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

The association of occupational stress factors and health-related habits with blood pressure and blood pressure change over a 5-year follow-up was studied in 388 Finnish white-collar and blue-collar workers. The occupational stress factors consisted of noise level, discomfort due to noise, monotony, and self-suppression of opinion. Behavioral variables included the frequency of mild intoxication, leisure-time physical activity, cigarette smoking, relative weight, and change in weight. In the cross-sectional study, only relative weight was positively associated with both the systolic and diastolic blood pressure. For the prediction of blood pressure change, multiple linear regression showed that in the total sample none of the nine variables was a statistically significant predictor of systolic blood pressure change over the follow-up period. The change in weight was the most significant predictor (P less than 0.001) of diastolic blood pressure change, followed by intoxication (P less than 0.01). Further analyses by sex and occupational status showed that among female white-collar workers, intoxication was the strongest predictor of both systolic and diastolic blood pressure changes. In this group, the total model explained 34% of the variability in systolic and 27.7% in diastolic blood pressure change. In other groups and in the total sample, the proportions explained were markedly smaller. Also, in some subgroups, self-suppression, noise, and physical activity were significant predictors of blood pressure change. It is concluded that in comparison with reduction of weight, the other behavioral and stress factors studied seem to be of minor importance in the prevention of high blood pressure in normal populations, even if these factors may be relevant in some susceptible subpopulations or in populations whose exposure levels are extreme.
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PMID:Occupational stress, health-related behavior, and blood pressure: a 5-year follow-up. 633 92

Low dose estrogen tablets, containing less than 50 mcg of ethinyl estradiol, were formulated because of the recognized dose response relationship with the steroid content of the tablet and side effects. These new oral contraceptives (OCs) are as effective as the older high-dose OCs, and available evidence reports fewer side effects. This discussion reviews pharmacology of these new OCs, the mechanism of action, contraindications, side effects, and problems with the low-dose estrogen OC. Ethinyl estradiol is the only estrogen used in the low-dose combination OC. There are several synthetic progestins: norethindrone, norethindrone acetate, norgestrel, levonorgestrel, and ethynodiol diacetate. These progestins have different potencies so the pharmacologic activity cannot be accurately predicted based on the amount present in the tablet. The synthetic steroids in OCs are absorbed in the small intestine, metabolized in the liver, excreted in the bile and feces with a half-life of 24 hours. The low-dose estrogen combination preparation is taken 3 out of every 4 weeks. Its contraceptive effect is primarily a result of hypothalamic mediated gonadotropin suppression with subsequent inhibition of ovulation. Contraindications to taking the low-dose OC are the same as for the higher dose OC: thromboembolic or cardiovascular disease, estrogen dependent neoplasia, markedly impaired liver function, undiagnosed genital bleeding, congenital hyperlipidemia, pregnancy, and women over age 30 who smoke. Relative contraindications include hypertension, diabetes mellitus, migraine headaches, uterine myomas, and epilepsy. The often quoted 2-5-fold increased incidence of thromboembolic disease, myocardial infarction, and stroke is based on large epidemiologic studies involving patients taking the older higher dose OCs. Current data from patients taking the newer low-dose medication demonstrate minimal if any increased incidence of these problems in young women who do not smoke. The low-dose estrogen OCs have minimal effect on lipid levels. Early reports of patients using the low-dose OC have shown little if any increased incidence of hypertension. The low-dose contraceptives have little effect on glucose tolerance, and there is no evidence to show an increased incidence of overt diabetes in OC users. There is no evidence that use of the combination OC causes an increase in cancer of the cervix, uterus, or ovaries. Clinical complaints of nausea, breast discomfort, chloasma, weight changes, and depression are reduced with the low-dose estrogen preparation. Hypomenorrhea while taking the OC occasionally occurs because the lower dose of estrogen is insufficient to stimulate the endometrial growth in face of the predominant progestin-atrophy effect.
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PMID:Oral contraceptives in 1984. 649 Mar 38

