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

Reversible Cushing's syndrome with typical physical appearance and increased basal plasma-cortisol level developed in a 48-year-old man with essential arterial hypertension, as a result of chronic alcohol abuse and could not be supressed by prolonged dexamethason inhibition. Alcohol abstinence within a few weeks produced remission with normal adrenocortical function and regulation without any other therapeutic measures. Renewed alcohol consumption quickly brought about again the alcohol-induced Cushing's syndrome. An abnormality of central regulation with inadequate ACTH secretion was the cause of the hypercortisolism. Previously reported cases of alcohol-induced Cushing's syndrome are not uniform: in some the diagnosis is in doubt.
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PMID:[Alcohol-induced Cushing's syndrome: case report (author's transl)]. 625 Jul 82

The severity of renal disease in systemic lupus erythematosus is variable. Renal biopsy is important to guide the treatment. The World Health Organization classification define six different histological categories with possible transformations from one category to another. Histological signs of activity or chronicity are important with respect to prognosis and treatment. Examination of renal biopsy allows predicting the reversibility of histological lesions following therapy. Apart from histological signs of severity, other factors may influence the prognosis: arterial hypertension, initial serum creatinine, the delay between onset of renal disease and treatment, the occurrence of exacerbations of the nephropathy, and the response to therapy by the end of the first year. The prognosis of severe forms of lupus nephritis, mainly diffuse proliferative glomerulonephritis, has improved during the last 20 years. The addition of immunosuppressive agents (cyclophosphamide, azathioprine) to corticosteroids is responsible for this improvement. Methylprednisolone pulses are as effective as oral high doses of prednisone during initial treatment and have fewer side effects. Many authors advocate monthly cyclophosphamide pulses over six months, sometimes followed by quarterly pulse cyclophosphamide. However, such an approach has not been proven to be more effective than an oral course of cyclophosphamide and/or azathioprine. On follow-up, steroid therapy should be slowly tapered, and close monitoring of lupus serological parameters (anti-DNA antibodies, complement), urinary protein excretion rate, urinary sediment and renal function allow one to detect exacerbations of the disease, which may require adapted therapy. While such protocols have improved the outcome, they have potential side effects. In addition to the deleterious effect of steroids on physical appearance, often badly tolerated by adolescents, immunosuppressive treatments increase the risks of severe infectious complications and the risks of cardiovascular complications in young adults.
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PMID:[Treatment of lupus nephritis in children]. 1062 4

A great deal of research has examined the hypothesis that the well-being of individuals is shaped not just by the absolute level of resources available to them but also the level of resources available to them relative to others in their cohort or community. Several causal pathways have been hypothesized to explain associations between relative social position and health. For example, greater community income could increase the overall availability of health care in a community or decrease the availability for people for any given level of individual income. Relative social position could also create stress, resulting in adverse health outcomes through increased hypertension and other pathways. We explore yet another pathway by which relative social position may affect health. Specifically, to the extent that norms about physical appearance might be shaped by one's observations of others, we examine whether obesity might constitute another physiologic pathway by which community attributes could influence aspects of individual health, such as hypertension. We examine this hypothesis in rural China, where income often limits food intake so that, if community norms are an important determinant of individual obesity, higher community income could increase the obesity rate in a community and therefore change norms about obesity. These norms, in turn, could increase individuals' chances of being obese given their income. To test this hypothesis, we use multilevel linear probability models to examine the relationship between ecologic factors, i.e., relative income and income inequality, and health risk factors, i.e., obesity and hypertension among a sample of Chinese adults interviewed in four waves over 9 years. The results suggest that, among rural Chinese residents, increasing community average income and income inequality are positively associated with both obesity and hypertension. However, the effect of relative income on hypertension is not accounted for by increases in obesity. We did not find a strong relationship between socioeconomic conditions and the health risk factors among urban residents, where norms might be likely to be less strongly influenced by local attributes. Hence, the present study provides evidence supporting the hypothesis that relative income and income inequality affect obesity and hypertension, but no evidence that the effects on hypertension operated through effects on obesity.
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PMID:Beefing up with the Chans: evidence for the effects of relative income and income inequality on health from the China Health and Nutrition Survey. 1832 51

