Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Oral contraceptives (OCs) were first introduced more than 30 years ago. OC manufacturers have reduced the dosage of synthetic estrogens (e.g., ethinyl estradiol, 100-150 mcg to 20-35 mcg) and progestins to limit their metabolic effects on lipoproteins, carbohydrates, and hemostasis. In addition to protection from pregnancy, OC benefits include lower incidence of painful periods, excessive bleeding, and iron deficiency anemia; reduction of ovarian cysts, benign breast tumors, and pelvic inflammatory disease; and protection against endometrial and ovarian cancers. The risk of a cardiovascular event (myocardial infarction, cerebrovascular events, venous thromboembolism, and deep vein thrombophlebitis) in OC users is 1-2/100,000 women years. Cardiovascular risk factors include smoking, hypertension, lipid disorders, severe obesity, diabetes mellitus, and cardiovascular events in first degree relatives before age 40. Thus, women with any of these risk factors should not use OCs. OCs do not increase the risk of breast cancer in women less than 59 years old. They may increase this risk if used over a long duration before the first fullterm pregnancy. OCs may cause a modest increase in cervical neoplasia. Low-dose OCs have a small effect on lipid metabolism. OCs increase serum triglycerides 30-50%. OCs increase insulin secretion and hyperinsulinemia increases the cardiovascular risk. Practitioners should evaluate clients before prescribing OCs. They should not prescribe OCs to women with hypertension, diabetes mellitus, lipid disorders, gynecological cancers, and previous cardiovascular disorders. Practitioners should tell clients that smoking is a leading risk factor and about OC's side effects (e.g., menstrual disturbances). The physical exam should include a cervical PAP smear, gynecological exam of the uterus and the ovaries, and a breast exam. Practitioners should test cholesterol and triglycerides before and during OC use. Premenopausal healthy women with no risk factors can use low-dose OCs.
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PMID:Update on oral contraception. 836 2

Two groups of eight anesthetized dogs with pulmonary artery hypertension (PAH) were compared. PAH was induced by submitting one group (HP) to hypoxia (FiO2 range: 6-10%) and the other group (ME) to microemboli through glass microbead injection into the pulmonary circulation. Hypoxia-induced PAH was moderate (PAP: +65%; PVR: +152%) contrasting with marked PAH after microbead injection (PAP: +190%; PVR: +389%). For similar effects on left ventricular contractility (LV dP/dt max and segmental myocardial shortening), heart rate and systemic vascular resistance, left ventricular end-diastolic pressure showed significant differences between the two groups (HP group: +75%, ME group: -9%), and so did left ventricular end-diastolic length (HP: +9%, ME: -11%). Thus, contrary to the injection of microbeads, hypoxia did not give rise to any pulmonary barrier, and consequently the changes in cardiac output (HP: +19%, ME: -15%) and hepatic blood flow (HP: +383%, ME: -77%) were significantly different. Hypoxia, and not microbead injection, was responsible for systemic hypertension (MAP: +34% and -4%, respectively). The microbead model resulted in a significantly higher PVR/SVR ratio compared to the hypoxic model (HP: 0.14, ME: 0.41). Hypoxia increased left and right myocardial blood flows whereas microbead injection affected only right ventricular blood flow, leading to significantly different RV/LV endocardial perfusion ratios (HP: +10%, ME: +98%). We conclude that microbead-induced PAH is more appropriate than hypoxia-induced PAH for hemodynamic and pharmacological studies.
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PMID:Comparison between acute hypoxia-induced and mechanically-induced pulmonary artery hypertension on the hemodynamics, myocardial contractility and regional blood flow in dogs. 880 76

Inhaled but not i.v. anaesthetics are reported to decrease pulmonary vascular resistance. The aim of this study was to compare the effects of isoflurane with those of propofol on the interaction between right ventricular (RV) function and the pulmonary vascular system in embolic pulmonary hypertension. Nine dogs received in random sequence propofol 18 mg kg-1 h-1 and 1.4% end-tidal isoflurane. Pulmonary haemodynamic state was evaluated by pulmonary arterial pressure/flow (PAP/Q) plots and pulmonary vascular impedance (PVZ) spectra. Right ventricular function was assessed by total hydraulic power (Wtot), ratio of oscillatory power (Wosc) to Wtot, and dP/dtmax. Measurements were obtained, with both anaesthetics, before and after pulmonary embolic hypertension induced by autologous blood clots. Embolism increased PAP, 0 Hz and low frequency input impedance, displaced first minimum of PAP/Q moduli and zero crossing of phase to higher frequencies, decreased characteristic impedance, decreased Wosc/Wtot without affecting Wtot, and increased dP/dtmax. Compared with propofol, isoflurane at baseline did not affect PAP/Q plots, PVZ or hydraulic power data, but decreased dP/dtmax. After embolism, isoflurane shifted PAP/Q plots to lower PAP without affecting PVZ, did not affect hydraulic power data and decreased dP/dtmax. We conclude that in canine embolic pulmonary hypertension, isoflurane compared with propofol impeded RV vascular coupling caused by decreased RV contractility, while after-load remained unchanged despite some decrease in pulmonary vascular tone.
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PMID:Comparison of the effects of isoflurane with those of propofol on pulmonary vascular impedance in experimental embolic pulmonary hypertension. 942 3

