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

Quantitative vitreous fluorophotometry was used to study the alteration of the blood-retinal barrier in 116 patients with diabetes mellitus of adult onset. The patients were in good stable metabolic control on injectable insulin, oral hypoglycaemics, or diet therapy. Vitreous fluorophotometry readings were abnormally high but similar in all three groups and in those with or without early background retinopathy. A higher incidence of systemic hypertension was noted in those patients requiring oral agents compared to those on insulin or diet therapy.
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PMID:Effects of therapy on vitreous fluorophotometry in diabetes mellitus. 29 86

1. Diabetics have a greater risk of experiencing and of dying from a CHD event than age matched non-diabetics. 2. The excess risk is particularly notable in insulin dependent female diabetics who seem to lose the usual 'protection' accorded to women. 3. The cause or causes of the excess risk are not known. There are a variety of 'risk factors' observed in diabetics which, in sum, may contribute. 4. At least in insulin-dependent diabetics some cardiac morbidity and mortality may also be due, not to coronary heart disease, but to a cardiomyopathy secondary to intramural obstructive vascular disease and/or disordered myocardial metabolism. 5. No therapy has yet been convincingly proved to reduce (or to increase) the risk of cardiac morbidity or mortality. Nevertheless, in treating diabetics there is an a priori case for using diets designed to lower plasma lipid levels as well as the blood sugar, for early treatment of hypertension and for discouraging cigarette smoking.
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PMID:Diabetes and the heart: coronary heart disease. 33 40

Blood glucose and plasma insulin levels were studied under fasting conditions and following an i.v. and an oral glucose load, respectively, in nine males with moderate hypertension before treatment, after one month on placebo and after three months on the cardioselective beta-receptor blocking agent metoprolol. The studies were performed under metabolic ward conditions. The reproducibility of blood glucose and plasma insulin values following an i.v. glucose load was very good. Medication with metoprolol caused no changes in the fasting levels of blood glucose or plasma insulin, nor in the blood glucose response following a glucose load given i.v. or orally. The initial and total integrated insulin response to the i.v. administration of glucose was similar before and during metroprolol. Following oral glucose both the total integrated blood glucose response and the insulin response were unaffected by treatment with metoprolol.
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PMID:Glucose tolerance and insulin release in hypertensive patients treated with the cardioselective beta-receptor blocking agent metoprolol. 33 95

Twenty-one insulin-dependent diabetics with azotemic nephropathy were evaluated for renal transplantation by selective coronary angiography and cine left ventriculography. All had hypertension, retinopathy, neuropathy, and required salt restriction plus diuretics for volume overload. There was no clinical or electrocardiographic evidence of ischemic coronary artery disease in twenty. Ten patients (five males, five females, mean age 29.3 years; mean duration of diabetes 21.9 years; mean serum cholesterol 239 mg%) had significant coronary artery disease, seven demonstrating focal abnormalities in left ventricular wall motion. Two patients (one male, one female; mean age 36.5 years; mean duration of diabetes 28.5 years; mean serum cholesterol 250 mg%) had no significant coronary artery disease, but demonstrated diffusely abnormal left ventricular wall motion with diminished ejection fraction. Thirty-eight percent had significant coronary artery disease unpredictable by electrocardiographic or clinical data. The finding of no significant coronary artery disease in 52% of a group with severe renal-hypertensive complications of diabetes is surprising. Two patients may have a demonstrated cardiomyopathy.
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PMID:Asymptomatic coronary artery disease: angiographic assessment of diabetics evaluated for renal transplantation. 36 Dec 77

Six normal subjects and six normotensive insulin-dependent diabetics underwent two insulin hypoglycaemia tests after administration for three days of either a placebo or of acebutolol--a cardioselective beta-blocker--at a dose of 400 mg per day. The order in which the tests were performed was decided by random selection. Acebutolol suppressed the tachycardia which occurred as a reaction to hypoglycaemia but did not interfere with other warning symptoms and signs. In both normal subjects and diabetics, acebutolol neither worsened the initial hypoglycaemia nor did it delay a return to normal values. The increase in lactate levels following hypoglycaemia was not reduced by acebutolol but free fatty acid rebound was suppressed. Hormonal responses (glucagon, cortisol, growth hormone) were unaffected by the beta-blocker. If they are confirmed by long term studies, these results would suggest that acebutolol is safer to use than non-cardioselective beta-blockers in the treatment of coronary insufficiency and of hypertension in diabetics exposed to the risk of hypoglycaemia.
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PMID:[The effects of acebutolol on endocrine and metabolic reactions induced by acute hypoglycaemia. Study in normal subjects and in insulin-dependent diabetics (author's transl)]. 39 44