The Bergen Clinical Blood Pressure Study in Norway was used to examine the relationship between body mass index (BMI (kg/m(2))) and total mortality in different age segments. Of 6,811 invited subjects, 5,653 (84%) participated in the study (1965-1971) and 4,520 (66%) died during 182,798 person-years of follow-up (1965-2007). Mean age at baseline was 47.5 years; range 22-75 years. BMI (kg/m(2)) was calculated from standardized measurements of body height and weight and divided into four groups (<22.0, 22.0-24.9, 25.0-27.9, > or =28.0). The 20 years cumulative risk of death related to baseline BMI was U-shaped in the elderly (aged 65-75 years), whereas the pattern was more linear in the youngest age group (20-44 years). In contrast to the younger age groups, the highest mortality in the elderly was in the lower BMI range (<22.0 kg/m(2)) (adjusted Cox proportional Hazard Ratio 1.39, 95% Confidence Interval 1.10, 1.75) compared to the BMI reference group (22.0-24.9 kg/m(2)). This pattern persisted after 72 months of early follow-up exclusion and it was robust to adjustments for a wide range of possible confounders including gender, history of cardiovascular disease, respiratory disease or hypertension, smoking habits, physical activity, socioeconomic status, physical appearance and other anthropometric measures. The study shows that a low BMI is an appreciable independent risk factor of total mortality in the elderly, and not a result of subclinical disease or confounding factors such as current or previous smoking. Awareness of this issue ought to be emphasized in advice, care and treatment of elderly subjects.
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PMID:Increased mortality in the slim elderly: a 42 years follow-up study in a general population. 1977 55

The objective of the study was to formulate a transdermal product containing Nicorandil as a model drug, because it has been first drug of choice to treat angina and hypertension. A further objective was to reduce its side effects. The transdermal product was prepared using various synthetic and natural gelling agents such as Carbopol 934p, Carbopol 974p, HPMC K15M and HPMC K100M. Various penetration enhancers were incorporated to enhance the diffusion across the rat skin. A further objective was to formulate organogels and minimize the concentration of penetration enhancer to 50% of the concentration used in gels and yet to achieve the maximum drug release. The prepared formulations were evaluated for their physical appearance, viscosity, spreadability, drug content and freeze thaw cycle. Based on in vitro studies across rat skin and human cadaver skin it was concluded that Nicrorandil transdermal organogel formulation using HPMC K100M with 2% w/w Transcutol-P shows increase in cumulative diffusion of Nicorandil amongst all other formulations.
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PMID:Development and evaluation of transdermal organogels containing nicorandil. 2374 25

This descriptive exploratory research aims to analyze the effects of bariatric surgery in the lifestyle of people with class III obesity in the workplace, through individual interviews with patients undergoing gastric bypass in gamma-Rouz. Data collection was conducted in June and July, 2011, by means of individual interviews, yielding three Collective Subject Discourse: "More willingness to work" "Life without comorbidities" and "Other effects of bariatric surgery." 30 patients with mean age 44 +/- 12 years old, 24 (80%) female, 19 (63%) performed paid professional activities, 10 (34%) did not work and one (3.3%) students, 23 (96%) hypertension and eight (33%) with a diagnosis of diabetes mellitus were included in the study. Difficulty handling with physical appearance: 13 (43%) and the emotional aspect: 21 (70%). Bariatric surgery positively affected the lifestyle of obese at work with reduction in comorbidities and physical and emotional problems, favoring social and professional reintegration of the individuals.
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PMID:[Bariatric surgery: its effects for obese in the workplace]. 2434 83

This systematic review aimed to evaluate the association between antihypertensive drugs and risk of breast cancer, and provide therapeutic implications for female hypertensive patients with different physical appearance. The prevalence of hypertension and female breast cancer is on the rise with age. It has been suggested that ARBs (angiotensin receptor blockers), ACEi (angiotensin-converting enzyme inhibitor), CCBs (calcium channel blockers), and BBs (beta-blockers) were widely used in hypertensive patients. Some researches have shown ARBs, ACEis, and beta-blockers to be effective drugs for blood pressure lowering as well as for reducing the risk of breast cancer in women. However, the research conclusions were inconsistent. To address the conflicting evidence from previous study, the study evaluates the risk of breast cancer in hypertensive women. In conclusion, we report the evidence that beta-blockers can reduce the risk of breast cancer recurrence, while ACEi and CCBs were not associated with an increased risk of breast cancer.
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PMID:Effect of antihypertensive drugs on breast cancer risk in female hypertensive patients: Evidence from observational studies. 2911 47

Polycystic ovary syndrome (PCOS) presents with a spectrum of conditions resulting from androgen excess, anovulation and metabolic syndrome. Patients with PCOS may see their primary care physicians for various presentations, including hirsutism, acne, menstrual irregularities, infertility, obesity, and psychiatric disorders such as anxiety and depression. Management of these patients should include screening for Type 2 diabetes mellitus, dyslipidaemia and hypertension. Treatment should be targeted to each patient's phenotype and personal expectations such as desire for pregnancy. Psychological well-being due to the effects on physical appearance is also an important consideration. Diet and exercise are major components in the management of patients with PCOS and obesity. The first-line therapy for fertility and metabolic syndrome in PCOS is lifestyle modification with diet and exercise, followed by pharmacological therapy.
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PMID:Managing polycystic ovary syndrome in primary care. 3049 39