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

We evaluated the effects of a single oral dose of 5 mg of isradipine compared to placebo in a randomized, double-blind, crossover study using gated radionuclide angiography at rest and during exercise in 20 patients with stable chronic angina. Isradipine improved both anginal symptomatology and ST-segment depression during exercise, with a concomitant favorable effect on the isotopic parameters exploring systolic and diastolic left ventricular function. There was a marked increase of the ejection fraction during exercise with isradipine compared to placebo (61 +/- 14% vs. 55 +/- 15%, respectively, p less than 0.001) as well as a significant improvement in the peak ejection rate and the peak filling rate at rest [2.56 +/- 0.62 vs. 2.16 +/- 0.54 end diastolic volume (EDV) per second and 2.14 +/- 0.59 vs. 1.87 +/- 0.37 EDV/s, respectively] and during exercise (3.49 +/- 0.97 vs. 3.10 +/- 1.07 EDV/s and 4.05 +/- 1.34 vs. 3.65 +/- 1.25 EDV/s, respectively). We conclude that isradipine has a beneficial effect on the clinical and electrocardiographic signs of exercise-induced ischemia, leading to a significant improvement of the systolic and diastolic parameters of left ventricular function. Therefore, isradipine is potentially a useful treatment for patients with exertional angina and hypertension, alone or associated with beta blocker medication.
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PMID:Effects of oral isradipine on left ventricular function at rest and during exercise in patients with stable chronic angina: a double-blind, placebo-controlled crossover study. 137 79

The study of the fibrinolytic system and the activity of interleukin 1 and 2 in 75 patients with various cardial manifestations of atherosclerosis (angina of effort, angina decubitus, arrhythmia, symptomatic hypertension) revealed a decrease in the activity of plasminogen--a blood activator--in patients with angina of effort, angina decubitus and cardiac arrhythmias. In those with atherosclerotic hypertension the activatory activity was in the normal limits. A decrease in the activity of interleukin 1 and 2 was noted in all those examined.
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PMID:[Fibrinolysis, interleukins and coronary atherosclerosis]. 150 14

The results of every carotid endarterectomy performed contralateral to an internal carotid artery occlusion (n = 36) (group I) were compared with those performed contralateral to a patent internal carotid artery (n = 169) (group II) over the last 10 years. The patients in each group were evenly matched with respect to male gender (66% vs 69%); mean age (66.7 vs 65.9 years); and incidence of hypertension (55.6% vs 53.2%), diabetes (16.7% vs 20.1%), and hyperlipidemia (8.3% vs 11.8%). Patients in group I had a higher incidence of previous myocardial infarction (25% vs 11.8%, p less than 0.05) and exertional angina (55.6% vs 29.6%, p less than 0.01). Indications for carotid endarterectomy were equivalent, including stroke (19.4% vs 21.9%), transient ischemic attacks (36.1% vs 35.5%), amaurosis fugax (16.7% vs 11.8%), nonhemispheric symptoms (5.6% vs 8.3%), and asymptomatic stenoses (22.2% vs 22.5%), respectively. Perioperative strokes occurred in one (2.8%) patient in group I and seven (4.1%) patients in group II (NS). Among the patients in group II the incidence of perioperative stroke did not correlate directly with the degree of contralateral ICA stenosis: greater than 90% (4%); 70% to 90% (6.7%); 50% to 70% (8.7%); and less than 50% (2.8%). The operative mortality rate was 0% among patients in group I and 1.2% among patients in group II (NS). Cardiac complications occurred in two (5.6%) patients in group I and nine (5.3%) patients in group II (NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Does contralateral internal carotid artery occlusion increase the risk of carotid endarterectomy? 152 36