The feasibility and reliability of the combination of several noninvasive methods using a multivariate method of analysis to predict pulmonary artery hypertension (PAH) is evaluated in 20 patients with chronic obstructive pulmonary disease. These methods comprised arterial blood gases (Pao2, Paco2), pulmonary functional parameters (FEV1), echo-Doppler parameters (tricuspid regurgitation jets, acceleration time on pulmonary valve), computed tomography measurements (transhilar distance, hilar thoracic index, and measurement of the descending branch of the right pulmonary artery to the lower lobe). A multiple stepwise regression analysis (including one Doppler parameter, two parameters of arterial blood gases, and one functional parameter) revealed a coefficient of determination (R2) equal to 0.954 for mean pulmonary artery pressure (MPAP) with a standard error of estimate (S.E.E.) of 5.25 mmHg. A stepwise regression analysis including computed tomography and radiographic parameters revealed an R2 equal to 0.970 for PAP with a S.E.E. of 4.26 mmHg. Logistical regression analysis classified correctly 80% of patients with PAH using noninvasive methods such as the diameter of the main pulmonary artery and the diameter of the left pulmonary arterial branch calculated by computed tomography. Not only the presence of PAH but also the level of MPAP can be estimated by the combination of multiple stepwise and logistical regression analyses.
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PMID:Non-invasive estimation of pulmonary arterial hypertension in chronic obstructive pulmonary disease. 992 4

The aim of the investigation was to study the lipid profile of industrial workers with attention to the relationship of lipid indexes with hypertension and overweight. 139 hypertensive male blue-collar workers were investigated, compared to 107 normotensive ones. The overweight and obese workers in each group were compared with normal body mass ones. Cholesterol and triacylglycerols (TG) were assayed by enzymatic tests CHOD-PAP and GPO-PAP respectively and the lipoprotein fractions were separated by precipitation method. Our results show high rate of industrial workers with dyslipoproteinemias, especially among the hypertensive and overweight and obese ones. The hypertension is associated with total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and low density lipoprotein TG (LDL-TG), while overweight is related with TG and high density lipoprotein cholesterol (HDL-C), effecting significantly on very low density lipoprotein TG (VLDL-TG). The high rate of persons with concentrations of the examined lipid indexes indicating moderate and high cardiovascular risk motivates multifactorial preventive strategy towards coping the hypertension, optimizing the nutritional habits, increase in physical activity and reduction of body mass.
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PMID:Dyslipoproteinemias in industrial workers: relationship with hypertension and overweight. 1085 42

It is not clear whether right ventricle to pulmonary artery coupling is modified by the site of vascular obstruction in patients with chronic severe pulmonary hypertension. We compared invasively (Swan Ganz) and non-invasively (echo/ /Doppler) assessed hemodynamics between two groups of patients with severe chronic thromboembolic pulmonary hypertension (CTEPH)--(n = 6; 52 +/- 24 yrs) and pulmonary arterial hypertension (PAH) (n = 5; 42 +/- 9 yrs) who had similar invasively measured right ventricular systolic pressure (CTEPH: 78 +/- 14 mm Hg; PAH: 83 +/- 17 mm Hg; p = NS), mean pulmonary arterial pressure (CTEPH: 51 +/- 10; PAH 56 +/- 11 mm Hg, p = NS) and pulmonary vascular resistance (CTEPH: 15.6 +/- 4.4 l/min; PAH: 19.2 +/- 6.1; p = ns). Patients with CTEPH have significantly shorter acceleration time corrected to ejection time (RVET): (AcT/RVET % = 24 +/- 5% vs 32 +/- 6% in PAH; p = 0.04) as well as AcT corrected by RR distance was highly significantly shorter (8 +/- 2% vs 12 +/- 2%; p = 0.006). AcT in the CTEPH group was shorter than in the PAH (60 +/- 5 vs 75 +/- 15; p = 0.047). The mid-systolic deceleration was significantly more frequent in the CTEPH group than in the PAH group (88% vs 30%; p = 0.005). If the mid-systolic deceleration was present in patients with PAH, the time to mid-systolic deceleration (t-N) had tendency to be longer in CTEPH group (118 +/- 22 ms vs 150 +/- 28 ms in PAH; p = 0.09). Significant differences appeared after correction t-N to RVET (t-N/RVET % = 46 +/- 9% vs 61 +/- 4%; p = 0.027) and to RR interval (t-N/RVET % = 16 +/- 2% vs 24 +/- 1%; p = 0.002). Doppler derived RV index proposed by Tei was slightly higher in CTEPH (0.81 +/- 0.18 vs 0.65 +/- 0.32 in PAH) but not significantly. Taken together our observations indicate that dynamical coupling between RV and pulmonary arteries is more disturbed in CTEPH than in PPH despite similar levels of chronically increased PAP.
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PMID:[Differences in hemodynamics of thromboembolic and primary pulmonary hypertension]. 1143 85