A double blind investigation comparing meglumine-Na diatrizoate (290 mg I/ml) and iohexol (300 mg I/ml) showed that patients receiving iohexol experienced significantly less discomfort. Patients who received diatrizoate commonly showed transient episodes of hypertension while those who received iohexol either showed no changes or transient episodes of hypotension. No significant changes in heart rate were observed in either group.
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PMID:Comparison of iohexol and meglumine-Na diatrizoate in cerebral angiography. 659 38

The hyperosmolality of current ionic angiographic media gives rise to several adverse effects. Use of the first low-osmolality medium, metrizamide (Amipaque), has been inhibited by expense and by the necessity for prior mixing into solution. Hexabrix is the first of such media to be available in stable solution, and its use in angiocardiography is reported, in direct comparison with Urografin, Triosil, Cardio-Conray, and metrizamide. The low osmolality media cause significantly less discomfort than ionic media, and are better tolerated in paediatric angiocardiography. In coronary angiography Hexabrix causes comparable T wave change to Urografin and more than Triosil or metrizamide, but tends to have less effect on heart rate. The risk of exacerbating pulmonary arterial hypertension in right heart angiography appears to be reduced.
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PMID:Hexabrix--a new contrast medium in angiocardiography. 702 Jul 27

Complications from mydriatic and cycloplegic drugs are rare compared with their extensive use. Adverse effects are often related to dosage or other factors. The ocular complications include increased intraocular pressure, pigmentation of the conjunctiva and cornea, pigment in the anterior chamber, lacrimal duct blockage, macular edema, corneal endothelium damage, hyperemia, allergy, discomfort, and blurred vision. The systemic complications are those common to sympathomimetic and parasympatholytic drugs and include tachycardia, hypertension, headache, faintness. pallor, trembling, excessive sweating, palpitations, arrhythmias, confusion, hallucinations, drowsiness, ataxia, flushed skin, high fever, dysarthria, thirst, dry mouth, convulsions, disorientation, nervousness, coma, and death. An understanding of all possible side effects is of paramount importance to those using these drugs in the treatment of anticholinesterase poisoning. This review is intended as a ready reference to the adverse effects of mydriatic and cycloplegic drugs.
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PMID:Mydriatic and cycloplegic drugs: a review of ocular and systemic complications. 703 29

More than 1200 patients who received pindolol for the treatment of hypertension, angina pectoris, and various arrhythmias in studies conducted in the United States were included in the New Drug Application submitted to the FDA. Nearly 1000 of these patients received pindolol as monotherapy. The side effects reported were generally transient and of mild or moderate severity. The most frequently reported side effects seen after pindolol administration, compared to those seen after placebo, were in decreasing order of incidence: headache, dizziness, insomnia, muscle pain, fatigue, weakness, nervousness, joint pain, edema, nausea, and muscle cramps. Other side effects that occurred more frequently with pindolol than with placebo but at a rather low incidence induced weight gain, bizarre dreams, visual disturbances, lethargy, and diarrhea. Nasal congestion, throat discomfort, nocturia, impotence, pruritus, anxiety, hypotension, bradycardia, and heart failure occurred only rarely. Of the 323 patients who received pindolol alone for the treatment of mild to moderate hypertension, only 20 (6.2%) were withdrawn from the study because of side effects. Overall, 3.4% of the patients treated with pindolol were withdrawn because of side effects, most of which involved the central nervous system, that is, insomnia, anxiety, dizziness, and headache. However, a few patients manifested some edema and weight gain while receiving pindolol alone. Review of the side effects data did not reveal a tendency for the incidence of side effects to be dose related. One placebo-controlled, double-blind study designed to evaluate the fixed dosages of 15, 30, and 60 mg in the treatment of mild to moderate hypertension suggested that only the incidences of insomnia and nervousness increased with increasing doses. However, these side effects were generally transient and of mild or moderate severity. The evidence indicates that pindolol has an acceptable safety profile and that any side effects that appear are generally well tolerated and disappear with continued treatment.
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PMID:Adverse reactions to pindolol administration. 704 82

