UMLS:C0020538 - FACTA Search

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

In diabetic nephropathy and hypertension, a major cause of mortality is from cardiovascular disease. Since low levels of antioxidants such as vitamin C have been associated with such complications, we have examined the uptake mechanisms for ascorbic acid (AA) and dehydroascorbic acid (DHA) in lymphoblasts from normal control subjects (CON), normoalbuminuric insulin-dependent diabetic (IDDM) patients (DCON), patients with IDDM and nephropathy (DN) and hypertensive patients (HT) using mass assays of uptake and measuring AA using high-performance liquid chromatography. Precautions were taken to prevent oxidation of AA and to take into account the instability of DHA in buffers. DHA uptake was the major mechanism in all four groups of subjects, and the Vmax (maximal uptake rate) was significantly lower in the DN cells (24.7 +/- 1.0 nmol [95% confidence intervals CI 22.5, 26.3] 10(6) cells(-1) h(-1)) compared to CON and DCON cells (33.9 +/- 2.1 [95% CI 29.4, 38.4] and 37.0 +/- 2.2 [95% CI 32.2, 41.8] nmol 10(6) cells(-1) h(-1), respectively, p < 0.001 for both). DHA Vmax was also lower in the HT group (23.2 +/- 1.1 [95% CI 20.7, 25.7] nmol 10(6) cells(-1) h(-1)) compared to the CON group (p < 0.001). There were no significant differences in the Km or passive membrane permeability for DHA or the AA uptake. DHA uptake showed a negative correlation to systolic blood pressure (r(s) = -0.49, p < 0.001). These findings suggest that impaired DHA uptake may be one component of the phenotype expressed by DN cells that may persist in culture. Impaired DHA uptake in vivo, especially in the presence of hyperglycaemia, leads to impaired regeneration of AA and depletion of anti-oxidant defences, exposing such individuals to increased risk of cardiovascular disease.
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PMID:Uptake mechanisms for ascorbate and dehydroascorbate in lymphoblasts from diabetic nephropathy and hypertensive patients. 956 48

During the last 30 y the region of highest premature cardiovascular mortality has shifted from the US and Finland to Central and Eastern Europe. Present male cardiovascular mortality in Latvia, Estonia, the Russian Federation, and Hungary has overtaken the maximum cardiovascular mortality reached in the US in the 1960s. This epidemic is only partially explainable by the high prevalence of the three traditional risk factors, i.e., hypercholesterolemia, hypertension, and smoking. The international WHO project MONICA, Finnish/Russian/Estonian, Swedish/Lithuanian, and US/Russian surveys have shown that there were no substantial differences between Eastern Europe and democratic countries regarding the prevalence of traditional risk factors with the significant exception of male smokers. The number of female smokers and plasma lipid levels (total and HDL-cholesterol and triacylglycerols) were even more favorable in East European. The intake of antioxidants from domestic and imported fruits, vegetables, vegetable oils, and nuts in most East European countries was substantially lower than in the West. The failure of economical and political systems to satisfy material and psychosocial population needs was probably an important factor in the cardiovascular disease epidemic in Eastern Europe. Antioxidant deficiencies, alcoholism, and psychosocial stress could become "new" cardiovascular risk factors in Eastern Europe. Smoking and alcoholism are definitely important risk factors, but additional local risk factors in Eastern Europe need to be identified with more specific target-prevention programs in individual Eastern Europe countries. This region is a prospective arena for research on additional lesser known cardiovascular risk factors, e.g., oxidative stress, chronic marginal deficiency of antioxidant vitamins (vitamin C, tocopherols, carotenoids) and low intake of folic acid and flavonoids.
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PMID:Cardiovascular disease prevention in eastern Europe. 961 11

Renal cell carcinoma (RCC) continues to be a frustrating tumor for clinicians to manage and treat. Progress has been made in the identification of risk factors, particularly dietary risk factors. An increased risk has been seen with frequent consumption of fried meat and poultry. Citrus fruits, vitamin C, beta-carotene, and alpha-tocopherol have demonstrated a protective effect against RCC. Other factors that have been associated with the risk of RCC are smoking (which doubles the risk), obesity, hypertension, and exposure to asbestos and petroleum products. Response rates for systemic treatment of RCC continue to hover at about 20%; however, some nonchemotherapy treatments may provide palliation with few side effects. In addition, lower dose combinations of interleukin-2 and interferon alfa may be as beneficial as higher dose regimens, but with less toxicity. Molecular prognostic factors, including proliferation markers, karyometric analyses, oncogenes, and cell adhesion molecules and proteases are areas of intense investigation and may provide mechanisms for identifying patients who require more (or less) aggressive treatment.
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PMID:Renal cell carcinoma. 961 63

