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

As part of an epidemiological study of hypertension, an analysis was made of the general practitioner records of all attenders at a screening survey. A blood pressure recording, made before screening, was found in 37-9 per cent of cases. The pressures obtained correlated well with those obtained by the screening unit, though the practitioners' readings tended to be lower. Further cases of hypertension were found, not diagnosed by the screening unit; the estimate made of the prevalence of hypertension at the survey could be corrected by inclusion of these cases. Chest pain, headaches, lightheadedness, and dizziness were common reasons for blood pressure measurement in general practice, but these symptoms were not associated with a rise in the blood pressure; symptoms were not helpful in the diagnosis of hypertension. Some form of screening programme is necessary to detect cases of hypertension. This could be carried out by general practitioners.
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PMID:Blood pressure measurement at screening and in general practice. 83 40

Prazosin was used as an additional antihypertensive agent for treating 38 patients with hypertension and renal functional impairment. The drug was effective in 29 of these patients at a mean daily dose of 7 mg. The mean blood pressure fall in these 29 patients was 28/22 mm Hg. The most frequent (10 patients) and important side effect of prazosin treatment was dizziness, which occurred on standing of after exertion and was seen either after the first dose or after a large dose increase. The "first-dose phenomenon" was a result of severe postural hypotension and was eliminated by using a starting dose of 0-5 mg every 12 hours, with the first dose being given before retiring to bed. Dosage increments were limited to 0-5 mg, beginning late in the evening. Eleven patients had a significant improvement in renal function, while a further eight patients had stable renal function. In no patient was there a deterioration in renal function which could be attributed to prazosin.
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PMID:Prazosin in the treatment of patients with hypertension and renal functional impairment. 91 33

Among 337 male patients who were hospitalized because of chronic ischemia of the leg, 103 (=30.6%) were shown to suffer from concomitant occlusive vascular disease of supraaortic branches. This was evaluated by simple examination like auscultation, bilateral blood pressure measurements, and palpation of pulses. In 52% the patients history revealed dizziness, hemiparesis and transient ischemic attacks (TIA). Arteriell hypertension promotes supraaortic vascular diseases as is shown by a relative frequency of 0.52 in contrast to 0.39. Combined occlusions of the iliac and femoropopliteal arteries are accompanied by supraaortic vascular disease in 40%, in femoropopliteal occlusion alone in only 20%. If the basic diagnostic approach is improved by directional ultra-sonic examinations of the carotid arteries, approximately 20% of all patients with advanced vascular disease of the iliac and femoropopliteal arteries have to be operated on for cerebrovascular disease.
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PMID:[The frequency of the combination of arterial occlusive disease in supraaortic and leg range. An analysis in the patient population of a vascular surgical department (author's transl)]. 92 53

Preliminary results of this retrospective-prospective analysis of renal hypertension in 110 children indicate that hypertension may be secondary to a wide variety of acute progresive, and chronic renal diseases which may be either congenital or acquired. Affected children may be detected at any time from infancy through adolescence. Symptoms usually associated with acute glomerulonephritis (i.e., headache, swelling, nausea, vomiting, anorexia, fatigue, dizziness, and fever) occur in both acute and chronic renal diseases associated with hypertension. Headache and swelling are the most common symptoms in this series. Peripheral edema, rales, and increased heart size were found in between 10 and 25% of these children. Differential diagnosis may be approached by a consideration of causes of acute and chronic hypertension. The child with chronic renal disease usually presents with a long history of fatigability, poor growth, and pallor, and laboratory tests reveal elevation of the creatinine and BUN along with anemia, hypocalcemia, and hyperphosphatemia. In contrast, the child with acute renal disease and hypertension presents with a history of prior good health followed by the abrupt onset of signs and symptoms of renal disease; laboratory tests usually reveal modest elevations of creatinine and BUN, anemia is unusual, an abnormal urinalysis is common, and serum calcium and phosphorous levels are usually normal. Renovascular and asymmetric renal parenchymal disease represent uncommon but important conditions because surgery may be curative. Treatment may be surgical, medical, or combined. Surgical conditions include renal trauma, hydronephrosis, asymmetric renal disease, and renal arterial disease. Adequate blood pressure control without medication can be expected following surgery in instances of unilateral involvement with a normal contralateral kidney. Meticulous assessment of the contralateral kidney is needed to determine that it is normal. If surgery is unsuccessful or is not indicated, pharmacologic therapy is initiated with a stepwise regimen starting with the mildest agent (e.g., thiazides) and then adding additional antihypertensive drugs when adequate blood pressure control has not yet been achieved. The goal of therapy is the lowest, safest, tolerated blood pressure levels. Long-term, carefully designed studies of antihypertensive agents for children with renal hypertension are not available. The need for collection and critical analysis of data concerning the clinical course of children with renal hypertension is evident from a review of the literature and from the preliminary data presented in this series. The presentation of such information and a critique of outcome variables will provide a basis for program planning for affected children and improvement in patient care where indicated.
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PMID:Renal hypertension in children. 99 44

