality. Behavioural factors were particularly important in accounting for the relationship between being separated/divorced and cardiovascular mortality in both men and women (33% and 21% of the relative change in the hazard ratios, respectively). The findings suggest that health behaviour, psychological distress and metabolic dysregulation data have varying explanatory power for understanding the observed relationship between cardiovascular disease mortality and unmarried states.
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PMID:Marital status, gender and cardiovascular mortality: behavioural, psychological distress and metabolic explanations. 1950 42

Obesity is the sixth major risk factor for the overall burden of disease globally, and is associated with a constellation of metabolic derangements starting early in life. Features of metabolic syndrome (MS) were assessed among obese young individuals in the UAE. Of the 260 obese young people screened, 44% were found to have MS. Prevalence of MS was more among boys than girls and there was a significant association with a positive family history of obesity, diabetes or hypertension. Subjective report of psychological distress was found in 95%, and significant depressive symptoms were present among three-quarters of those with MS. The prevalence and magnitude of obesity and its sequelae including MS is increasing world wide, and newly modernized countries are particularly at risk. Child health professionals must be aware of this and attempts should be made for early identification and necessary intervention including attention to psychological issues.
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PMID:Metabolic syndrome among the young obese in the United Arab Emirates. 2003 59

This study examined the associations among chronic health conditions, sociodemographic factors, and depressive symptomatology in older married couples. Data from the 2004 wave of the Health and Retirement Study (n = 2,184 couples) were analyzed. Results indicated a reciprocal relationship in depressive symptoms between spouses. Additionally, post hoc analyses indicated that husbands' stroke and high blood pressure were related to increased depressive symptomatology among wives. Beyond the reciprocal relationship, husbands were unaffected by wives' health. These results suggest sex differences underlying psychological distress in the context of physical health among older adults and that older women with husbands who have high levels of depressive symptomatology, high blood pressure, or a history of stroke may be at particular risk of experiencing depressive symptoms.
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PMID:Physical health and depression: a dyadic study of chronic health conditions and depressive symptomatology in older adult couples. 2049 55

There is conflicting evidence regarding the association of hypertension with psychological distress, such as anxiety and depressive symptoms. The association may be because of a direct effect of the raised blood pressure, adverse effects of treatment, or the consequences of labeling. In a representative study of 33 105 adults (aged 51.7+/-12.1 years; 45.8% men), we measured levels of psychological distress using the 12-item General Health Questionnaire and collected blood pressure, data on history of hypertension diagnosis, and medication usage. Awareness of hypertension was confirmed through a physician diagnosis or the use of antihypertensive medication, and unaware hypertension was defined by elevated clinic blood pressure (systolic/diastolic > or =140/90 mm Hg) without previous treatment or diagnosis. In comparison with normotensive participants, an elevated risk of distress (General Health Questionnaire score > or =4) was observed in aware hypertensive participants (multivariable adjusted odds ratio: 1.57 [95% CI: 1.41 to 1.74]) but not in unaware hypertensives (odds ratio: 0.91 [95% CI: 0.78 to 1.07]). Antihypertensive medication and comorbidity were also associated with psychological distress, although this did not explain the greater risk of distress in aware hypertensives. We observed a weak curvilinear association between systolic blood pressure and distress, which suggested that distressed participants were more likely to have low or highly elevated blood pressure. These findings suggest that labeling individuals as hypertensive, rather than having elevated blood pressure, per se, may partially explain the greater levels of distress in patients treated for hypertension.
Hypertension 2010 Sep
PMID:Hypertension awareness and psychological distress. 2104 1


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