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

Atherosclerosis is one of the most common causes of peripheral vascular disease. Complications result from arteries compromised because of focal accumulations of lipids and other materials within and between cells in the vessel walls. Factors including hyperlipidemia, hypertension, diabetes mellitus, obesity, physical inactivity, smoking, social stress, and genetic background have been implicated as promoting a higher risk of atherosclerosis and its consequences.
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PMID:Atherosclerosis: a major cause of peripheral vascular disease. 58 6

About 50 per cent of people in modern societies have blood pressure sufficiently elevated to result in increased mortality. This proportion is much smaller in undisrupted societies of hunter-gatherers. In most cases the elevated blood pressure in modern societies is associated with physiological changes characteristic of chronic stress. The difference between blood pressure in modern populations and that in undisrupted hunter-gatherer societies cannot be accounted for by genetic differences or differences in salt consumption. Two primary features of modern society which contribute to the elevation of blood pressure are community disruption and increased work pressure. Drug therapy and relaxation therapies for hypertension attempt to counteract the physiological effects of social stress. However, it is more appropriate to use the occurrence of hypertension as an indicator of fundamental social problems which need to be solved.
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PMID:Hypertension as a disease of modern society. 123 Apr 37

It has been determined that the prevalence and incidence of coronary artery disease has been lower in Puerto Rico than in the United States. In a controlled comparison with a matched cohort of men from Framingham, Mass, Puerto Rican men were found to have lower serum cholesterol and lower systolic blood pressure, to smoke less, to be more active physically, and to be less sensitive to coronary risk factors. Community surveys have shown that there is moderately less hypertension but more diabetes and possibly more obesity in Puerto Rico than in the United States. Hispanic groups in the United States have shown similar characteristics. Possible reasons for the relative protection from coronary artery disease in Puerto Rico include genetic factors, diet, and life-style. Recent epidemiologic data show that, although mortality from coronary disease and stroke has been steadily decreasing in the United States, it is increasing in Puerto Rico. Recent life-style and dietary changes, social stress, increased life expectancy, and a high death rate from diabetes and hypertension may be contributing to this reversal. Stronger efforts to control cardiovascular risk factors and to improve the management of diabetes and hypertension are needed in Puerto Rico.
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PMID:Cardiovascular health in Puerto Ricans compared to other population groups in the United States. 184 33

A health needs assessment was conducted with Arab-American immigrants in northern California. Data were obtained from community forums, key informants, the U.S. Census, and from a survey of 47 Arab immigrants. In the community forums, parenting difficulties, marital conflicts, and health risks were identified. Key informants (clergy, community leaders, health professionals) identified mental health problems related to child rearing, referrals for appropriate services, education to assist Arab women interface with the health and education systems, and translation and cultural interpretation for Arab patients and health care providers. Arab patients requesting health care identified referrals for appropriate care, advocacy, education about the medical regimen, and technical assistance obtaining care. Social indicators indicated potential needs for health services for those of lower income. A survey of 47 Arab-Americans indicated that predominant illnesses experienced in the past year were upper respiratory infections, cardiovascular and hypertension, diabetes, and family and social stress. Health-related problems reported most frequently were family stress, adjusting to the U.S., managing acute illness, coping with adolescents, and marital stress. For the most part, this group was satisfied with medical care received and stated that their most important health services were health education, availability of Arab speaking health providers, and referrals for appropriate treatment.
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PMID:Assessing Arab-American health care needs. 279 30

Responsiveness to endothelium-dependent (acetylcholine and A23187) and endothelium-independent (nitroprusside and 8-bromo cyclic guanosine 3',5'-monophosphate [cGMP]) vasodilators was examined in two vascular preparations from hypertensive and normotensive mice. CBA Agouti mice were made hypertensive by exposure to social stress in a complex population cage. After 2 months, the hindquarter vascular bed was pump-perfused at a constant flow with plasma substitute to evaluate changes in perfusion pressure, and helical strips of aorta were suspended in muscle baths for measurement of isometric force generation. Tissues were treated with methoxamine to induce contractile tone. Threshold dilator responses to acetylcholine were elicited at a significantly lower dose in the hindquarters of hypertensive mice than in those from normotensive mice, indicating increased vasodilator sensitivity. In contrast, vasodilator responsiveness to nitroprusside in hindquarters of hypertensive mice did not differ from that in hindquarters of normotensive mice. Aortas from hypertensive mice were more sensitive (lower ED50) to the relaxant effects of acetylcholine and A23187 than those from normotensive mice. The relaxant effects of nitroprusside and 8-bromo cGMP on aortas from hypertensive mice were not significantly different from those in normotensive aortas. Aortic strips that had been rubbed on the lumen surface with a wooden stick did not relax to acetylcholine or A23187. In aortas that were not initially contracted with methoxamine, acetylcholine and A23187 caused small contractions from baseline. The magnitude of these contractile responses were potentiated after removal of the endothelium, and the potentiation was greater in aortas from hypertensive mice. These results demonstrate an increased responsiveness to endothelium-dependent vasodilators in this psychosocial model of hypertension.
Hypertension 1987 Mar
PMID:Increased vasodilator responses to acetylcholine in psychosocial hypertensive mice. 302 55