What regulates the activity of the central nervous renin-angiotensin system is not known. To define whether control of this central system is linked to that in the periphery, simultaneous blood and cerebrospinal fluid (CSF) samples for measurement of immunoreactive angiotensin II were drawn from anesthetized dogs during hemorrhage, furosemide-induced volume depletion, insulin-hypoglycemia, beta-adrenergic blockade and saline infusion. Despite vigorous increments or decrements in plasma innunoreactive angiotensin II, CSF levels remained stable. Since immunoreactive angiotensin II in dog CSF is claimed to be mainly the heptapeptide des-Asp1-angiotensin II (angiotensin III), the possibility that the level of this peptide within CSF simply reflects plasma concentrations was assessed by infusing angiotensin III (2.5 and 25 ng/kg/min intravenously, each for 60 minutes) and monitoring plasma and CSF peptide levels. Whereas plasma immunoreactive angiotensin II levels increased appropriately across the infusions, no change in CSF levels was observed. These studies indicate the angiotensin III does not cross the blood-CSF barrier, at least in the short term.
Hypertension
PMID:Independence of the central nervous and the peripheral renin-angiotensin systems in the dog. 39 35

Early experience with the treatment of patients with insulin-dependent diabetes and renal failure by chronic hemodialysis indicated a high mortality and increased incidence of medical complications. Since 1972, a marked improvement in survival and reduction in incidence of complications has been attributed to more rigorous control of fluid overload, hypertension, and blood sugar levels by insulin therapy and careful dietary management. A diet has been developed which combines the diet used by dialysis patients with suitable modifications for the insulin-dependent patient with diabetes. The importance of patient education is stressed in an attempt to improve patient compliance.
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PMID:Dietary management of patients with diabetes treated by hemodialysis. 46 38

For the judgment of the peripheral blood supply 16 insulin-dependent diabetics with necrobiosis lipoidica at the lower extremities were compared with 15 insulin-dependent diabetics without necrobiosis lipoidica. The vascular changes in form of retinopathy, nephropathy, neuropathy, hypertension, the results of the radiologically provable vascular changes, oscillograms and impedance plethysmograms as well as the results of the muscle and skin clearance and angioscintigraphy were evaluated. The at last mentioned methods give an insight into the microangiopathy. The apparantly contradicting findings of the muscle clearance (smaller blood supply) and of the skin clearance (increased blood flow) find their explanation by the angioscintigraphically proved different regional parameters of blood flow in the necrobiotic regions. The angiopathic findings are characterized by the enrichment of activity in the marginal seam as a sign of hyperemia and decreased accumulation in the centre as an expression of necrobiosis. The changes of the connective tissue and their causes of development are discussed. Angiopathic and traumatic influences conditioned by metabolism, apart from local peculiarities are taken into consideration.
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PMID:[Peripheral blood flow in patients with necrobiosis lipoidica (diabeticorum)]. 54 2

Rats with renal and spontaneous hypertension do no differ from control normotensive rats in 14C-glucose uptake and triglyceride synthesis by the adipose tissue in vitro, both with and without insulin stimulation. Adrenalectomy (which eliminates the stabilizing effect of the corticosteroid hormones on the adipocyte membrane) reveals the differences between the hypertensive and normotensive rats in the response of the adipose tissue to insulin. While the adrenalectomized control rats show a significantly lowered "sensitivity" of the adipocytes to insulin, the adrenalectomized hypertensive rats do not reveal a noticeable change in glucose uptake and triglyceride synthesis under insulin stimulation of glucose transport (the adipose tissue of hypertensive rats "doesn't notice" adrenalectomy). The data obtained may indicate changes in the properties of the adipocyte membranes of rats with chronic arterial hypertension and suggest the presence of an extensive alteration of the function of cell membranes in both types of hypertension.
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PMID:Glucose uptake and triglyceride synthesis in adipose tissue of spontaneously and renal hypertensive rats (alterations revealed by adrenalectomy). 57 Nov 14

In 500 obese patients (146 men, mean age 37 +/- 13 years, Broca index 147 +/- 24; 354 women, mean age 36 +/- 14 years, Broca index 151 +/- 28) cardiovascular risk factors (RF) were investigated. The most frequent RF was hypertension (71 per cent), followed by glucose intolerance (49 per cent), hypertriglyceridemia (31 per cent), hypercholesterolemia (22 per cent) and hyperuricemia (22 per cent). Only 12 per cent of the patients were without RF. These patients were younger and less obese than the patients with RF. The prevalence of RF increased with increasing age and overweight. Analysis revealed significant correlations between overweight and blood pressure, blood glucose, insulin and age. Significant correlations between age and hypertension, blood glucose cholesterol, triglycerides and overweight were detected. The correlation between overweight and the sum of all RF was higher (r = 0.35) than the one between age and the sum of all (r = 0.23). Obese patients had a high prevalence of RF. Increasing overweight and (to a lesser extent) age are both associated with increased prevalence of RF. On the basis of the prevalence of RF, patients with gross obesity (Broca index greater than around 150) were considered to be at a high risk in respect of coronary heart disease.
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PMID:Cardiovascular risk factors in gross obesity. 61 33


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