Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors compare the haemodynamic effects of intravenous nitroglycerin (IV TNT) in 14 patients developing hypertension (mean blood pressure greater than 90 mmHg) and in seven normotensive patients (70 less than mean blood pressure less than 90 mmHg) after cardiac surgery with extracorporeal circulation (ECC). TNT was administered at doses of 0.5, 1, 2 microgram.kg-1.min-1 then 2 microgram.kg-1.min-1 with the association of vascular filling in order to restore right and left arterial pressures to their initial values. Various haemodynamic parameters were measured or calculated. The results obtained: in the hypertensive patients, at the low dose (0.5 microgram.kg-1.min-1) a prevalent venodilatory action was noted: RAP: 7.64 +/- 2.76 p less than 0.05; LAP: 9.07 +/- 3.19 p less than 0.05; at the middle dose (1 microgram.mg-1.min-1) venodilation continued resulting in a fall in BP 95.28 +/- 26.11 p less than 0.01 and above all in Cl: 2.28 +/- 0.36 p less than 0.01; at the maximum dose used, the action of TNT affected both the venous and arteriolar sector causing a major fall in BP: 89.64 +/- 23.88 p less than 0.001, in Cl: 2.29 +/- 0.33 p less than 0.01 and above all RVSI: 19.94 +/- 6.24 p less than 0.05. The association of vascular filling led to an increase in RAP and LAP (p = NS), Cl (p = NS) whilst BP remained low: 92.78 +/- 17.56 p less than 0.001 and also RVSI: 18.12 +/- 4.44 p less than 0.01. In the normotensive patients the administration of TNT, whatever the dose used, did not cause any significant changes (p = NS). In conclusion, the authors emphasise the value of the use of TNT in postoperative hypertensive states, in particular when associated with myocardial ischaemia.
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PMID:[Value of intravenous nitroglycerin in hypertension after extracorporeal circulation]. 611 1

Pulmonary congestion is usually absent in cardiac tamponade. To examine the effects of experimental pericardial tamponade on pulmonary fluid volumes, we studied 14 anesthetized dogs with indicator-dilution techniques to measure extravascular (EVLW) and intravascular (PBV) pulmonary fluid volumes. Seven dogs were studied at two levels of tamponade and seven were studied during two levels of left atrial (LA) hypertension produced with an LA balloon. EVLW and PBV were measured in both groups at control state and then at two levels of elevated LA pressure (P). When LAP was raised by the balloon, PBV rose with the increase in LAP (4.9 +/- 2 cc/kg control at LAP 1.2 +/- 1.0 mm Hg versus 6.8 +/- 2.1 cc/kg at LAP 8.4 +/- 1.4 mm Hg and 6.8 +/- 2.1 cc/kg at LAP 14.7 +/- 2.0 mm Hg; both intervention PBV values p less than 0.01 vs control). During tamponade, PBV did not change (4.1 +/- 1.1 cc/kg at LAP 1.3 +/- 2.2 mm Hg control versus 4.4 +/- 1.0 cc/kg at LAP 7.4 +/- 1.4 mm Hg and 4.8 +/- 1.3 cc/kg at LAP 12.7 +/- 2.8 mm Hg). EVLW changes were similar during elevation of LAP in both groups (tamponade dogs 7.1 +/- 2.6 cc/kg, 7.1 +/- 1.6 cc/kg and 8.9 +/- 2.1 cc/kg, respectively; and LA hypertension dogs 6.9 +/- 2.5 cc/kg, 7.3 +/- 2.0 cc/kg, and 8.0 +/- 2.0 cc/kg, respectively. We conclude that during cardiac tamponade there is little change in PBV in response to rises in LAP. This is significantly different from the changes seen when increasing LAP by inflating an LA balloon, where fluid is shifted from the peripheral to the central circulation. EVLW changes were similar for the two methods during elevation of LAP.
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PMID:Intravascular and extravascular pulmonary fluid volumes during acute experimental pericardial tamponade. 637 32

To analyze left atrial (LA) pump function, aortic root echocardiograms and LA pressure (P) by a Millar 's catheter tip manometer were recorded simultaneously in 26 patients (pts) in regular sinus rhythm [six normal subjects (C), three with angina pectoris (AP), eight with old myocardial infarction (MI), three with congestive cardiomyopathy (CCM), three with hypertension (HT), one with hypertrophic cardiomyopathy (HCM), one with mitral regurgitation and mild stenosis (MRs), and one with mitral regurgitation (MR)]. The pressure-dimension curve of the LA composed of two loops; an A-loop (pump function of the LA) and a V-loop. The following parameters were measured: Da = LA dimension at the beginning of the active atrial shortening, S-A-loop = the area of the A-loop, mean V = mean LA velocity of fractional fiber shortening, and peak T = maximum (LAP X LAD) during active atrial shortening phase. The S-A-loop was directly proportional to Da (r = 0.62, p less than 0.001) and the mean V was inversely correlated with the peak T (r = -0.76, p less than 0.001). This indicated that Starling's mechanism was operative and force-velocity relation exited in the LA. In HT, Da, the S-A-loop, the ratio of the S-A-loop to Da, and the ratio of mean V to peak T tended to be larger than those in other pts groups. Thus, the present results suggested that LA pump function was augmented in HT, probably due not only to Starling's effect but also to enhanced inotropic state of the LA.
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PMID:[Studies on systolic performance of the left atrium]. 667 91

