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

Ten hospitals participated in a cross-sectional study to determine the prevalence of vascular complications in non-insulin dependent diabetes mellitus (NIDDM). The patients were 1433 females and 627 males, aged 24-88 years (mean +/- S.D. = 58.0 +/- 9.9). Duration of diabetes varied from newly diagnosed to 42 years (mean +/- S.D. = 8.2 +/- 6.5). Obesity was noted in 16.9% of males and 27.4% of females. The prevalence of hypertension, myocardial infarction (MI), hemiplegia, absent dorsalis pedis pulse, gangrene and amputation were 38.4, 2.8, 3.7, 5.8, 0.3 and 1.3%, respectively. Diabetic retinopathy (DR) was found in 32.1% of the patients. Proteinuria of > or = 2+ was observed in 18.7% of the patients. Stepwise multiple logistic regression analysis revealed that hypertension was significantly and independently correlated with MI, hemiplegia and DR but not with proteinuria or absent dorsalis pedis pulse. DR and proteinuria had a strong correlation with each other. Age of the patients weakly correlated with macrovascular diseases. Diabetic control and duration showed a weak correlation with microvascular complications. This study showed that DR was frequently found in Thai NIDDM. Hypertension was not only the commonest disorder but it also showed an independent association with other vascular complications. Early detection and intervention for both need to be emphasized and re-enforced in clinical practice.
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PMID:Vascular complications in non-insulin dependent diabetics in Thailand. Thai Multicenter Research Group on Diabetes Mellitus. 783 13

Twelve cases of Stanford Type-A aortic dissection were operated in an acute phase. The male vs female ratio was 3:9, and their ages ranged from 47 to 79 (mean 61.3) years old. Most of them complained of chest and/or back pain, and four of them complained of syncope. Eight patients had the history of hypertension. As to the complications of aortic dissection, cardiac tamponade was seen in two cases, myocardial infarction in one, and transient hemiplegia and paraplegia in one case each. In five cases, moderate to severe aortic regurgitation was also noted. All but one case were operated within twenty-four hours after admission. The replacement of the ascending aorta with a tube graft was performed in all cases including the two cases whose entries were located in the aortic arch. CABG was done concomitantly in three cases, and aortic valve replacement and CABG in one case. The open distal anastomosis was carried out under the systemic circulatory arrest combined with the retrograde cerebral perfusion. The systemic perfusion was reinstituted after the distal anastomosis was completed. In cases whose dissecting pseudo-lumen of the distal aorta was not thrombosed, the arterial cannulation site was shifted from the femoral artery to the tube graft. All but two cases were discharged from the hospital in good condition. One case, who had been transferred to the operating room under cardiac massage due to myocardial infarction, was lost by severe LOS three weeks postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Surgical treatment of acute Stanford Type-A aortic dissection]. 783 14

The authors report the case of a 39-year-old woman with type I neurofibromatosis who presented a right incomplete proportional hemiplegia which progressively worsened over a 6-month period. Left hemispheric atrophy with heterogeneous features, predominant in the temporoparietal region, was revealed by computerized tomography. Atrophy was associated with diffuse vascular lesions in the distal part of the left sylvian and anterior cerebral arteries, leading to major cortical hypoperfusion. Vascular examination showed no hypertension nor any sign of arterial involvement in another region. This case illustrates the nature of vasculopathy associated with neurofibromatosis. Its expression is polymorphous, with lesions inducing stenosis (the most common ones), aneurysmal lesions or veritable angiodysplasias (either hypo- or hyperplastic). The vascular expression of neurofibromatosis is often overlooked. However, in the presence of an inexplicable occlusive or aneurysmal vasculopathy, it is advisable to search for signs of neurofibromatosis since ill-defined forms exist.
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PMID:[Cerebral atrophy of vascular origin in the course of neurofibromatosis]. 785 77

