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

The incidence of cardiovascular risk factors was studied in 83 renal transplant recipients: 84.3% showed at least one cardiovascular risk factor, hyperuricaemia was found in 42.2%, hypertension in 39.7%, hypercholesterolaemia in 31.3%, hypertriglyceridaemia in 27.7%, diabetes mellitus in 19.3%, obesity in 14% and nicotine abuse in 13.2% of the patients. Patients aged from 30 to 39 and 40 to 49 showed a mean incidence of 2.7 and 2.9, respectively out of the 7 investigated cardiovascular risk factors. The results demonstrate that renal transplant patients are a high-risk group for the development of degenerative cardiovascular diseases.
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PMID:[Frequency of cardiovascular risk factors in renal transplant patients (author's transl)]. 35 73

Hypertension is a powerful and widespread cardiovascular risk factor, that can be effectively treated, but is still considerably undertreated. Better control of hypertension could be achieved by enhancing case finding, stimulating antihypertensive drug prescription, and improving patient compliance through a better doctor-patient relationship. Whatever the effectiveness of the current programmes of control of hypertension in the community, it remains to develop a preventive approach based on reducing salt intake and preventing overweight in young adults.
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PMID:[Reducing the burden of hypertension on the community. From control to prevention (author's transl)]. 74 60

In connection with a population study including 703 randomly selected 55-year-old men, 20 men with the highest blood pressure were selected for a careful follow-up and treatment for 1 year. Controls without hypertension were randomly selected from the remainder of the same population. Electrocardiogram at rest and in connection with an exercise test, changes in fundus oculi, orthostatic tests, peripheral arterial blood flow, chemical analyses and other variables were recorded on three occasions during the observation year. Drug treatment was standardized. Basic treatment was induced with polythiazide, which normalized the blood pressure in the majority of the hypertensive cases. The most striking findings in the hypertensive group before treatment were, besides the high blood pressure at rest, high blood pressure during exercise, an increased peripheral blood-flow through the calves, and an increased heart rate. During treatment, the blood pressure were selected for a careful follow-up and blood-flow were almost "normalized"; the heart-rate remained elevated. The investigation shows that it is quite easy to achieve adequate reduction of blood pressure in hypertension among middle-aged men, as found in the "real world" outside the hospital. The main problem today is not to normalize the blood pressure but rather to detect hypertension and to maintain the therapy for several years. Hypertension is considered to be the cardiovascular risk factor that is probably most amenable to preventive approaches to public health.
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PMID:Detection, treatment and follow-up of hypertension in a community sample of 55-year-old men. 117 91

Sleep obstructive apnea syndrome (SOAS) is a common condition with a strong male predominance. Its incidence is more than 1 percent in the population as a whole. It exists in snorers. Both snoring and SOAS are linked to the presence of abnormalities (congenital or acquired) of the upper respiratory tract. The nocturnal cardiovascular consequences of SOAS are directly linked to apnea. Bradycardia occurs during apnea and tachycardia when ventilation restarts. Paroxysmal nocturnal hypertension is a constant feature. Even in individuals who are normotensive during the day, each restarting of ventilation is accompanied by peaking of blood pressure. The pulmonary artery pressure curve follows that of systemic blood pressure. Complications begin when SOAS has been present for several years: 1) Chronic: permanent systemic hypertension is common (56 percent of SOAS). It is often refractory to antihypertensive treatment. 2) Acute: the onset of myocardial infarction and of cerebrovascular accidents explains the heavy mortality of SOAS (37 percent at 8 years in untreated individuals with a number of episodes of apnea exceeding 20 per hour of sleep). Other acute complications are less common: acute pulmonary edema, nocturnal sudden death. These events may be prevented by treatment suppressing apnea: actuarial survival curves are then superimposable upon those of the population as a whole. Thus SOAS is a cardiovascular risk factor which is remarkably reversible by specific treatment, though which most often passes unrecognized.
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PMID:[Obstructive sleep apnea syndrome in adults and cardiovascular risk]. 130 Sep 16

Left ventricular hypertrophy (LVH) is a well defined cardiovascular risk factor and is frequently detected by echocardiography in hypertensive patients. Systolic cardiac function at rest is usually preserved in hypertension, however, diastolic function may be frequently altered. Evidence for these changes has been demonstrated by Echo-Doppler even without concomitant existence of LVH. Quantitative and qualitative changes in contractile proteins and interstitial tissue as well as reduction of coronary reserve may be related to the mentioned dysfunction. Recent studies have confirmed the precocity of diastolic dysfunction both in laboratory animals as well as man. Further significant differences have been shown between normotensives with and without a family history of systemic hypertension. The relative importance of diastolic disfunction is also related to its possible role in the genesis of cardiac failure and its probable role in the modulation of cardiopulmonary reflexes in addition to the hemodynamics of arterial hypertension. It is not yet known if the presence of diastolic dysfunction is a mechanism or a risk marker like LVH.
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PMID:[Precocity of diastolic dysfunction in hypertensive cardiopathy]. 138 59