Measurements including spirographic examination, arterial blood gas tensions, standard electrocardiogram are routinely used to define risk factors for patients undergoing lung tissue resection. In some instances routine functional check-ups should be accompanied by the assessment of the hemodynamics of pulmonary circulation. The purpose of the study was to evaluate the correlations between gasometric and hemodynamic parameters measured at rest and after exercise. In case of the presence of such correlations I wanted to find the principles to provide pulmonary artery hypertension in order to avoid right heart catheterization. The gasometric parameters in systemic and in mixed venous blood (pH, PaO2, PaCO2, SaO2) as well as hemodynamic parameters of pulmonary circulation (PAP, PCWP, CVP) were measured in 50 male patients with lung carcinoma. All measurements were taken at rest and after an exercise test--5 minutes, 50 W workload on cycle ergometer in supine position. CI, PVR and SVR were calculated. The study proved statistically significant correlations between gasometric and hemodynamic parameters and made possible to calculate the regression lines equations, which help to predict pulmonary artery pressure before tissue resection.
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PMID:Comparative analysis of the gasometric and hemodynamic parameters in preoperative evaluation of patients with lung cancer. 1289 3

Kidney transplant recipients are prone to hypertension, dyslipidemia, and cardiovascular death. Hypertension is associated with hemostatic abnormalities. Thrombin activatable fibrinolysis inhibitor (TAFI) is a glycoprotein that links coagulation and fibrinolysis. The purpose of this study was to assess TAFI concentrations in renal transplant recipients in relation to blood pressure. Additionally, we evaluated thrombin activity (thrombin-antithrombin complex [TAT], prothrombin fragments 1+2 [F1+2]), thrombomodulin (TM), and the degree of plasmin generation (plasmin-antiplasmin complex [PAP]) using commercially available kits. The studies were performed on 86 renal allograft recipients (48 women, 38 men) at age range 26 to 73 years. The immunosuppressive regimen consisted of cyclosporine (CsA), prednisone, and azathioprine (n = 58) or mycophenolate mofetil (MMF; n = 28). All patients maintained sufficient and stable graft function, showing no clinical signs of rejection. In patients with hypertension (n = 68), we observed significantly higher concentrations of TAFI and of markers of thrombin generation (F1+2, TAT), and of thrombomodulin with significantly prolonged euglobulin clot lysis time (ECLT), which reflects overall fibrinolytic activity and lower fibrinolytic activity index (FAI). Both groups did not differ with respect to age, creatinine clearance, body mass index, time after transplantation, albumin, fibrinogen, and PAP. Diastolic blood pressure correlated significantly with TAFI concentrations, uric acid, and prednisone dose, whereas systolic blood pressure correlated with urea, uric acid, creatinine clearance, and MCV. Elevated TAFI concentrations and enhanced thrombin generation in hypertensive kidney transplant recipients may contribute to the hypofibrinolysis and progressive atherosclerosis in this population. Blood pressure was related to kidney function, maintenance prednisone dose, and TAFI concentration.
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PMID:Thrombin activatable fibrinolysis inhibitor in hypertensive kidney transplant recipients. 1650 76

