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

102 patients using Trinordiol, a triphasic oral contraceptive (OC) containing ethinyl estradiol and d-norgestrel, were followed for 932 cycles in a study of secondary effects. Follow-up visits were scheduled after 1,3, and 6 months and every 6 months thereafter. 26 patients discontinued use of the pills during the study after using them for a total of 159 cycles. 5 discontinued because of abdominal pain, 1 for breast tenderness, and 1 because of headaches or migraines. 7 discontinued because of metrorrhagia, 4 for weight gain, 3 for amenorrhea, 2 for nausea and vomiting, and 1 each for nervousness, water retention, acne, desire for pregnancy, leaving the country, hypertension, and unknown motivation. the average age of patients was 23.6 years, with a range from 14-48. 76% were aged 15-29 years. 52.9% were nulliparas. 58.8% were Belgian, 21.6% were from Mediterranean Europe, 10.8% were Moroccan, and 7.9% were from black Africa. Only 1 patient, a 37 year old, developed hypertension. 15 patients gained more than 2 kg and 17 lost more than 2 kg. 15.8% complained of spotting during the 1st cycle compared to 3.1% during the 6th cycle, 5.2% during cycle 7-12, and 9.1% during cycle 13-30. Among 35 patients who did not discontinue treatment, 7 complained of amenorrhea and 1 of scanty menstrual bleeding, 14 of pain including 7 cases of pelvic pain, 2 of dysmenorrhea, 3 of breast tenderness, and 2 of headaches, 15 of leukorrhea, 3 of nausea, 2 of dizziness, and 1 each of fatigue, acne, galactorrhea, and cutaneous pruritus. 1 case of myoma at the level of the uterine cornu was identified after 24 cycles of treatment. In all, 61 patients had some complaint, while 41 were totally satisfied. No patient became pregnant during the study.
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PMID:[Clinical study of the secondary effects associated with taking a triphasic anti-ovulatory contraceptive]. 670 4

Clinical hypertension is to be found in 1-4% of oral contraceptive (OC) users, and it is a major risk in the development of cardiovascular diseases. Most data on OC caused hypertension are based on high dose OC combinations, or those containing 50-100 mcg of estrogen and 1-4 mg of progestogen. 30 women with persistent hypertension induced by high dose combinations were divided into 4 groups. In group A the high dose combination was replaced by a lower dose combination; in group B the high dose combination was replaced by norethisterone only; in group C the high dose combination was stopped and barrier methods used for 6 months, after which a low dose combination was given for 6 months, followed by barrier methods for a further 6 months; in group D the same method as in group C was used, but norethisterone alone was substituted. In both groups A and B systolic and diastolic blood pressure experienced a significant drop; after 1 year group B, taking low dose progestin only, had shown a further small drop, with blood pressure significantly lower than that in group A. However, in neither group did the blood pressure return to pre-OC levels. When 30 mcg ethinyl estradiol and 150-250 mcg levonorgestrel was introduced (group C) blood pressure rose again after 6 months, but to levels which were significantly lower than those recorded in the higher combinations. Norethisterone 350 mcg alone (group D) also induced a small significant rise in blood pressure after 6 months. The results of this study suggest that women with hypertension caused by high dose OCs may experience great improvement by treatment with low dose combined OCs or by low dose progestogen alone.
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PMID:Effect on blood pressure or changing from high to low dose steroid preparations in women with oral contraceptive induced hypertension. 681 Apr 59

This study investigates whether qualitative rather than quantitative differences in renin substrate were associated with estrogen induction of hypertension by comparing the plasma concentration of high molecular weight renin substrate (HMS) in 18 healthy normotensive, nonpregnant women aged 35-50 taking no medication; 20 normotensive subjects receiving estrogens as oral contraceptives (OCs) or ethinyl estradiol (EE) 50 mcg; and 5 women on OCs or EE 50 mcg who became hypertensive on estrogen therapy. A significant increase in renin substrate was evident in all women with elevated plasma estrogen levels. The difference in total renin substrate levels of normotensive and hypertensive subjects was not statistically significant. HMS differed from the normal molecular weight substrate (NMS) in electrophoretic mobility, isoelectric point, and immunologic cross-reactivity. Kinetic analysis indicated that it also had a significantly higher affinity for the enzyme renin than the major circulating form (Km=1800 +or- 290 versus 3520 +or- 260 ng angiotensin I equivalents/ml). The results suggest that substrate composition may play an important role in blood pressure regulation.
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PMID:An increase in high-molecular weight renin substrate associated with estrogenic hypertension. 683 97

