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

Ventricular ectopic beats (VEB) were studied in 100 consecutive patients prior to discharge after an acute myocardial infarction and again after 1 yr, on 6-h recordings. VEB were found in 71 patients prior to discharge. Reinfarction and sudden death taken together were significantly more common in the 35 patients who had severe VEB, i.e. multiform, paired, R-on-T or ventricular tachycardia (P less than 0.05). Reinvestigation after 1 yr of 73 survivors who had not reinfarcted revealed a nonsignificant overall increase in patients with VEB from 67 to 78% together with an increase in degree of severity. The intraindividual pattern, however, differed considerably. Several clinical findings including angina pectoris, heart fialure, hypertension, diabetes mellitus, hyperlipidemia, antiarrhythmic therapy, and smoking, failed to differentiate patients with increasing VEB severity from the remainder.
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PMID:Ventricular arrhythmias prior to discharge and one year after acute myocardial infarction. 89 82

One hundred and seventy Black diabetic patients who regularly attend the Baragwanath Diabetic Clinic were studied. Just over 50% of patients suffered from hypertension, and 10% had angina pectoris. Retinopathy was present in 25% of the patients. The incidence of hypertriglyceridaemia and hypercholesterolaemia was much lower than has previously been found among White diabetic patients in Johannesburg. Attention is drawn to the lack of adequate health education given to Black diabetic patients and also to the reliance on oral hypoglycaemic agents in preference to dietary therapy. It is suggested that there is a need for health educators from the patient's own ethnic group if these problems are to be overcome.
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PMID:Problems experienced in a diabetic clinic for Blacks. 89 12

In a retrospective study by means of a half-standardized method of interview in 154 patients with acute myocardial infarction and in a control group of the same age (n = 100) anamnestic data were established, particularly taking into consideration the preinfarction phase. 27% of the patients were surprised by an acute myocardial infarction without prodromal symptoms, in 32% the first occurrence of complaints of angina pectoris was during the last two months before the infarction. 41% had a preexisting angina pectoris which usually showed a crescendo-course with increasing approximation to the infarction. More than half of the patients reported on physical activity or/and emotional stress as causal factors of the preinfarction complaints. The correlation with the localisation of the infarction showed above all an occurrence of the prodromal symptoms in infarctions of the anterior wall and in lesions of the myocardium which in most cases could be ascertained only enzymatically. A greater accumulation of the prodromi was furthermore found in younger patients, in hypertension and preexisting restriction of the heart function. 70% of the patients with warning symptoms consulted a physician because of their heart complaints. In the control group 22% of the persons reported on heart complaints.
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PMID:[Catamnestic studies on the prodomal phase of myocardial infarct]. 91 May 29

A clinical and metabolic study of 61 patients with myoocardial infarct before the age of 40 yr showed a high frequency of familial involvement, particularly in subjects with type IIA and IIB hyperbetalipoproteinaemia. Excess weight and arterial hypertension were rare, while premonitory angina was absent in 59%. Four subjects were diabetic. Oral glucose tolerance was normal in 14 and of diabetic type in 26 of 40 patients examined; the insulin response pointed to insulin-resistance. Dyslipidaemia was noted in 45%, including type IIA and IIB hyperbetalipoproteinaemia in 27%. Distribution of the frequency of infarct in function of cholesterolaemia classes gave a bimodal curve indicative of distinct normo- and hypercholesterolaemic groups within the series. Reduced glucose tolerance was more frequent in patients with low blood cholesterol. This suggests that reduced tolerance and high blood cholesterol are independent risk factors in coronary disease. No relation between the clinical and metabolic data could be ascertained.
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PMID:[Clinical and metabolic aspects of juvenile myocardial infarct]. 99 98

The records of 185 consecutive patients having myocardial revascularization were reviewed with regard to preoperative administration of propranolol and intraoperative or postoperative complications. Tachycardia and hypertension before cardiopulmonary bypass were slightly more common in patients never taking propranolol or those who had discontinued it for more than 48 hours before operation. There was no statistically significant difference in the incidence of postbypass hypotension among patients who took propranolol within 24 hours of operation, those who discontinued it more than 24 hours before operation, and those who never took the drug. Operative mortality was not significantly different among patients who received propranolol within 48 hours of operation (3%), those who never took it and those who discontinued it more than 48 hours before operation (4%). Early in the series, five patients had an acute myocardial infarction within 48 hours after routine preoperative withdrawal of propranolol. Because complete withdrawal of propranolol in patients with unstable angina pectoris may lead to acute myocardial infarction, we recommend gradual withdrawal of the drug during 48 hours before operation. If this is not possible because anginal pain recurs or intensifies, then reduced doses may be given safely up to 10 hours before revascularization, provided that the patient is a satisfactory candidate for bypass and that adequate myocardial revascularization can be accomplished.
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PMID:Propranolol therapy in patients undergoing myocardial revascularization. 99 7