To investigate how cigarette smoking increases the risk of cardiovascular disease, risk factors were compared between 166 cigarette smokers and 312 non-smokers, in a random sample of males (Chinese, Malays and Asian Indians) aged 30-69 years from the general population of Singapore. There was adjusted for age and ethnic group. The prevalence of hypertension was lower in cigarette smokers (15.2%) than non-smokers (21.9%), with the difference reduced by adjustment for body mass index (BMI). Smokers had: lower mean serum HDL-cholesterol (0.76 versus 0.81 mmol/l) and higher mean serum fasting triglyceride (1.92 versus 1.71 mmol/l), which will increase atherosclerosis; higher mean plasma fibrinogen (2.75 versus 2.67 g/l) and plasminogen activator inhibitor 1 [PAI-1] (24.9 versus 22.2 ng/ml), which will increase thrombosis; and lower mean plasma vitamin C (4.4 versus 6.4 mg/l) and serum selenium (118 versus 123 microg/l), which may increase atherosclerosis. Adjustment for BMI slightly increased the differences for HDL-cholesterol, fasting triglyceride, fibrinogen and PAI-1, indicating that less generalised obesity among smokers reduces their increased cardiovascular disease risk. Smoking was not found to be related to: diabetes mellitus; serum total cholesterol, LDL-cholesterol, apolipoproteins A1 and B and lipoprotein(a); plasma factor VIIc and prothrombin fragment 1 + 2; and plasma vitamins A and E and serum ferritin. There was no evidence of increased insulin resistance in smokers, as measured by mean fasting serum insulin.
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PMID:Cardiovascular risk factors in relation to cigarette smoking: a population-based survey among Asians in Singapore. 962 68

Lipid profiles as well as vitamins A, C and E were determined in a sample of 90 men and 151 women with ages within 35 and 50 years old. Comparing the lipid profiles obtained in the study with the limits established by the National Cholesterol Education Program, resulted that a little more than 60% of the group had total cholesterol and LDL cholesterol levels in the desirable range, 20 to 30% had levels in the marginal range while 10 to 15% had levels in the high risk range. This distribution of the risk is more favorable than that observed in populations with a high risk of heart diseases such us the British or American populations, which show a substantially higher segment of the people in the high risk level. When the protective effect of the HDL cholesterol was included in the estimation of the risk by calculating the indexes: Total cholesterol/HDL chol., LDL Chol/HDL chol. or Total Chol-HDL chol. 65 to 80% of the population had values within the normal range and the first of these indexes, indicated that the men had a higher risk than the women. Integrating both methods of estimating the risk and considering that the risk of the individuals in the marginal range defined by the National Cholesterol Education Program is minimal unless they have two additional risk factors, it appears that an important segment (20-30%) of the studied population may benefit from programs aiming to reduce other risk factors such as smoking, high blood pressure, diabetes or overweight. The vitamin levels measured in this study indicated that the vast majority of the population had their levels in the safe range but an important segment had vitamin C serum levels indicative of poor consumption of this vitamin. Since vitamin C is high in fruits and vegetables we concluded that the studied population had a low consumption of these foods. Due to the existing evidence of a protective effect of fruits and vegetables in heart and other chronic diseases it was concluded that institutions such as the one studied here should engage in preventive campaigns emphasizing a reduction of both risk factors and the consumption of saturated fats. The results of this study also indicate that the consumption of fruits and vegetables should be encouraged.
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PMID:[Serum lipids and vitamin A, C and E concentrations in an adult population of Caracas City]. 983 Apr 85

The vascular endothelium plays a key role in the local regulation of vascular tone by the release of vasodilator substances (i.e. endothelium-derived relaxing factor (EDRF = nitric oxide, NO) and prostacyclin) and vasoconstrictor substances (i.e. thromboxane A2, free radicals, or endothelin). Using either agents like acetylcholine or changes in flow to stimulate the release of EDRF (NO), clinical studies have revealed the importance of EDRF in both basal and stimulated control of vascular tone in large epicardial coronary arteries and in the coronary microcirculation. The regulatory function of the endothelium is altered by cardiovascular risk factors or disorders such as hypercholesterolemia, chronic smoking, hypertension or chronic heart failure. Endothelial dysfunction appears to have detrimental functional consequences as well as adverse longterm effects, including vascular remodelling. Endothelial dysfunction is associated with impaired tissue perfusion particularly during stress and paradoxical vasoconstriction of large conduit vessels including the coronary arteries. These effects may cause or contribute to myocardial ischemia. Several mechanisms may be involved in the development of endothelial dysfunction, such as reduced synthesis and release of EDRF or enhanced inactivation of EDRF after its release from endothelial cells by radicals or oxidized low-density lipoprotein (LDL). Increased plasma levels of oxidized LDL have been noted in chronic smokers and are related to the extent endothelial dysfunction, raising the possibility that chronic smoking potentiates endothelial dysfunction by increasing circulating and tissue levels of oxidized LDL. In heart failure, cytokines and/or reduced flow (reflecting reduced shear stress) may be involved in the development of endothelial dysfunction and can be reversed by physical training. Other mechanisms include an activated renin-angiotensin system (i.e. postmyocardial infarction) with increased breakdown of bradykinin by enhanced angiotensin converting enzyme (ACE) activity. There is evidence that endogenous bradykinin is involved in coronary vasomotor control both in coronary conduit and resistance vessels. ACE inhibitors enhance endothelial function by a bradykinin-dependent mechanism and probably also by blunting the generation of superoxide anion. Endothelial dysfunction appears to be reversible by administering L-arginine, the precursor of nitric oxide, lowering cholesterol levels, physical training, antioxidants such as vitamin C, or ACE inhibition.
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PMID:Endothelial dysfunction in human disease. 1007 15

