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

Uteroplacental spiral arteries in placental bed biopsies and placentas form 80 pregnancies were studied by light and electron microscopy; of these 30 were complicated by fatal growth retardation(less than 10th centile) and 45 by hypertension during pregnancy. The physiological changes of the spiral arteries and the vascular pathology present in hypertensive pregnancy and fetal growth retardation were investigated. In normotensive pregnancies complicated by fetal growth retardation, the physiological changes of pregnancy frequently did not extend beyond the decidual segments of the utero-placental arteries. In pregnancies complicated by pre-eclampsia, the physiological changes of pregnancy were not always restricted to the decidual segments of the utero-placental arteries. Atheromatous-like lesions of similar morphology were found in spiral arteries from both normotensive and hypertensive pregnancies complicated by fetal growth retardation. No arteriopathy was found which was specific for pre-eclampsia.
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PMID:An ultrastructural study of utero-placental spiral arteries in hypertensive and normotensive pregnancy and fetal growth retardation. 724 26

Numerous elastic and muscular arteries and arterioles of the SHR and Wistar Kyoto were morphologically and comparatively studied before (4th week) and after (20th, 30th and 60th week) high blood pressure set in. The vascular changes observed occurred after the increase in blood pressure, were proportional to its duration, and differed in frequency and intensity: myocyte hypertrophy, medial thickening and fibrosis (omnipresent) greater than cell proliferation and migration, lymphomonocyte invasion, intima thickening (localised) greater than signs of degeneration (vacuolar, hyaline); necrosis and repair (late - 60th week and scattered). The morphogenesis of SHR arteriopathy was characterised by the pre-eminence of cell phenomena over insudation phenomena. Three processes of unequal importance (myocyte hypertrophy, connective neogenesis greater than myocyte hyperplasia) lead to a thickening of the arterial and arteriolar media (vascular wall adaptation to the increased blood pressure). The intimal fibro-muscular thickening (scattered and unevenly distributed) arose from reactions of local arterial cells (migration and proliferation) and lymphomonocyte immigration. The chronology and severity of lesions presented certain variations from some arteries to others i.e. more pronounced reaction of the media in the central vasculature; those in the intima were more extensive and serious at orifices and bifurcations and in small arteries and arterioles (obstructive arteriolopathy); heart and kidney vasculatures were affected earlier and more seriously. The "atherogenic impact" of the medial fibrosis and thickening, of obstructive arteriolopathy in vasa vasorum, of the increase in glucosaminoglycan content, and of the invasion by platelets and monocytes was discussed.
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PMID:[Morphogenesis of central and peripheral arteriopathies in the spontanously hypertensive rat. 1. Histological characteristics]. 732 9

After an introduction about the importance or not of arterial hypertension as a risk factor arteriosclerosis of the lower limbs, wer report on a group of 193 patients affected by peripheral arteriopathy, divided for different class of systemic arterial pressure. We verified that the clinical development of the disease is better in the hypertensive subjects and in particular in the moderately hypertensive subjects (between 150 and 170 mmHg). It coincides with the clinical impression by which this research is born.
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PMID:[Does hypertension improve the prognosis in peripheral arterial disease?]. 746 37

Dihydropyridines are the most numerous available calcium antagonists. While belonging to the same group these drugs have physical, chemical, pharmacokinetic or pharmacodynamic properties which are sometimes specific and can explain differences in the targets and the vascular selectivity. These properties can be related to lipophilic or hydrophilic characteristics, existence or lack of 'use-dependence', possible liaison to membrane phospholipids, and differences in elimination half lives. Selectivity of dihydropyridines also depends on the nature of the target structure (amount of intra-cellular calcium storage and mechanism of its release, electrophysiological properties of these cells) and of its pathological state (atherosclerosis and/or hypertension). Some of these properties could explain the anti-atherogenic effects, myocardial impact, cerebral and renal vascular flow and action in some pathological situations (Raynaud's syndrome, chronic arteriopathy, migraine...). A better knowledge of these different properties could lead to a more accurate choice of the drugs and to a decrease in the incidence of their side effects.
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PMID:[Vascular effects of dihydropyridines]. 763 Dec 83

A retrospective study concerned 8 aneurysms of the renal artery. There were 6 females and 2 males with a mean age of 50.7 years. Diagnosis was obtained angiographically in all cases, in 7 during a reno-vascular work-up for hypertension and fortuitously in 1 after angiography for arteriopathy of the lower limbs. The aneurysm was due to fibromuscular dysplasia in 5 cases and to atheromatous lesions in 3. Reconstruction techniques and their indications were analyzed on the basis of a review of the literature. Outcome for hypertensive patients are the same for the different techniques.
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PMID:[Renal artery aneurysms. Our experience]. 764 92

Atherosclerotic lower-limb arteriopathy is a serious disease. Its prevalence often underestimated when relying only on questioning the patient. A simple early detection method is the systolic index, i.e. the ratio of systolic ankle over brachial pressure. This ratio should normally be greater than 0.9. Lower values indicate detectable arterial obstruction as revealed by reduced peripheral perfusion. Under 0.75 patients are considered as suffering from peripheral vascular disease and require further investigations and specialist opinion. With an index between 0.75 and 0.90 patients are classified as stage I or II of the disease. In a survey by 180 General Practitioners, which were trained by angiologists to measure ankle pressure, more than 1,400 patients, between 40 and 75-years old, with at least one vascular risk factor (hypertension, diabetes, lipids, tobacco) were selected. Tobacco was the most prevalent vascular risk factor, then diabetes (particularly in men). 23.8% of patients recorded values between 0.90 and 0.75 and thus suffering from peripheral vascular disease (certainly age dependent). Clinically absent pulses at the posterior tibial and the dorsalis pedis artery were found is 19 and 27% of patients respectively. Most of the patients received a pharmacological substance allowing to check this index sensitivity. Thus systolic index is a simple low cost method for early detection and care and more general utilisation is proposed.
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PMID:[Early diagnosis of arteriopathy of the legs using measures adapted to general practitioners: the systolic index and pulse perception]. 774 56

