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)

The angiotensin-converting enzyme (ACE) gene is a potential candidate gene for risk of asthma, COPD, and COPD co-morbidity. In 9034 Danish adults, we determined whether individuals homozygous or heterozygous for the ACE D allele are at greater risk of asthma, COPD, or COPD co-morbidity compared with ACE II homozygous individuals. In the general population, serum ACE activity increased with the number of D alleles (Kruskal-Wallis ANOVA: II vs. ID, p<0.001; ID vs. DD, p<0.001); however, this did not translate into altered risk of asthma or COPD. In the general population, the odds ratio (95% confidence interval) for asthma was 1.2 (0.9-1.4) for ID individuals and 1.2 (0.9-1.5) for DD individuals compared with II individuals. In the general population, the odds ratio for COPD was 0.9 (0.8-1.1) for ID individuals and 1.0 (0.8-1.2) for DD individuals compared with II individuals. Among patients with COPD, the odds ratio for ischemic heart disease was 1.1 (0.8-1.6) for ID individuals and 1.2 (0.8-1.7) for DD individuals compared with II individuals; corresponding odds ratios for hypertension were 1.1 (0.7-1.5) and 0.8 (0.5-1.2), and for low physical activity 0.9 (0.5-1.4) and 0.7 (0.4-1.2). The results were similar upon adjustment for sex, age, smoking status, body mass index, total cholesterol, and ACE inhibitor/angiotensin II type 1 receptor blocker use. These data suggest that lifelong genetically elevated ACE activity is not a major risk factor for asthma or COPD, or for ischemic heart disease, hypertension, and low physical activity in COPD patients.
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PMID:Elevated ACE activity is not associated with asthma, COPD, and COPD co-morbidity. 1942 14

Recent reports on the simultaneous occurrence of systemic inflammation and airflow obstruction are usually based on a highly selective patient population, but their importance warrants further evaluation in the general population. The objectives were to study the interrelationship between airflow obstruction, smoking, hypertension, obesity and CRP as a marker of systemic inflammation in a randomly selected sample of the general Icelandic population (n = 939). This study comprised 758 randomly selected men and women 40 years and older living in Reykjavik, Iceland, and who were participating in the Burden of Obstructive Lung Disease (BOLD) study (81% response rate). In addition to the BOLD protocol, which included post-bronchodilator spirometry, they answered questions about general health and medication. Serum samples were taken for measurement of C-reactive protein (CRP). In the sample-245 individuals (33%) reported having hypertension. Subjects with hypertension were older, had a higher BMI and higher CRP levels. Subjects with hypertension had lower values of FEV(1) than predicted (89.9 +/- 18.5 vs. 94.5 +/- 14.4%) (p < 0.001) and FVC (92.2 +/- 15.1 vs. 95.3 +/- 12.3%) (p = 0.002). These differences remained significant after adjusting for age, BMI, CRP and smoking. Hypertension and CRP levels above the median were both independently and additively associated with lower FEV(1) and FVC. In addition a lower FVC% was also associated with a higher BMI (> 30 mg/m2). Use of betablocking antihypertensives was not related to lung function. Hypertension, BMI and systemic inflammation affect lung function independently of each other. All three variables have a negative effect on FVC, while hypertension and high CRP were independently associated with impaired FEV(1).
COPD 2009 Aug
PMID:Hypertension, systemic inflammation and body weight in relation to lung function impairment-an epidemiological study. 1981 83

A 80-year-old woman with a history of severe degenerative dementia, with behavioral and psychological symptoms of dementia (BPSD), COPD and hypertension, was admitted to our hospital (Geriatric Unit, University Hospital of Parma) for an acute change in her cognitive status, with stupor status. The clinical question was: "What is the cause of this rapid worsening of cognitive and mental condition in a demented patient?" A diagnosis of Non-Convulsive Status Epilecticus (NCSE), defined by behavioral or cognitive changes from a patient's baseline state of functioning, with seizure activity on EEG, should be considered when patients with severe dementia are admitted to hospital. It is sufficient for the diagnosis of NCSE to be suspected and not strictly confirmed to start preliminary treatment with an antiepileptic drug.
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PMID:Is Non-Convulsive Status Epilepticus (NCSE) undertreated in patients affected by dementia? 1995 28