Studies of the pulmonary circulation in normal man, performed with external radiation detectors, have shown that pulmonary blood volume is about 10% of total blood volume. Pulmonary blood volume was unchanged in patients with acute or chronic left atrial hypertension and in normal persons during expansion of total blood volume in spite of marked increases in pulmonary vascular pressures. However, pulmonary blood volume was greatly increased in patients with polycythemia rubra vera and a large total blood volume and in patients with a left to right shunt but normal pulmonary intravascular pressure. Studies of regional myocardial perfusion with injection of xenon-133 solution into the left coronary artery revealed localized areas of ischemia distal to stenotic lesions even when the patient was at rest. During angina produced by pacing, more severe ischemia occurred, thus suggesting that functional factors reduce local perfusion below resting levels. In patients with "variant" angina, intravenous injection of thallium-201 chloride during spontaneous attacks has revealed large cold areas in myocardial scintigrams not present under control conditions, thus suggesting severe transmural reduction of perfusion in heart muscle corresponding to S-T segment elevation in the electrocardiogram.
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PMID:Pathophysiologic studies of the pulmonary and coronary circulations in man. 99 14

157 cases affected with "unstable angina" and hospitalized were observed over a period of from 8 to 24 months (average observation time: 16 1/2 months). The patients were treated with: nitroderivates, beta blocking drugs (when not contra-indicated); treatment of side affects (hypertension; arrhythmias, decompensation, associated pathology, correction of risk factors of coronary heart disease). 9 cases were lost and 148 were studied for the course of the illness. 10.6% died from cardiopathy (2.8% through sudden death; 7.4% from myocardial infarction); there was a 12.1% total incidence of myocardial infarction; 50% of the cases were alive but with sumptoms of stabilized angina, whilst 32.4% were completely asymptomatic. Coronographic alterations and myocardial contractility negatively affect the course of the illness. Negative effects (disease or infarction) were not checked in the cases of stenosis of only one coronary branch. In the casuistry, there were no negative effects in patients with stenosis of one coronary branch, and in cases of two or more branches, negative effects were 28%. 41% of patients with alterations of ventrical contractility gave negative results. An asymptomatic course of the illness was checked more frequently in the intermediate stages than in angina cases.
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PMID:[Natural history of unstable angina. Observations on 157 cases (author's transl)]. 101 Jan 71

Coronary and left ventricular angiography repeated after an interval of 19 months in 84 patients showed progression of coronary sclerosis in 42 and of ventricular lesions in 7. No relation between the morphology and seriousness of the initial coronary lesions and their progression was noted. No significant differences were observed between patients with and without progression as far as the clinical data and risk factors (angina pectoris, prior myocardial infarct, cholesterol, arterial hypertension, and diabetes) were concerned, though there was a significantly higher percentage in obese subjects.
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PMID:[Progression of coronary sclerosis demonstrated by repeated coronarography. Experience with 80 cases]. 101 15

Exercise electrocardiograms were done on one thousand patients referred to the laboratory of exercise tests for: suggestive symptoms of acute heart failure, old miocardial infarction abnormal resting ECG, or evaluation of coronary reserve. The average value of cardiac rate reached for the group, was close to 80%. The maximum exercise loads managed by the men were superior to those of the women, and in general those managed in the negative test were superior in relation to the positive tests. Of the one thousand cases, 20.2% had positive exercise ECG's. There was no difference inthe percentages of positivity between the two sexes, 20.75% and 19.11% for men and women respecitvely. The percentages of positivity are greater in those subjects sent to the laboratory for suspicion of angina pectoris, old MI, or abnormal resting ECG, than in those referred for detection of ischemic heart disease. The groups of patients with diabetes mellitus, arterial hypertension, old MI, and abnormal resting ECG had the highest incidence of positive tests: 41%, 37.5%, 30.6%, and 28.2% respectively. The most frequent localization of the ST segment alterations was the anterior portion, with percentages of 85.1% similar to those mentioned in the literature. The frequency of arrithmias, of 12.4% in this group, is a little less than that described in similar groups, but it corroborates the predominance of non-lethal ventricular arrithmias. The mortality in the tests performed was null.
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PMID:[Results of 1000 electrocardiographic exercise tests. Their correlation with previous ischemic cardiopathy and arteriosclerotic risk factors]. 102 33

The authors study the long-term prognosis of a population of male subjects having survived 24 to 48 hours to their first myocardial infarction. The mean annual mortality is 6%. The long-term cumulated survival is particualarly influenced by a high blood pressure and by heart failure occurring during the acute episode and in a lesser proportion by age; the prognosis at long-term is not or little influenced by family history, cholesterolemia, cigarette smoking or the presence of angina before infarction. The presence or absence of heart failure and high blood pressure allows to make sub-groups with very different long-term prognosis. In the framework of secondary prevention of ischaemic heart diseases, the authors propose to start a controlled study implying both a programme of physical activity and a long-term energical treatment of arterial hypertension.
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PMID:[Long-term prognosis of myocardial infarct]. 108 65


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