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 aim of our study was to examine the use of pharmacological therapy and to evaluate the economical aspects of treating hypertension (HT) in elderly patients in Poland. Two hundred and sixty eight elderly persons (147 females, 121 males; mean age: 72.2 +/- 6.0 years) were selected from Polish population by stratified and cluster random sampling with quotas. BP measurement was performed 3 times every 2 minutes at respondents home. In the questionnaire, awareness of HT was assessed. Prevalence of hypertension among subjects aged 65 years and over by JNC VI criteria (SAP > or = 140 mm Hg, DAP > or = 90 mm Hg or hypotensive therapy) was 74%. Awareness of HT was equal to 61%. Eleven percent of all hypertensives were well controlled. Among hypertensives, 71% took prescribed antihypertensive drugs on a regular basis. Patients with HT were taking the following antihypertensive drugs: diuretics 16%, diuretics and reserpine 20%, beta-blockers 19%, ACE inhibitors 53%, calcium antagonists 30%, and other 3%. Newer drugs were prescribed in 7%, and multi-source (generic) products in 93%. The average cost of treatment with one drug was 147 PLN (37.5 USD) per year (newer drugs: 413 PLN; multi-source product 126 PLN). Assuming those data and number of elderly people in Poland (4.335 mln), we estimated that 3.208 mln of subjects have had hypertension according to JNC VI criteria. Only 1.957 mln of patients with HT have been detected and only 0.353 mln of hypertensives have been well controlled. The approximate global cost of antihypertensive drugs per year in elderly patients in Poland has been equal to 285 mln PLN (72.8 mln USD). In hypothetical situation with optimal (100%) detection and control of HT the global cost by the actual rate of regularity in taking drugs would increase to 569 mln PLN (145.3 mln USD). The prevalence of HT in elderly people in Poland is very high. In elderly hypertensives ACE inhibitors are used most often. More than 90% of prescribed drugs are multi-source products. An optimal improvement of HT detection and control would cause a two-fold augmentation of the costs of pharmacological therapy.
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PMID:[Pharmacotherapy of arterial hypertension and pharmacoeconomic aspects of hypotensive therapy in elderly patients in Poland]. 1094 86

In a randomized double-blind study, we compared the effect of remifentanil and alfentanil on the cardiovascular response to laryngoscopy and tracheal intubation in patients on long-term treatment for hypertension. Forty ASA II-III patients were allocated to receive (i) remifentanil 0.5 microg kg(-1) followed by an infusion of 0.1 microg kg min(-1) or (ii) alfentanil 10 microg kg(-1) followed by an infusion of saline; all patients received glycopyrrolate 200 microg before the study drug. Anaesthesia was induced with propofol and rocuronium and maintained with 1% isoflurane and 66% nitrous oxide in oxygen. Laryngoscopy and tracheal intubation were performed after establishment of neuromuscular block. Arterial pressure and heart rate (HR) were measured non-invasively at 1 min intervals from 3 min before induction until 5 min after intubation. Systolic (SAP), diastolic and mean arterial pressure decreased significantly after induction in both groups (P<0.05). Maximum increases in mean SAP after laryngoscopy and intubation were 35 and 41 mm Hg in the remifentanil and alfentanil groups, respectively. After intubation, arterial pressure did not increase above baseline values in either group. HR remained stable after induction of anaesthesia, but increased above baseline values after intubation. Mean maximum HR was 87 beats min(-1) for the remifentanil group (12 beats min(-1) above baseline; P=0.065) and 89 beats min(-1) for the alfentanil group (15 beats min(-1) above baseline; P<0.05). There were no significant differences between groups in HR or arterial pressure at any time. There were no incidences of bradycardia. Seven patients in the remifentanil group and four in the alfentanil group received ephedrine for hypotension (i.e. SAP<100 mm Hg).
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PMID:Comparison of effects of remifentanil and alfentanil on cardiovascular response to tracheal intubation in hypertensive patients. 1157 17

The function of vascular endothelium as a biomechanical sensor permits alterations in gene expression in the vascular tree in response to wall stress. The present study explored the mechanism by which the arterial endothelium responds to changes in dietary salt. Normotensive rats were fed diets containing varying amounts of NaCl for 4 days. At that time, levels of phosphorylated p38 MAP kinase, p42/44 MAP kinase, and p46/54 JNK/SAP kinase increased when the diet contained > or = 3.0% NaCl. Kinase assays demonstrated dose-response relationships between dietary salt intake and the activities of p38 MAP kinase and p42/44 MAP kinase. Aortic segments from animals on the 8.0% NaCl diet produced greater amounts of total and active transforming growth factor-beta 1 (TGF-beta1) and nitric oxide. The MEK1 inhibitor, PD-098059, and the p38 MAP kinase inhibitor, SB-203580, decreased production of these bioactive compounds to background levels. Intravenous injection of tetraethylammonium chloride (TEA) into rats on the 8.0% NaCl diet decreased the activities of p38 MAP kinase and p42/44 MAP kinase, compared with rats on the same diet and given vehicle intravenously. These findings provided direct evidence that dietary salt modulated gene expression in the arterial wall through a tetraethylammonium-sensitive mechanism and activation of the p38 and p42/44 MAP kinase pathways.
Hypertension 2002 Feb
PMID:Increased dietary salt activates rat aortic endothelium. 1184 91