The authors report 22 cases of myocardial infarction documented by selective left ventriculography and coronary angiography in women under 45 years of age. The average age in this series was 36 +/- 6.8 years. Two patient groups were identified: Group I (n = 16) with the cardiovascular risk factor of oral contraception (mean age 33.9 +/- 5 years); and Group II (n = 6) comprising older patients (43.8 +/- 1.8 years) with a high prevalence of other risk factors (hyperlipidaemia, hypertension, diabetes). Myocardial infarction tended to be the inaugural event in Group I (9 out of 16 cases, 56.2%) whereas symptoms of effort angina were commonly observed in Group II (5 out of 6 cases, 83.3%). Coronary angiography showed more severe coronary lesions in Group II (score 1.5) than in Group I (score 0.75) in which isolated, single vessel disease mainly affecting the left anterior descending artery or normal coronary angiography was observed. Thrombolytic therapy was performed in 8 patients: percutaneous transluminal angioplasty was performed in 4 patients in the first month with a primary success in 3 cases. Coronary bypass surgery was performed in 1 case. The outcome during follow-up lasting 44.5 +/- 4.2 months was mainly favourable as 15 of the 20 patients had no secondary complications. Nevertheless, 2 patients died in the hospital period (1 from cardiogenic shock and 1 from complications of transluminal coronary angioplasty), 2 patients died less than 1 year after acute myocardial infarction (1 sudden death, 1 cardiogenic shock). Although oral contraception was withdrawn in all cases, many women continued to smoke.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Myocardial infarction in young women: apropos of 22 cases. Pathogenic and prognostic approach]. 155 Apr 34

Insulin resistance associated with hyperinsulinemia (metabolic syndrome) emerged in recent years as an important health risk which is present in approximately 25% of the normal population in western industrialized societies. Insulin resistance as assessed for the whole body arises from a reduced glucose utilization of skeletal muscle. If the metabolic syndrome persists over a prolonged period of time, detrimental influences on the cardiovascular system become apparent involving diabetes mellitus, hypertension, and arteriosclerosis. Of particular pathogenic relevance is an unbalanced influence of insulin arising either from a diminished or enhanced insulin action depending on whether the various tissues of the body exhibit a reduced or unchanged insulin sensitivity. Since insulin resistance and hyperinsulinemia appear to be affected by various lifestyle factors, the unique opportunity exists of reducing cardiovascular mortality by correcting this syndrome at a time when degenerative changes have not occurred in the cardiovascular system. Of great importance is the finding that dietary factors can have a modulatory action on insulin sensitivity. In animal experiments, an increased intake of (saturated) fat and refined carbohydrates increased insulin resistance. Since psychosocial distress is expected to be associated with a sustained activation of the sympathoadrenal axis, it is likely also to aggravate the metabolic syndrome. A factor with a beneficial action appears to be physical exercise. In view of the high incidence of cardiovascular diseases, further research on lifestyle factors with an insulin-sensitizing or insulin-desensitizing action is required. Of prime importance is the reevaluation of established dietary recommendations and diets should be designed which take into account the individual cardiovascular risk factor profile.
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PMID:Insulin resistance, hyperinsulinemia, and cardiovascular disease. The need for novel dietary prevention strategies. 159 Jul 42

The personality predisposition "John Henryism" (JH) is a self-perception that one can meet demands of the environment through hard work and determination. The JH scale measures "efficacy of mental and physical vigor, commitment to hard work, and determination to reach one's goals." Previous research found an increased prevalence of hypertension among African-Americans with high JH scores and low socioeconomic status (SES). Six hundred fifty-three adult African-Americans in a church-based cardiovascular risk factor screening program completed the JH questionnaire. The prevalence of cholesterol greater than or equal to 240 mg/dl was highest (27%) among the high-JH/low-SES group when adjusted for age, sex, and body mass index. High JH/low SES was not associated with a greater prevalence of high blood pressure. Findings of this study suggest the need for additional research on John Henryism, socioeconomic factors, and cardiovascular risk among randomly selected samples of geographically and economically diverse African-Americans.
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PMID:A test of the John Henryism hypothesis: cholesterol and blood pressure. 160 7

It is highly probable that the menopause, spontaneous or above all artificially induced, is a cardiovascular risk factor. However, it is less important than other conditions (hypertension, smoking, obesity, diabetes, hypercholesterolemia) with which it is often associated and which it may favourise or worsen. In this respect, hormone replacement therapy is probably beneficial, probably by an action on the arterial endothelium itself, and certainly by opposing the factors which favourise the development of atheroma (metabolic and hemostasis disorders). Its aims and techniques, and hence its cardiovascular consequences, are very different from those of hormonal contraception, with which it must neither be compared nor confused. It would be reasonable, on the basis of these advantages, to extend the indications of post-menopausal hormone replacement therapy to an increasing number of women and for a longer period.
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PMID:[Cardiovascular risk after menopause]. 161 97

Treatment of both systolic-diastolic and isolated systolic hypertension in patients over age 65 has been shown to decrease subsequent cardiovascular morbidity and mortality. In the European Working Party on High Blood Pressure in the Elderly study, the number of morbid and mortal cardiovascular events prevented in the treatment group was 29/1,000 person-years, whereas in the Systolic Hypertension in the Elderly Program, the number was 55/1,000 person-years. This magnitude of reduction is substantial, but in the case of primary prevention in the elderly, a large number of patients must be treated to benefit relatively few. Better strategies of targeting treatment based on risk over and above that of high blood pressure are needed. Certainly, patients with more than one cardiovascular risk factor or evidence of end-organ damage should be treated more aggressively.
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PMID:The hypertensive patient. Not just a number. 161 34


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