The objective of this work was to investigate the insulin sensitivity (SI) and the beta cell function (BCF) in different glucose tolerance statuses in a comparative cross-sectional study. Eighty-four patients with different glucose tolerance statues were classified as normoglicemic-control group (NC) patients without family history of type 2 diabetes (DM2) or hypertension (HTN); normoglicemic-patients with familiar history of DM2 or HTN (FPDM2); patients with glucose intolerance (IGT group) and patients with diagnostic of DM2 <10 years (DM2 group). In each patient was obtained a clinical history and an oral glucose tolerance test (75 g) was performed. Glucose (GOD-PAP) and insulin (RIA) were quantified. Insulin Sensitivity (IS) (Whole Body Insulin Sensitivity Index), Insulin resistance (IR) (HOMA) and BCF (insulinogenic index) were evaluated. The statistical analysis was realized in SPSS v. 10.0. It was found that glucose was similar among NC, FPDM2 and IGT groups. Insulin was higher in the FPDM2 (26.71 +/- 22.25 microU/mL), and IGT (34.10 +/- 34.98 microU/mL) in comparison with NC (22.83 +/- 21.26 microU/mL) (p < 0.01). IS was different among NC and IGT group (0.74 +/- 0.43 to 0.29 +/- 0.18, p < 0.05) and among IGT and DM2 (0.29 +/- 0.18 to 0.86 +/- 0.55, p < 0.001). BCF was different among the DM2 and NC (0.051 +/- 0.05 to 1.28 +/- 1.99 microU.mL/mg.dL, p < 0.05), DM2 and FPDM2 group (0.051 +/- 0.05 to 1.23 +/- 1.51 microU.mL/mg.dL, p < 0.01), DM2 and IGT (0.051 +/- 0.05 to 2.64 +/- 2.22 microU.mL/mg.dL, p < 0.001). SI was inversely related to corporal weight and IMC (r = -0.38, p = 0.001 and r = -0.33, p = 0.004, respectively). BCF was related to age (r = -0.27, p = 0.016), the area under curve of glucose (r = -0.30, p = 0.010) and body weight (r = 0.34, p = 0.002). In conclusion, the decrease of glucose tolerance was associated with the lowering of Insulin Sensitivity (IS). The beta cell function (FCB) was lower in the diabetic patients group in comparison with the TGA and FPDM2 groups. These measurements need to be included in patients with high risk for early identification and changes in life style to protect the normal functioning of beta cell and to prevent the onset of IGT or DM2.
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PMID:[Insulin sensitivity and beta cell function in different glucose tolerance status]. 1688 77

High-frequency echocardiography and high-field-strength magnetic resonance imaging (MRI) are new noninvasive methods for quantifying pulmonary arterial hypertension (PAH) and right ventricular (RV) hypertrophy (RVH). We compared these noninvasive methods of assessing the pulmonary circulation to the gold standard, cardiac catheterization (micromanometer-tipped catheters), in rats with monocrotaline-induced PAH and normal controls. Closed-chest, Sprague-Dawley rats were anesthetized with inhaled isoflurane (25 monocrotaline, 6 age-matched controls). Noninvasive studies used 37.5-MHz ultrasound (Vevo 770; VisualSonics) or a 9.4-T MRI (Bruker BioSpin). Catheterization used a 1.4-F micromanometer-tipped Millar catheter and a thermodilution catheter to measure cardiac output (CO). We compared noninvasive measures of pulmonary artery (PA) pressure (PAP) using PA acceleration time (PAAT) and CO, using the geometric PA flow method and RV free wall (RVFW) thickness/mass with cardiac catheterization and/or autopsy. Blinded operators performed comparisons using each method within 2 days of another. In a subset of rats with monocrotaline PAH, weekly echocardiograms, catheterization, and autopsy data assessed disease progression. Heart rate was similar during all studies (>323 beats/min). PAAT shortened, and the PA flow envelope displayed systolic "notching," reflective of downstream vascular remodeling/stiffening, within 3 wk of monocrotaline. MRI and echocardiography measures of PAAT were highly correlated (r(2) = 0.87) and were inversely proportional to invasive mean PAP (r(2) = 0.72). Mean PAP by echocardiography was estimated as 58.7 - (1.21 x PAAT). Invasive and noninvasive CO measurement correlated well (r(2) >or= 0.75). Noninvasive measures of RVFW thickness/mass correlated well with postmortem measurements. We conclude that high-resolution echocardiography and MRI accurately determine CO, PAP, and RV thickness/mass, offering similar results as high-fidelity right heart catheterization and autopsy, and that PAAT accurately estimates PAP and permits serial monitoring of experimental PAH. These tools are useful for assessment of the rodent pulmonary circulation and RVH.
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PMID:Validation of high-resolution echocardiography and magnetic resonance imaging vs. high-fidelity catheterization in experimental pulmonary hypertension. 2058 Nov 1


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