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

The effect of diazepam (0.15 and 0.5 mg/kg) and chlordiazepoxide (1.0 and 2.0 mg/kg) on the blood supply and cardiac action were investigated in experiments on cats anesthetized with urethan and chlorasol. Both these compounds were found to lower the vascular resistance to the blood flow, to bring down the coronary circulation rate and the oxygen intake of the heart. The preparations exert a marked influence on the work of the heart and the state of hemodynamics. Diazepam causes the development of an appreciable hypertension, bradycardia and reduces the cardiac ejection. Chlordiazepoxide produces a less pronounced fall of the arterial pressure, bradycardia and reduced the cardiac ejection. Unlike chlordiazepoxide diapezam reduces the contractibility of the myocardium, this being manifested in lessening the maximum acceleration of the blood flow in the aorta and in an increase of the systolic contraction time. Inhibition of the myocardium contractility occurring under the influence of diazepam may, to a certain degree, explain more pronounced hypotension observable on administration of this preparation.
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PMID:[Effect of tranquilizers (diazepam and chlordiazepoxide) on the blood supply and activity of the heart]. 122 3

The effects of intravenous as well as dorsal midbrain injections of morphine and chlordiazepoxide on the blood pressure rise induced by electrical stimulation of the dorsal periaqueductal gray matter (DPAG) were studied in unanesthetized rats. Chlordiazepoxide applied systemically or locally into the DPAG, as well as locally applied but not systemically injected morphine were found to attenuate the centrally-induced hypertension. These data together with others suggest that benzodiazepines as well as local injections of morphine into the DPAG decrease the aversive effect induced by DPAG stimulation.
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PMID:Chlordiazepoxide and morphine reduce pressor response to brain stimulation in awake rats. 408 Jul 74

Water-deprived rats were given access to either water or a highly preferred 0.9% NaCl solution in a 30 min drinking test. The animals consumed substantially more saline than water. Chlordiazepoxide (2.5-20.0 mg/kg) was administered IP before the drinking test. Analysis of the results revealed a significant drug treatment X fluid condition interaction. Chlordiazepoxide produced a preferential enhancement of saline intake, achieving a peak effect at 5.0 mg/kg. Consideration of the time-course of drinking showed some complexity in the way in which chlordiazepoxide affected the saline drinking. During the first 6 min of the drinking period, the drug treatments tended to depress consumption, reaching a significant effect at 20.0 mg/kg. However, in the following 16 min interval of the drinking test, chlordiazepoxide significantly elevated saline consumption. The mechanism for this second effect may have been a retardation in the development of satiety. Finally, at the end of the drinking test, when saline consumption had become satiated, chlordiazepoxide exerted no discernible effect. The enhancement of saline consumption by chlordiazepoxide appears to have been benzodiazepine-receptor mediated, since the effect was reversed by treatment with Ro15-1788, a benzodiazepine receptor antagonist. The implications of a benzodiazepine-induced increase in salt intake are briefly considered. The over consumption of salt is contraindicated in certain clinical conditions. Both stress and hypertension are associated with elevated salt appetite. Treatment of these conditions using benzodiazepines may require due consideration of the possible stimulant effect of these drugs on salt appetite.
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PMID:Enhancement of saline consumption by chlordiazepoxide in thirsty rats: antagonism by Ro15-1788. 608 71

