Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

When captopril was first introduced, it was used in high doses for severe hypertension, often in the presence of renal insufficiency, and side effects such as proteinuria, rash, neutropenia, and altered taste sensation were noted. Upon analysis, these effects were most commonly seen in patients with renal disease, autoimmune disease, or collagen vascular disease. These complications usually reversed rapidly upon discontinuation of treatment. In contrast, the growing use of the angiotensin converting enzyme inhibitors, captopril and enalapril, for treating mild to moderate hypertension and the trend toward the use of lower doses has shown these agents to be well tolerated with a low frequency of troublesome adverse effects. In fact, the original spectrum of adverse effects has virtually disappeared with the use of lower doses in patients with uncomplicated hypertension. In low doses, the converting enzyme inhibitors produce remarkably few incidences of symptomatic discomfort; the most common is skin rash, which often responds to dosage reduction. Cough and rare occurrences of angioedema have also been reported. Moreover, evidence is evolving that indicates that the converting enzyme inhibitors may sometimes decrease proteinuria and improve renal function; these effects may be especially important in diabetic hypertensive patients. Of note, these drugs can also attenuate the unwanted metabolic side effects of concurrent diuretic treatment.
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PMID:Safety issues during antihypertensive treatment with angiotensin converting enzyme inhibitors. 306 5

In Japan, most couples use traditional methods, with about 80% relying on the condom and a further significant proportion on the rhythm method. In fact a combination of both methods is common among married couples. The oral contraceptives have the following advantages: Reversibility, simple and easy to use, coitally independent, no skill or knowledge required for its use, high acceptability, no pain or discomfort at use, self-administration, while they have the following disadvantages: Inadequate during lactation, sustained motivation in the female side required, clinical contraindication exists, possible side-effects such as nausea, vomiting, breast tenderness, weight gain, questionable possibility of serious side effects such as hypertension, thromboembolic diseases etc., medical supervision and follow up required, expensive cost. The use of the steroidal preparations for contraceptive purpose in Japan awaits official approval. Under present regulations, it is not illegal for the physicians to prescribe the pill, and currently six preparations are available and all contain 50 microgram of estrogen. The reduction in the estrogen and progestogen content of the pill did not appreciably compromise contraceptive potential while untoward effects were considerably lowered. The development and use of the new progestogen also contributed to minimize the possible side effects. Efforts are now being directed at a pill which minimizes metabolic change, decreases the incidence of breakthrough bleeding or spotting, without compromising efficacy. It is with these goals in mind that the multi-phasic pills have been developed in the belief that many of the undesirable side-effects can be circumvented while maintaining almost 100% conception control.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Progress of contraceptive methods--OC and IUD]. 325 63

A new portable device for the indirect measurement of arterial blood pressure was successfully applied to detect paroxysmal hypertension and circadian fluctuation of blood pressure in patients with phaeochromocytoma. The device utilizes the volume-oscillometric technique, it is equipped with a microprocessor and allows long-term automatic monitoring of indirect blood pressure in the human finger. Compared with conventional fully automated portable devices of the arm-cuff type, our current equipment is lighter, less noisy, and causes less discomfort. With this device repeated measurements can be made without causing stress or discomfort, and without disturbing sleep. The arterial pressure measurement obtained using this device was reliable and reproducible. In some patients certain symptoms, possibly due to phaeochromocytoma, had been observed for several years before the study, although hypertension had not been identified. While these patients had consistently high circulating catecholamine levels, nocturnal falls in blood pressure were clearly documented. This suggests that plasma catecholamines released from the phaeochromocytoma, though excessive, may be of less physiological importance than other regulatory mechanisms concerned with circadian fluctuation of blood pressure, e.g. the sympathetic nervous system and/or hypothalamo-pituitary-adrenal system. This new device has proved to be a reliable means of monitoring long-term blood pressure and is useful in the diagnosis of paroxysmal hypertension in patients with phaeochromocytoma.
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PMID:Hypertensive episodes and circadian fluctuations of blood pressure in patients with phaeochromocytoma: studies by long-term blood pressure monitoring based on a volume-oscillometric method. 335 Dec 98

