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)

Concomitant arterial hypertension and metabolic disorders is a frequent finding raising the risk of micro- and macrovascular complications. While prevalence of stroke and myocardial infarction is going down in hypertensives, end-stage renal disease (ESRD) becomes a bigger problem especially in diabetic hypertensives. The metabolic abnormalities are linked to the hypertension by the sympathoadrenal system mediated by insulin resistance (IR); subjects with hyperinsulinemia and increased sympathetic activity tend to have higher blood pressure, typical dyslipidemia, reduced fibrinolytic activity and other risk factors (RF) called metabolic syndrome of IR. Albuminuria (AUR) is considered as an important RF for the development of nephropathy, ESRD, cardiovascular diseases. AUR is a marker of cardiovascular and total mortality in diabetic and/or non-diabetic hypertensives. AUR reflects the endothelial dysfunction not only in glomerulus but also in the other arteries. Tissue Renin-Angiotensin System plays a significant role in the pathogenesis of hypertension and metabolic disorders; it affects the arterial wall, kidneys and heart longitudinally. Life style is very essential in the treatment of hypertension and metabolic disorders: rational diet with reduced amount of salt and animal proteins, non-smoking and sufficient physical activity. Antihypertensive drugs without any metabolic side effects and with the renal protection are necessary for the patients with hypertension and metabolic disturbances. ACE-inhibitors and/or some of the Ca-antagonists seems to be valuable especially as combined therapy.
 ...
PMID:[New approaches in the treatment of hypertension in metabolic diseases]. 972 74

Life style measures (weight reduction and control, reduction of total fat calories to < 30% of total calories, modification of fat intake to increased monounsaturated vegetable fat, increased intake of dietary fibers, increased physical activity, controlled stress relaxation) are the basis of longterm therapy of coronary heart disease. For transformation to daily life both patient and doctor need motivation, information, patience, and realistic aims. For realization the 10 rules of medical information should be followed. The patient must be informed that the "new lifestyle" is not punishing but means a new quality of life. With respect to the most important metabolic syndrome with hyperinsulinemia due to insulin resistance, weight reduction is the most important measure for preventing complications of atherosclerosis. The patient should use a diary for weight control and blood pressure self-measurement. Secondary prevention of CHD has been shown useful and effective; however, most patients need additionally drug therapy to avoid or retard progression of the coronary heart disease. The targets for cholesterol and blood pressure control are low; the responsibility of the patient remains high. Besides weight reduction, stopping smoking, lowering lipids, controlling hypertension, and aspirin are the most important.
 ...
PMID:[Changes in life style as a causal therapeutic approach in coronary heart disease]. 982 71

Death from myocardial infarction was a rare clinical entity at the beginning of this century, but with an ageing population it is poised to become the most common cause of death worldwide. Ample epidemiological evidence confirms the clinical impression that cardiovascular risk factors--hypertension, glucose intolerance, dyslipidaemia, obesity--tend to 'cluster' in individual patients. This metabolic syndrome, or 'Syndrome X', which is thought to be underpinned by decreased insulin sensitivity, was first described in 1966 by Camus and popularized by Reaven in 1988. The enthusiasm and interest generated have led to the elucidation of some details concerning the pathogenesis of insulin resistance and coronary artery disease but have done little to change treatments or outcomes. Meanwhile, a global epidemic of Type 2 diabetes mellitus is said to be on the horizon- and it has been calculated that by the year 2230, 100% of the adult United States population will be obese.
 ...
PMID:The metabolic syndrome: overeating, inactivity, poor compliance or 'dud' advice? 982 66

The AT1 receptor mediates many biological effects of the renin angiotensin system such as vasoconstriction and cell proliferation. The expression level of the AT1 receptor is subjected to various pathophysiological influences. Insulin, which is elevated in the metabolic syndrome, induces a overexpression of vascular AT1 receptors leading to an enhanced biological efficacy of angiotensin II. This heterologous regulation of the AT1 receptor by insulin may explain the fact that the metabolic syndrome is frequently associated with hypertension and atherosclerosis.
 ...
PMID:Interaction between insulin and AT1 receptor. Relevance for hypertension and arteriosclerosis. 983 76

Experimental models of genetic hypertension are used to develop paradigms to study human essential hypertension while removing some of the complexity inherent in the study of human subjects. Since 1991 several quantitative trait loci responsible for blood pressure regulation have been identified in various rat crosses. More recently, a series of interesting quantitative trait loci influencing cardiac hypertrophy, stroke, metabolic syndrome and renal damage has also been described. It is recognized that the identification of large chromosomal regions containing a quantitative trait locus is only a first step towards gene identification. The next step is the production of congenic strains and substrains to confirm the existence of the quantitative trait locus and to narrow down the chromosomal region of interest. Several congenic strains have already been produced, with further refinement of the methodology currently in progress. The ultimate goal is to achieve positional cloning of the causal gene, a task which has so far been elusive. There are several areas of cross-fertilization between experimental and human genetics of hypertension, with a successful transfer of two loci directly from rats to humans and with new pharmacogenetic approaches which may be utilized in both experimental and clinical settings.
 ...
PMID:Genetics of experimental hypertension. 988 70

