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

Late survival rates were compared and analysed for 1070 patients undergoing repair of ruptured infrarenal abdominal aortic aneurysm (RAAA, n = 364, mean age 70.0 years, male:female ratio 5.6:1) and non-ruptured abdominal aortic aneurysm (AAA, n = 706, mean age 66.6 years, male: female ratio 5.4:1) between January 1970 and July 1992 at the Department of Thoracic and Cardiovascular Surgery of Helsinki University Central Hospital, Finland. There was a statistically significant difference in survival rates between the RAAA and AAA groups during the first three months after repair of abdominal aortic aneurysm. Operative mortality rates were 7.4% for electively repaired abdominal aortic aneurysms and 48.7% for ruptured abdominal aortic aneurysms. For 3-month postoperative survivors there existed no statistically significant difference in late survival rates, nor did these rates differ from those of an age- and sex-matched population. Five-year survival rates for 3-month postoperative survivors were 60% in the RAAA group and 67% in the AAA group. Median survival time was 5.7 years and 7.5 years, respectively. Coronary artery disease, hypertension, chronic obstructive pulmonary disease and renal insufficiency statistically significantly reduced late survival rates after 3 months post-surgery for non-ruptured abdominal aortic aneurysm, whereas these risk factors did not alter late prognosis after successful repair of ruptured abdominal aortic aneurysm. Cerebrovascular disease reduced late survival rates both in AAA (median survival time 6.3 years) and RAAA group (median survival time 4.9 years). Of late deaths 41% were caused by coronary artery disease in the AAA group and 38% in the RAAA group.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Comparison of long-term survival after repair of ruptured and non-ruptured abdominal aortic aneurysm. 772 78

Propranolol has been suggested to slow aortic aneurysm (AAA) expansion by a mechanism independent of simple blood pressure (BP) reduction. To investigate this hypothesis, we designed a series of experiments to examine the effects of hypertension and propranolol upon AAA expansion. Using an established animal model, we induced AAA in normotensive and genetically hypertensive rats by perfusion of the isolated infrarenal aorta with elastase for two hours. Systolic tail BP was monitored with a plethysmograph. AAA size was measured directly with a micrometer on postoperative days 7 and 14. All data are expressed as the mean +/- standard deviation (SD). BP (mmHg) was significantly higher in hypertensive rats: 164 +/- 15 versus 119 +/- 7 (p < 0.001). AAA were also significantly larger in hypertensive rats with a mean expansion rate (mm/day) nearly twice that of normotensive animals: 0.13 +/- 0.09 versus 0.07 +/- 0.03. In a second series of animals, propranolol treatment was compared to placebo. In those animals, hypertensive propranolol-treated rats had significantly smaller AAA than placebo-treated controls (p < 0.05). There was no difference in normotensive animals but these rats had an unexplained paradoxical rise in BP with treatment. In this model, hypertension increases the expansion rate of AAA. Propranolol reduced the size of AAA in hypertensive animals, at least in part because of a decrease in BP. Other possible mechanisms of propranolol's action may be operative and require further study.
 ...
PMID:Effects of hypertension and propranolol upon aneurysm expansion in the Anidjar/Dobrin aneurysm model. 895 85

During a recent 30-month period, we repaired 10 ruptured abdominal aortic aneurysms (RAAA) at our institution. To evaluate the survival, postoperative morbidity, and financial impact of treating RAAA, we compared these patients with 10 randomly selected patients undergoing elective AAA (EAAA). Both groups were comparable for age, gender, and incidence of diabetes, hypertension, coronary artery disease, chronic obstructive pulmonary disease (COPD), and renal failure. Although we have noted a dramatic increase in survival for RAAA (90%), the morbidity continues to be unacceptably high (60%). Efforts should be made toward better detection of AAA prior to rupture as well as development of strategies to minimize or prevent these major complications. Potential average savings accrued from one patient undergoing EAAA repair rather than RAAA repair ($93,139. 21) can be used to perform screening abdominal ultrasound tests in patients at increased risk of having an AAA.
 ...
PMID:Ruptured versus elective abdominal aortic aneurysm repair: outcome and cost. 1054 16

The objective of this report was to analyze the current surgical results of operative treatment in patients suffering ruptured AAA (abdominal aortic aneurysms) and to define those independent predictive factors for mortality. During a period of 2 years, from January 1996 to December 1997, 144 patients operated on for ruptured AAA in 10 hospitals were included in a multicenter retrospective study. Among the collected variables concerning each patient, those with potential relation to surgical mortality were studied: gender, age, diabetes, hypertension, cardiopathy, pulmonary obstructive disease, preoperative renal dysfunction, symptomatic cerebrovascular disease, peripheral vascular disease, hematocrit on admission, preoperative hypotension < 80 mmHg, loss of consciousness, cardiac arrest, aortic aneurysm location (infrarenal versus non-infrarenal), iliac involvement, aneurysm size, type of rupture, left renal vein ligature, ligature of a patent inferior mesenteric artery, place of aortic cross-clamping, type of grafting, exclusion of both hypogastric arteries, venous technical complications, associated surgery, use of cell saver, intraoperative blood loss, and postoperative complications (renal failure, sepsis, coagulopathy, cardiac complications, pulmonary complications, colon ischemia, prosthetic graft complications, and need for reoperation). Those variables with statistical significance in the univariate analysis were introduced into a multivariate logistic regression model to determine the independent predictors of death. From our results we concluded that surgery for ruptured abdominal aortic aneurysms continues to have an excessively high mortality rate. Even though some preoperative variables could be identified as predictors of mortality, an absolute mortality risk has not yet been determined and the decision to negate surgery should be individualized rather than taken on that basis only. Early diagnosis and treatment of symptomatic aneurysms would improve mortality figures and selective screening should be contemplated.
 ...
PMID:Factors increasing the mortality rate for patients with ruptured abdominal aortic aneurysms. 1176 39