Chronostructure of arterial pressure (AP) and heart rate (HR) was studied in 62 residents of Tumen Region North with arterial hypertension (AH) aged 18-50 years and 56 AH controls living in the temperate zone. The groups were matched by age, sex, AH duration, office systolic and diastolic arterial pressure (SAP and DAP, respectively). Circadian AP profile with night hypertension was registered in 76.6 and 28.3% patients of the test and control groups, respectively. Test group patients had more pronounced defects in DAP and HR chronostructures. Thus, AH patients living in the Tumen North demonstrate abnormal circadian AP profile and AP and HR chronostructure. This may be prognostically important for development of cardiovascular complications.
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PMID:[Characteristics of circadian rhythms of arterial pressure and heart rate in hypertensive subjects living in the North of the Tiumen' region]. 1236 Jun 10

Arterial pressure (AP) was monitored in 46 patients with arterial hypertension (AH) aged 18-50 years and in 33 healthy subjects living in Russian North (Tyumen Ob area, Nyagan). The comparison group consisted of 55 patients with AH and 33 healthy subjects living in a moderate climatic zone (Tyumen). The groups were comparable by gender, age, duration of AH, office systolic and diastolic AP (SAP and DAP). Healthy subjects of Tyumen North compared to those living in the moderate climate had more pronounced vegetative imbalance which may transform into AH. The North AH is characterized by high meteorability, impaired circadian AH profile with reduction of the SAP fall day-night and an increase of the DAP fall, greater variability of AP, elevated AP day load, low night DAP. This classifies AH in the northerners as isolated systolic. While AH development in the North takes place due to marked AP fluctuations, in moderate climate it follows a classic variant--due to a DAP rise. The above changes may help prognosis of emergence of cardiovascular complications in hypertensive patients living in the North.
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PMID:[Development and course of arterial hypertension based on 24-hour monitoring of arterial pressure in a population of the Tyumen region]. 1502 93

Key parameters of 24-h blood pressure monitoring (BPM) in 46 18-50-year-old patients (men and women) with arterial hypertension (AH) stage I, II and 33 healthy persons living in the Tyumen North (Khanty-Mansiysky Region, the town of Nyagan) were investigated. The comparison group consisted of 55 patients with AH stage I, II and 33 healthy persons living in moderate climate (Tyumen) matched by sex, age, duration of AH, office systolic and diastolic arterial pressure (SAP, DAP). General patterns of 24-h and seasonal rhythms of AP fluctuations in healthy northerners and citizens of moderate climatic zone and mismatch of these rhythms in AH patients more evident in the northerners are shown. Paired correlations were obtained which indirectly confirm the priority role of daily AP rhythm in development of visceral lesions irrespective of the season of the year and climatic load. In the North, when winter meets spring, a surge of SAP, DAP and mean AP occurs as well as an increase in heart rate, number of patients with disturbed circadian profile of AP. In moderate climate these changes are more typical for summer period. The results of the study necessitate design of programs of additional pharmacological and preventive measures for hypertensive northerners with consideration of AP seasonal rhythms and climatic load.
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PMID:[Circadian rhythms and seasonally dependent variability of arterial pressure in patients with arterial hypertension in the Khanty-Mansiysky region]. 1516 2