The cardiovascular structural remodelling associated with psychogenic hypertension was investigated in genetically normotensive rats subjected to isolation stress. Male Wistar rats were stressed by intermittent social isolation and compared to control rats living in groups. The stressed rats had higher systolic blood pressures than the control rats throughout the study. After 1 week of isolation, ornithine decarboxylase activity, a marker for hypertrophy, was increased in the right ventricle of the stressed rats. After 6 weeks of intermittent isolation, the myocardium of the stressed rats was hypertrophied, involving both right and left ventricles. The aorta was also hypertrophied, whereas the tail artery remained unaffected. Later, after 12 weeks of isolation, the left ventricular hypertrophy persisted whereas the right ventricle and aorta returned to normal. It seems, therefore, that social stress hypertension is accompanied by very early structural changes, which affect at least the heart and the aorta, and cannot be directly linked to the severity or duration of hypertension.
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PMID:Cardiovascular structural changes induced by isolation-stress hypertension in the rat. 324 Nov 86

Reasons are given why calcium, obesity and genetics cannot be considered primary factors in the etiology of essential hypertension. This leaves the major protagonists as salt and neuroendocrine responses to the emotions aroused by the social environment. Most essential hypertension is renin dependent and associated with the physiological changes induced by arousal of the defence response. The psychosocial stimulation associated with this arousal induces an increase in salt appetite. This makes the salt consumption of society a measure of the social stress to which it is exposed. Primitive people whose blood pressure remains normal throughout their lives may lack modern societies' physically protective achievements but their religiously prescribed social solidarity may protect them from psychosocial stress. Our chronic suppression of awareness of emotional arousal together with loss of the ritualized support of affiliative behavior may result in repressed emotional responses which find somatic expression in diseases such as essential hypertension. Hypertensiologist George Pickering proposed that the primitive's ritual and taboo (the equivalent in our society might be the Alcoholic's Anonymous belief in a 'Higher Power') protect them from much anger and despair. He gave this precedence over salt as the primary factor in essential hypertension. New evidence supports this. Despite a high salt diet the blood pressure of socially adjusted rodents remains normal throughout their lifespan. On the other hand, the hypertension that develops when they are psychosocially stimulated is not abated by a low salt diet. In humans, the blood pressure of cloistered, secluded Italian nuns on a high salt diet has remained normal for 20 years while that of nearby village women has risen at a startling 2 mmHg/annum during the same period. On the other hand, in rapidly changing Malawi mature adult, rural and urban blood pressures are rising fast despite a low salt intake. Thus the evidence today argues that the most important factor in the etiology of essential hypertension is not salt but psychosocial stimulation.
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PMID:Stress, salt and hypertension. 327 18

The present study attempted to determine if exercise, in the absence of physical training, could alter development of hypertension during chronic exposure to a psychosocial stressor. Two groups of genetically normotensive rats were exposed to social stress for 7 days, following 5 weeks of acclimation to social isolation. One group had access to exercise in a running wheel during the stress period, while the second group did not. Blood pressure, heart rate, body weight, and running activity were monitored throughout the study, and heart and adrenal gland weights were obtained following sacrifice of the animals after exposure to stress. Blood pressure increased significantly to hypertensive levels on days 4 and 7 in the group denied access to exercise but was unchanged in the exercise group. Degree of attenuation of stress-induced hypertension was unrelated to amount of running activity. There were no differences in body weight, heart rate, or organ weight between groups. Exercise appeared to act specifically via diversional, or coping, mechanisms to buffer the response of the body to stress.
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PMID:Attenuation of stress-induced hypertension by exercise independent of training effects: an animal model. 356 Feb 14

Multiple factors contributing to coronary heart disease (CHD) and underlying atherosclerosis have been identified. Biologic factors include aging, gender, and family history. Potentially modifiable risk factors are: cigarette smoking; high blood pressure; elevated levels of plasma total and low density lipoprotein and low levels of high density lipoprotein cholesterol; diabetes mellitus; obesity; dietary habits; physical inactivity and poor physical fitness; and perhaps response to psycho-social stress. CHD risk increases with the number of risk factors and their levels. Resting and exercise ECG abnormalities further increase risk. Because of differences in levels of these risk factors, a great deal of variability exists in probability of CHD at any age. Using age alone to predict risk of heart attack results in high rates of false positives. Favorable alterations in modifiable risk factors by the American public appears to be primarily responsible for the progressive decline in CHD mortality rates in this country since 1968. This decline has occurred at all ages during a period of dramatic increase in prevalence of people over 65 yr of age in the United States. This confirms that modifiable risk factors are much more important than age in the etiology of CHD, and clearly demonstrates that CHD is not an inevitable part of the aging process.
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PMID:Age and other predictors of coronary heart disease. 357 48

The effects of decaffeinated green tea on CBA mice have been contrasted with those of water during 3 to 5 months of exposure to various intensities of social stress. Intensity was modified by using different types of caging: Henry-Stephens complex population cages for maximum stress, open field population cages for intermediate levels, and siblings in standard mouse boxes for minimal stress. Two population densities were used: high, with 16 males and 16 females per population cage; and low, with approximately half this number. In three sets of experiments, 58 comparisons were made between body weight, blood pressure, pulse rate, scarring, blood urea nitrogen (BUN), adrenal and heart weights, plasma corticosterone, adult male mortality, and number of weanlings of those on decaffeinated green tea and matched groups on water. Twenty-five of the comparisons indicated less arousal with the decaffeinated green tea and in none was the water favored. Blood pressure fell from 150 to 133 mm Hg. These results support the proposal that the polyphenols (bioflavonoids) of tea may have a beneficial sedative action.
Hypertension
PMID:Reduction of chronic psychosocial hypertension in mice by decaffeinated tea. 653 55


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