COPD is a complex and heterogeneous disease, in which multiple genes and environmental factors are involved. The disease is associated with a high risk of comorbidity and systemic manifestations. The majority of the patients with COPD suffer from additional chronic diseases like hypertension, diabetes, heart disease, osteoporosis or cancer. Parameter, assessing selectively the lung function, are only conditionally suited for capturing the COPD as a whole. In future subtyping of COPD might give the opportunity to better understand the heterogeneity of the disease. A holistic approach, understanding COPD not as an isolated disease of the lung, but as a "chronic systemic inflammatory syndrome" (CSIS), promises further improvement. Systemic inflammations seems to be a common mechanism leading to chronic diseases by sharing risk factors like smoking, overweight, hypertension and elevated blood lipids. In response to this approach, the diagnosis and therapy of COPD must include the whole entity of comorbidities.
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PMID:[COPD: from obstructive lung disease to chronic systemic inflammatory syndrome?]. 2001 39

A 60-year old male patient with obesity and type 2 diabetes mellitus consulted due to high blood pressure, fearful of suffering ischemic heart disease. He also had a background of smoking 20 cigarettes/day for the last 30 years, but this did not concern him. In the questioning, he reported, although he did not consider it important, that he had cough and dyspnea on moderate exertions for some years. It is very unlikely that any internal medicine physician would doubt about whether to evaluate and treat his type 2 diabetes mellitus or high blood pressure, calculate his cardiovascular risk or if he has a metabolic syndrome, attempt to reduce his obesity and to make him stop smoking. However, should we label him as having chronic bronchitis or COPD? Should we perform a spirometry and bronchodilator test, treat his probable COPD? All his current symptoms are probably only due to COPD.
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PMID:[Approach to COPD management in Internal Medicine]. 2034 75

The aim of this study was to understand the prevalence of chronic conditions and medical expenditures of the elderly for health care planning development of chronic conditions. This research is based on the representative sample (N=114,873) of seniors over 65 years nationwide. The CCI by the U.S. Agency for Healthcare Research and Quality (AHRQ), and clinical classifications software (CCS) were adopted to determine chronic condition diagnosis codes and classify the diseases. The results are presented by descriptive and multiple regression analysis. The chronic condition prevalence for seniors is 70.4% and the medical expenditures for seniors with chronic conditions accounts for 92.7% of the total medical expenditures for seniors, while 25% of the medical expenditure is spent on 8.2% of seniors who have five chronic conditions and above. Chronic conditions suffered by the elderly, in the order of its prevalence, are hypertension (36.1%), COPD (23.7%), and cataracts (16.7%). From the viewpoint of annual average medical expenditures, cardiovascular diseases rank the most costly diseases, with average medical expenditures as high as $4291. Urinary disease and diabetes ranks the second and the third most costly with an average expenditure of $3644 and $3594. This research showed that the average medical expenditure for seniors with chronic conditions is 5.4 times higher compared with seniors without chronic conditions. It is recommended to further study the characteristics of the target population that spends the most in medical expenditures to outline a more beneficial disease management model, reduce avoidable medical costs and achieve the goal of saving medical resources.
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PMID:The prevalence of chronic conditions and medical expenditures of the elderly by chronic condition indicator (CCI). 2045 88

BACKGROUND: We present the case of a 64-year-old patient who presented to his primary care physician with fatigue, worsening shortness of breath, abdominal discomfort and a rapidly growing abdominal girth, although he had lost 5 kg of weight within 3 months. He had a history of untreated hypertension, compensated renal insufficiency and COPD. Despite weight loss and fatigue, the patient did not experience any other constitutional symptoms such as fever, night sweats or loss of appetite. Investigations: Physical examination, blood tests, CT scan of the abdomen, MRI scan of the abdomen, fine needle biopsy, excisional biopsy, Video Capsule Endoscopy, histology, PET scan. Diagnosis: Inflammatory myofibroblastic tumor, chylous ascites, chyloperitoneum. Management: Systemic chemotherapy, total parenteral nutrition and octreotide therapy. CONCLUSION: WE DESCRIBE THE CASE OF A PATIENT IN WHOM TWO EXTREMELY RARE PHENOMENA ARE PRESENT IN COMBINATION: the diagnosis of an inflammatory myofibroblastic tumor and chylous ascites. While the tumor could be stabilized by different regimens of chemotherapy, the chyloperitoneum was treated with parenteral nutrition and subcutaneous octreotide injections, which resulted in a significant reduction of the amount of chylous ascites drained during regular paracentesis.
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PMID:Chylous Ascites in a Patient with Inflammatory Myofibroblastic Tumor. 2074 Jan 78