The aim of this study was to evaluate clinical sequelae of accessory renal artery exclusion during endo-AAA repair. Medical records and pre- and postoperative CT scans were reviewed from 114 AAA patients treated with the AneuRx stent graft between 1996-2001. Thirty-seven accessory renal arteries were identified in 32/114 patients (28%) with 19/32 patients having infrarenally located accessory renal arteries. In group I (11 patients), the stent graft excluded 11 accessory renal arteries. In group II (8 patients), eight accessory renal arteries were not excluded. Average infrarenal neck length was 24.9 mm in group I vs. 30.7 mm in group II (p = 0.07). The average length of device seal was similar in both groups (19.4 vs. 18.5 mm, p = 0.67). There were no perioperative deaths, significant postoperative hypertension, rise in serum creatinine, or postoperative renal infarctions in either group. Three of eight patients (38%) in the non-excluded group developed type I proximal endoleaks whereas none in the excluded patient group did (p = 0.06). Accessory renal arteries may be safely excluded during endovascular AAA repair and may result in a more secure proximal device fixation.
 ...
PMID:Endovascular abdominal aortic aneurysm repair using the AneuRx stent graft: impact of excluding accessory renal arteries. 1472 63

There is still controversy as to which surgical method is the most suitable for repair of abdominal aortic aneurysm with concomitant horseshoe kidney (AAA-HSK). We report three cases of AAA-HSK treated with endovascular aneurysm repair. In one of these patients we sacrificed the accessory renal artery by applying coils before the operation. Renal infarction, hypertension, or elevated serum creatinine level was not observed in any of our patients. If the blood supply to the kidneys is taken into consideration, endovascular aneurysm repair is our preferred surgical method for repair of AAA-HSK when anatomic conditions are suitable for stent-graft application and kidney function is normal.
 ...
PMID:Endovascular aneurysm repair: Treatment of choice for abdominal aortic aneurysm coincident with horseshoe kidney? Three case reports and review of literature. 1529 35

Active Absorbable Algal Calcium (AAA Ca) is made by submaximally (800 degrees ) heating cleaned oyster shell under reduced pressure and mixing it with similarly heated seaweed (Cystophyllum fusiforme). AAA Ca, the best absorbed from the intestine than other available calcium compounds, consequently most efficiently suppresses parathyroid hormone secretion, increases bone mineral density and decreases vertebral fracture. Aging is associated with calcium deficiency, mostly because of the decreased biosynthesis of 1,25 (OH)2 vitamin D in the kidney. Parathyroid hormone consequently increases, contributing to various diseases associated with aging such as osteoporosis or decrease of calcium in the bone, as well as hypertension, arteriosclerosis, Alzheimer's disease and osteoarthritis due to paradoxical increase of calcium in vascular walls, brain, cartilage and intracellular compartment of many kinds of cells. Mild calcium deficiency is hard to detect despite these serious consequences because of the remarkable constancy of blood calcium concentration maintained by elaborate homeostatic control. Only by successfully counteracting calcium deficiency by AAA Ca with outstanding absorbability, the phenomenon of calcium paradox becomes a recognizable reality within our reach.
 ...
PMID:[Active absorbable algal calcium (AAACa) changes calcium paradigm]. 1563 77

Active Absorbable Algal Calcium (AAA Ca) is made by submaximally (800 degrees C) heating cleaned oyster shell under reduced pressure and mix it with similarly heated seaweed (Cystophyllum fusiforme). AAA Ca, best absorbed from the intestine among available calcium compounds, consequently most efficiently suppresses parathyroid hormone secretion, increases bone mineral density and decreases vertebral fracture. Aging is associated with calcium deficiency, mostly because of the decreased biosynthesis of 1,25 (OH)2 vitamin D in the kidney. Parathyroid hormone consequently increases, contributing to various diseases associated with aging such as osteoporosis or decrease of calcium in the bone, as well as hypertension, arteriosclerosis, Alzheimer's disease and osteoarthritis due to paradoxical increase of calcium in vascular walls, brain, cartilage and intracellular compartment of many kinds of cells. Mild calcium deficiency is hard to detect despite these serious consequences because of the remarkable constancy of blood calcium concentration maintained by elaborate homeostatic control. Only by successfully counteracting calcium deficiency by AAA Ca with outstanding absorbability, the phenomenon of calcium paradox becomes a recognizable reality within our reach.
 ...
PMID:Active Absorbable Algal Calcium (AAA Ca): new Japanese technology for osteoporosis and calcium paradox disease. 1564 84

