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)

Diabetes mellitus is often associated with hypertension and is an additional cardiovascular risk factor. It is therefore important that antihypertensive drugs should have no negative metabolic effects. We present here the results of two distinct studies investigating the clinical efficacy and the metabolic effects of lacidipine in hypertensive patients without concomitant diabetes. Patients in the first study (group A) were hypertensive with non-insulin-dependent diabetes mellitus (NIDDM) and stable blood glucose levels in the 3 months before entering the study. Patients in the second study (group B) were hypertensive without diabetes mellitus. Before the commencement of the study, antihypertensive treatment was discontinued in all patients for a 4-week washout period, followed by 4 weeks of run-in with placebo. Patients were then treated with lacidipine (4 mg o.d.) for 6 months. After 1-2 months, the dose was doubled in patients with uncontrolled blood pressure. Every 2 months, lipid and carbohydrate metabolism were investigated by blood chemistry analyses. The results demonstrate that lacidipine 4-8 mg o.d. is efficacious and well tolerated in hypertensive patients, even in the presence of diabetes mellitus.
 ...
PMID:Antihypertensive and metabolic effects of lacidipine in patients with NIDDM and/or hypertension. 760 95

Hypertension is well recognized to be an important cardiovascular risk factor and antihypertensive therapy has been shown to decrease cardiovascular mortality and morbidity as blood pressure control is achieved. At present, management of hypertension is obtained with effective compounds that exhibit a satisfactory safety profile. Among the antihypertensive drugs, calcium antagonists have been proven to possess this property. In the present study, our objective was to compare the antihypertensive effect of two new long-acting dihydropyridines, lacidipine and amlodipine, as once-daily monotherapies in mild-to-moderate hypertensive patients. Eighty hypertensive patients were recruited and after a 3-week washout period were randomized to receive lacidipine 4 mg once daily or amlodipine 10 mg once daily. After 4 weeks, hydrochlorothiazide 12.5 mg was added in patients not adequately controlled, and patients were treated for a total of 8 weeks. At this time, supine mean diastolic blood pressure decrease was 16 mm Hg in the lacidipine group and 10 mm Hg in the amlodipine group (p < = 0.01). Adverse events were reported in 28% of patients treated with lacidipine and in 48% of patients receiving amlodipine. Results of our pilot clinical experience show that lacidipine is a well-tolerated and effective compound, compared with amlodipine, in mild-to-moderate hypertensive patients.
 ...
PMID:Efficacy and safety evaluation of lacidipine compared with amlodipine in mild-to-moderate hypertensive patients. 760 17

Insulin resistance is a condition which is present in many different diseases all characterized by an increased risk of cardiovascular morbidity and mortality. Generally, the contribution of insulin resistance to the development of cardiovascular pathology is considered to be due to its metabolic consequences. However, recent findings suggest alternative mechanisms by which insulin resistance could exert its role of cardiovascular risk factor. In fact, it has been demonstrated that insulin resistant hypertensive patients have a sympathetic response to euglycemic hyperinsulinemia which is three-fold greater than in normal subjects. This phenomenon could represent an important link between sympathetic nervous system and arterial hypertension. Furthermore, in normal subjects it has been demonstrated that hyperinsulinemia modulates the sympathetic induced vascular response and that this effect is lost in insulin resistant hypertensives. This latter phenomenon could further worsen the consequences of sympathetic overactivity.
 ...
PMID:[Non-hemodynamic mechanisms of cardiovascular risk in the hypertensive patient: insulin resistance]. 763 86

An increasing number of clinical trials have demonstrated that obese patients are more likely than lean individuals to be hypertensive. Moreover, both obesity and arterial hypertension have been identified as independent risk factors for cardiovascular disease. Pathophysiologically, obesity appears to have a major influence on the hemodynamic changes associated with hypertension. The available evidence suggests that at any given level of arterial pressure, obese hypertensive patients have a higher cardiac output and lower total peripheral resistance than do lean patients. Recent reports have indicated that obesity exerts a disparate effect on target organs in hypertension. Whereas at rest obesity seems to mitigate cardiovascular changes in the systemic vascular bed caused by hypertension, no such mitigation was observed in the renovasculature; left ventricular hypertrophy as a major cardiovascular risk factor was even exacerbated by the presence of obesity. The different hemodynamic patterns in obese hypertensive patients have recently been shown clinically relevant for treating hypertensive patients.
 ...
PMID:Obesity and hypertension. 780 53

