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

The single drug therapy of diazepam can be introduced to effectively control convulsions in eclampsia. This treatment will have particular application in rural obstetrics where eclampsia is seen in severe form. The dose schedule of diazepam, as described in this study, shows the therapy to have a stabilizing effect on hypertension and pulse rate. It causes neither respiratory depression nor oliguria. Diazepam is an effective muscle relaxant. Its depressive effect on the newborn is in no way inferior to that of lytic cocktail therapy. The drug is readily available at low cost, even in the remote rural areas, and can be easily administered by any doctor or midwife.
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PMID:Diazepam therapy in eclampsia. 4 87

Because of its analgesic and amnesic effects, ketamine has potential advantages as a primary agent for patients undergoing open-heart surgery. However, the undesirable positive inotropic and chronotropic effects associated with ketamine have deterred its use. Diazepam pretreatment appears to block these unwanted effects. Sixteen randomly selected patients were given a combination of diazepam, 0.4 mg/kg, followed by ketamine, 2 mg/kg, and nitrous oxide, 50%. The authors compared the circulatory responses to induction, intubation, and operation with those obtained in a matched group of patients who received morphine, 3 mg/kg, and nitrous oxide, 50%. All patients underwent mitral- or aortic-valve replacement. Circulatory responses were not significantly different between the two groups. In both groups, heart rate, mean arterial blood pressure, and rate-pressure product increased significantly with intubation of the trachea, incision of the skin, and sternotomy. The incidences of hypertension, hypotension, and arrhythmias, and the need for inotropic drugs were not significantly different between the two groups. No intraoperative awareness occurred in either group. It is concluded that diazepam-ketamine anesthesia is a satisfactory alternative to morphine anesthesia for patient undergoing heart-valve replacement.
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PMID:Comparison of anesthesia with diazepam and ketamine vs. morphine in patients undergoing heart-valve replacement. 38 14

With improving standards of antenatal care, severe pre-eclampsia dn eclampsia are becoming less common and experience in the management of these conditions is lessening. Co-ordinated plans for the care of patients should be established by obstetricians and anaesthetists working as a team. A suitable regime for drug therapy in severe pre-eclampsia or eclampsia is the following: Initial management Diazepam 10 mg slowly i.v. Pethidine 100-150 mg i.m. or i.v. in incremental dosage, or extradural blocks, if analgesia is also required. Hydrallazine 20 mg i.v. initially, followed by 5 mg at intervals of 20 min until the diastolic pressure is less than 110 mm Hg. Then, preferably by syringe pump in a concentration of 2 mg/ml, at a rate of 2-20 mg/h. If vomiting occurs this can be controlled by administration of atropine. Subsequent management Sedation and anticonvulsant therapy. Continue diazepam and, in severe cases, institute chlormethiazole infusion. Continue analgesia with pethidine or extradural block. Control of hypertension by adjusting the dose of hydrallazine. If tachycardia exceeds 120 beat/min give propanolol 2-4 mg i.v. Plasma protein depletion with groww oedema is treated by administration of salt-free albumin or plasma protein fraction. Diuretic therapy is indicated if there is gross oedema or signs suggestive of acute renal failure. Oliguria associated with increased blood urea may be a result of renal failure or dehydration. The latter should be evident from the patient's condition and central venous pressure, but i.v. fluids and frusemide 20-40 mg can be used as a therapeutic test. Mannitol reduces cerebral oedema and may be given if diuresis has been first produced with frusemide. Potassium chloride is given if the plasma potassium decreases to less than 3 mmol/litre. Heparin therapy is considered if there is clinical evidence of disseminated intravascular coagulation.
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PMID:The management of severe pre-eclampsia and eclampsia. 83 44

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 calcium-intake relationship with other alimentary and anthropometric variables was investigates in a group of 60 adult (19-75 year-old) subjects, 50 females and 10 males, with essential arterial hypertension (DAP > 90 mmHg). The calcium intake was assessed by three different protocols: 24-hour food intake recall, food-frequency questionnaire and 3 day self-food intake register, repeated along with anthropometric measurements on three different occasions (2-15 month-intervals). The calcium intake assessed by the three methods, as well as the anthropometric data, were statistically similar on all three occasions. The mean data were then compared with those form the control, composed of 75 healthy subjects matched with the hypertensive group by age and sex. The patients ingested less calcium (mean +/- SD) than the controls on the daily (517 +/- 271 x 740 +/- 353 mg/d) and body-weight (8.1 +/- 5.0 x 11.4 +/- 5.9 mg/kg/d) basis. Among the males the calcium intake was the only difference found between groups and could be attributed to the lower intake of calcium-rich foods. The hypertensive females showed also higher lean-body mass (Body-mass index and arm muscle circumference). Thus the calcium intake discriminated both groups being associated with changes in other nutritional parameters only in females.
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PMID:[Evaluation of dietary intake of calcium in adult subjects with idiopathic arterial hypertension]. 130 18

A subcommittee of the American Psychiatric Association's Psychiatric Systems Interface Disorders Work Group was charged with examining the diagnostic category, Psychological Factors Affecting Physical Condition, for possible revision in the DSM-IV. As members of this subcommittee, we conducted a literature review to better characterize the current state of knowledge regarding the relationship between psychological factors and cardiovascular disease. This review, divided into two parts, focuses on three problems: coronary artery disease, sudden death, and hypertension. For each of these cardiovascular disorders, we describe models for understanding the relationship of psychological factors to the disorder, review the results of relevant research studies, and provide recommendations for further research.
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PMID:Psychological factors affecting physical condition. Cardiovascular disease literature review. Part I: Coronary artery disease and sudden death. 155 78