Seasonal and circadian variation in the incidence of ruptured abdominal aortic aneurysm (RAAA) has been reported. We explored the role of atmospheric pressure changes on rupture incidence and its relationship to cardiovascular risk factors. During a three year-period, 1st April 1998 and 31st March 2001, data was prospectively acquired on 144 Ruptured Abdominal Aortic Aneurysm (RAAA) presenting to the Regional Vascular Surgery Unit at the Royal Victoria Hospital, Belfast, Northern Ireland. For each patient the chronology of acute onset of symptoms and presentation to the regional vascular unit was recorded, along with details of standard cardiovascular risk factors. During the same period meteorological data including atmospheric pressure and air temperature were recorded daily at the regional meteorological research unit, Armagh. We then analyzed the monthly mean values for daily rupture incidence in relation to the monthly values for atmospheric pressure, pressure change and temperature. Furthermore atmospheric pressure on the day of rupture, and day preceding rupture, were also analyzed in relation to days without rupture presentation and between individual ruptures for various cardiovascular risk factors. Data demonstrated a significant monthly variation in aneurysm rupture frequency, (p<0.03, ANOVA). There was also a significant monthly variation in mean barometric atmospheric pressure, (p<0.0001, ANOVA), months with high rupture frequency also exhibiting low average pressures in the months of April (0.24 +/- 0.04 ruptures per day and 1007.78 +/- 1.23 mB) and September (0.16 +/- 0.04 ruptures per day and 1007.12 +/- 1.14 mB), respectively. The average barometric pressures were found to be significantly lower on those days when ruptures occurred (n=1127) compared to days when ruptures did not occur (n=969 days), (1009.98 +/- 1.11 versus 1012.09 +/- 0.41, p<0.05). Full data on risk factors was available on 103 of the 144 rupture patients and was further analyzed. Interestingly, RAAA with a known history of hypertension, (n=43), presented on days with significantly lower atmospheric pressure than those without, (n=60), (1008.61 +/- 2.16 versus 1012.14 +/- 1.70, p<0.05). Further analysis of ruptures grouped into those occurring on days above or below mean annual atmospheric pressure 1013.25 (approximately 1 atmosphere), by Chi-square test, revealed three cardiovascular risk factors significantly associated with low-pressure rupture, (p<0.05). Data represents mean +/- SEM, statistical comparisons with Student t-test and ANOVA. These data demonstrate a significant association between periods of low barometric pressure and high incidence of ruptured aneurysm, especially in those patients with known hypertension. The association between rupture incidence and barometric pressure warrants further study as it may influence the timing of elective AAA repair.
 ...
PMID:Periods of low atmospheric pressure are associated with high abdominal aortic aneurysm rupture rates in Northern Ireland. 1623 64

Carotid duplex ultrasonography (DUS) is routinely performed prior to coronary artery bypass graft surgery (CABG) on all patients > 65 years old because of the reported associated risk of finding concomitant carotid artery stenosis. Identifying risk factors that correlate with severe carotid stenosis may result in more cost-effective screening for patients with asymptomatic carotid artery disease prior to CABG. We performed a retrospective study to identify risk factors for significant carotid artery disease in patients scheduled to undergo CABG between March 2005 and March 2008 at the Massachusetts General Hospital. Patients with carotid stenosis >or= 70% identified by DUS (n = 50) were matched by age and sex to control patients who had < 50% stenosis (n = 50). Data were analyzed using the chi-squared test or analysis of variance as appropriate. Logistic regression was used to examine multivariate correlates of carotid stenosis. A total of 643 patients were screened to arrive at the patient cohorts described below. This produced a prevalence of 7.7% for significant (> 70%) carotid disease. The patient cohorts were predominantly male with no significant difference in the incidence of diabetes, hypertension, extent of coronary artery disease (CAD) (i.e. left main coronary artery disease (LMCA) and one, two-, or three-vessel CAD) or lipid abnormalities in the two groups. Univariate analysis identified the presence of peripheral arterial disease (PAD, p = 0.001), a cervical bruit (p < 0.0001), a prior neurological event (p = 0.020), and the presence of an abdominal aortic aneurysm (AAA; p = 0.046) as significant predictors of >or= 70% internal carotid artery stenosis. Logistic regression analysis revealed that the presence of a carotid bruit (p = 0.0068) and PAD (p = 0.0194) were associated with an increased risk of significant carotid artery disease. In conclusion, the presence of a carotid bruit or PAD predicts an increased likelihood of significant carotid artery disease in patients undergoing CABG. Unlike previous studies, LMCA or extent of CAD did not correlate with significant carotid artery disease. Using these predictive models, a prospective outcomes trial is required to validate these criteria.
 ...
PMID:Correlates of carotid stenosis in patients undergoing coronary artery bypass grafting--a case control study. 1965 73


1 2 Next >>