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

The hypertensive encephalopathy is a syndrome consisting of a sudden elevation of arterial pressure usually preceded by severe headache and followed by convulsions, coma or a variety of transitory cerebral phenomena. The syndrome may complicate acute glomerulonephritis, toxemia of pregnancy and essential or malignant hypertension. Two syndromes must be differentiated from true hypertensive encephalopathy: 1. acute anxiety state with labile hypertension and 2. acute pulmonary edema due to hypertensive heart disease. At least in patients with acute anxiety states, the use of antihypertensive agents is usually not indicated. Since encephalopathy is always accompanied by increased vascular resistance and since clinical experience has demonstrated clearing of the sensorium, cessation of convulsions and release of vasoconstriction following reduction of blood pressure, the primary aim of therapy should be prompt lowering of arterial pressure. The two agents of choice are diazoxide and sodium nitroprusside. Stroke is differentiated from encephalopathy by the persistence of lateralizing signs. The aggressiveness of antihypertensive therapy in this situation depends on the severity of the hypertensive process. Rapid reduction of blood pressure is indicated in patients found to have accelerated hypertension while a more gradual lowering of pressure appears warranted for patients with chronic arterial hypertension and evidence of generalized arteriosclerosis.
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PMID:Management of hypertensive encephalopathy. 72 Oct 56

A 21-year-old nurse presented with severe headache after ingesting one phenylpropanolamine (Trimolets) tablet. Examination revealed hypertension. Although no specific therapy was administered to the patient, her blood pressure normalized within a few hours of admission to hospital and has remained normal since. The patient declined rechallenge with the suspected drug.
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PMID:Hypertension after ingestion of Trimolets. 73 45

Two patients presenting with headache and radiological features of an enlarged sella turcica were found to have the primary empty sell syndrome. Whilst under observation, 1 patient developed papilloedema and was shown to have benign intracranial hypertension. The second patient also had raised intracranial pressure. A relationship between the empty sella syndrome and benign intracranial hypertension has previously been reported and it is suggested that in a patient with a congenitally incompetent diaphragma sella, chronically raised intracranial pressure caused herniation of the subarachnoid space into the sella turcica. Subsequently, sella turcica enlargement and remodelling occurs, sometimes with endocrine, visual and other sequelae. The clinical, radiological and CT scan features of the empty sella syndrome are discussed and the indications for major radiological studies are considered.
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PMID:Primary empty sella syndrome and benign intracranial hypertension. 75 18

The article reports on the case of a young patient on OC (oral contraception) for 3 months who suddenly developed benign endocranic hypertension. Such cases have been frequently reported in the published literature, especially, but not always, in connection with obese patients. Suspension of OC treatment usually terminates the problem. The cause of the association OC-headache is not yet well known.
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PMID:[Cerebral pseudotumor and oral contraceptives (cerebral case)]. 75 41

Nineteen patients with various solid tumors were treated with Corynebacterium parvum for 10 consecutive days at doses ranging from 0.5 to 6 mg/m2. Major toxic effects included rigors and cyanosis, hypertension, headache, nausea, and vomiting. Toxicity was maximal during the first 3 days of treatment and decreased or even disappeared when, on subsequent days, increasing doses of the vaccine were given. Objective tumor regressions were observed in four patients.
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PMID:Phase I study of corynebacterium parvum in patients with solid tumors. 76 53

A brief survey of the literature on the side effects of oral contraceptives is given. Of the many influences on laboratory results those related to (reversible) cholestasis or to a change in protein synthesis are the most important ones. A decrease of the tolerance for glucose is sometimes observed. Few of the clinical side effects attributed to oral contraceptives can be directly correlated with the pharmaceutical action of these drugs. Many so-called side effects of the pill are due to other factors such as altered psychosociological or sexual behavior, etc. However, among users of oral contraceptives there is a significant decrease in the number of benign tumors, particularly of the breast, the uterus and the ovaries. It is still an open question if this also signifies protection against cancer. Anemias due to iron deficiency are less frequent among users of the pill. According to recent studies arterial hypertension and cholecystopathies are probably directly related to oral contraceptives, but a causal relation has not been proven for migraine, headaches, depression etc. An elevated risk for vascular complications seems to be well established: there is a 4-6-fold increase of the estimated risk for venous thrombo-embolism and a 4-9-fold increase for cerebrovascular accidents among users of oral contraceptives when compared with nonpregnant women of the same age not using the pill. Oral contraceptives act as a supplementary factor of risk which may cumulate with other similar factors, such as arterial hypertension, hyperlipidemia, overweight, smoking etc. Mortality due to oral contraceptives is very much 10-50 x) inferior to the one caused by delivery and the post partum state. Since the number of failures in prevention of pregnancies is less for oral contraceptives than for any other method of contraception, the overall risk of death under oral contraceptives in this age group of women is least.
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PMID:[Real and seeming side-effects of oral contraceptives with an emphasis on medical and haematological problems. Review of literature (author's transl)]. 79 Mar 74

A crossover comparison of metoprolol and hydrochlorothiazide has been performed in 20 patients with mild hypertension. Both drugs caused almost identical statistically significant reduction in blood pressure of about 20 mm Hg systolic and 15 mm Hg diastolic. The side effects during active therapy were few and mild, but 5 patients experienced subjective symptoms during the first few days following abrupt withdrawal of metoprolol, namely general malaise, palpitations, headache, sweating and tremor. The symptoms were more pronounced in the standing position and disappeared at once on resumption of beta-blocker therapy, or gradually over 5 - 7 days when placebo tablets were given. In 11 of the 20 patients hydrochlorothiazide produced subnormal serum potassium levels and potassium supplements were given. The serum uric acid level was also significantly increased during hydrochlorothiazide treatment.
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PMID:Comparison of metoprolol as hydrochlorothiazide and antihypertensive agents. 79 49

The case of a 14-year old girl presenting with headaches, severe progressive hypertension and high plasma renin levels, in whom a voluminous epithelial liver hamartoma or adenoma was discovered at surgery is documented. The morphological characteristics of the hamartomatous abnormality are described and evidences are put forward which would suggest that the liver lesion might have been the site of the abnormal renin production which was responsible for the systemic arterial hypertension.
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PMID:Epithelial liver hamartoma, systemic arterial hypertension and renin hypersecretion. 80 56

In industrial countries the symptoms "headache" has an incidence of about 10%, and hypertension between 20 and 25%. Both terms are summary and may be pointers to and warning signals of the most varied disease processes. While, in malignant hypertensions, and pheochromocytoma, headache is a cardinal symptom, its causal connection with permanently raised blood pressure in the "benign" forms is viewed with scepticism. The observation that hypertensives frequently complain of headaches with a maximum intensity in the early hours of the morning is connected with the fall in blood pressure with accumulation of CO2 in shallow breathing. Headache as a symptom characteristic of hypertension is frequently only facultative in nature and must be classified among the series of symptoms of sequelae. But it offers a sufficient reason to institute a selective examination programme, especially as hypertension is still the most common cause of death even today.
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PMID:[Headache associated with hypertension from the internist's and neurologist's point of view (author's transl)]. 81 25

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


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