Abnormalities of left ventricular (LV) systolic performance develop during exercise in patients with coronary artery disease (CAD) as a result of ischemia-induced regional wall motion abnormalities. Like patients with hypertension and those with hypertrophic cardiomyopathy, patients with CAD display abnormalities of LV diastolic performance under basal conditions in the absence of ischemia. The purpose of these studies was to compare the effects of bepridil versus those of propranolol or diltiazem in patients with exertional angina pectoris. LV systolic and diastolic performance were assessed at rest and during peak upright bicycle exercise by first-pass radionuclide ventriculography. Compared with propranolol, bepridil increased exercise capacity, cardiac output, and stroke volume and decreased systemic vascular resistance. Compared with diltiazem, bepridil increased exercise capacity, peak filling rate, and early diastolic filling fraction and decreased systemic vascular resistance, heart rate, time to peak filling rate, and atrial filling volume. Bepridil therapy is associated with improved exercise capacity and decreased anginal frequency and nitroglycerin consumption. In addition, its use is accompanied by favorable changes in LV systolic and diastolic function at rest and during exercise. These changes are consistent with benefits resulting from resolution of myocardial ischemia as well as from positive lusitropic effects of bepridil on the ventricular myocardium.
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PMID:Effects of antianginal therapy on left ventricular systolic and diastolic performance: comparison of the response to bepridil, propranolol, and diltiazem. 155 88

Central hemodynamics of coronary patients living in the arid zone (215 males aged 40-72 and 150 females aged 40-75) was assessed in comfortable weather conditions, 1-2 days before the invasion of the dust storm, upon its invasion and in hot weather season (+26-30 degrees C). Angina of effort functional class I, II and III was in 102, 198 and 65 patients, respectively. Atmospheric conditions before the invasion of the dust storm form a hypoxic type of weather while on the day of the storm the weather appears spastic resulting in arterial hypertension, elevated total peripheral resistance and heart beat in diminution of cardiac output and stroke volume. Hot weather brings about a hypotensive response, total peripheral resistance falls, cardiac output increases at the expense of enhanced heart beat as stroke volume decreases. It is concluded that under the climatic conditions of an arid zone coronary patients develop a complex of hemodynamic responses which function with strain to supply blood to organs and tissues.
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PMID:[The central hemodynamic reaction of patients with ischemic heart disease to the climatic and weather conditions of an arid zone]. 192 94

A variety of experimental studies suggest that diastolic left ventricular (LV) function changes after acute myocardial infarction (AMI), but limited data exist on these changes in humans. To assess diastolic filling after AMI, 60 patients underwent Doppler echocardiographic examination within 24 hours of AMI. Of 54 patients who also underwent catheterization, 45 (83%) were successfully reperfused. A subgroup of 17 patients underwent a follow-up Doppler examination at 7 days after infarction, whereas 15 patients with stable exertional angina served as control subjects. There was no significant difference in age, gender, incidence of systemic hypertension or diabetes mellitus, heart rate, mean arterial pressure or severity of coronary artery disease between the infarct and control groups. The infarct group had a lower velocity time integral total (9.9 +/- 0.4 cm vs 12.0 +/- 0.9 cm, p less than 0.001), a lower velocity time integral E (5.8 +/- 0.3 cm vs 6.8 +/- 0.5 cm, p less than 0.01) and a lower velocity time integral 0.333 (3.5 +/- 0.4 cm vs 6.1 +/- 0.5 cm, p less than 0.01) than the control group. In addition, velocity time integral A/total was significantly greater in the infarction group (0.44 +/- 0.03 vs 0.35 +/- 0.04, p less than 0.01) compared to the control group. The follow-up subgroup showed an increase in velocity time integral total (p less than 0.01), velocity time integral E (p less than 0.05) and velocity time integral 0.333/total (p less than 0.05) over the first 7 days after infarction. The final recovery values at 7 days were not significantly different from those of the coronary artery disease group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Transient left ventricular filling abnormalities (diastolic stunning) after acute myocardial infarction. 222 Jun 12