We sought to assess continuity of care for elderly patients in Korea and to examine any association between continuity of care and health outcomes (hospitalization, emergency department visits, health care costs). This was a retrospective cohort study using the Korea National Health Insurance Claims Database. Elderly people, 65-84 yr of age, who were first diagnosed with diabetes mellitus (n=268,220), hypertension (n=858,927), asthma (n=129,550), or chronic obstructive pulmonary disease (COPD, n=131,512) in 2002 were followed up for four years, until 2006. The mean of the Continuity of Care Index was 0.735 for hypertension, 0.709 for diabetes mellitus, 0.700 for COPD, and 0.663 for asthma. As continuity of care increased, in all four diseases, the risks of hospitalization and emergency department visits decreased, as did health care costs. In the Korean health care system, elderly patients with greater continuity of care with health care providers had lower risks of hospital and emergency department use and lower health care costs. In conclusion, policy makers need to develop and try actively the program to improve the continuity of care in elderly patients with chronic diseases.
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PMID:Continuity of care for elderly patients with diabetes mellitus, hypertension, asthma, and chronic obstructive pulmonary disease in Korea. 2080 67

Pulmonary hypertension is characterized by progressive involvement of the pulmonary vessels that leads to increased vascular resistance and consequently to right ventricular failure. Vascular lesions are a common factor in a wide spectrum of diseases, and their result, pulmonary hypertension, is a severe clinical condition with a poor prognosis that worsens the normal course of the diseases to which it is associated (COPD, collagen disease, sarcoidosis, and congenital or acquired heart disease). It is important for pulmonary hypertension to be diagnosed as early as possible because nowadays drugs can reduce mortality and improve the quality of life; furthermore, some types of pulmonary hypertension (e.g., chronic thromboembolism and those associated with some congenital heart diseases like left-to-right shunt) can be treated surgically. In cases of suspected pulmonary hypertension, imaging methods can confirm the diagnosis, suggest a cause, help choose the most appropriate treatment, and monitor the response to treatment. This review describes the approach to pulmonary hypertension using different imaging techniques; special emphasis is given to the role of multidetector CT (MDCT), which makes it possible to study all the organs in the thorax in a single acquisition. We review the radiological signs of pulmonary hypertension and the current (Dana Point) radiological criteria for classifying the type of hypertension based on alterations in the lung parenchyma, mediastinum, pleural spaces, and pericardium, as well as on the study of the chambers of the heart.
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PMID:[Pulmonary hypertension: the contribution of MDCT to the diagnosis of its different types]. 2092 8

In this retrospective analysis, all patients (n=714; male=590; female=124 and female male ratio = 1: 4.76) came to Pulsar, a sleep laboratory of Kolkata, for polysomnography during ten years period were analyzed. More than half (62.46%) cases were between 41-60 years and 14.43% cases between 61-80 years age group. Fifty-two percent cases were referred by pulmonologists, followed by internist (15%), and 7% cases were self referred. Though obstructive sleep apnea was responsible for increased cardiovascular mortality and resistant hypertension, only 4% cases were referred by cardiologists. We observed hypertension as co-morbidity in 52.63% cases and ischemic heart disease in 22.83% cases. Snoring was the presenting complain in 98.88% cases, chocking was present in 48.88% cases and excessive daytime sleepiness was found in 96.64% cases. Females showed comparatively higher frequency of sleep disordered breathing than males with increasing basal metabolic rate. Nocturnal fall of SPO2 below 90% was observed in 86.97% of study population. We found abnormal respiratory disturbance index (> 5/hr of sleep) in 84.59% of our patients, normal respiratory disturbance index (< or = 5/hr of sleep) in 9.94% cases and isolated nocturnal hypoxemia in 5.46% cases (74.36% of the last category having obstructive airway disease). Snoring with respiratory disturbance index (RDI) < or = 5/hr was observed in 102 cases, of them 81.37% had simple snoring without significant arousal whereas 18.63% had multiple sleep fragmentation. We estimated that 84.06% of males, 87.10% of females and 84.59% of study population had obstructive sleep apnea. Split night polysomnography was performed in 362 cases, and of them 15.47% cases could not tolerate continuous positive airway pressure (CPAP) due to local or psychological reasons. In the present one time split-night CPAP titration study, we could not correct OSA in 19.06% subjects. Inadequate correction of hypoxemia due to co-morbid condition like COPD, asthma, obesity, hypothyroidism was the main responsible factor (49.28%). Treatment with CPAP was effective in 68.23% cases in first attempt. More than half of the cases (62.42%) required 10 cm of H20 or less CPAP.
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PMID:Polysomnographic profile in a sleep laboratory in Kolkata: a retrospective analysis of 714 cases. 2112 Dec 4


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