The present study was performed to compare hemodynamic effect of intravenous Nitroglycerin (TNT i.v.) in 14 patients developing acute hypertension (Group I) and in 7 non hypertensives after open heart surgery (Group II). In all patients, m.a. 56.6 yrs, (10 mitral and/or aortic prosthetic valve replacements, 9 aorto-coronary bypass, 1 open mitral commissurotomy, 1 closure of atrial septal defect) TNT was infused at doses of 0.5, 1, 2 microgram X kg X min. and subsequently at 2 microgram X kg X min. after volume administration (2 + V.A.) to maintain right and left atrial pressure the same as control (P = N.S.). Mean arterial, right and left atrial pressures (MAP, RAP, LAP), cardiac frequency and index (CF, CI and systemic vascular resistance index (SVRI) were monitorized. TNT i.v. resulted in hypertensive patients (Group I) in reduction vs. control of: a) RAP (--20.17%) and LAP (--20.58%) at 0.5 microgram X kg X min. b) RAP (--26.13%), LAP (--27.50%), MAP (--19.94%) and CI (--12.98%) at 1 microgram X kg X X min. c) RAP (--22.47%), LAP (--26.89%), MAP (--24.68%), CI (--12.6%) and SVRI (--17.34%) at 2 microgram X kg X min. When RAP and LAP was maintained by volume administration TNT i.v. (2 microgram X kg X min.) resulted in an even greater increase in CI and a greater decrease in MAP and SVRI ((--22.04% and --24.88% respectively). No significant hemodynamic modification (P less than or equal to 0.05) were observed in non hypertensive patients (Group II) at all doses of TNT i.v. The results confirm a predominant venodilator effect of TNT at low doses and a good effect on arterial resistances at high doses in hypertensive patients. In view of previous reports of differing effects on ischemia TNT i.v. may be preferable to other vasodilator drugs for control of acute post-ECG hypertension, only on condition to maintain an adequate left ventricular filling pressure to prevent a fall of cardiac index. Moreover the absence of significant (P less than or equal to 0.05) hemodynamic modifications in non hypertensive patients may be a further advantage in the treatment of myocardial ischemia with i.v. TNT.
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PMID:[Effect of intravenous nytroglicerin in hypertensive patients during and after open heart surgery (author's transl)]. 678 Apr 1

The hypertension immediately after open heart surgery for coronary heart disease was chosen to evaluate the suitability of computer-controlled infusion sodium nitroprusside, to improve the circulatory state in heart failure by reducing the impedance to the left ventricular ejection. Sodium nitroprusside produced a prompt reduction of MAP to a preset level and a rise in cardiac index from an average of 2.1 +/- 0.3 to 2.4 +/- 0.4 when infused alone and to 3.1 +/- 0.5 1/min m2 (p less than 0.05, + 48%) after volume was infused to maintain LAP at a constant level to eliminate the effects of preload. The rise in cardiac index was associated with marked decrease in systemic vascular resistance from 2260 +/- 530 to 1415 +/- 280 and 1130 +/- 1130 +/- 270 dyns (p less than 0.005, 63%) respectively. The initial values of SVR correlated well with the fall of SVR (r = 0.78). Our results suggest that systemic vascular resistance is a strong indicator of the vascular responsiveness to vasodilation, the computer-controlled infusion of sodium-nitroprusside being suitable for the "titration" of the high systemic vascular resistance.
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PMID:[Hemodynamic effects of computer-guided blood pressure-lowering with nitroprusside sodium during the postoperative phase after aortocoronary bypass operations]. 698 28

The aim of this study was to evaluate the effects after 10 years of external valvuloplasty of the femoral vein (limited anterior plication or LAP). After informed consent patients with venous hypertension due to deep and superficial venous incompetence were randomized into two treatment groups. Both groups were treated with superficial vein surgery (ligation and section of the major incompetent superficial veins). Group 2 was treated with the same procedure and with LAP. External valvuloplasty of the superficial femoral vein was performed with plication of the anterior vein wall after limited dissection of the vein. Results were evaluated with color-duplex scanning and ambulatory venous pressure (AVP) measurements. Endpoints were AVP, refilling time (RT), presence/absence of reflux at the superficial femoral vein, the variation in the diameter of the vein, and quality of life score (QLS). No complications were observed. All femoral veins treated with LAP were competent after 10 years. Significantly lower AVP and longer RT were observed in the LAP group. Also the average diameter of the vein was smaller in the LAP group. Moreover, QLS was significantly better in the LAP group after 10 years. In conclusion, in selected subjects, with moderate deep venous incompetence, functional cusps, or incompetence mainly due to relative enlargement of the femoral vein, LAP may be an effective alternative to external valvuloplasty.
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PMID:External femoral vein valvuloplasty with limited anterior plication (LAP): a 10-year randomized, follow-up study. 1043 92

