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)

Angiotensin-converting enzyme (ACE) inhibitors are a group of drugs recently introduced to treat hypertension and congestive heart failure. There are many reports of a dry cough in patients treated with (ACE) inhibitors, but this is often considered a rare side effect. Eleven of 30 patients treated with the investigational ACE inhibitor cilazapril complained about a chronic cough.
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PMID:Cough caused by cilazapril. 296 78

Cough accompanied by an increased sensitivity of the cough reflex is the most common symptom of inflammatory airway disease. This symptom is also frequently reported in patients receiving angiotensin-converting enzyme (ACE) inhibitors as therapy for heart failure or hypertension, although the underlying mechanism is unknown. We have investigated the possibility that the inflammatory peptide bradykinin, normally degraded by ACE, causes sensitization of airway sensory nerves and an enhancement of the cough reflex in conscious guinea pigs. Treatment of guinea pigs for two weeks with captopril led to an increased cough response to inhaled citric acid, which was prevented by concomitant treatment with the bradykinin receptor antagonist icatibant. A similar icatibant-sensitive enhancement of citric acid-evoked cough was seen in untreated animals after prior inhalation of bradykinin, although cough evoked by hypertonic saline was unaffected. In electrophysiological studies performed in vitro, responses of single vagal C fibers to capsaicin, applied to receptive fields of single-fiber units in the trachea, were also markedly increased after perfusion with bradykinin, whereas A delta fiber responses to hypertonic saline were unaffected. These results indicate that bradykinin-evoked sensitization of airway sensory nerves may underlie the pathogenesis of ACE-inhibitor cough. Bradykinin receptor antagonists may be of benefit in treating chronic cough seen with this and other inflammatory conditions.
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PMID:Bradykinin-evoked sensitization of airway sensory nerves: a mechanism for ACE-inhibitor cough. 867 30

Gastroesophageal reflux disease (GERD) is the abnormal retrograde flow of gastric contents into the esophagus. While disorders of the esophagus related to GERD are fairly well characterized, supraesophageal symptoms may be nonspecific and easily missed. Fewer than half of the patients with otolaryngologic complications of reflux exhibit the classic findings of heartburn and regurgitation. GERD has been implicated in a broad range of disorders including laryngitis, chronic hoarseness, globus pharyngeus, laryngeal carcinoma, cricopharyngeal hypertension, Zenker's diverticulum, and chronic cough. A high index of suspicion is essential for timely diagnosis and treatment of the otolaryngologic manifestations of GERD.
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PMID:Otolaryngologic manifestations of gastroesophageal reflux disease. 1031 2

Arterial hypertension is a major risk factor for microangiopathic diabetic complications and associated with an increased cardiovascular morbidity and mortality. An intensified antihypertensive treatment reduces microangiopathic complications and cardiovascular morbidity and mortality in diabetic patients. Even in normotensive type 1 and type 2 diabetic patients, the treatment with ACE inhibitors may prevent the later development of diabetic nephropathy. Treatment with ACE inhibitors increases the concentrations of bradykinin, which is responsible for the side effects such as cough and urticaria in some patients. On the other hand, bradykinin may have beneficial intrarenal effects decreasing the intraglomerular pressure. The novel angiotensin II receptor type 1 antagonists do not influence the bradykinin concentrations and seem to be tolerated by patients suffering from chronic cough with ACE inhibitor therapy. It is still unclear whether the different intrarenal effects are of clinical relevance in the long-term treatment of diabetic patients. In studies with diabetic animals the nephroprotective effects of ACE inhibitors and angiotensin II type 1 receptor antagonists are comparable. It was shown that glucose and lipid metabolism is not influenced by treatment with angiotensin II type 1 receptor antagonists. Further compared to Felodipine the reduction of urinary albumin excretion rate (UAER) was more pronounced by Losartane in Chinese type 2 diabetic patients. Short-term studies directly comparing the renal effects of ACE inhibitors with AT II type 1 receptor antagonists revealed similar reduction of blood pressure and albumin excretion rate in patients with diabetic nephropathy, so a combination of both substances might be useful. Data from ongoing long-term trials are still missing. Further, it is unknown whether different phenotypes of the ACE gene (DD, II polymorphism) require different therapeutic options. In conclusion, treatment with angiotensin II receptor antagonists is well-tolerated and has no adverse effects on metabolic control in diabetic patients. The beneficial effect on microangiopathic complications however has to be proven in randomized long-term studies in direct comparison with ACE inhibitors, which were clearly shown to delay the development and progression of diabetic nephropathy.
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PMID:[Angiotensin II type-1 receptor antagonists and diabetes mellitus]. 1145 Jan 65

