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

This study examines the efforts and needs associated with family care for disabled and frail adults. A survey of 117 primary caregivers focused on: the health problems associated with caregiving; the existence of informal, family support systems; the use of formal social services, and the need for additional social service programs. Most caregivers report physical and emotional problems due to caregiving ranging from hypertension and back problems to depression and mental exhaustion. The characteristics of caregivers at high risk for health problems are identified. Less than half of the caregivers have family or friends to assist them with caregiving. At least one type of social service was being used by over 80% of caregivers, with utilization patterns in male and female caregivers. Based on the study findings, several policy implications are reviewed.
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PMID:The unmet needs of family caregivers for frail and disabled adults. 315 88

Pial-arachnoidal microvessels (40-210 micron) were studied by fluorescent microscopy in anaesthetized, immobilized and ventilated newborn piglets in the course of bilateral experimental pneumothorax (BEP; n = 10) using the open cranial window technique. Na+-fluorescein and fluorescein isothiocyanate (FITC)-dextran (mol.wt. 40,000 and 70,000 Da) administered i.v. served as blood-brain barrier (BBB) indicators. After gradual exhaustion of compensatory mechanisms a critical phase, characterized by severe acidosis, bradycardia, arterial hypotension following hypertension and arterial hypoxaemia ensued, with vasoconstriction following vasodilation. Moreover, progressive circulation disturbances, sludging and microthrombi formation occurred in small venules. Concomitantly, diffuse BBB opening for Na+-fluorescein ensued in all piglets with BEP as shown by extended fluorescence in the brain tissue around the small venules (less than 80 micron); never observed for FITC-dextran and in the control animals (n = 4) without BEP. In the acute phase of pneumothorax a selective opening of the BBB should be considered.
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PMID:Selective opening of the blood-brain barrier in newborn piglets with experimental pneumothorax. 321 68

Fifty untreated male patients aged 32 +/- 10 (s.d.) years, referred for hypertension, in whom organ damage was limited to WHO stages I and II, without underlying disease, performed a graded, uninterrupted exercise on a bicycle ergometer up to exhaustion. Mean brachial intra-arterial pressure at rest ranged from 74 to 152 mmHg. Maximal voluntary oxygen uptake was independently and negatively related to resting blood pressure (P less than 0.05), age (P = 0.05), and positively to body weight (P less than 0.05). Pulmonary wedge pressure and the components of the Fick equation--heart rate, stroke volume and arteriovenous oxygen difference--were measured in order to study the mechanisms involved. Stroke volume at peak exercise was inversely (P less than 0.05), and pulmonary wedge pressure positively (P less than 0.01), related to mean brachial artery pressure at rest. Peak heart rate was not significantly related to the severity of hypertension, but was inversely related to age (P less than 0.01). Stroke volume and pulmonary wedge pressure at the end of exercise were both similar in older and younger patients. Arteriovenous oxygen difference at peak exercise was not related either to blood pressure or to age. In conclusion, both high blood pressure and age reduce maximal voluntary oxygen uptake independently of each other by separate mechanisms; the former by an impairment of cardiac function, the latter by the limitation of peak heart rate.
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PMID:Maximal aerobic power in essential hypertension. 323 35

Calcium ions are ubiquitous messengers of numerous cellular functions. Under normal conditions, they translate the membrane signal into specific cellular activity by electromechanical or electrosecretory coupling. An enhancement of the transmembrane calcium influx results in exaggerated cellular function, such as increased vascular contractility. Therefore, a reduction of transmembrane calcium influx by calcium antagonists effectively reduces high blood pressure (BP). It has been shown that the long-term treatment of genetically hypertensive rats with dihydropyridine calcium antagonists ameliorates the tissue damage that occurs in association with high BP in various organs. This tissue protection is not secondary to the reduction of hypertension as it can be demonstrated in the absence of BP reduction. This favourable effect may be attributed to the prevention of intracellular calcium overload which results in an exhaustion of energy-rich phosphates, excessive activation of proteolytic and phospholytic enzymes, membrane destruction and cellular death. In acute ischaemia experiments, inhibition of excessive transmembrane calcium influx by the dihydropyridine calcium antagonists prevents vascular and parenchymal damage. Moreover, long-term treatment with dihydropyridine calcium antagonists prevents vascular and parenchymatous damage in advanced or accelerated hypertension. In accordance with this concept, calcium antagonists have been shown to exert protective effects against acute ischaemic damage in both the heart and the kidney.
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PMID:Tissue protection by nifedipine and its calcium antagonistic derivatives in vascular damage. 333 29

