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

Reports of complications due to estrogen-progestagen combinations are summarized. Common minor symptoms include nausea, abdominal distress, headache, depression, and weight gain. Some of these are directly due to the pill, but others are not; for instance, depression may result from pyrodoxine deficiency, but psychodynamic factors explain the problem in others. Effects on the reproductive organs include secondary amenorrhea in about 2 of every 1000 women; structural and functional changes of the ovaries, uterus, and cervix; increase in incidence of yeast vulvovaginitis; and inhibition of lactation. Most changes in laboratory values of various constituents of blood and other body fluids reflect changes in hepatic function. Thromboembolic diseases, hypertension, and hypertriglyceridemia are rare but more serious conditions for which the pill may be responsible in some cases. Contribution of the pill to carcinogenesis and fetal abnormalities has not been proven.
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PMID:Clinical complications of oral contraceptives. 109 Jan 18

Facts about oral contraceptives and their use are provided for the practcing generalist and specialist. Identification of oral contraceptives is given in chart form including company, name, contents, pill color, number in pack and special markings. Section 2 entitled "facts that may be helpful in prescribing or changing the prescription of oral contraceptives" includes potency of progestins and estrogens and symptoms indicating excessive or deficient progestin and estrogen activity. Contraindications such as migraine headaches, epilepsy, hepatic disease, renal disease and hypertension are among the reasons for obtaining a complete family history prior to prescription of oral contraceptives. This information provides the basis for choice of contraception tailored to the individual. A 100 pound 17 year old with a normal menstrual history and with adequate estrogen production would be safest with a medication low in estrogen and progestin. An older heavier woman with prolonged menstruation and cramps would require a pill which is potent in progestins since these are excellent for causing endometrium regression and vascular reduction. Length of time on oral c ontraceptives depends upon the patient's general health. If responding well to contraceptives the patient should continue to use them because 1) the body is programmed for lengthy periods of ovulation suppression; 2) the patient becomes accustomed to infertility and 3) too many unplanned pregnancies occur during rest intervals. Complaints of nausea, migraine headaches, change in libido, chloasma or thrombophlebitis determine the termination of the drug.
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PMID:The identification, selection and use of oral contraceptives. 112 61

Restovar, a low dose combined oral contraceptive containing .75 mg lynestrenol and 37.5 mcg ethinyl estradiol was given to 83 women for up to 25 cycles or 1265 total. A cycle contained 22 pills begun on the first day of menstruation or withdrawal bleeding from previous pill cycles. Each woman was questioned regularly on side effects and bleeding, had weight and blood pressure taken, and received gynecologic exams before and after pill treatment. There were no pregnancies. Latency from end of the cycle to bleeding was 2-3 days in 87%; cycles lasted 28 days in 80%; bleeding lasted 3-4 days in 84%; flow was moderate in 72%; and spotting occurred in 4.2% of cylces and breakthrough bleeding in 2.4%; withdrawal bleeding was absent in 4.2% of cycles. The most common side effects were breast pain in 1.9% of cycles and headaches in 1.2%. These complaints as well as nausea, vomiting, leucorrhea, nervousness and depression were reported as less frequent or absent more often than present or aggravated. 6 women quit for drug related reasons. There was no significant weight change or hypertension (means 126/82 and 120/80 before and during Restovar. Thus this low dose pill is remarkably effective and well tolerated.
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PMID:[Clinical study of restovar, an oral contraceptive with a low estrogen content]. 114 76

Intrauterine (PGF) prostaglandin F2alpha (5 mg) was administered for termination of early pregnancy in 14 healthy volunteers. With 11 complete abortions, the efficiency rate of this technique is below conventional methods. In addition, the incidence of infection was high, occurring in 12 out of 14 subjects. Because of persistent bleeding, 6 patients underwent a dilatation and curettage. Other significant side effects included transient hypertension, pain, nausea, and restlessness. In the patients with a complete abortion, the mean plasma progesterone concentration fell 37% after 8 hours post-PGF2alpha instillation and 90% 14 days later. The mean plasma estradiol-17beta fell 26% over the initial 8 hour period and 75% over the next 14 days.
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PMID:Intrauterine instillation of prostaglandin F2ALPHA IN EARLY PREGNANCY. 116 90

