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

Various modifiable risk factors have been associated with inflammation and haemostasis, although the accumulative effects have not yet been examined. We therefore explored additive and independent associations of modifiable risk factors (smoking, alcohol, cholesterol, obesity, hypertension, physical activity) with inflammatory (CRP) and haemostatic (fibrinogen) markers. Data were collected from a sample of 7670 healthy asymptomatic participants (45.9% men, aged 46.2+/-15.6 years). A graded increase in the risk of inflammation (CRP> or =3 mg/L) with increasing numbers of modifiable risk factors was demonstrated (odds ratio for > or =4 risk factors=5.09, 95% CI, 3.96-6.55). Similar associations were found in relation to haemostasis. Central adiposity was the strongest independent predictor of inflammation (OR=3.45, 95% CI, 3.07-3.87) although smoking most strongly predicted haemostasis (OR=2.19, 95% CI, 1.94-2.48). These findings suggest that targeting multiple risk factors is likely to have the greatest benefit for cardiovascular prevention.
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PMID:The accumulative effects of modifiable risk factors on inflammation and haemostasis. 1841 Oct 23

Women with a history of preeclampsia or eclampsia (seizure during preeclamptic pregnancy) are at increased risk for cardiovascular disease after pregnancy for reasons that remain unclear. Prospective studies during pregnancy suggest that inflammation, dyslipidemia, and insulin resistance are associated with increased risk of preeclampsia. Elevated serum C-reactive protein (CRP >3 mg/L) is an indicator of inflammation and cardiovascular risk. We hypothesized that Icelandic postmenopausal women with a history of eclampsia would manifest higher concentrations of serum CRP than Icelandic postmenopausal controls with a history of uncomplicated pregnancies. We also asked whether elevated CRP is associated with the dyslipidemia and insulin resistance previously identified in this cohort. CRP, measured by high-sensitivity enzyme-linked immunoassay, was higher in women with prior eclampsia (n=25) than controls (n=28) (median mg/L [interquartile range]: 9.0 [0.9 to 13.2] versus 2.0 [0.3 to 5.1]; P<0.03). This difference remained significant after adjustment for body mass index, smoking, hormone replacement, and current age. Women with prior eclampsia clustered into either high CRP (range 8.97 to 40.6 mg/L, n=13) or lower CRP (median 1.0, range 0.05 to 3.77, n=12) subsets. The prior eclampsia/high CRP subset displayed significantly elevated systolic blood pressures, lower high-density lipoprotein (HDL) cholesterol, higher apolipoprotein B, and higher fasting insulin and homeostasis model of insulin resistance (HOMA) values compared to controls, whereas the prior eclampsia/low CRP subset differed from controls only by marginally increased apolipoprotein B. The triad of inflammation, low HDL, and insulin resistance may elevate risk for both preeclampsia/eclampsia and cardiovascular disease in later life.
Hypertension 2008 Jun
PMID:C-reactive protein is elevated 30 years after eclamptic pregnancy. 1841 89

The role of adiponectin, a marker of the metabolic syndrome, on the pathogenesis of hypertension in comparison with markers of adipose tissue mass (leptin) and inflammation (high-sensitivity C-reactive protein [hs-CRP]) remains to be clarified. The eligible study population consisted of 2,045 residents aged > or =40 years who had participated in a community-based survey and had complete data for serum adiponectin, leptin, and hs-CRP, and for whom homeostasis model assessment of insulin resistance (HOMA-IR) had been calculated from insulin and plasma glucose. Among all eligible participants, as well as in the subgroup of nondiabetic normotensives (blood pressure <140/90 mmHg and without antihypertensive medication), all three markers were significantly correlated with systolic blood pressure (negative correlation for adiponectin and positive correlations for leptin and hs-CRP). Among all participants, systolic blood pressure and the presence of hypertension were determined mainly by age, sex, body mass index, and waist circumference. None of the markers further contributed to the multivariate linear regression or logistic regression models. In contrast, adiponectin, but not leptin, hs-CRP, or HOMA-IR, was significantly associated with systolic blood pressure and the presence of pre-hypertension (blood pressure within 120-139/80-89 mmHg) after adjustment for age, sex, body mass index, and waist circumference in the nondiabetic normotensive subgroup. Similarly, adiponectin was independently associated with diastolic blood pressure in the nondiabetic normotensive subgroup but not in the whole population. In conclusion, adiponectin, but not leptin or hs-CRP, was independently associated with blood pressure in a nondiabetic normotensive subgroup.
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PMID:Adiponectin, but not leptin or high-sensitivity C-reactive protein, is associated with blood pressure independently of general and abdominal adiposity. 1863 74

