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)

Estrogen replacement therapy is effective for the prevention and treatment of postmenopausal osteoporosis and should be offered to all women at high risk for osteoporosis. Such therapy is particularly beneficial for prevention of spinal compression fractures; in addition, it alleviates menopausal symptoms (hot flushes, genitourinary symptoms, and changes in mood). In each patient, these benefits must be weighted against the potential risks of endometrial hyperplasia and carcinoma, breast tenderness, hypertension, vascular headaches, and the inconvenience of menstrual bleeding if the uterus is intact. The risk of endometrial cancer associated with estrogen replacement therapy can be considerably reduced by the addition of a progestin, and other side effects can be diminished or eliminated by use of the new transdermal estrogen preparations. Thus, estrogen replacement therapy should be considered in all women who have experienced natural or surgically induced menopause, and it is advisable in women who have osteoporosis or an increased risk for this disorder and no contra-indications to its use. Estrogen replacement therapy should be instituted as soon after menopause as possible and seems to be well tolerated until at least 75 years of age.
 ...
PMID:Estrogen replacement therapy: current recommendations. 328 71

Female spontaneously hypertensive rats (SHR) were injected subcutaneously with mestranol twice a week for 12 weeks. Isolated segments of thoracic aorta were then used to generate relaxation response curves to acetylcholine or ATP after precontraction with phenylephrine. Estrogen treatment attenuated the development of hypertension. Further, augmented endothelium-dependent relaxation to acetylcholine was seen in the estrogen-treated SHR. There was no difference, however, in the relaxation produced by ATP. Since the relaxation of both acetylcholine and ATP is endothelium-dependent, these findings suggest that different mechanisms may be involved in the relaxation produced by acetylcholine and ATP.
 ...
PMID:Endothelium-dependent relaxation in estrogen-treated spontaneously hypertensive rats. 335 42

This article reviews the effects of estrogens on protein production by the liver, lipid metabolism, bone maturation and structure, and mineral metabolism. Also presented is a comparison of natural steroidal estrogens (estradiol, estrone, conjugated estrogens, and equine estrogens), synthetic steroidal estrogens (esters and 17-alpha-ethinyl estradiol), and nonsteroidal estrogens (diethylstilbestrol, dienestrol, and chlorotrianisene). Delivery of estrogens by different routes produces different effects. However, the metabolic changes that occur from enzyme induction within hepatic tissue are probably related to the type and dosage of estrogen rather than to the route of administration. Preparations containing estrogens that occur naturally in humans have the least exaggerated potency in the hepatic system relative to their estrogenicity, while conjugated estrogens that contain a mixture of equine estrogens are 2-3 times more potent in the hepatic system and ethinyl estradiol and diethylstilbestrol demonstrate a hepatic potency that is 4-18 fold greater than their estrogen potency. Estrogen is believed to induce a hypercoagulation state associated with both oral contraceptive (OC) use and pregnancy, but the clinical significance of increased levels of clotting factors remains undetermined. Estrogen appears to inhibit bone resorption in postmenopausal women and improve calcium balance. Although estrogen receptors are present in the kidney, their physiologic significance remains unknown. Estrogen does cause an increase in levels of plasma renin substrate, plasma renin activity, and angiotensin. Estrogen-induced increases in angiotensin, leading to renal sodium retention, appear to be the mechanism underlying the association of OCs with hypertension.
 ...
PMID:Pharmacology of estrogens and estrogen-induced effects on nonreproductive organs and systems. 377 5

The data in the literature on clinical and experimental studies of cardiovascular disorders caused by hormonal contraception are reviewed. The review indicates that even small doses of estrogens and progesterone increase the volume of circulating blood. Estrogen/gestagen preparations cause increased serum levels of low-density lipoproteins and, therefore, can contribute to the development of cardiovascular diseases. From these data, it is concluded that hormonal contraceptives should not be given to women with lipid metabolism disorders. Risk analysis shows that short-term (less than 12-18 months) use of contraceptive estrogens and gestagens produces only insignificant and reversible changes in the cardiovascular system. High risks of arterial hypertension, thromboembolism, and myocardial infarction are caused by uncontrolled, long-term use of pills containing high gestagen doses (over 50 ug).
 ...
PMID:[Effect of hormonal contraceptives on cardiovascular function]. 636 72

A cohort of 23 233 women who had received estrogen prescriptions was recruited for a prospective study of estrogen therapy and the associated risk of endometrial cancer. For a detailed study, a comprehensive questionnaire was mailed to 735 randomly sampled cohort members, and 89 per cent of them responded. Estrogen exposure and its implications were described in a preceding paper (part I). The present paper reports the distribution in the cohort sample of personal features known to be risk factors for endometrial cancer. A comparison with results from various materials derived from population-based surveys and case-control studies implied that the cohort members might have a lower proportion of nulliparity (infertility) and a somewhat higher prevalence of hypertension. Differences in the distributions of age at menarche or menopause, weight, height and prevalence of diabetes were according to these comparisons slight and probably without clinical significance. It was concluded that the prevalence of risk factors for endometrial cancer other than estrogen exposure was not higher in the cohort than in the background population. Moreover, approximately one-fifth of the estrogen takers had been freed of their risk through hysterectomies.
 ...
PMID:Characteristics of estrogen-treated women. A descriptive epidemiological study of a Swedish population. Part II. 663 3