The introduction of dinoprost tromethamine (Prostin F2 Alpha) as an abortifacient in the second trimester of pregnancy represents the first clinical use of a prostaglandin. Various synthetic analogues of the naturally occurring derivatives are being employed investigationally in the treatment of peptic ulcer, hypertension, asthma, and hypercalcemia. In the United States, dinoprost tromethamine is primarily administered intra-amniotically. Despite the fact that a substantial number of patients experience allergic reactions, hypertension, bronchospasm, nausea, vomiting, cramps, and diarrhea, the efficacy and relative safety of dinoprost tromethamine establish it as superior to intra-amniotic instillation of hypertonic saline. Cervical laceration, laceration or rupture of the lower uterine segment, retention of the placenta, and hemorrhage in part reflect the intensity of uterine contraction induced by dinoprost. Experience in administration improves the therapeutic response and diminishes adverse reactions.
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PMID:The prostaglandins. 117 7

Twenty-six patients with hypertension secondary to acute poststreptococcal glomerulonephritis were treated by the rapid intravenous infusion of diazoxide. The average pretreatment systolic pressure was 159 mm Hg. Five minutes after administration, the average systolic pressure was 122 mm Hg (a 23% reduction). The average initial diastolic pressure was 104 mm Hg, which fell 5 minutes after diazoxide injection to 71 mm Hg (a 32% reduction). No hypotensive episodes were noted. Occasional episodes of nausea occurred. Concentrations of blood glucose increased after administration of diazoxide; however, no values were above 155 mg/dl. Diazoxide appears to be a safe antihypertensive drug that is effective in the treatment of hypertension secondary to acute poststreptococcal glomerulonephritis.
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PMID:Intravenous diazoxide in acute poststreptococcal glomerulonephritis. 118 52

The aim of this 16-week trial was to determine the safety and efficacy of a step-care regimen of ramipril, an angiotensin converting enzyme inhibitor, from the minimal active dose (2.5 mg) in patients treated for mild to moderate hypertension. The trial was conducted by 102 general practitioners in 770 patients with mild to moderate hypertension. After a response rate to a 4-week placebo therapy of 9.1%, 57.0% of patients given active treatment with ramipril responded to daily doses of 2.5 mg. Ramipril 5 mg daily was effective in 55.6% of the remaining patients. There was no apparent statistically significant difference between the treatments with ramipril 10 mg or a combination of ramipril 5 mg + Lasix 20 mg daily (44.7% and 47.4% response respectively) in a 6-week double-blind arm of the study. In total, more than 90% of patients responded to treatment with ramipril by the end of the study. The incidence of adverse events was generally low, such as headache, cough, dizziness, asthenia, cramps and nausea. The incidence of cough appeared to be related both to the dosage of ramipril given and to outbreaks of influenza syndrome. Thirty-eight patients discontinued active treatment as a result of minor events such as cough, dizziness or diarrhoea, and one case each of myalgia and papular rash. There were no significant variations in laboratory parameters during the study, especially fasting blood glucose and apolipoprotein A1 and B. The results of this study provide evidence of the safety and efficacy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The French multicentre study of ramipril in ambulatory patients with mild-to-moderate hypertension. 130 60

HELLP syndrome continues to be a clinical entity of difficult diagnosis. Weinstein first defined it in 1982 giving the practicing obstetrician a sequence of useful initials (H = hemolysis; EL = elevated liver enzymes; LP = low platelets). Since then a lot has been written and it has become clear that the syndrome is a form of severe preeclampsia. The American College of Obstetrics and Gynecology does not include HELLP in the description of severe pre-eclampsia as such but does accept each of its components as being part of severe pre-eclampsia. The case presented deals with a 33 year old white female, admitted at 27 weeks gestation with nausea, epigastric pain resembling acute abdomen, nose bleeding and mild hypertension. The analysis revealed an abnormal liver profile with elevated GOT, GPT and LDH, heavy proteinuria (14.4 g/day), decreased platelet count (92000/mm3) and elevated total bilirubin. Pregnancy was terminated by cesarean section 24 hours after admission because the patient's condition was deteriorating. Obviously in pre-eclampsia/eclampsia there is a systematic injury to all tissues. Proof of this is the hypertension as a consequence of vascular spasm and proteinuria due to glomerular injury. In HELLP the sequence of events is probably altered; hepatic injury precedes vascular and renal injury of conventional preeclampsia. The syndrome results from many clinical and pathological symptoms derived from endothelial microvascular injury which determine a rapid platelet activation causing vascular spasm, platelet aggregation and further endothelial injury through a feedback mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Massive proteinuria and HELLP syndrome]. 130 8

