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

A number of biologic actions of insulin lend credence to the hypothesis that insulin resistance can produce hypertension, perhaps by stimulating a hyperkinetic circulation. But it may do so only in lean individuals.
Hosp Pract (Off Ed) 1992 Feb
PMID:'Syndrome X': is it a significant cause of hypertension? Affirmative. 134 39

Ambulatory monitoring is a strategy that may effectively address the phenomenon of "white coat" hypertension and determine whether the peaks and troughs that typify circadian variations should be considerations in blood pressure management. In selected patients, ABPM may indeed be useful both for diagnosing hypertension and for monitoring response to therapy.
Hosp Pract (Off Ed) 1992 Jul 15
PMID:Ambulatory blood pressure monitoring: clinical uses. 162 57

The ideal therapeutic strategy would be to reverse the underlying cause of cardiac dysfunction, such as hypertension or valvular disease, while removing or minimizing those concurrent conditions or factors that tend to exacerbate symptoms. For most patients, vasodilator therapy has been shown to reduce mortality in moderate to advanced CHF.
Hosp Pract (Off Ed) 1991 Nov 15
PMID:Therapeutic strategies for CHF in the 1990s. 168 29

Effective therapy is available but the diagnosis of renovascular hypertension is often elusive. Those affected constitute a minority of the hypertensive population, and traditional screening tests have poor sensitivity and specificity. The merits and limitations of the captopril challenge test and the captopril renogram, alone or in combination, are discussed.
Hosp Pract (Off Ed) 1992 Jan 15
PMID:ACE inhibitors in the diagnosis of renovascular hypertension. 173 Jul 91

Anxiety, overtreatment, inappropriate combination therapy, and noncompliance are all characterized as prevalent etiologic factors in so-called resistant hypertension. But perhaps the most common problem that expresses itself as resistant hypertension is failure to adequately control intravascular volume. The key point is that a cause for resistance is almost always discoverable.
Hosp Pract (Off Ed) 1991 Mar
PMID:Managing the problem patient. 189 19

Acute dissections mandate surgery after the patient has been stabilized medically. Hypertension appears to be a prerequisite in the pathogenesis of aortic dissection, and control of ventricular contraction velocity may be prophylactic.
Hosp Pract (Off Ed) 1991 Feb 28
PMID:Aortic dissection: diagnosis and management. 189 75

The diverse manifestations of this tumor reflect variations in the hormones it releases and their patterns of release and in the individual-to-individual differences in catecholamine sensitivities. There is relatively little correlation between circulating levels of the catecholamines and the extent or even existence of hypertension in these patients. An unusual case starts the discussion.
Hosp Pract (Off Ed) 1990 Jun 15
PMID:Diagnosis and management of pheochromocytoma. 211 16

Although renin and angiotensin are still a puzzle, we are learning where some of the pieces fit. Recent studies indicate that in addition to ameliorating hypertension, ACE inhibitor therapy can prolong life in patients with severe congestive failure. Development of renin inhibitors and angiotensin II receptor antagonists may provide greater therapeutic specificity.
Hosp Pract (Off Ed) 1990 Aug 15
PMID:The renin-angiotensin system in hypertension: an update. 211 34

A case is presented of a healthy, 36-year-old woman with leiomyomas of the uterus to illustrate the broad dimensions of choosing an appropriate contraceptive method. Additionally, this woman had a history of pregnancy-induced hypertension, gestational diabetes, and a family history of breast and endometrial cancer. The woman presented for contraceptive advice 5 days after a regular, normal menstruation. She reported that she generally had been healthy, with no current medical problems and had used several barrier methods of contraception. The woman found the barrier methods to be unreliable as well as somewhat difficult to use. The clinical problem was how best to provide this woman with contraception. The patient was divorced and sexually active, and she wanted to remarry and to have more children. As this patient was parous and had not experienced previous problems with excessive menstrual blood loss or dysmenorrhea, she might have tolerated an IUD well. However, women with leiomyomas, especially the kind that produce an irregular cavity, should not use an IUD. Additionally, IUDs have been linked to an increased incidence of pelvic inflammatory disease, particularly in women with multiple partners. Consideration was given to steroid contraceptives -- oral (OCs), injectable, and implantable -- for this patient. The last 2 modalities were potential options as the patient had no immediate plans for conception. Various aspects of the patient's family history as well as the physical findings needed to be evaluated in relation to the use of hormones. In this context, the familial predisposition to breast cancer was considered. As the results of the Centers for Disease Control and the National Institute of Child Health and Human Development Cancer and Steroid Hormone Study showed no change in risk of breast cancer in OC users, regardless of age at 1st use or subsequent duration of use and other large epidemiologic studies have confirmed these findings, the patient's family history of breast cancer was not a contradindication to OC use. The somewhat remote family history of endometrial carcinoma was not epidemiologically significant. The fact that no adverse effect of high dose contraceptives on existing tumors has surfaced in 2 decades of OC use by millions of women is reassuring. A large body of clinical information concludes that there is no contraindication to prescribing OCs for women with gestational diabetes. Concerns about the cardiovascular effects of OCs stemming from reports in the 1960s and 1970s remain questionable and are not likely to be relevant to contemporary OCs. Injectable medroxyprogesterone, which is remarkably free of adverse reactions, proved or suspected, after 2 decades of use, was chosen as an appropriate contraception option for the patient described.
Hosp Pract (Off Ed) 1987 Mar 30
PMID:Medical aspects of contraception. 310 32

Changes in potassium levels clearly have hemodynamic significance. In mechanistic terms, they affect the transmembrane potential of vascular smooth muscle cells. They also influence the levels and activity of pressor hormones and of intracellular messengers involved in vasoconstriction. Furthermore, they alter the body's handling of sodium. As the net result, perhaps, of these phenomena, chronic supplementation of dietary potassium is associated with a small but appreciable decline in blood pressure. In humans, the effect, which could be predicted epidemiologically, has been demonstrated in studies of potassium administration in hypertensive patients. In experimental animals, the effect is most pronounced in salt-sensitive models of hypertension. The studies done to date do not permit firm recommendations about modification of dietary potassium content for hypertensive patients. However, in certain clinical settings, potassium repletion even for mildly depressed levels is vitally important, and in other circumstances, excess potassium clearly is dangerous. Still, indications are emerging that potassium may be valuable in preventing renal damage and stroke, quite apart from any effect on hypertension itself. Continued investigation will be of great value in the effort to arrive at a firm understanding of the precise roles that potassium may play in the treatment of hypertension or the prevention of its sequelae.
Hosp Pract (Off Ed) 1988 Dec 15
PMID:Potassium: weighing the evidence for supplementation. 314 7


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