Moyamoya disease is a rare disorder characterized by progressive occlusive cerebral arteriopathy associated with an extensive network of collateral vessels. Renovascular hypertension has rarely been associated with this disease. We report on a girl with renovascular hypertension and 2 renal artery aneurysms who was found to have moyamoya disease. Successful surgical treatment was achieved with extracorporeal arterial repair and renal autotransplantation. The relationship between moyamoya disease and renovascular hypertension is reviewed.
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PMID:Surgical treatment of renovascular hypertension in moyamoya disease: case report and review of the literature. 781 17

We studied a sample of adult population over 20 years old of Donori (totally 2049 inhabitants), a small town near Cagliari, South Sardinia, to: (1) Evaluate the prevalence of peripheral arterial occlusive disease of lower limbs (PAOD) diagnosed by standard questionnaire and US CW Doppler examination and associated risk factors in South Sardinia. (2) Compare the reliability of these two diagnostic methods. Our study included the answers to a standard anamnestic questionnaire (according to the WHO recommendations), physical examination and CW Doppler study of the lower limb arteries, the determination of the arterial systolic and diastolic pressure, ankle/arm pressure ratio, Body Mass Index, blood glucose, total and HDL-cholesterol, triglycerides and fibrinogen (the hematochemical examination only on 50% of the sample). The surveyed sample was of 577 subjects (37.96% of 1520, the eligible subjects over 20 years old), 237 males and 340 females. An arteriopathy was diagnosed by means of CW Doppler in 27 subjects, 20 M and 7 F. The overall prevalence of PAOD was 4.67% of the sample (2.06% of females, 8.43% of males). Prevalence steadily increased with age, and, surprisingly, the disease was not absent in young people (2 cases within males with age < or = 40 years). Conversely only 18.5% of PAOD patients were symptomatic. The overall prevalence of associated risk factors was: diabetes 3.6%, hypercholesterolaemia 59.1%, smoking 21.3%, arterial hypertension 21.6%, obesity 17.9%, hypertriglyceridaemia 9.3%, hyperfibrinogenaemia 4.67%. Among the males a significant correlation has been found, among the values of BMI vs age and total cholesterol, age vs total cholesterol, systolic blood pressure, diastolic pressure, fibrinogenaemia. Among the females, the systolic and diastolic pressure, BMI, total cholesterol, LDL-cholesterol, triglycerides and fibrinogen are significantly correlated with age; BMI correlates with systolic and diastolic blood pressure, fibrinogen; a nearly significant correlation has been found between BMI and triglycerides.
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PMID:Prevalence of peripheral arterial occlusive disease and associated risk factors in a sample of southern Sardinian population. 782

Data from the clinical charts of 44 diabetic patients with oculomotor palsy were studied. The sixth cranial nerve was involved in 55 p. 100 of cases, the third in 39 p. 100 and the fourth in 6 p. 100 of cases. Forty three patients had type II diabetes mellitus; in 19 the oculomotor palsy revealed diabetes, while in 25 patients diabetes mellitus had been diagnosed for 9.5 +/- 6.2 years. The oculomotor palsy resolved within an average of 93 days on average (range 156-39 days). Twenty eight patients had arterial hypertension and 23 ischemic cardiopathy of peripheral arteriopathy. There appeared to be no correlation between oculomotor palsy and the quality of glycemia control, renal function, the presence of diabetic retinopathy, or other diabetic neurological complications.
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PMID:[Paralysis of oculomotor nerves in diabetes mellitus. A retrospective study of 44 cases]. 802 75

A retrospective community-wide survey identified 109 patients younger than 40 years of age with lower extremity ischemia: 72 men and 37 women, mean age 36 years (range 25 to 40 years), black-to-white ratio-1:1. Initially, 66 patients had claudication and 43 had severe ischemia. Cardiovascular risk factors were smoking (85%), hypertension (47%), coronary artery disease (30%), hyperlipidemia (27%), diabetes (25%), and visceral arteriopathy (17%). Unique risk factors included hypercoagulability (15%) and clinical arterial hypoplasia (15%). Twenty-three (21%) patients were treated medically; 74 (68%) underwent primary revascularization and 12 (11%) primary major limb amputation. Forty-six (53%) patients required secondary procedures, of which 34 (74%) were performed within 1 year of primary intervention. A total of 29 (27%) patients ultimately required amputation (10 bilateral). Women had higher prevalence of diabetes (p < 0.01), arterial hypoplasia (p < 0.05), and tendency for more severe ischemia (p = 0.11). No racial differences in severity of symptoms or outcome of treatment were found. By multiple logistic regression analysis, typical cardiovascular risk factors did not predict severity of symptoms, need for surgical treatment, or outcome. However, diabetes was associated with tissue loss (p < 0.05) and primary amputation (p < 0.001). Further, adjusted odds ratios indicate that arterial hypoplasia had a protective effect on distal vasculature (p < 0.05) and predicting need for revascularization (p < 0.05), but not on treatment failure. Hypercoagulability had the highest predictive value for presence of severe ischemia (p < 0.05), need for primary amputation (p < 0.01), and early failure of surgical treatment (p < 0.05).
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PMID:Lower extremity ischemia in adults younger than forty years of age: a community-wide survey of premature atherosclerotic arterial disease. 817 42


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