The purpose of this placebo-control, double-blind, randomized and crossover study is to evaluate the effect of nicardipine and nifedipine in Chinese senile hypertension. Among totally 37 senile hypertensive patients enrolled, 26 patients (25 males, 1 female) from 55 to 78 years of age (mean 65) who had finished one part or whole protocol were studied. Totally 18 cases after 6-week treatment of nicardipine (Perdipine) had blood pressure decrease significantly from 152.6 +/- 12.3/99.6 +/- 5.7 to 140.4 +/- 15.6/93.8 +/- 8.1 mmHg in supine position (P < 0.05), and from 153.3 +/- 12.7/98.7 +/- 7.7 to 139.2 +/- 13.5/90.7 +/- 7.6 mmHg in standing position (p < 0.05). Twenty-five cases after 6-week treatment of nifedipine (Towarat) also had significant blood pressure decrease from 155.0 +/- 13.3/99.5 +/- 8.4 to 144.2 +/- 10.0/95.3 +/- 9.2 mmHg in supine position (P < 0.05), and from 151.5 +/- 17.8/100.6 +/- 9.5 to 138.6 +/- 12.8/90.4 +/- 8.3 mmHg in standing position (p < 0.05). Heart rate was unchanged in both groups. Both nicardipine and nifedipine decreased blood pressure and increased heart rate significantly with the first dose of medication in the morning (P < 0.05). There was 6.5% and 9.0% decrease of systolic and diastolic blood pressure with nicardipine in supine position, 10.1% and 11.2% decrease with nifedipine in supine position, 6.3% and 7.2% decrease with nicardipine in standing position, and 9.7% and 10.6% decrease with nifedipine in standing position. The major side-effects were palpitation (20%) and lower abdominal distension (16%) with nicardipine; and nausea or vomiting (22%) and dizziness (15%) with nifedipine.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Comparison of nicardipine and nifedipine in treatment of Chinese senile hypertension placebo-control, double-blind, randomized and crossover study]. 133 92

The methods used presently for abortion of the attacks of migraine and cluster headache are not fully satisfactory which causes that the search for new therapies is continuing. Although the mechanism of migraine attacks remains unexplained, it is thought that an important role in it is played by serotonin receptors, vasodilation in certain regions and opening of arteriovenous communications in the head. Sumatriptan is an agonist of 5-HT1 -like receptors and exerts a selective vasoconstricting effect on the arteries of the head, particularly in the rami of the carotid artery. In 1988 the first reports appeared on the effectiveness of the drug in migraine attacks. In the following years extensive, multicentre and international studies of the drug were carried out on over 600 healthy volunteers and nearly 6000 patients with migraine. The studies demonstrated that Sumatriptan was effective in abortion of migraine attacks. After oral administration of 100 mg or subcutaneous injection of 6 mg in nearly 70% of cases the attack regressed or was greatly alleviated, similarly as other symptoms accompanying the headache such as photophobia, nausea, vomiting. Studies were undertaken also on the effectiveness of Sumatriptan in emergency treatment of cluster headache, and good results were again achieved. The tolerance of the drug is good, although in some cases side effects develop, usually transient and mild, among them tingling, feeling of pressure, heat or heaviness of the head or chest, taste change and burning sensation at the site of injection. Sumatriptan, similarly as all novel drugs, requires caution in its use, particularly in patients with coronary heart disease and hypertension, and also in old patients. As yet, the use of the drug in paediatric migraine or in pregnancy is not recommended.
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PMID:[Sumatriptan and its use in treatment of migraine and cluster headaches]. 133 66


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