The aim of the study was to assess the current cardiovascular risk factor profile including data on treatment of a representative population over the age of 65 in Germany. From a total of 1190 inhabitants > or = 65 years living in two Bavarian villages near Munich, 982 could be visited at home ("door-to-door" survey), where a questionnaire and the measurement section were performed (response rate 82.5%). Blood pressure was measured three times in the sitting position with a standard sphygmomanometer, ("actual") hypertension was defined as systolic blood pressure > or = 160 mm Hg and/or diastolic blood pressure > or = 95 mm Hg or effective antihypertensive treatment. Obesity was defined as body mass index > or = 27.8 kg/m2 for men or > or = 27.3 kg/m2 for women, hypercholesterolemia as total cholesterol > or = 250 mg/dl (6.5 mmol/l), diabetes as fasting serum glucose > 120 mg/dl, glucosuria or treatment with insulin or oral antidiabetics. With a prevalence of 53% hypertension was the leading risk factor, followed by obesity with 35% and hypercholesterolemia with 21%; smoking and diabetes were observed in < 10%. Hypertension and obesity tended to be more prevalent in women, diabetes in men; hypercholesterolemia was significantly more prevalent in women. While the prevalence of hypertension increased up to the age groups "75-79 years" in men and "80-84 years" in women, there was a constant decrease with age for obesity, hypercholesterolemia and smoking. Three-quarters of the participants showed a minimum of one cardiovascular risk factor, the risk factor combination "hypertension/hypercholesterolemia/smoking" was observed however only in 1%.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Cardiovascular risk factors in patients over 65-years of age in Germany. Results of the STEPHY Study (Starnberg Trial on Epidemiology of Parkinsonism and Hypertension in the Elderly)]. 782 73

Several epidemiologic and clinical studies over the past years have shown that insulin resistance and hyperinsulinemia are related to dyslipidemia, hypertension, android obesity and non-insulin-dependent diabetes mellitus (NIDDM). The insulin-resistance syndrome is thus closely associated with a cluster of potent cardiovascular risk factors, thereby explaining the 3-4 times higher incidence of cardiovascular disease in NIDDM. Recent observations point to the fact that insulin resistance is genetically determined and can be diagnosed a long time before the clinical manifestation of diabetes mellitus in the prediabetic stage (stage of hyperinsulinemia, hypertension and hyperlipidemia). Hence, it is not surprising that many NIDDM subjects suffer from cardiovascular complications already at the time diabetes is diagnosed. The pathogenetic mechanism of insulin resistance/hyperinsulinemia as cardiovascular risk factor is considered to be a direct atherogenic action of insulin on vessel wall cells and an indirect effect on upper body obesity, blood pressure, lipids and hemostasis.
 ...
PMID:[Insulin resistance and cardiovascular complications]. 784 94