A new portable device for the indirect measurement of ambulatory blood pressure in the finger was successfully applied to normotensive and hypertensive subjects in and outside a ward setting. The device uses the volume-oscillometric technique and, equipped with a microprocessor, permits long-term ambulatory monitoring of indirect systolic and mean blood pressure at desired intervals (once every 1-10 min). Systolic and mean blood pressures obtained by this method were well correlated with those measured by the direct (Oxford) and arm-cuff methods. Systolic and diastolic blood pressure obtained by the volume-oscillometric device were almost identical with those recorded by an arm-cuff. Systolic blood pressure obtained by the volume oscillometric method was, however, significantly lower than that measured by the direct method. The new device has also been used to measure blood pressure during treadmill exercise and ice-water immersion. Mean values of blood pressure and the SD of these averaged for 24 hours, or for every hour, were reproducible when the measurements were repeated under the same condition. The present device is portable, causes minimal noise, can detect rapid change in blood pressure and causes less discomfort when compared to the conventional arm-cuff method. Regular measurements can be made with minimal sleep disturbance. This fully automatic volume-oscillometric device allows reliable 24-hour monitoring of ambulatory blood pressure not only in but also outside a ward setting, and as such is useful for studies of hypertension.
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PMID:A finger volume-oscillometric device for monitoring ambulatory blood pressure: laboratory and clinical evaluations. 343 78

Alimentary motivation (AM) disorders, varying in nature, markedness and duration, were found in 102 individuals with marginal arterial hypertension (64 of those showing obesity). Enhanced AM with an undulating recurrence pattern was established in 71.6%. Normal AM was noted in 24.5%, and reduced AM, in 3.9% of the patients. A relationship between elevated BP and AM changes was recorded in 70.5% of cases. Unstable or altogether lacking effect of the will effort to suppress alimentary discomfort (in 31 of 73 patients) suggests that anorexic agents should be added to combined treatment schemes for patients with marginal arterial hypertension and enhanced AM.
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PMID:[Clinical evaluation of food motivation in borderline arterial hypertension]. 347 49

There were 631 patients treated for proven urogenital tuberculosis in 1966-1985. Indications for nephrectomy were retrospectively analyzed in 137 (21.7%) patients operated. A badly damaged or functionless kidney was removed in 85 (62.0%) patients for the early control of persistent tuberculous cystitis; in 18 (13.1%) because of chronic, nonspecific urinary infection, dispersed calcifications with subsequent nephrolithiasis, pain or other discomfort; in 16 (11.7%) due to supposed nephrogenic hypertension, and in 3 (2.2%) because of extrarenal disease. In 15 (10.9%) patients the symptomless kidney was removed preventively. The management of renal tuberculosis by itself did not need nephrectomy.
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PMID:Persistent tuberculous cystitis: the most common indication for nephrectomy in the management of urogenital tuberculosis. 358 54

The treatments of mild hypertension with atenolol and prazosin in occupationally active men and women were compared in a double blind cross-over with placebo. The hypotensive effect of the beta-adreno-receptor blocking drug, atenolol, were striking and in accordance with current knowledge, using one daily dose of 100 mg. In contrast, the hypotensive effect of taking 2 mg prazosin twice a day was modest, averaging about 3% when compared with placebo, somewhat less but still detectable during the performance of muscular exercises. Atenolol medication significantly reduced heart rate and blood pressure responses to muscular exercises, covering a range of work loads experienced during ordinary working days. No increased feeling of muscular fatigue or other discomfort during muscular work compared to that on prazosin and placebo medication could be detected. It was therefore concluded that atenolol medication was a useful treatment of mild hypertension and did not reduce the normal working ability and exercise tolerance. Prazosin medication did not significantly change working ability and exercise tolerance.
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PMID:Working ability and exercise tolerance during treatment of mild hypertension. II. A comparison between atenolol and prazosin medication. 389 71