411 patients suffering from endometrial carcinoma were seen at the Roswell Park Memorial Institure in Buffalo, New York, between 1970 and 1978. These patients were matched and compared with 338 controls having no neoplastic disease or neoplasms other than of the female genital tract. There was a significantly higher incidence of diabetes, hypertension, and obesity in the uterine cancer patients than in the controls. On the other hand, nulliparity or family history of uterine or other cancer could not be correlated with endometrial cancer in these patients. The control and cancer groups did not differ markedly in the use of estrogens for menopausal or gynecologic reasons. Estrogen use in oral contraceptives (OCs) and for uncertain or unknown reasons was higher in the control than in the cancer group. The uterine cancer group was slightly older (median age 64.2) than the control group (median age 59.7), but this difference is small and believed unlikely to account for the results described.
 ...
PMID:Estrogens and endometrial cancer. 694 29

This is a summary discussion of the 3 types of OCs (oral contraceptives) (combined, sequential, and progestogen-only), their mechanisms of action, their relative effectiveness, and the side effects they cause. It is certainly safer for women to take OCs than to become pregnant, judging from maternal mortality statistics. This is especially true for developing countries. However, hypertension is increased 3-fold, deep venous thrombosis 5-fold, and cerebrovascular disease 4-fold in OC users. The majority of the known side effects are attributed to estrogen, although progestogen is not without blame. The major side effects mentioned, in addition to those listed above, are migraine, diabetes, carcinogenic effects, and possible teratogenic effects. Drug interactions with different drugs may reduce the effectiveness of the OC estrogen, thereby resulting in pregnancy. Estrogen also interacts with other drugs.
 ...
PMID:Oral contraceptives, side effects and drug interactions. 723 87

The Collaborative Group for the Study of Stroke in Young Women and other similar studies linked oral contraceptives with increased risk of cardiovascular diseases. It is hypothesized that an increased risk for stroke should also be seen among postmenopausal women using estrogens as compared with nonusers. To test this hypothesis, a total of 198 postmenopausal subjects, most of whom were between 50 to 80 years of age, and with a diagnosis of stroke during the period 1972 to 1974, were compared with 396 controls (those who had not had strokes) chosen randomly from the data bank of the Kaiser Foundation Health Plan. The 198 subjects were from the Northern California Kaiser Foundation Hospitals. Both groups were studied for estrogen use and for the associated risk factors of diabetes, hypertension, and coronary artery disease. Of those who had had strokes, 20.7 percent had been taking estrogens, compared to 18.4% in the control group (the difference was insignificant at Chi-Square=0.4396). Relative risk of stroke was calculated by the relative odds method to be 1.16 times as great in estrogen users as nonusers, with 95% confidence limits of 0.75 and 1.77. Estrogen replacement therapy is beneficial for some postmenopausal women. Its risks and benefits must be carefully weighed. This study refutes the association between estrogen use in physiological replacement doses and increased risk of stroke in postmenopausal women.
 ...
PMID:The role of estrogens as a risk factor for stroke in postmenopausal women. 734 44

Clinical and pathologic findings were compared in 43 postmenopausal endometrial carcinoma patients who had received exogenous estrogens prior to diagnosis and 79 similar patients unexposed to estrogens. Estrogen non-users were more likely to manifest lower parity, later menopause, obesity, hypertension, and diabetes, all of which have been considered to be constitutional risk factors for the development of endometrial carcinoma. Although estrogen users and non-users had similar extent of disease as judged by clinical stage, there was a tendency to more myometrial invasion in hysterectomy specimens from non-users, as well as greater frequency of unfavorable histologic types and grades of tumor. At short-term follow-up, more recurrences occurred in non-users, and this tendency appeared to be independent of clinical stage, histologic type, histologic grade, or modality of treatment. The significance of these and other observation to the determination of the risk-benefit ratio for estrogen administration is discussed.
 ...
PMID:Endometrial carcinoma: clinical-pathologic comparison of cases in postmenopausal women receiving and not receiving exogenous estrogens. 738 46

Various aspects of climacteric treatment with natural human estrogens are discussed. Estradiol, estradiol valerate, estron sulfate, or estriol are used separately or together in various preparations to treat the symptoms of approaching menopause. Estrogen treatment causes proliferation of the endometrium and causes a decrease in LHRH, FSH, and LH secretion. Treatment can take the form of continuous or cyclic treatment with estrogens alone, or sequential estrogne/gestagen preparations can be used. Ovarian function decreases as menopause approaches and results in the cessation of ovulation. Then the hypolutein phase begins, during which the secretion of progesterone is reduced and menstrual bleeding irregularities begin to occur. Eventually, estrogen production decreases so much that menstruation ceases completely, and symptoms such as heat flashes are experienced. Women who want treatment for climacteric symptoms but who want no regular menstrual bleeding can be administered low doses of pure estrogen. Regular abrasio control of endometrial development should be performed, however. Pure estrogen treatment can also be used in the case of hysterectomized women. Otherwise, a sequential treatment is generally indicated. Possible side effects of estrogen substitution therapy are changes in the genitalia, breasts, menstrual bleeding, blood pressure, and weight. There is also an indication that estrogen use can induce endometrial cancer. Besides the definite contraindication of endometrial cancer, relative contraindications of estrogen therapy include breast cancer, reduced liver function, thromboembolic disease, and serious hypertension. Estrogen therapy is to be used to solve acute climacteric symptoms; women should be well informed about possible side effects and that the therapy is no panacea for all menopausal problems.
 ...
PMID:[Peroral treatment with natural human estrogens in the climacteric]. 744 54


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>