The reported maternal mortality of 59% that results from rupture of the liver in pregnancy is probably excessive if modern diagnostic and treatment techniques are fully utilized. The rarity and variable presentation should not lead to an incorrect diagnosis and possible fatal outcome. Pregnant patients or patients who recently have undergone delivery, especially those with hypertension, who complain of epigastric and/or discomfort in the right upper quadrant of the abdomen should be considered to be candidates for rupture of the liver. Ultrasound, which is generally available, is an adequate diagnostic technique in most patients. Computed tomography and technetium scanning are helpful tools. Ligation of specific bleeding points, compression, deep hepatic sutures, omental pedicles, topical agents, ligation of the hepatic artery, hepatic artery embolization, and other techniques should be used prior to performance of lobectomy. Drainage is recommended. Replacement of blood, correction of coagulation defects, monitoring of respiratory function, and attention to known postoperative complications should improve the outcome of patients with this serious complication.
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PMID:Improving survival with liver rupture complicating pregnancy. 705 55

This paper documents diagnosis and treatment of hypotension among a sample of subjects visiting blood pressure screening booths as part of a hypertension screening survey in Montreal. Of 1019 subjects, over one quarter had been diagnosed as hypotensive. Though low blood pressure is harmless for the majority of people, almost 10% of the screened sample reported receiving treatment from their physicians for the condition. Treatment typically consisted of harmless, but ineffective placebo-like medications including veal liver extract capsules or injections, iron capsules, tonics and vitamin B12 liquid, injections or capsules. Additional analysis discovered little meaningful difference in systolic and diastolic readings among individuals treated for hypotension, those diagnosed but not treated, and an undiagnosed group. Subjects receiving the hypotensive label from practitioners were typically older women with less education and income. Findings are discussed in light of the overlap between statistical and pathological models of illness; presenting symptoms of patients and their demands for treatment; and assumptions of physicians in diagnostic decision-making. It is speculated that medical definition of a nondisease such as low blood pressure may serve to individualize discomfort when true etiology lies in the environment; legitimate neglect of responsibilities and obligations by assigning one to the sick role; or cause organization of vague impulses into symptoms. Hypotension should be included in utilization studies to determine prevalence of treatment, life history of those being treated and complaints offered for treatment.
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PMID:Treatment for a nondisease: the case of low blood pressure. 710 Sep 54

Twenty-five patients with hypersplenism caused by portal hypertension were treated by repeated partial splenic embolization. Fourteen surviving patients were followed for up to six years showing a good response on peripheral blood count and bleeding tendency. Three patients died in connection with the treatment and another eight died within half a year because of the underlying liver disease. The discomfort and complications of fever, pain, pleural effusion, and abscess formation and the possibility to avoid these by repeated partial embolization under antibiotic cover are discussed. The results are compared with reports in the reviewed actual literature and the splenic embolization is given a place among the means of a successful selective symptomatic treatment of partial hypertension.
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PMID:Evaluation of splenic embolization in patients with portal hypertension and hypersplenism. 712 39

The effect of graded change of the CSF amount on the clinical status, intracerebral pressure and brain bioelectrical activity was studied in 31 patients operated on for brain tumors of various sites. Normally, the graded change in the CSF amount made with an object of examining the biophysical characteristics of the intracranial system did not produce the impairment of the patients status. Discomfort sensation that occurred in rare cases was not a consequence of either hypo- or hypertension as such but of the absence of CNS ability to adapt rapidly to the changes of the pressure in the cranium. The graded change in the CSF amount and thus in the CSF pressure caused minimum transitory changes in the intracerebral pressure of interstitial liquid and in brain bioelectrical activity. The data obtained indicate the feasibility of studying the biophysic characteristics of the intracranial system by means of graded changes of the CSF amount in neurosurgical patients undergoing acute postoperative period.
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PMID:[Intracerebral pressure and the EEG following graded changes in cerebrospinal fluid volume]. 727 80


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