Earlier behavioral results led to the suggestion that GABA exerts a tonic inhibitory influence in the dorsal periaqueductal gray (DPAG) matter of the rat integrating defensive behavior. In the present experiments, the role of GABAergic mechanisms in the modulation of the autonomic component of the defense reaction was studied. Thus, the effects of intravenous (IV) injections of chlordiazepoxide as well as of intracerebral (IC) injections of midazolam in the dorsal midbrain, on the blood pressure (BP), heart rate (HR) and respiratory increases induced by electrical stimulation of the DPAG were measured in rats anesthetized with urethane. Chlordiazepoxide (10 mg/kg, IV) as well as midazolam (40 and 160 nmol, IC) attenuated the centrally-induced hypertension, without affecting basal BP. The tachycardia induced by aversive brain stimulation was similarly decreased by the benzodiazepines. In addition, the HR baseline was significantly raised by chlordiazepoxide and by the highest dose of midazolam. The tachypnea induced by brain electrical stimulation was also reduced by both benzodiazepines. Basal respiratory rate was slightly, but significantly decreased by chlordiazepoxide as well as by the two doses of midazolam used and to a lesser extent by the vehicle alone. Chlordiazepoxide attenuated the increase in respiratory depth caused by brain stimulation, while basal respiratory amplitude was not affected. The effects of midazolam on this parameter were unclear. Microinjection of bicuculline (5 and 10 nmol) or picrotoxin (0.3 and 1 nmol) into the DPAG increased the BP, HR and respiration, like the electrical stimulation. The latency and duration of bucuculline effects were shorter than those of picrotoxin.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:GABA modulation of the defense reaction induced by brain electrical stimulation. 631 41

Eight young children with renal failure, undergoing continuous peritoneal dialysis (CDP) and presenting an anemia (hemoglobin level [Hb] 57 to 89 g/l) were treated by subcutaneous recombinant human erythropoietin (rHu EPO) twice weekly. The initial dose of 75 U/kg was adjusted to induce progressive increase of Hb with a target level of 100-120 g/l. Treatment duration was 24 weeks in five of these children and 10 to 13 weeks in the three others. In seven cases out of eight, anemia was corrected. The target Hb level was reached in 3 to 21 weeks with rHu EPO doses of 150 to 300 U/kg/w (mean: 200 U/kg/w) for four children without recent transfusion; then the median maintenance dose was 135 U/kg/w (range: 50-300 U/kg/w). In only one patient, Hb never reached a level higher than 77 g/l despite weekly dose of 350 U/kg, a reticulocytosis of 5.6%, rHu EPO treatment lasting up to 24 weeks and the absence of iron deficiency. In any case, no transfusion was necessary after the first day of rHu EPO treatment. In three patients, the increase of a preexisting hypertension required the adaptation of antihypertensive treatments. One patient presented a marked thrombocytosis. In conclusion, twice-a-week subcutaneous injections of 75 to 150 U/kg of rHu EPO appear to be well tolerated and effective in the treatment of anemia of CPD children.
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PMID:[Effectiveness of and tolerance to human recombinant erythropoietin in the treatment of kidney failure anemia in children undergoing continuous peritoneal dialysis. Multicenter study]. 777 95

Alcohol withdrawal syndrome (AWS) may result in nausea, vomiting, diarrhea, weakness, sweating, tremors, tachycardia, hypertension, agitation, delirium, hallucinations, seizures, and death beginning 6 hours after alcohol cessation in alcoholics. Benzodiazepines are cross-tolerant with ethanol and are considered first-line therapy for treating AWS. Chlordiazepoxide and diazepam are first metabolized by hepatic oxidation, then glucuronidation. Lorazepam and oxazepam undergo only hepatic glucuronidation. Benzodiazepine oxidation is decreased in persons with liver disease and the elderly. Accumulation with resultant excessive sedation and respiratory depression may be significant when administering chlordiazepoxide or diazepam to patients with impaired oxidative metabolism. Lorazepam and oxazepam metabolism is minimally affected by age and liver disease. Chlordiazepoxide and diazepam are erratically absorbed by the intramuscular route. Lorazepam is predictably absorbed by the intramuscular route. Oxazepam is not available in parenteral form. Lorazepam appears to be the safest empiric choice among the various benzodiazepines for treating AWS in the elderly and in patients with liver disease, or those who require therapy by the intramuscular route.
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PMID:Benzodiazepines for alcohol withdrawal in the elderly and in patients with liver disease. 870 Jul 92