A collaborative study was undertaken to assess the efficacy of multifactor prevention of myocardial infarction and cerebral stroke. A representative group of 5951 males aged 40-50 years was examined in Kaunas. Coronary heart disease (CHD) was detected in 11.1%, including 2.7% who had a history of myocardial infarction, 2.5% had exertional angina, its painless type was found in 5.9%. In males with CHD, arterial hypertension, hypercholesterolemia, obesity were more common and smoking was more infrequent than in those without the disease. The results of the 5-year follow-up showed that CHD males had higher total and cardiovascular mortality and myocardial infarction morbidity rates than males without CHD. Males with prior MI and pain-free CHD significantly differed from those from the control group in total and cardiovascular mortality rates. No statistically significant difference was found in MI mortality and morbidity rates between male patients with exertional angina and controls.
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PMID:[Prevalence of risk factors and indicators of mortality among males 40-59 years of age with various forms of ischemic heart disease (data of a 5-year prospective study)]. 258 60

Labetalol is a non-selective beta-adrenoceptor antagonist agent with added alpha 1-adrenergic blocking properties, beta 2-stimulating action, and direct vasodilatory activity. A multi-center, double-blind, parallel group study compared the safety and efficacy of labetalol to propranolol in the treatment of patients with both exertional angina and mild to moderate systemic hypertension. An initial 4 to 5 week placebo washout phase was followed by a five week titration phase and a four month maintenance phase. Labetalol and propranolol had similar effects in reducing supine and standing blood pressures, except for a greater reduction in standing systolic blood pressure seen in the labetalol group. There were comparable effects by both treatments on angina attacks, nitroglycerin use, and exercise tolerance. Adverse effects were frequent with both drugs, but were generally minor. Thus, labetalol appears to be an effective alternative to propranolol in the treatment of patients with coexisting angina pectoris and hypertension, with the choice of agent dependent on the clinical situation.
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PMID:Labetalol compared with propranolol in patients with both angina pectoris and systemic hypertension: a double-blind study. 266 51

Clinically significant differences between various beta-adrenoceptor blocking drugs exist. Patients with ischaemic heart disease and exertional angina pectoris benefit from all types of beta-blockers. Drugs with intrinsic sympathomimetic action (ISA) given intravenously may be safer in some patients with acute myocardial infarction than those drugs without ISA. In cardiac patients at rest they may have a vasodilator action and cause less myocardial depression than beta-blockers without ISA. When, however, the cardiac sympathetic tone is high pindolol and other beta-blockers with ISA act as any other beta-blockers, producing haemodynamic impairment. Studies have shown that beta-blockers with ISA confer less benefit in secondary prevention after myocardial infarction and they are not suitable for the treatment of obstructive cardiomyopathy. Non-selective beta-blockers may be advantageous in hypokalaemic arrhythmias. Beta 1-blockers may be preferred for patients with bronchoconstriction, diabetes, peripheral vascular disease and, theoretically to some extent in theory also in patients with hypertension. The extent and nature of side effects may also influence the selection of the most suitable beta-blocker in cardiovascular therapy.
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PMID:Differences in betablocking drugs in cardiovascular therapy. 290 77

Initial manifestations of cerebrovascular pathology (CVP) in the presence of arterial hypertension (n-26) and atherosclerosis (n-428) were combined with various cardiovascular disorders ranging from cardialgia to coronary heart disease in 67.4% of the patients. Cardial disturbances were expressed as an atypical pain syndrome in 47% and as angina of effort and postinfarction cardiosclerosis in 23.2% of the patients. Electrocardiographic changes were elicited in 52.6-62% of the patients. Bicycle ergometry revealed a decrease in all parameters of tolerance to physical exercise. Disorders of the general and cerebral hemodynamics were more pronounced in atherosclerotic patients; at the first stages of cerebral pathology they predominantly presented the normokinetic type of the hemodynamics (40.6%) while its more marked forms were associated with the hypokinetic type of the circulation (52). The early diagnosis of cardial and hemodynamic disorders is necessary for the presention of acute disturbances of the cerebral circulation.
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PMID:[Cardiac and hemodynamic disorders in the pathogenesis of the initial manifestations of cerebrovascular pathology]. 293 10


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