In a randomised, double-blind trial among patients receiving antihypertensive medication, the effects of the oral treatment with coenzyme Q10 (60 mg twice daily) were compared for 8 weeks in 30 (coenzyme Q10: group A) and 29 (B vitamin complex: group B) patients known to have essential hypertension and presenting with coronary artery disease (CAD). After 8 weeks of follow-up, the following indices were reduced in the coenzyme Q10 group: systolic and diastolic blood pressure, fasting and 2-h plasma insulin, glucose, triglycerides, lipid peroxides, malondialdehyde and diene conjugates. The following indices were increased: HDL-cholesterol, vitamins A, C, E and beta-carotene (all changes P<0.05). The only changes in the group taking the B vitamin complex were increases in vitamin C and beta-carotene (P<0.05). These findings indicate that treatment with coenzyme Q10 decreases blood pressure possibly by decreasing oxidative stress and insulin response in patients with known hypertension receiving conventional antihypertensive drugs.
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PMID:Effect of hydrosoluble coenzyme Q10 on blood pressures and insulin resistance in hypertensive patients with coronary artery disease. 1020 18

Ischaemic heart disease is an emerging public health problem in Sri Lanka. Implementation of programs for lifetime control and prevention of established coronary risk factors such as smoking, hyperlipidaemia, hypertension, diabetes and hereditary risk are costly and unaffordable in countries such as Sri Lanka with limited resources for health care. Other potential risk factors which are less expensive with regard to prevention require investigation. This paper summarises several studies done over the past decade at Peradeniya, to investigate three such potential coronary risk factors of IHD, namely homocysteine, vitamin C and dietary fat.
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PMID:Heart attacks: exploring new preventive strategies. 1035 75

A large body of evidence suggests that several nutrients are related to blood pressure. Less is known about the eating patterns of special populations, such as those at risk for hypertension, or how demographic factors affect the diets of these populations. This article characterizes the usual diets of participants before they enrolled in the Dietary Approaches to Stop Hypertension (DASH) trial. During screening for DASH, 380 participants completed the National Cancer Institute food frequency questionnaire. Nutrient and food group intake, the Keys score (a measure of a diet's atherogenicity), and the Diet Quality Index were estimated from the food frequency questionnaire. The effects of age, sex, race, baseline weight, and education on these dietary factors were assessed among DASH participants and compared with similar data from the Third National Health and Nutrition Examination Survey and other published reports. Among DASH participants, African-Americans reported lower intakes of dairy products (P < .001), calcium (P < .001), and magnesium (P < .05) than did whites. Older women reported greater intakes of calcium, magnesium, and potassium (all P < .05) and less fat (P < .05) than did younger women. Older men consumed fewer servings of fruits (P < .03), less vitamin C (P < .05), and had a higher Keys score (P < .05) than did younger men. Heavier (body mass index > or = 25) participants reported lower intakes of protein and potassium, but higher fat and energy intakes (all P < .05). Taken together, these data show that younger, overweight African-American women have the least healthful diets, because they consume more atherogenic foods and fewer of the nutrients related to decreased blood pressure. Overall Diet Quality Index scores did not differ between African-American and white participants. Despite differences in dietary assessment methods between the population samples of DASH and the Third National Health and Nutrition Examination Survey, within each population sample patterns of micronutrient intake were similar between African-American and white participants.
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PMID:Pre-enrollment diets of Dietary Approaches to Stop Hypertension trial participants. DASH Collaborative Research Group. 1045 Feb 91

In 1998, nitric oxide (NO) was extensively explored. First studies demonstrating a beneficial effect of inhaled NO in patients with pulmonary hypertension, right ventricular dysfunction and intractable heart failure were published. It was further shown, that, in patients with essential hypertension, impaired vasodilatation can be improved by vitamin C as an antioxidant, an effect that can be reversed by NO-synthase inhibition. Unlike arotinolol, which has no antioxidat effect, carvedilol is a beta- and alpha-blocker with antioxidative properties that may prevent the development of nitrate tolerance. In clinical cardiology, the main focus is on the prevention and therapy of coronary heart disease, heart failure and hypertension: a Task force report on the prevention of coronary heart disease in clinical practice. Proceedings on anticoagulant therapy and Guidelines for antithrombotic management were published in 1998. There is an agreement that in mild hypertension the decision how to treat should be based on the estimate of cardiovascular risk and not on an arbitrary blood pressure threshold. Diuretics and betablockers should be preferred unless they are contraindicated, or there are positive indications for other drug classes. Studies also strongly suggest that therapy with relatively small doses of two different classes of drugs is the effective way to treat the majority of patients and minimize side effects. In heart failure, the evidence for the current treatment with diuretics, ACE-inhibitors and digoxin, in selected patients, is well established.
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PMID:[Cardiology 1998]. 1051 May 45

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