Our aim is to determine if there exists a difference in risk factors and diagnosis between patients being treated on internal medicine ward for coronary heart disease who have higher levels of cholesterol in their blood and other patients, without proved higher levels of cholesterol, hospitalized for coronary heart disease. We followed patients hospitalized in General Hospital Zabok for coronary heart disease for the period between 2004-2006y. On admission patients were diagnosed with coronary heart disease based on laboratory markers specific for the disease (CK, troponin, LDH,CRP), ECG and history taking. We analyzed two groups of patients for diagnosis and risk factors on discharge from the hospital: one group with proven hypercholesterolemia, the other with coronary heart disease without hypercholesterolemia. For the duration of the study there were no significant alternations concerning risk factors for coronary heart disease, and hypertension was the most prevalent of these factors in both groups. Values of HDL, as an indirect indicator of coronary heart disease, were lower in both groups for the duration of the study. In group of patients with hypercholesterolemia myocardial infarction with a ST segment elevation, as a discharge diagnosis, was a more prevalent complication of the disease, while for the group of patients without hypercholesterolemia stable angina pectoris was more prevalent and this is explained as atheroma plaque stabilization when there are normal values of blood cholesterol.
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PMID:Risk factor analysis and diagnoses of coronary heart disease in patients with hypercholesterolemia from Croatian Zagorje County. 1875 83

Although smoking and hypertension are classic risk factors for atherothrombotic diseases, the relationship of dyslipidemia and vascular diseases, other than myocardial infarction, is less clearly established, especially in young subjects. In the current study, a detailed analysis of the lipid and apolipoprotein profiles was conducted in young patients of ischemic cerebral stroke (IS) and peripheral arterial disease (PAD). Plasma levels of C-reactive protein (hs-CRP), total cholesterol (TC), high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), triglycerides (TG), and apolipoproteins A-I (ApoA-I) and apolipoproteins B (ApoB), which include the ApoB/ApoA-I ratio, were analyzed in a group of 81 patients who presented with IS (n = 46) or PAD (n = 35) as well as in 167 control subjects. Significant differences were observed for hs-CRP, TC, HDLc, LDLc, TG, ApoA-I, and ApoB levels, as well as for the ApoB/ApoA-I ratio, between the control and the IS or PAD groups. However, after adjustment for sex, age, smoking, hypertension, hs-CRP, and dyslipidemia (LDLc, TC, HDLc, TG, ApoA, ApoB, and ApoB/ApoA-I ratio), hs-CRP, ApoB, and the ApoB/ApoA-I ratio were independently associated with increased risks of IS or PAD. Increased ApoB/ApoA-I ratio and hs-CRP levels are independently associated with occurrence of IS and PAD in young patients and are significant markers of alterations on lipid and apolipoproteic profiles and inflammatory responses, respectively, in these patients.
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PMID:ApoB/ApoA-I ratio in young patients with ischemic cerebral stroke or peripheral arterial disease. 1877 40

An 11-year-old girl was admitted with backpain, weight loss, fatigue and behavioural disturbances, starting seven weeks before admission. Physical examination showed acrodynia, tremor, cachexia, hypertension and extensive gingival ulceration. Routine laboratory tests were normal, except for a CRP of 98 mg/l. Screening tests for recreational drugs as well as antibody assays for HIV, hepatitis B and borrelia burgdorferia were negative. Chest X-ray, brain CAT and MRI scan were all normal. Lumbar puncture didn't show any abnormalities. Eventually a 24-hour urine test confirmed the diagnosis that was suspected by further questioning.
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PMID:A previously healthy 11-year-old girl with behavioural disturbances, desquamation of the skin and loss of teeth. 1904 36

Migraine is a common disorder in which changes in cortical excitability, neuroinflammation and dysfunction of the vascular wall contribute to its pathophysiology. Repeated attacks of migraine over prolonged periods result in inflammatory arteriopathy of the cranial vessels. Several studies indicate that migraine is associated with special pattern of inflammatory markers and some adverse vascular risk factors including: increased levels of CRP, ILs, TNF-alpha and adhesion molecules which are markers of systemic inflammation, oxidative stress and thrombosis, increased body weight, high blood pressure, hypercholesterolemia, impaired insulin sensitivity, high homocysteine levels, stroke and coronary heart disease. Such comorbidities are not explained by bias but indicate possible shared underlying pathogenic mechanisms. Recent studies have shown involvement of cranial as well as peripheral vascular dysfunction with migraine indicating that migraine may be a local manifestation of a systemic disease rather than a primary brain phenomenon. The associated inflammatory process of migraine together with the associated adverse medical comorbidities exposes patients to endothelial vascular wall injury which further increases migraine susceptibility and progression as well as increases the risk for atherogenesis. The knowledge that migraine is a risk for vascular diseases raises important clinical implications, recommendations and future perspectives in migraine treatment and prevention.
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PMID:The vascular risk associations with migraine: relation to migraine susceptibility and progression. 1905 16