In the period of vasorenal hypertension formation in rats phase changes in the kallikrein-kinin system of the blood are observed: one month after kidney-skin anastomosis a significant increase of the levels of prekallikrein, kininogen and kallikrein inhibitor is noted and by the end of the second month a drastic decrease of the levels of these components occurs due to the "unregulated" activation of the kallikrein-kinin system of the blood. Antiadrenergic agents (reserpine, tropaphen) prescribed for treatment of hypertension prevent the development of the "unregulated" activation of the kallikrein-kinin system and reduce consumption of its components. These drugs are advisable to use under threat of the kallikrein-kinin system exhaustion. beta-adrenoblocking agent obsidan and myotropic drugs produce a significant enhancement of kallikreino- and kininogenesis, but the degree of activation of the processes is less pronounced than in untreated hypertensive rats.
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PMID:[Effect of antiadrenergic and myotropic hypotensive agents on the blood kallikrein-kinin system in experimental hypertension]. 341 23

During the phase of long-lasting adaptation to chronic emotional painful stress three stages have been distinguished on the basis of physiological and neurobiochemical data. The first stage (1 week of stress)--transition from urgent to long-lasting adaptation--corresponds to labilization of vegetative indices, predominance of fear reactions and suppression of research behaviour in rats, inhibition of lipid peroxidation, activation of superoxide scavenging activity, decrease in cholesterol content in brain lipids. The second stage (2 weeks of stress)--long-lasting adaptation--is characterized by normalization of the behaviour, stabilization of high blood pressure, maximum brain antiradical activity and low level of lipid peroxidation. The third stage (3 weeks of stress)--transition from long-lasting adaptation to exhaustion--is characterized by blood pressure lowering, disturbed regulation of vegetative functions, behavioural hyperactivity in the open field, increased lipid peroxidation and decreased phospholipid content.
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PMID:[Characteristics of free-radical oxidation and antiradical protection of the brain in adaptation to chronic stress]. 341 49

The etiology of exercise-induced upper limb hypertension after repair of coarctation of the aorta is unknown. We hypothesized that blood flow across the coarctation repair site is a major determinant of such exercise-induced hypertension. Because arm ergometry should produce a smaller increase in descending aortic blood flow than treadmill exercise, we compared the changes in upper limb pressure and the coarctation gradient produced by each type of exercise at equivalent levels of heart rate and peak oxygen consumption in 28 children with repaired coarctation of the aorta. The children were classified into three groups: Group I, resting gradient less than 15 mm Hg and treadmill gradient less than 20 mm Hg; Group II, resting gradient less than 15 mm Hg and treadmill gradient greater than 20 mm Hg; and Group III, resting gradient greater than or equal to 15 mm Hg. Twelve children with no heart disease served as control subjects. All children were exercised to exhaustion with 45 minutes' rest between the two exercise protocols. There were no differences in maximal heart rate and oxygen consumption between the two types of exercise. In all groups, treadmill exercise produced a larger increase in arm systolic blood pressure and arm-leg gradient than did arm exercise. With treadmill exercise coarctation Groups II and III developed a greater rise in both arm-leg gradient and arm systolic pressure than was observed in the control subjects (p less than 0.05). However, with arm exercise, Group III developed a significantly greater rise in both arm pressure and arm-leg gradient (p less than 0.05) than was observed in the control subjects.
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PMID:Exercise-induced hypertension after repair of coarctation of the aorta: arm versus leg exercise. 371 12