Highlights of papers presented at an international symposium on advantages and risks of oral contraceptives, and the details of the results of 2 studies are discussed. 1 study compared the effects of a combination of 30 mcg of ethinyl estradiol and 150 mcg of levonorgestrel with a reduced dose 3-phase combination of these hormones; it involved 489 women with 2777 menstrual cycles for a 6-month period. No pregnancies occurred. Missed menstruation occurred in 0.9% of the cycles with the 3-phase combination, contrasted with 2.3% of the 30/150 mcg combination group. Bleeding disorders were more frequent in the 30/150 pill group (15.7% vs. 10.1%). Spotting occurred in 8% of cases in both groups. The 3-phase pills proved to be safe and were preferred because they caused less bleeding. Another study compared the effects of 2 Swedish-made contraceptives by administering Neovletta (N) to 50%, Trionetta (T) to 25%, and Trionetta 28 (T 28) to another 25% of the 862 women with 6472 menstrual cycles who participated at 12 family planning centers in Sweden. T and N contain the same amount of estrogens, but T contains 40% less gestagen than N. The T 28 treatment also included 7 placebo tablets. Results showed that only 1 pregnancy occurred in the T group, despite a high rate of failure to take the pills (8.1-9.4%). Menstruation was normalized in both the N group (90.4%) and the T group (94.2%) reaching the normal 28 (+ or - 2) days cycle. Missed menstruation occurred in 0.6% of the T group as opposed to 2.3% of the N group. There was a significant difference in spotting and irregular bleeding between the 2 groups: 6.3%-15.8% for N and 3.0-9.0% for T. Also, there was a higher rate of bleeding problems for T 28 than for T. 8.6-8.8% of women in both groups quit the experiment because of complications, e.g., bleeding, nausea, headache, and hypertension. Both pills proved to be reliable and safe, but the new 3-phase preparation, T, is recommended because it does not reduce the beneficial HDL cholesterol as does N.
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PMID:[Report from an international symposium about advantages and risks of oral contraceptives. Amsterdam, March 1982]. 692 Nov 98

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.
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PMID:Estrogens and endometrial cancer. 694 29

The renin-angiotensin-aldosterone system appears to be under neural and hormonal control. Plasma angiotensinogen concentration is elevated in Cushing's disease, during pregnancy and in women taking oral contraceptives. An in vitro liver slice system was used to study the hormonal control of angiotensinogen synthesis and release in the rat. Dexamethasone administration in vivo resulted in increase in the in vitro rate of release of angiotensinogen by liver slices into the incubation media. This increase was inhibited by actinomycin D, an inhibitor of protein synthesis and vincristine which blocks secretion. Similarly, ethinyl estradiol treatment resulted in a 50% increase in angiotensinogen production. Hyperthyroid state was achieved by injecting rats with L-thyroxine daily for seven days. Hepatic production rate of angiotensinogen rose 21/2-fold above control and was accompanied by increases in plasma angiotensinogen concentration and plasma renin activity. In contrast, plasma angiotensinogen concentration and plasma renin activity were reduced in thyroidectomized rats. The rate of angiotensinogen production by liver slices of these rats decreased by five-fold below that of intact animals. These changes were largely corrected when thyroidectomized rats were treated with replacement doses of L-thyroxine. We conclude that hepatic angiotensinogen biosynthesis is under hormonal control. Glucocorticoid, estrogen and thyroid hormones all stimulate angiotensinogen production. These results may in part explain the pathogenesis of hypertension associated with certain disease states.
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PMID:Hormonal control of angiotensinogen production. 704 Aug 93

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.
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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.
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PMID:The role of estrogens as a risk factor for stroke in postmenopausal women. 734 44

It is well known that there exists a significant correlation between cardiovascular mortality and pathology and estrogen therapy. Arterial hypertension and cerebral thrombosis can be added complications. It is estimated that of over a million OC (oral contraception) users, 100 are susceptible of vascular accidents, and 5 of death. If the absolute value of such risk can be considered small, it augments signfiicantly in connection with such factors as hypertension, diabetes, hyperlipidemia, and especially, smoking. The physiopathology of alterations caused by OCs is still under discussion, but it is possible that synthetic estrogen and ethinyl estradiol are mainly responsible for side effects, while estradiol-17 beta seems to limit the development of vascular risk. Reducing the dosage of ethinyl estradiol, as in the minipill, does not solve the metabolic problem.
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PMID:[Estrogen therapy and vascular risk]. 738 69

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.
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PMID:Endometrial carcinoma: clinical-pathologic comparison of cases in postmenopausal women receiving and not receiving exogenous estrogens. 738 46


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