Recent work shows a high prevalence of low testosterone and inappropriately low LH and FSH concentrations in type 2 diabetes. This syndrome of hypogonadotrophic hypogonadism (HH) is associated with obesity, and other features of the metabolic syndrome (obesity and overweight, hypertension and hyperlipidemia) in patients with type 2 diabetes. However, the duration of diabetes or HbA1c were not related to HH. Furthermore, recent data show that HH is also observed frequently in patients with the metabolic syndrome without diabetes but is not associated with type 1 diabetes. Thus, HH appears be related to the two major conditions associated with insulin resistance: type 2 diabetes and the metabolic syndrome. CRP concentrations have been shown to be elevated in patients with HH and are inversely related to plasma testosterone concentrations. This inverse relationship between plasma free testosterone and CRP concentrations in patients with type 2 diabetes suggests that inflammation may play an important role in the pathogenesis of this syndrome. This is of interest since inflammatory mechanisms may have a cardinal role in the pathogenesis of insulin resistance. It is relevant that in the mouse, deletion of the insulin receptor in neurons leads to HH in addition to a state of systemic insulin resistance. It has also been shown that insulin facilitates the secretion of gonadotrophin releasing hormone (GnRH) from neuronal cell cultures. Thus, HH may be the result of insulin resistance at the level of the GnRH secreting neuron. Low testosterone concentrations in type 2 diabetic men have also been related to a significantly lower hematocrit and thus to an increased frequency of mild anemia. Low testosterone concentrations are also related to an increase in total and regional adiposity, and to lower bone density. This review discusses these issues and attempts to make the syndrome relevant as a clinical entity. Clinical trials are required to determine whether testosterone replacement alleviates symptoms related to sexual dysfunction, and features of the metabolic syndrome, insulin resistance and inflammation.
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PMID:Hypogonadotrophic hypogonadism in type 2 diabetes, obesity and the metabolic syndrome. 1907 78

There is evidence that proinflammation may be linked to the development of hypertension (HT). We examined the association of both the interleukin-1 beta (IL-1beta) and the interleukin 1-receptor antagonist (IL-1ra) with future blood pressure (BP) and HT occurrence (BP >or= 140/90 mmHg, or antihypertensive drug) in a population-based prospective study. Our study consisted of 396 (147 men and 249 women) middle-aged, baseline apparently healthy, normotensive subjects participating in a 6.5-year follow-up study. Subjects with high-sensitivity CRP (hs-CRP) < 10 mg/L were excluded at the initial visit. At follow-up, the occurrence of HT was 32%. The levels of baseline IL-1beta and IL-1ra were significantly higher for subjects who developed HT during the follow-up than for those who did not (IL-1beta; 0.67 +/- 0.62 pg/mL versus 0.56 +/- 0.32 pg/mL, P = .020 and IL-1ra; 184 +/- 132 pg/mL versus 154 +/- 89 pg/mL, P = .007). After adjustments for age, follow-up time, sex, baseline systolic BP, and BMI, our results confirm a statistically significant (P = .036) linear association between the quartiles of IL-1beta and change of systolic BP during the study. After adjustments for age, follow-up time, sex, and BMI, our results also show a linear association between incident HT and the quartiles of IL-1ra. (P = .026). These results provide evidence that proinflammation may precede BP elevation and HT.
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PMID:Proinflammation and hypertension: a population-based study. 1912 4

Epidemiological studies indicate an increased cardiovascular risk in users of combined oral contraceptives (COC) but not progestagen-only preparations. A specially high risk was observed in women older than 35 years with additional cardiovascular risk factors like smoking or hypertension. The mechanisms underlying arterial occlusion can not be explained by hormonal effects on the vascular tonus, nor by effects on newer risk parameters like homocysteine or transforming growth factor-beta. However, CRP increases during oral and transdermal COC use, an effect which can not be observed during use of a progestagen-only implant. Studies concerning the effect of COC on the vasotonus, nitric oxide, homocysteine and CRP usually include young healthy women with intact endothelial function. Females with nicotinabusus, hypertension and hypercholesterolemia have a damaged endothelium. The effect of hormonal treatment on the endothelium in these women might include decreased ability to release the strong vasodilator nitric oxid and as a consequence of that impaired vasodilation.
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PMID:[Effect of combined hormonal contraceptives on the vascular endothelium und new cardiovascular risk parameters]. 1918 Apr 28


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