Obesity is an essential risk factor for hypertension, coronary heart disease and stroke as well as for metabolic disturbances, especially for type 2 diabetes, hyper- and dyslipidemia, and it is responsible for the metabolic syndrome with insulin resistance and hyperinsulinemia. Disturbances in the lung function are also induced by obesity, as a higher risk for arthrosis on the lower extremities. Some oncological diseases like breast-, endometrial-, and prostatic cancer are associated with obesity. It is evident, that the fat distribution plays an important role in the development of obesity associated diseases: the accumulation of visceral fat has a higher risk as the peripheral fat, probably due to the different metabolism.
 ...
PMID:[Obesity: entrance port to multimorbidity]. 988 99

While the hyperleptinemia of obesity is likely to be associated with the metabolic complications of obesity/hyperinsulinemia/insulin resistance, it is not associated with diabetes, with the relative hypercortisolism of upper body obesity, with hypertension in women, (it is in men), or with dyslipidemia. Overall, the correlations between leptin and the metabolic diseases associated with obesity are weak. The equivocal results of an association of leptin with components of the metabolic syndrome make it unlikely that leptin affects these directly. (On the other hand, these correlations, when found, preclude any causal relationship between leptin and metabolic diseases.) There are experimental data showing a definite role for insulin and glucocorticoids in the regulation of leptin, and of leptin in the regulation of insulin. More data are required on the effects of leptin, but it is likely that leptin will not be a major link between obesity and the metabolic syndrome. Certainly, however, when leptin is available for clinical use, its effect on different aspects of the metabolic syndrome will be worth studying.
 ...
PMID:Therapeutic controversy: Obesity--a modern-day epidemic. 992 54

Kuzmak's adjustable gastric banding procedure is well established and has proven to be efficacious in obese patients. After gastric banding we observed a good weight loss and an improvement in metabolic syndrome diseases. Therefore we were able to reduce the dosage of preoperative medication in patients with diabetes or hypertension.
 ...
PMID:[Reducing concomitant illnesses of morbid obesity after gastric banding]. 993 77

The aim of the study was to assess the total prevalence of obesity, non-insulin-dependent diabetes mellitus (NIDDM), hypertension, hypertriglyceridemia, hypercholesterolemia and central fat distribution, in a population-based survey. Two-hundred and ten individuals from the community were selected by random digit dialing. Obesity was defined as a body mass index > or = 25 kg/m2, central distribution of fat if the waist-to-hip ratio > 0.80 in women and 1.0 in men, diabetes was diagnosed if fasting plasma glucose levels > or = 140 mg/dl and/or currently under treatment, hypertension was defined as a systolic blood pressure > or = 140 mm Hg and/or diastolic blood pressure > 90 mm Hg and/or currently taking antihypertensive medications, hypertriglyceridemia was defined as a fasting serum triglyceride concentration > or = 200 mg/kg and hypercholesterolemia as a fasting serum cholesterol level > or = 200 mg/dl and/or currently taking specific medication. Prevalence rates of obesity, NIDDM, hypertension, hypertriglyceridemia, hypercholesterolemia and central fat distribution were 54.3%, 8.0%, 60.0%, 13.9%, 67.0% and 46.7% respectively. The prevalence of each of these conditions in its isolated form was 2.8% for obesity, 0.0% for diabetes, 3.8% for hypertension, 0.5% for hypertriglyceridaemia, 12.0% for hypercholesterolemia and 0.1% for the central fat distribution pattern. The large differences in prevalence between isolated and combined forms in the six disorders analyzed indicate a great overlap between these cardiovascular risk factors, and give epidemiologic support to a proposed metabolic syndrome.
 ...
PMID:[The clustering of cardiovascular risk factors in the urban population of Porto]. 1019 77

The more and more exact and simple determination of insulin provides an opportunity for exploration of the states of insulin resistance. It turned out hereby that the so-called type 1 diabetes is merely a consequence of insulin deficiency and it occurs mainly in the young. In contrary, the so-called type 2 diabetes is a multifactorial, often hyperinsulinaemic condition of insulin resistance and it occurs mainly in the adults. Furthermore, the epidemiological observations of the last decades elucidated that insulin resistance and compensating hyperinsulinaemia are common not only in type 2 diabetes but in other conditions as in ischaemic vascular diseases, hypertension, obesity, lipid alterations, coagulation disturbances, too. It became evident that the so-called late vascular complications of diabetes mellitus may develop before or without the existance of any disturbances in carbohydrate metabolism. These facts encouraged the recognition of metabolic syndrome-X. According to this hypothesis, insulin resistance and compensatorial hyperinsulinaemia are the causes of atherosclerosis, hypertension, upper body obesity, dyslipidaemia, type 2 diabetes and disturbances of coagulation. Following the last years, it became evident that hyperuricaemia, microalbuminuria and even type A personality are common in this syndrome of insulin resistance.
 ...
PMID:[From type 2 diabetes to metabolic X syndrome]. 1021 54


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