One hundred cases of hypertensive complications due to irregular drug-therapy were studied in medicine units of Dhaka Medical College Hospital for the period of one year from February 7, 1989 to February 6, 1990. Among those stroke had headed the list (48%) manifesting in various ways e.g. cerebral haemorrhage with focal neurological signs--hemiplegia, hemiperesis, aphasia etc. Hypertension associated with varying degrees of cardiac ischaemias and heart failure was seen in 14% and 10% cases respectively. Highest incidence of complications was seen in 1-5 years after detection of hypertension with mean age of 55 +/- 18.70 years. Out of 48 cases of strokes, smoker were 41 (75.92%). Regarding reasons of noncompliance of drugs, personal carelessness was the prominent one (47%). Among the risk-factors for atherosclerosis family history tops the list (66%). Diabetes coexists with hypertension in 13% cases. Ocular complications were seen in 06% cases of malignant hypertension with variable retinal changes.
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PMID:Study of complications in hypertensive patients having irregular treatment. 803 Dec 88

Involvement of the central nervous system (CNS) is a major complication of renal hypertension and is usually due to hypertensive encephalopathy. During a 17-year period we observed 25 children with renal hypertension associated with CNS manifestations in the absence of (group A) and 33 in the presence of advanced renal failure (group B). Convulsions were the most important symptom (65% in both groups combined). Other manifestations were reduced consciousness (69%), visual disturbances (28%), hemiplegia (14%), and cranial nerve palsy (10%). In 56% of children in group A, hypertension was recognised only after appearance of CNS symptoms. Three patients in group A and 19 in group B died. Intracranial haemorrhage associated with hemiplegia was found in 3 cases. From 1970-1977 to 1978-1986 the number of patients and the mortality in group B declined dramatically, probably as a result of improved antihypertensive and renal replacement therapy. In contrast, in group A the number of patients and of CNS symptoms remained similar. The study underlines the importance of frequent blood pressure monitoring in presence of acute or chronic renal disease.
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PMID:Involvement of the central nervous system in renal hypertension. 844 7

A retrospective study of acute stroke diagnosed in the last ten years (20 cases: 12 girls and 8 boys) with an incidence rate of 1.26 cases per year per 100,000 inhabitants under 15 years of age) in our health area. Average age; 7.83 years (range: 2 months to 15 years). Confirming diagnosis was performed by computerised tomography (CT) scan, magnetic resonance (MR) imaging, echography and/or cerebral arteriography. Ten cases of ischaemic stroke and ten of haemorrhagic stroke were catalogued. Average follow-up was 5.45 years (range: 9 months to 10.8 years). Fibromuscular dysplasia, arthritis and meningitis are predominant in ischaemic stroke etiology, there also being one case of Moya-Moya. Haemorrhagic strokes are mostly produced by arteriovenous malformation. The predominant presenting form of ischaemic stroke was hemiplegia and of haemorrhagic strokes it was intracranial hypertension. There were no deaths as a result of ischaemic accidents but three in the cerebral haemorrhage group. Treatment was surgical in two cases, embolisation in two others and medical support in the remaining sixteen. There were no cases of relapse, except in the Moya-Moya case. Clinical position and the ability to carry on day to day life were most affected in the cerebral attack cases, which would indicate ischaemic stroke recuperation is worse than that for haemorrhagic strokes.
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PMID:[Cerebrovascular accidents in childhood]. 855 8