Angiotensin-converting enzyme (ACE) inhibitors are among the first-choice drugs for treating hypertension and congestive heart disease. It has been reported, however, that these drugs could induce chronic cough and airway hyperresponsiveness. The aim of this work was to assess in pigs the effects of bradykinin and tachykinins on citric-acid-induced coughing after ACE inhibitor pretreatment. Coughing was induced by challenging pigs with an aerosol of 0.8 M citric acid over 15 min. Coughs were counted by a trained observer for 30 min. The animals underwent two cough induction tests two days apart (days 1 and 3), the first being taken as a control. All drugs were injected intravenously 30 min before the second challenge. In the control group, no difference was observed between days 1 and 3. The ACE inhibitor enalapril (7.5 and 15 microg/kg) caused the cough frequency to increase significantly. In contrast, a dose-related decrease was observed with Hoe140 (icatibant), a bradykinin B2 receptor antagonist (0.5 and 1 mg/kg). When both drugs were administered simultaneously (15 microg/kg for enalapril and 1 mg/kg for Hoe140), a significant increase was observed as compared with the control value obtained on day 1. When enalapril was combined with the three tachykinin receptor antagonists SR 140333 (NK1 receptor antagonist), SR 48968 (NK2 receptor antagonist) and SR 142801 (NK3 receptor antagonist), a significant decrease was observed as compared with control value obtained on day 1; the percentage of variation was also significantly different as compared with those observed in enalapril groups at both doses. These data suggest that ACE-inhibitor-induced enhancement of the cough reflex is mainly due to tachykinins and not to bradykinin in our pig model. Bradykinin, however, plays a major role in coughing induced by citric acid alone.
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PMID:Role of bradykinin and tachykinins in the potentiation by enalapril of coughing induced by citric acid in pigs. 1146 10

This study had three objectives: firstly, it aimed to examine an appropriate model for preventing and controlling the risk of meningococcal disease as a result of an epidemic carrying by returning pilgrims at Hat Yai International Airport; secondly, it aimed to establish the number of meningococcal carriers among pilgrims returning from Saudi Arabia; thirdly, it considered the health problems that arose during the Hajj pilgrimage. A structured questionnaire was used to collect data from 374 pilgrims at the Hat Yai airport checkpoint between March 15th and April 2nd, 2001. Each subject provided a naso-pharyngeal swab and reported on their health status by postcard once they had reached their homes 7-10 days later. It was found that most of the pilgrims were from Satun Province (23%). The average age was 50.5 years (range 20 to 86; SD 12.8). More than half of the pilgrims had some knowledge of meningococcal meningitis. Most, about 80.7%, knew that vaccination against meningococcal infection is required before traveling to Saudi Arabia. About 77.8% were vaccinated at the Provincial Health Office (PHO) in their hometown. Nearly 19% had underlying diseases such as chronic cough, asthma, diabetes, hypertension, headache and rheumatism. During their pilgrimage some were troubled by symptoms of respiratory tract disease, fever and headache. All had negative laboratory results. Only 16.6% returned postcards describing their self-assessed health status. About 30.6% described themselves as healthy. Among those who reported sick, coughs, sore throats and stomach aches were prevalent. Health education and public information about vaccine need to be strengthened. The best place to get the vaccination is their hometown PHO. Trained health personnel, instead of tour leaders or guides, should pay attention to the health of the pilgrims. The tour leaders are an important target group for improved health knowledge because most pilgrims will trust and follow them. Even though there were negative laboratory results, it is worth having a good surveillance system for meningococcal meningitis in order to prevent epidemics and reduce mortality among returning pilgrims.
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PMID:Surveillance for meningococcal carriage by Muslims returning from the Hajj to Hat Yai Airport, Thailand. 1297 92