Possibly the most important outcomes of bariatric surgery involve changes in obesity-related illness, quality of life (QOL), and psychologic well-being. Dramatic improvement or resolution of serious medical comorbidity accompanies the weight loss following laparoscopic adjustable gastric banding with the LAP-BAND (INAMED Health, Santa Barbara, CA). There are major improvements in the conditions of the metabolic syndrome, which is characterized by impaired glucose tolerance, dyslipidemia, and hypertension. Improvement in insulin sensitivity and pancreatic beta-cell function associated with weight loss induces remission in the majority of type 2 diabetics and reduces the risk of others developing type 2 diabetes. Improvement in dyslipidemia is characterized by raised high-density lipoprotein cholesterol and lower triglyceride concentrations. Together with lower blood pressure, these changes provide a substantial reduction in cardiovascular risk. Other medical conditions caused or aggravated by obesity are also significantly improved, including sleep apnea, daytime sleepiness, asthma, and gastroesophageal reflux. Weight loss is associated with improved fertility and more favorable pregnancy outcomes. All aspects of QOL improve substantially, especially physical disability, and post-weight-loss QOL measures approximate those of the general population. There are also major improvements in body image and reduction in depressive illness. These changes provide perhaps the most compelling data regarding the value of LAP-BAND surgery and underlie the great satisfaction experienced by patients.
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PMID:Changes in comorbidities and improvements in quality of life after LAP-BAND placement. 1252 52

We present a case of peritonitis and death due to the misplacement of a laparoscopic adjustable band inserted through, instead of around, the stomach. This represents the first case in the published literature where a LAP-BAND perforated the stomach, followed by peritonitis and death. The morbidly obese female patient with a history of hypertension and arthritis was 47 years old, 5 feet 6 inches tall, weighed 361 pounds, and had a body mass index of 58.3. She underwent a 2-hour, elective, LAP-band insertion operation to achieve weight loss; 27 hours after band insertion, following the conduction of all FDA-mandated Lap-Band postoperative protocol (including a radiologic Gastrogrografin swallow), the patient was discharged with "no evidence of esophageal stasis or obstruction." She remained out of hospital care and in her residence until she called for and was taken by an ambulance to an alternate, local hospital (57 hours after band insertion), when gastric perforation was confirmed via x-ray and CT scans. No open surgery was attempted to repair the damage, and cardiac arrest ensued 7 hours after admission to the second hospital. The patient was pronounced dead 64 hours after LAP-band insertion. This unique case is significant, given that there were no deaths of this kind reported in The LAP-BAND(R) Adjustable Gastric Banding System Summary of Safety and Effectiveness Data by the United States Center for Devices and Radiologic Health, of the Food and Drug Administration, or in searches of the published literature.
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PMID:LAP-banding obesity: a case of stomach perforation, peritonitis, and death. 1612 Oct 91

Many types of bioactive peptides that inhibit angiotensin I, angiotensin I converting enzyme (ACE) and Ang II type 1 receptor (AT1) in the cardiovascular system contribute to the prevention and treatment of hypertension. These inhibitory peptides are derived from many food proteins or artificial synthetic products. Further research examining the bioavailability of ACE inhibitory peptides will lead to the development of more effective ACE inhibitory peptides and foods. Our research also demonstrates that ACE inhibitory peptide LAP may lower blood pressure with no adverse effects.
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PMID:The antihypertensive effect of peptides: a novel alternative to drugs? 1838 15

Lentinus edodes is the first medicinal macrofungus to enter the realm of modern biotechnology. It is the second most popular edible mushroom in the global market which is attributed not only to its nutritional value but also to possible potential for therapeutic applications. Lentinus edodes is used medicinally for diseases involving depressed immune function (including AIDS), cancer, environmental allergies, fungal infection, frequent flu and colds, bronchial inflammation, heart disease, hyperlipidemia (including high blood cholesterol), hypertension, infectious disease, diabetes, hepatitis and regulating urinary inconsistencies. It is the source of several well-studied preparations with proven pharmacological properties, especially the polysaccharide lentinan, eritadenine, shiitake mushroom mycelium, and culture media extracts (LEM, LAP and KS-2). Antibiotic, anti-carcinogenic and antiviral compounds have been isolated intracellularly (fruiting body and mycelia) and extracellularly (culture media). Some of these substances were lentinan, lectins and eritadenine. The aim of this review is to discuss the therapeutic applications of this macrofungus. The potential of this macrofungus is unquestionable in the most important areas of applied biotechnology.
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PMID:Lentinus edodes: a macrofungus with pharmacological activities. 2049 36


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