We examined effects of pharmacological inhibition of nitric oxide synthase (NOS) and genetic deficiency of the endothelial isoform of NOS (eNOS) on structure and mechanics of cerebral arterioles. We measured pressure, diameter, and cross-sectional area (CSA) of the vessel wall (histologically) in maximally dilated cerebral arterioles in mice that were untreated or treated for 3 months with the NOS inhibitor, N(G)-nitro-L-arginine methyl ester (L-NAME; 10 mg/kg per day in drinking water). Treatment with L-NAME increased systemic arterial mean pressure (SAP; 143+/-4 versus 121+/-4 mm Hg, P<0.05) and CSA (437+/-27 versus 310+/-34 microm2, P<0.05). These findings suggest that hypertension induced in mice by NOS inhibition is accompanied by hypertrophy of cerebral arterioles. To determine the role of the eNOS isoform in regulation of cerebral vascular growth, we examined mice with targeted disruption of one (heterozygous) or both (homozygous) genes encoding eNOS. Wild-type littermates served as controls. SAP and CSA were significantly increased in homozygous (SAP, 141+/-5 versus 122+/-3 mm Hg in wild-type mice, P<0.05; CSA, 410+/-18 versus 306+/-15 microm2 in wild-type mice, P<0.05), but not in heterozygous (SAP, 135+/-4 mm Hg; CSA, 316+/-32 microm2) eNOS-deficient mice. Carotid ligation normalized cerebral arteriolar pulse pressure did not prevent increases in CSA in homozygous eNOS-deficient mice. Thus, cerebral arterioles undergo hypertrophy in homozygous eNOS-deficient mice, even in the absence of increases in arteriolar pulse pressure. These findings suggest that eNOS plays a major role in regulation of cerebral vascular growth.
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PMID:Structure of cerebral arterioles in mice deficient in expression of the gene for endothelial nitric oxide synthase. 1538 43

Survey on research and development of Fructus Gardeniae in the recent 10 years. Gardenia yellow has been used for food colorent, medicine, feedingstuff and cosmetic. Garnedia blue has been used for developing another pigment with red and yellow. Fructus Gardeniae has been used in digestive system for cholecyst constracting and gall-stone eliminating, for declining peroxide on SAP mouse and increasing immune ability, for protecting liver against cancel, anti-acetylcholinic restraining on stomach enginery, in cardiovascular system it has been used for centrally anti-hypertension, preventing atheroma and thrombus, also Fructus Gardeniae has been used for anti-inflammation, treating parenchyma injure etc. Geniposide used for increasing production in agriculture has wider perspect.
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PMID:[Research and development of Fructus Gardeniae]. 1678 Jan 51

The nucleus of the solitary tract (NTS) receives primary afferents involved in cardiovascular regulation. We investigated the role of NK(1)-receptor bearing neurons in the NTS on cardiovascular reflexes in awake rats fitted with chronic venous and arterial cannulae. These neurons were lesioned selectively with saporin conjugated with substance P (SP-SAP, 2 microM, bilateral injections of 20 nL in the subpostremal NTS, or 200 nL in both the subpostremal and the commissural NTS). Before, and 7 and 14 days after injection of SP-SAP, we measured changes in blood pressure and heart rate induced by i.v. injection of phenylephrine and nitroprusside (baroreceptor reflex), cyanide (arterial chemoreceptor reflex), and phenylbiguanide (Bezold-Jarisch reflex). The smaller injections with SP-SAP completely abolished NK1 receptor staining in the subpostremal NTS. The larger injections abolished NK1 receptor immunoreactivity in an area that extended from the commissural NTS to the rostral end of the subpostremal NTS. The lesions seemed to affect only a limited number of neurons, since neutral red stained sections did not show any obvious reduction in cell number. The smaller lesions reduced the gain of baroreflex bradycardia and the hypotension induced by phenylbiguanide. The larger lesions completely abolished the response to phenylbiguanide, blocked the baroreflex bradycardia induced by phenylephrine, severely blunted the baroreflex tachycardia, and blocked the bradycardia and reduced the hypertension induced by cyanide. Thus, these responses depend critically on NK(1)-receptor bearing neurons in the NTS.
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PMID:Ablation of NK1 receptor bearing neurons in the nucleus of the solitary tract blunts cardiovascular reflexes in awake rats. 1698 39

The paper presents a retrospective analysis of the medical records of 147 patients with arterial hypertension (AH) and old ischemic cerebral stroke (ICS), who had undergone annual hospital treatment and 24-hour arterial pressure monitoring (24HAPM) for five years before ICS developed. The patients were observed and underwent 24HAPM during five years after ICS as well. The changes in average 24-hour systolic arterial pressure (SAP av.) within the 10 years were analyzed in 98 of the 147 patients who had remained in the group by the end of the observation period. The changes in SAP av. after ICS were variable. Most patients displayed slight SAP av. growth by the end of the investigation; at the same time, in 6 of the 98 patients SAP av. became lower by 7 mbar or more after ICS. The authors suppose that this decrease in the arterial pressure occurred due to the disappearance of cerebral ischemic focus in the area of ICS. The authors propose the term "ischemic cerebrovascular AH" and an algorithm of the examination of AH patients with non-stable arterial pressure due to brachiocephalic arterial pathology.
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PMID:[The change of the degree of arterial hypertension after ischemic cerebral stroke according to 24-hour arterial pressure monitoring results]. 1821 51


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