Platelets were evaluated in normal pregnant women and in pregnant subjects with mild and severe preeclampsia, nonpregnant control subjects, and pregnant subjects with chronic hypertension. The parameters studied included platelet count, presence of circulating platelet aggregates, and in vitro platelet aggregability by means of a variety of agonists of platelet aggregation. When subjects with a normal pregnancy were compared to nonpregnant controls, they demonstrated a significantly lower platelet count and an increase in circulating platelet aggregates and in vitro hypoaggregability. Significant differences among the groups of pregnant subjects could not be found. These studies suggest the occurrence of platelet activation in pregnancy. This activation causes in vivo platelet aggregation followed by exhaustion of platelets.
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PMID:Alterations in platelet concentration and aggregation in normal pregnancy and preeclampsia. 375 71

Eleven physically active men with systemic hypertension were studied after 5 weeks of treatment with placebo, atenolol or propranolol. A double-blind, crossover randomized design was used. Blood pressure (BP), heart rate (HR), physical performance capacity, rate of perceived exertion and blood lactate concentrations were measured during rest, exercise to exhaustion and postexercise, at 8 and 24 hours after intake of the last dose. Blood pressure at rest and during exercise was similarly decreased with both drugs (8 and 24 hours), and there was no difference between 8 and 24 hours with any of the treatments. Heart rate (8 hours) was decreased similarly by both drugs, but after 24 hours, HR at increased workloads (above 120 watts) was higher with atenolol compared with propranolol. Maximal HR was lower with propranolol than atenolol at both 8 and 24 hours. Maximal exercise loads (8 and 24 hours) were 231 and 232 watts with placebo, 211 and 212 with propranolol and 228 and 227 with atenolol. That is, maximal workload was decreased with propranolol compared with placebo and atenolol at both 8 and 24 hours. No difference was found between placebo and atenolol at either 8 or 24 hours. The rate of perceived exertion values were higher with propranolol than atenolol. Blood lactate concentrations did not differ according to treatments. The results indicate that atenolol, when given in a dose that decreases resting and exercise BP to the same extent as propranolol, limits physical performance less than propranolol.
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PMID:Effect of beta 1-selective and nonselective beta blockade on blood pressure relative to physical performance in men with systemic hypertension. 399 53

During exercise, patients with chronic obstructive pulmonary disease (COPD) increase their pulmonary arterial wedge (Ppaw) and left ventricular (LV) end-diastolic pressures more than normal control subjects. The increase in pressure is commonly attributed to an increase in intrathoracic pressure (Pit). However, mean esophageal pressure (Pes) does not increase with supine exercise in patients with COPD. Because changes in Pes may not represent changes in Pit when recorded in the supine position, we measured Ppaw and Pes during upright exercise in 8 patients with severe air-flow limitation (mean +/- SD) FEV1, 0.88 +/- 0.27 L secondary to COPD and no history or electrocardiographic abnormalities suggesting a previous myocardial infarct, history of angina, evidence of systemic hypertension, or use of cardiac medications. In addition, all patients completed a progressive exercise test to exhaustion without angina or ST segment changes, and all had normal LV function at rest assessed by equilibrium radionuclide ventriculography. The Ppaw increased a mean of 7.2 +/- 4.3 mmHg, whereas Pes increased a mean of only 1.3 +/- 1.6 mmHg. By multiple linear regression analysis, Ppaw was significantly associated with the work level performed (p less than 0.01), but had no significant association with Pes (p greater than 0.1). The change in Ppaw could not be attributed to changes in Pes. If changes in Pes during upright exercise are representative of changes in Pit or juxtacardiac pressure, a rise in Pit does not explain the exercise-induced increase in Ppaw and LV end-diastolic pressure that occurs in patients with COPD.
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PMID:Increases in intrathoracic pressure do not explain the rise in left ventricular end-diastolic pressure that occurs during exercise in patients with chronic obstructive pulmonary disease. 403 36


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