The original fascination with the medullary circulation of the kidney was driven by the unique structure of vasa recta capillary circulation, which Berliner and colleagues (Berliner, R. W., N. G. Levinsky, D. G. Davidson, and M. Eden. Am. J. Med. 24: 730-744, 1958) demonstrated could provide the economy of countercurrent exchange to concentrate large volumes of blood filtrate and produce small volumes of concentrated urine. We now believe we have found another equally important function of the renal medullary circulation. The data show that it is indeed the forces defined by Starling 100 years ago that are responsible for the pressure-natriuresis mechanisms through the transmission of changes of renal perfusion pressure to the vasa recta circulation. Despite receiving only 5-10% of the total renal blood flow, increases of blood flow to this region of the kidney cause a washout of the medullary urea gradient and a rise of the renal interstitial fluid pressure. These forces reduce tubular reabsorption of sodium and water, leading to a natriuresis and diuresis. Many of Starling's intrinsic chemicals, which he named "hormones," importantly modulate this pressure-natriuresis response by altering both the sensitivity and range of arterial pressure around which these responses occur. The vasculature of the renal medulla is uniquely sensitive to many of these vasoactive agents. Finally, we have found that the renal medullary circulation can play an important role in determining the level of arterial pressure required to achieve long-term fluid and electrolyte homeostasis by establishing the slope and set point of the pressure-natriuresis relationship. Measurable decreases of blood flow to the renal medulla with imperceptible changes of total renal blood flow can lead to the development of hypertension. Many questions remain, and it is now evident that this is a very complex regulatory system. It appears, however, that the medullary blood flow is a potent determinant of both sodium and water excretion and signals changes in blood volume and arterial pressure to the tubules via the physical forces that Professor Starling so clearly defined 100 years ago.
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PMID:Role of the renal medulla in volume and arterial pressure regulation. 924 26

Epidemiological studies have observed statistical associations between short-term exposure to increased ambient particulate air pollution and increased hospital admissions, medication use, pulmonary morbidity, and mortality. To examine the effects of particle air pollution in animals, rats with a preexisting pulmonary inflammation (induced by 1600 microg/m(3) ozone) or hypertension (induced by monocrotaline, MCT) were nose-only exposed to concentrated freshly generated diesel exhaust particles (DEP) mixed with ambient air (CDP). It was hypothesized that a single 6-h exposure to PM exacerbates respiratory inflammatory processes, which affects health parameters in the blood. Histopathology of lung and nose, bronchiolar lavage (BAL), and blood analyses were performed at 1, 2, and 4 days after of the CDP exposure. Morphometry of BrdU-labeled cells in lung and nose was performed at 4 days postexposure. One day after ozone exposure, a mild inflammatory reaction in the centriacinar area was present, consisting of an increase in cellularity of septa and in the number of alveolar macrophages, decreasing in time. Additional CDP exposure did not influence this pattern, except for alveolar macrophages that were loaded with CDP. The only effect seen in the nose after ozone exposure was a slight hypertrophy of the septal mucous cells. Additional exposure to CDP did not change this appearance. MCT-treated rats showed hypertrophy of the media of the pulmonary muscular arteries that was not effected by CDP. BrdU labeling of predominantly Clara cells in the terminal bronchioles was significantly increased after ozone exposure as well as after MCT treatment, whereas this labeling index was markedly enhanced after an additional exposure to CDP. However, no increases in Clara cell protein (CC16) levels were measured of Clara cell protein (CC16) in either BAL or blood. BrdU labeling in the nasal epithelium was not influenced by exposure to ozone or ozone + CDP. CDP exposures did not induce significant toxic effects in the lungs. CDP exposures clearly induced an oxidative stress that was indicated by increasing glutathione levels in BAL with time. In addition, blood fibrinogen levels were enhanced in pulmonary hypertensive rats exposed to CDP. The present study demonstrates that very high CDP concentrations are needed to result in pulmonary changes in animal models with a preexisting pulmonary inflammation or hypertension that continue for days after a single exposure. In addition, CDP has the potential to induce changes in blood. It has not yet been determined how the effects seen with CDP would compare to similar levels of ambient particles.
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PMID:Effects of diesel exhaust enriched concentrated PM2.5 in ozone preexposed or monocrotaline-treated rats. 1212 72