We studied 15 resected cases with a history of apoplexy (2.5%) among 599 cases of esophageal cancer admitted between 1972 and 1993. Fourteen were male, and female, aged 48 to 77 years. Twelve had suffered from cerebral infarction, 2 intracerebral hemorrhage, and one subarachnoid hemorrhage. Duration from apoplexy to operation was between 2 months and 19 years in the cerebral infarction cases, between 8 and 10 years in the intracerebral hemorrhage cases and 4 years in the subarachnoid hemorrhage case. Preoperative neurological disturbance was found in 7 of the 12 cerebral infarction cases, and in both intracerebral hemorrhage cases. Four cases showed hemiplegia, and the other 5 cases showed partial paralysis of limbs. Preoperative complications were found in 7 of the 15 cases, and consisted of diabetes mellitus in 5, hypertension in 4, bronchial asthma in one, and renal dysfunction in one case. Intra- and postoperative complications were found in 11 of the 15 cases, and consisted of anastomotic leakage in 5, delirium in 3, apoplexy in 2, peritonitis in one, ARDS in one, intraoperative cardiac arrest in one, and wound infection in one. Postoperative disorders of consciousness were found in 5 cases, consisting of delirium in 3, and excitation at awakening of anethesia in 2 cases. Rate of direct operative death was 6.7% in preoperative apoplectic patients, and 8.5% in non-apoplectic patients, and there was no significant difference between the 2 groups. On the other hand, rate of postoperative apoplexy was 13.3% in the preoperative apoplectic patients, and 0.4% in non-apoplectic patients. There was a significant difference between them (p < 0.01). But they were cured of it, and left our hospital. It is concluded that active surgical treatment can be indicated for esophageal cancer patients with a history of apoplexy, if more attention is given to the management of diabetes mellitus or hypertension.
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PMID:[Analysis of specificity of resected esophageal cancer patients with a history of apoplexy]. 866 64

Hypertension is rarely observed in childhood. The renal diseases are the most common causes of this condition. Headache, seizures, cranial nerve palsy and hemiplegia are the most frequent neurological manifestations. The Authors report on a patient with a severe involvement of central nervous system due to renal hypertension. The main clinical features were recurrent episodes of facial nerve palsy.
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PMID:[Recurrent facial paralysis in a child with renovascular hypertension]. 868 6

A 65 years old woman with chronic high blood pressure and diabetes mellitus presented with a mutism akinetic of sudden onset and a right total hemiplegia with a Babinski sign secondary to a left anterior cerebral artery infarction. She had had six months earlier a transient gait disturbance. At that time, the CT scan showed lacunar infarcts of the head of both caudate nuclei. Neuropathological examination revealed that the left infarction of the anterior cerebral artery involved the superior frontal gyrus, the supplementary motor area, the cingulate gyrus and the corpus callosum. There were also multiple lacunes of the head of both caudate nuclei, anterior limb of the internal capsules, white matter, basal ganglia and thalami. The mutism akinetic was thought to be the result of a bilateral disruption of a functional loop including on each side, the supplementary motor area, the cingulate gyrus, the subcallosal tract and the head of the caudate nucleus. On the right side, the lesion of the caudate nucleus could have interrupted this loop normally involved in the induction of voluntary movements and in the communication with the external surroundings.
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PMID:[Akinetic mutism with right hemiplegia caused by infarction in the territory of the left anterior cerebral artery]. 876 28

Effects of NBP on liability of stroke, life span and neurological deficits following stroke were studied in stroke prone spontaneously hypertensive rats (SHRsp). The SHRsp rat was kept on 1% NaCl solution as drinking water and was fed 15 g soft food containing 0.6-0.8 g NaCl per day. Total NaCl intake for one rat was 1.1-1.3 g per day. After the onset of stroke, tap water and normal food was given instead of that containing NaCl. The neurological deficits were evaluated by a specially designed scoring system. These symptoms were divided into 4 degrees (1-4). Grade 1. stress (mild). Grade 2. forelimb or head twitch or with stress (severe). Grade 3. hemiparalysis, body inclined or disabled. Grade 4. paralysis, tremor or convulsion. Blood pressure, heart rate and body weight were measured once every 2 weeks. The weights of heart, brain and kidneys were also measured. The results show that NBP pre-treatment at the dose of 100 mg.kg-1.d-1 po delayed the onset of stroke. So, like nimodipine, NBP showed a stroke preventive action in SHRsp rats. In addition, treatment with NBP 100 mg.kg-1.d-1 po after the onset of stroke, the life span was prolonged and the score of neurological deficit decreased significantly. Because high blood pressure can not be lowered by NBP treatment, therefore, the protective effect against stroke can not be explained by the effect of hypotension. No change was found in BP, HR and the organ weight. The results indicate that NBP is expected to be useful in the treatment of stroke.
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PMID:[Effect of dl-3-n-butylphthalide (NBP) on life span and neurological deficit in SHRsp rats]. 876 59


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