DMSO is a clear odorless liquid, inexpensively produced as a by-product of the paper industry. It is widely available in the USA as a solvent but its medical use is currently restricted by the FDA to the palliative treatment of interstitial cystitis and to certain experimental applications. Cutaneous manifestations of scleroderma appear to resolve (albeit equivocally) following topical applications of high concentrations of DMSO. A limited number of small clinical trials indicate that intravenous DMSO may be of benefit in the treatment of amyloidosis, possibly by mobilizing amyloid deposits out of tissues into urine. Dermal application of DMSO seems to provide rapid, temporary, relief of pain in patients with arthritis and connective tissue injuries. However, claims for antiinflammatory effects or acceleration of healing are currently unwarranted. There is no evidence that DMSO can alter progression of degenerative joint disease, and, for this reason, DMSO may be considered for palliative treatment only and not to the exclusion of standard antiinflammatory agents. The safety of DMSO in combination with other drugs has not been established; neurotoxic interactions with sulindac have been reported. In experimental animals, intravenous DMSO is as effective as mannitol and dexamethasone in reversing cerebral edema and intracranial hypertension. An initial clinical trial in 11 patients tends to support this latter application. DMSO enhances diffusion of other chemicals through the skin, and, for this reason, mixtures of idoxuridine and DMSO are used for topical treatment of herpes zoster in the UK. Adverse reactions to DMSO are common, but are usually minor and related to the concentration of DMSO in the medication solution. Consequently, the most frequent side effects, such as skin rash and pruritus after dermal application, intravascular hemolysis after intravenous infusion and gastrointestinal discomfort after oral administration, can be avoided in large part by employing more dilute solutions. Most clinical trials of DMSO have not incorporated the components of experimental design necessary for objective, statistical evaluation of efficacy. Randomized comparisons between DMSO, placebo and known active treatments were rarely completed. Final approval of topical DMSO for treatment of rheumatic diseases in particular will require a multi-center, randomized comparison between high and low concentrations of DMSO and an orally-active, nonsteroidal antiinflammatory agent.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Medical use of dimethyl sulfoxide (DMSO). 391 2

Labile high blood pressure and associated complaints (eg, severe headache, palpitation, and vague discomfort in the chest) in a 28-year-old woman with pheochromocytoma were stabilized by adding nifedipine to the conventional regimen of alpha- and beta-blocking agents. Electrocardiographic (ECG) data (ST depressions, prolonged QT intervals, and giant negative T waves during a hypertensive attack) and findings in biopsied myocardial specimens (slight cell infiltration composed mainly of lymphocytes associated with interstitial fibrosis) had suggested the presence of catecholamine cardiomyopathy. Oral administration of 10 mg of nifedipine alone had rapidly resulted in normalization of blood pressure and complete relief from associated signs and symptoms. Because conventional preoperative treatment with alpha- and beta-blockers did not alleviate the hypertensive attacks, a 20-mg long-acting nifedipine tablet was added to the regimen. The effect of twice-daily administration of a 20-mg long-acting nifedipine tablet (combined with alpha- and beta-blockers) was so prominent that it was possible for the patient to undergo surgery for removal of the right adrenal gland and a 4-cm tumor at the gland. After surgery there were no abnormal ECG findings.
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PMID:Preoperative management of pheochromocytoma with the calcium-antagonist nifedipine. 399 32

The present study describes developmental changes in autonomic controls of heart rate in a strain of rats genetically predisposed to hypertension (spontaneously hypertensive rats or SHR) and in a normotensive strain of rats (Wistar-Kyoto rats or WKY). Rat pups were tested at 4, 8, 12, and 16 days to determine heart rate changes after selective pharmacological treatments. Specifically, freely moving pups were treated with selective beta-adrenergic and muscarinic receptor blockers (i.e., atenolol and atropine methylnitrate), using procedures designed to produce minimal pain or discomfort. The results indicated that by 4 days of age there is a substantial sympathetic acceleratory influence on heart rate. Comparison of inferred autonomic control of the heart in prehypertensive SHR and normotensive WKY pups suggested exaggeration of this early sympathetic influence among SHR pups. After 2 wk of age, however, equivalent autonomic control of heart rate was seen in SHR and WKY rats, with the higher basal heart rate of SHR rats being mediated by an increased intrinsic heart rate (i.e., heart rate after combined blockade). These findings suggest that enhanced sympathetic nervous system activity may be an early expression of the genetic predisposition to develop hypertension.
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PMID:Development of autonomic control of heart rate in genetically hypertensive and normotensive rats. 614 73


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