It has been observed that diabetes results in increased neuropeptide Y (NPY) in various brain regions, especially the paraventricular nucleus, which projects to the nucleus of the solitary tract (NTS). Because previous studies indicated a pathophysiological relationship between diabetes and NPY, we investigated the effect of diabetes on the sensitivity of NTS-mediated responses to NPY administration. Rats were made diabetic using streptozocin (55 mg/kg iv) and maintained for 48 to 50 days. Normal and streptozocin-diabetic rats were anesthetized with urethan and alpha-chloralose, instrumented for cardiovascular and respiratory monitoring, and positioned in a stereotaxic apparatus. The brain stem was exposed surgically. NPY (0.15 nmol/kg) was microinjected into the NTS and the cardiovascular and respiratory parameters were monitored for 60 min. Diabetes increased systolic (SAP), diastolic (DAP), and mean (Pa) blood pressure but not pulse pressure (PP) and heart rate (HR). Respiratory parameters were not altered. NPY significantly decreased SAP, DAP, Pa, PP, HR, respiratory rate, and minute volume in normal animals. In diabetic animals, NPY also decreased SAP, DAP, and Pa but pronouncedly increased PP. Although NPY decreased the SAP and Pa in diabetic animals, the response was attenuated compared with normal animals. The respiratory parameters and HR of diabetic animals, unlike normal animals, did not respond to NPY administration. We conclude that chronic diabetes results in a decreased sensitivity to NTS-mediated responses and that the hyporesponsiveness of the NTS to NPY modulation may be important in the tendency toward elevated blood pressure and hypertension in diabetes.
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PMID:Decreased cardiorespiratory effects of neuropeptide Y in the nucleus tractus solitarius in diabetes. 159 Apr 79

The aim of the study was to analyse electrocardiographic alterations in 30 patients with slight to moderate essential arterial hypertension during the course of hypertensive attacks (DAP greater than 115 mmHg). Standard hematochemical tests were performed in basal conditions, together with 24-h ECG monitoring and an echocardiogram to measure the left ventricular mass index. Echographic monitoring was carried out during hypertensive attacks and for 2 h after the return to basal pressure values. In basal conditions patients showed slight hypopotassemia (23%), left ventricular echographic involvement (57%), left ventricular hypertrophy with or without systolic strain (43%), and ventricular extrasystole (VE) classified as Lown's 1st and 2nd class (17%). During the course of hypertensive attacks, there was a significant increase in systolic strain, the appearance of anterolateral subendocardial ischemia (10%), left anterior hemiblock (3%), lateral subepicardial ischemia (3%), and a marked increase in VE (67%) which were complex in 40% of cases (Lown's classes 3, 4 and 5). A significant correlation was found between the left ventricular mass index and VE/h. The authors stress the multifactorial pathogenesis of echographic alterations and underline left ventricular involvement, acute hemodynamic strain and consequent alterations of coronary perfusion, hypopotassemia, and increased levels of circulating catecholamines.
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PMID:[Electrocardiographic changes in hypertensive emergencies. Their incidence and possible pathogenetic mechanisms]. 172 64

A study of the prevalence of arterial hypertension and obesity has been performed in the community of Hospitalet de Llobregat which is an industrial town of 289,000 inhabitants in the vicinity of Barcelona. We have studied a population sample of 801 individuals over the age of 19 years, randomly chosen from the elections lists from 1986, and who were classified according to age and sex. Four hundred and thirty two subjects (54%) had a Quetelet index (QI) of 25 or above. Out of these, 300 (38%) had a QI between 25-30 and 124 (16%) had a QI of 30 or above. Obesity prevalence defined as an QI greater than or = 25 was lower in the youngest group (20-39 years), both in males as in females, with a significant difference p less than 0.05). Arterial hypertension prevalence (SAP greater than 160 and/or DAP greater than 95 mmHg) was 19.8%. When individuals with DAP of 90-94 were included, prevalence was 25.7%. A positive correlation between QI and arterial blood pressure was found in the sample studied as a whole, both for systolic arterial pressure (r = 0.23; p less than 0.001; R2 = 0.053) as for diastolic arterial pressure (r = 0.23; p less than 0.001; R2 = 0.053). Arterial hypertension prevalence (SAP greater than 160 and or DAP greater than 90 mmHg plus those individuals with lower values but were on hypotensive treatment) was higher in obese individuals (QI greater than 25). The difference was statistically significant in males below 60. In females a tendency was observed in women below 40. (p = 0.054).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Obesity and arterial hypertension. A cross-sectional study of their prevalence in the population of L'Hospitalet de Llobregat]. 210 32

The multicentre ramipril trial was original in that the CEI was tested at its lowest effective dosage level. More than 80 p. 100 of the patients responded to a single-drug treatment with ramipril 5 mg per day or less. At that dosage level the drug was well tolerated and no severe or serious side-effect was noted. A relation could be demonstrated between the prevalence of cough and the dose of ramipril. The trial was carried out in a population of ambulatory patients with moderate, uncomplicated arterial hypertension (DAP between 95 and 115 mmHg and SAP less than or equal to 200 mmHg). It was conducted according to the "Good Clinical Practice" rules by 102 general practitioners, under their usual conditions of work, and this provided them with experience for further clinical studies of hypertension and with education for the managements of that disease in private practice.
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PMID:[The French ambulatory multicenter trial of Triatec: conclusions of the trial]. 214 99


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