Improved recognition of the relationship between childhood and adult blood pressures and identification of end-organ damage in children, adolescents, and young adults with hypertension has led to increased focus by pediatricians and general practitioners on the detection, evaluation, and treatment of hypertension. Notably, detection, evaluation, and treatment of pediatric hypertension has increased significantly since the first Task Force Report on High Blood Pressure in Children and Adolescents in 1977 with advances in both nonpharmacologic and pharmacologic treatments.Angiotensin-converting enzyme inhibitors (e.g. captopril, enalapril, lisinopril, ramipril) and calcium channel antagonists (e.g. nifedipine, amlodipine, felodipine, isradipine) are the most commonly prescribed antihypertensive medications in children due to their low adverse-effect profiles. Diuretics (e.g. thiazide diuretics, loop diuretics, and potassium-sparing diuretics) are usually reserved as adjunct therapy. Newer agents, such as angiotensin receptor antagonists (e.g. irbesartan), are currently being studied in children and adolescents. These agents may be an option in children with chronic cough secondary to angiotensin-converting enzyme inhibitors. beta-Adrenoreceptor antagonists (e.g. propranolol, atenolol, metoprolol, and labetalol), alpha-adrenoreceptor antagonists, alpha-adrenoreceptor agonists, direct vasodilators, peripheral adrenoreceptor neuron agonists, and combination products are less commonly used in pediatric patients because of adverse events but may be an option in children unresponsive to calcium channel blockers, angiotensin converting-enzyme inhibitors, or angiotensin receptor blockers.
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PMID:Pharmacologic treatment of chronic pediatric hypertension. 1577 9

A 58-year-old woman presented with chronic cough felt to be multifactorial secondary to asthma, gastroesophageal reflux disease, and chronic sinusitis. Additional medical history included obstructive sleep apnea, type 2 diabetes, and hypertension. She had a 40- year history of tobacco use, but quit 10 years ago. Her examination was significant for obesity and cobble stoning of the oropharynx. Pulmonary function testing and arterial blood gases were unrevealing. Chest films were normal. High-resolution computed tomography revealed multiple focal lucencies in a mosaic pattern consistent with air trapping and small airways disease. Bronchoscopy revealed normal airways and a noninflammatory bronchoalveolar lavage. Transbronchial biopsies revealed inflammatory infiltrates of the peribronchiolar interstitium. Lung biopsy revealed pulmonary neuroendocrine cell hyperplasia with tumorlets that stained positive for neuroendocrine tissue. We present the case of a woman with chronic cough, multiple medical problems, and pulmonary neuroendocrine cell hyperplasia with tumorlets.
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PMID:The demonstration of pulmonary neuroendocrine cell hyperplasia with tumorlets in a patient with chronic cough and a history of multiple medical problems. 1597 15

Since 1990, a large number of people have been experiencing various health problems from drinking arsenic contaminated water (50-1860 microg/L) in 13 counties of Inner Mongolia, China, most of which are located in the Hetao Plain area. It is calculated that 411,243 people are currently at risk from arsenic poisoning. Clinical and epidemiological investigations were carried out on 13,021 people to ascertain the nature and degree of morbidity that occurred due to chronic arsenic toxicity. In all of the studied patients, 22% had typical hyperkeratosis on the palms or soles and some had raindrop-like hyperpigmentation and depigmentation on the trunk. Other data recorded included subjective and objective symptoms, such as chronic cough (35.0%) and insomnia (37.5%). During physical checkups of 680 villagers in arsenic affected areas, liver function tests showed elevated globulin levels in 6.8% (P value=0.006) of the subjects. Neurotoxicity manifesting as loss of hearing 5.88 (P value=0.005), loss of taste 5.44% (P value=0.001), blurred vision 17.35% (P value=0.000), tingling and numbness of the limbs 33.53% (P value=0.000) and hypertension 8.09% (P value=0.000) were significantly higher in the arsenic affected villages and arsenic pollution also seemed to affect patients' social life and mental health. To solve the problem of arsenic exposure, the quality of drinking water needs to be improved by reducing the arsenic content. We also plan to carry out a survey to detect the incidence and types of cancer among this population.
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PMID:Chronic arsenic poisoning in drinking water in Inner Mongolia and its associated health effects. 1795 86

Once the diagnosis of pulmonary arterial hypertension is established, wheezing and chronic cough are rarely described during the course of the disease. The present study reports on two nonsmoking patients with severe pulmonary arterial hypertension, confirmed by right-heart catheterisation, who developed chronic cough, wheezing and irreversible obstructive lung disease masquerading as adult-onset severe refractory asthma. In both cases, extrinsic proximal airway obstruction by dilated pulmonary arteries was demonstrated by fibreoptic bronchoscopy and computed tomography of the chest. The present observations add dilatation of the central pulmonary arteries with compression of the mainstem bronchi to the list of masqueraders of asthma in patients with pulmonary arterial hypertension.
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PMID:Pulmonary arterial hypertension masquerading as severe refractory asthma. 1866 91


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