Prazosin was used as an additional antihypertensive agent for treating 16 patients with hypertension and significant renal functional impairment. The drug was effective in 13 patients at a mean daily dose of 7.9 mg. The most important side effect of prazosin treatment was dizziness which occurred on standing or following exertion, and was seen either after the first dose or following a large increase in dose. This could be prevented by giving the very first dose of 0.5 mg late in the evening. Five patients complained of palpitations. In no patient was there a deterioration in renal function which could be attributed to prazosin. Five women had a significant improvement in renal function.
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PMID:Prazosin in the treatment of patients with hypertension and renal functional impairment. 107 80

Administration of the vasodilator agent, prazosin, in dosages from 3-0 to 7-5 mg per day, significantly reduced diastolic and systolic blood pressure in a group of 14 patients with mild or moderate hypertension. Nine of these patients had a lowering of diastolic blood pressure which was at least 10 mm Hg greater than that caused by placebo. Side effects, chiefly dizziness or lassitude, occurred in over half the patients, but were mild and of short duration and did not necessitate suspension of treatment. The antihypertensive effect of prazosin was similar to that produced by methyldopa or propranolol given in comparable doses. If prazosin and propranolol were given concurrently, blood pressure fell to a level which was significantly lower than that associated with the use of either of these agents alone.
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PMID:Treatment of hypertension with an antihypertensive agent possessing vasodilator activity. 109 22

The clinical features in 268 patients with diffuse cerebral atrophy of initially unknown origin have been analysed. Pneumoencephalography showed supratentorial ventricular atrophy in 87 per cent (cortical in 71 per cent), and brain stem and/or cerebellar atrophy in 17 per cent of the patients. Epileptic seizures, dizziness and clumsiness were the most frequent initial symptoms. Vibration in work, psychic impairment, gait difficulties, co-ordinative dysfunction, excessive use of alcohol, and arterial hypertension dominated the clinical picture. Serum cholesterol and triglycerides, and beta-globulins in the cerebrospinal fluid protein electrophoresis were normal. Diffuse cerebral atrophy without defined cause appears to affect all parts of the brain, with particular predilection for the frontotemporal area and the left side, and to have diffuse and unspecific clinical characteristics.
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PMID:Pneumoencephalographic and clinical characteristics of diffuse cerebral atrophy. 121 60

PR-G-138-C1, a new antihypertensive agent with vasodilating properties, was studied in ten patients with moderate to severe hypertension. The patients were admitted to a metabolic ward and followed on a 2 gm salt diet. Placebo was given daily until blood pressure and weight were stabilized. A dose titration was then started with increasing single daily doses of 3, 5, 8, and 10 mg of PR-G-138-C1 orally. The dose at which the mean arterial pressure was reduced by 15 mm Hg was continued for a total of seven days. PR-G-138-C1 lowered sitting mean arterial pressures significantly in all subjects (133.8+/-15.1 leads to 116.0+/-12.4 mm Hg, p less than 0.001). The antihypertensive effect was first noted 30 minutes following drug administration and persisted for as long as six hours with a peak effect at one hour. All patients had a significant increase in sitting pulse rate (80.4+/-9.11 leads to 90.0+/-6.91/min, p less than 0.002). Blood pressure reduction and increase in pulse rate were dose related. The most common side effects noted were headaches in eight out of ten patients and postural dizziness in seven out of ten patients. There were no signs of fluid retention (weight gain or edema). Electrocardiogram and other laboratory parameters remained essentially unchanged.
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PMID:Initial clinical experience with a new peripheral vasodilator, PR-G-138-Cl, in hypertensive patients. 123 41

Temporal bone changes are described in a 57-year-old man who had sudden onset of dizziness and unilateral deafness two months before death. The patient suffered from hypertension, and congestive and renal failure. At autopsy, subarachnoid hemorrhage with punctate cortical hemorrhages and arteriolar thickening involved the right superior cerebellar hemisphere. The pathological changes involved primarily the right cochlea, saccule and posterior ampulla, and were consistent with vascular embarrassment of the temporal bone of two months duration. The cochlea demonstrated total loss of the organ of Corti and severe degenerative changes of the stria vascularis, spiral ligament, outer sulcus cells and distal cochlear nerve fibers. The saccule demonstrated loss of its macula and nerve fibers. The posterior ampulla showed evidence of previous rupture of its membranous wall with fibrosis and beginning bone formation. Fresh hemorrhage, present in some areas of both temporal bones, was related to the patient's terminal subarachnoid hemorrhage.
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PMID:Sudden deafnfess of vascular origin: a human temporal bone study. 125 20

Heart block was noted in 60 (35 complete and 25 second-degree) of 410 patients with acute inferior wall myocardial infarction. This group with heart block was compared to a control group of 30 patients with acute inferior wall infarction without heart block. The incidences of prior myocardial infarction and hypertension, in addition to the highest level of serum creatine phosphokinase and a maximum degree of ST-segment elevation in the inferior leads, were all greater in patients with heart block, as compared to the controls. The incidences of various complications, including dizziness and syncope, transient hypotension, cardiogenic shock, and congestive heart failure, were also higher in the group with heart block, while sinus nodal distrubances and atrial arrhythmias occurred with equal frequency. The mortality in those with heart block was 28 percent compared to 13 percent for the control. It is concluded that patients with heart block complicating acute inferior myocardial infarction have a greater amount of myocardial necrosis, a higher incidence of complications, and a higher mortality. Insertion of a temporary pacemaker should be considered when specific indications are present and not routinely.
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PMID:Heart block complicating acute inferior wall myocardial infarction. 126 67


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