The Accupril Canadian Clinical Evaluation and Patient Teaching (ACCEPT) study was a multicenter, 6-month, open-label, postmarketing surveillance study where the efficacy and safety of quinapril, an angiotensin-converting enzyme (ACE) inhibitor, was evaluated in a general population of patients with essential hypertension. Participating physicians followed their normal office procedures for the initiation of quinapril therapy (a dose of 10 mg QD in the majority of cases). The dose was titrated to blood pressure response, generally at 2-week intervals, for a maintenance dose of 10 mg QD to 20 mg QD in most cases (86% at 6 months) and not to exceed 40 mg QD. The use of concomitant antihypertensive medications was left to the discretion of the physician. By random assignment, physicians obtained patient informed consent on either a detailed form that listed possible quinapril side effects or a less specific form, which did not list particular side effects. The purpose of using two different forms was to assess any potential association between the frequency of adverse-event reporting and patient's awareness of quinapril side effects. The patients also received an educational package that provided general information on hypertension and lifestyle modifications known to reduce cardiovascular risk factors. An intent-to-treat analysis included data from 3742 patients in whom the median age was 56 years and the median duration of hypertension was 5 years. The demographic characteristics of these patients were similar to those identified in Canadian hypertensive patients in a recent population-based survey. Nearly 80% of the ACCEPT study patients had more than one cardiovascular risk factor, in addition to hypertension. Among 2979 patients receiving quinapril at 3 months, 77% were stabilized. Among 2517 patients continuing to receive quinapril at 6 months, 84% were stabilized. Greater declines in both diastolic and systolic blood pressures were evident among patients who continued to receive quinapril as part of an antihypertensive regimen than among those who discontinued quinapril treatment. Blood pressure responses to quinapril were similar in newly diagnosed patients and those with a history of hypertension. A total of 980 patients (26.2%) reported one or more adverse events. Cough was most frequently reported and was deemed as definitely related to quinapril therapy by the treating physician in 3.6% of cases. Serious adverse events occurred in 55 patients (1.5%) and were assessed as possibly related to quinapril in only three patients.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:A postmarketing surveillance evaluation of quinapril in 3742 Canadian hypertensive patients: the ACCEPT Study. Accupril Canadian Clinical Evaluation and Patient Teaching. 785 44

The association between serum uric acid concentration and some cardiovascular risk factors was examined in a working Hong Kong Chinese population (mean age 38 years), consisting of 910 men and 603 women. There was no significant age-related rise in serum uric acid concentration. Positive associations were found between serum uric acid concentration and body mass index, waist hip ratio, systolic and diastolic blood pressure, urea, creatinine, protein, glucose (fasting and 2 hours after 75 g oral glucose load), 2 hour insulin, triglycerides, and apolipoprotein B in men. Similar, but fewer, associations were seen in women, with the addition of a positive association with age. In both sexes, serum uric acid was negatively associated with high-density lipoprotein cholesterol. These findings complement the well-known clinical association between gout and cardiovascular and metabolic diseases, such as hypertension, hyperlipidaemia and diabetes mellitus, and suggest that serum uric acid may be a marker for the presence of an adverse cardiovascular risk factor profile.
 ...
PMID:Association between serum uric acid and some cardiovascular risk factors in a Chinese population. 793 26

Obesity and overweight have great clinical and social significance and are associated with a number of medical and surgical complications. We attempt here to summarize current knowledge on the subject and describe the research we are presently carrying out in this field. After a brief introduction, definition, and discussion of etiopathogenesis, the indexes of ponderal excess and epidemiology are illustrated. The cardiovascular adjustments and the relationships between obesity and hypertension, ischemic heart disease and congestive heart failure are then treated. One aim of our investigation was to study the modifications of an entire set of biological and clinical parameters which could concretely formulate and/or identify some pathophysiological links between obesity and heart disease. We thus studied obese subjects with hypertension, diabetes and multiple cardiovascular risk factors. We also studied a group of asymptomatic obese subjects, whom we define as "the healthy obese". Our results, supported by the medical literature, led to the conclusion that obesity is an important and/or independent cardiovascular risk factor. We think, however, that it would be prudent to await for the results of interventional trials and follow-up studies involving a large number of young, healthy obese subjects in order to monitor the most important biological variables over the long term.
 ...
PMID:Obesity and cardiovascular diseases. 800 89

Sixty newly diagnosed adult patients with mild to moderate essential hypertension were assessed to determine their cardiovascular risk factor profiles. Detailed history and physical examinations were done. Resting 12-lead ECG was done and serum levels of uric acid, fasting cholesterol, and fasting glucose were determined. Twenty nine patients had hypertension and two or more cardiovascular risk factors. The most prevalent cardiovascular risk factors other than hypertension were electro-cardiovascular left ventricular hypertrophy (31.7%), obesity (28.3%) and hypercholesterolaemia (28.3%). About a half of these patients (48.3%) can be classified as high risk hypertensives. This calls for aggressive management of cardiovascular risk factors as a whole and not just hypertension alone if we are to reduce incidence of hypertensive complications.
 ...
PMID:Cardiovascular risk factor profiles in mild to moderate hypertensives seen at Kenyatta National Hospital. 803 70


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