To study the relationship between pre-pregnancy body mass index (BMI) and weight gain during pregnancy with pregnancy and birth outcomes, with a focus on gestational diabetes and hypertension and their role in the association with fetal growth. We studied 1,884 mothers and offspring from the Eden mother-child cohort. Weight before pregnancy (W1) and weight after delivery (W2) were collected and we calculated BMI and net gestational weight gain (netGWG = (W2 - W1)/(weeks of gestation)). Gestational diabetes, hypertension gestational age and birth weight were collected. We used multivariate linear or logistic models to study the association between BMI, netGWG and pregnancy and birth outcomes, adjusting for center, maternal age and height, parity and average number of cigarettes smoked per day during pregnancy. High BMI was more strongly related to the risk of giving birth to a large-for-gestational-age (LGA) baby than high netGWG (odds ratio OR [95% CI] of 3.23 [1.86-5.60] and 1.61 [0.91-2.85], respectively). However, after excluding mothers with gestational diabetes or hypertension the ORs for LGA, respectively weakened (OR 2.57 [1.29-5.13]) for obese women and strengthened for high netGWG (OR 2.08 [1.14-3.80]). Low in comparison to normal netGWG had an OR of 2.18 [1.20-3.99] for pre-term birth, which became stronger after accounting for blood pressure and glucose disorders (OR 2.70 [1.37-5.34]). Higher net gestational weight gain was significantly associated with an increased risk of LGA only after accounting for blood pressure and glucose disorders. High gestational weight gain should not be neglected in regard to risk of LGA in women without apparent risk factors.
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PMID:Pre-pregnancy body mass index and weight gain during pregnancy: relations with gestational diabetes and hypertension, and birth outcomes. 2125 62

Background: Cardiovascular diseases (CVDs) are part of the leading causes of mortality and morbidity in developing countries, including South Africa, where they are a major public health issue. Understanding the joint spatial clustering of CVDs and associated risk factors to determine areas in need of enhanced integrated interventions would help develop targeted, cost-effective and productive mediations. We estimated joint spatial associations and clustering patterns of 2 CVDs (stroke and heart attack) and 3 risk factors (hypertension, high blood cholesterol (HBC) and smoking) among adults in South Africa. Methods: We used cross-sectional secondary adult (15-64-year olds) health data from the South African Demographic Health Survey 2016. Age and gender standardized disease incidence ratios were analyzed using joint spatial global and local bivariate Moran's Index statistics. Results: We found significantly positive univariate spatial clustering for stroke (Moran; s Index = 0.128), smoking (0.606) hypertension (0.236) and high blood cholesterol (0.385). Smoking and high blood cholesterol (0.366), smoking and stroke (0.218) and stroke and high blood cholesterol (0.184) were the only bivariate outcomes with significant bivariate clustering. There was a joint stroke-smoking local "hot spots" cluster among four districts in the urban western part of the country (City of Cape Town; Cape Winelands; Overberg and Eden) and a joint "cold spots" cluster in the rural north-western part of the country. Similar joint "hot spots" clustering was found for stroke and high blood cholesterol, which also had "cold spots" cluster in the rural east-central part of the country. Smoking and high blood cholesterol had a "hot spots" cluster among five districts in the urban western part of the country (City of Cape Town; Cape Winelands; Overberg; Eden, and West Coast) and "cold spots" around the rural districts in east-southern parts of the country. Conclusions: Our study showed that districts tended to co-cluster based on the rates of CVDs and risk factors, where higher rates were found in urban places than in rural areas. These findings are suggestive of a more contagious and spatial diffusion process among interdependent districts in urban districts. Urbanization or rurality needs to be considered when intervention initiatives are implemented with more general approaches in rural areas. The finding of "hot spot" co-clusters in urban areas means that integrated intervention programmes aimed at reducing the risk of CVDs and associated risk factors would be cost-effective and more productive.
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PMID:Spatial Co-Clustering of Cardiovascular Diseases and Select Risk Factors among Adults in South Africa. 3244 72


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