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

The nutritional roles, requirements, and metabolism and the quantitative relationship between dietary intakes and health for a number of the minerals and trace elements have been more clearly defined in recent years, but there are still considerable deficiencies in our understanding of these issues, e.g., the significance of calcium in the etiology and treatment of osteoporosis and hypertension. Reliable information is now available on the content, and the principal factors affecting it, of most of the minerals and trace elements in human and cow's milks. However, for some of the trace elements, there is still a wide variation in reported values in the literature, which is due, at least in part, to analytical difficulties. The contribution of cow milk and milk products to the diet in Western countries is significant for sodium, potassium, chloride, calcium, phosphorus, zinc, and iodine. Iodine is the only trace element for which there has been any suggestion of excessive amounts in cow milk. However, there is evidence of a decline in milk iodine concentrations in the United States in recent years, although the situation in other countries less clear. Breast milk usually has adequate mineral and trace element contents for feeding full-term infants, with the exceptions of fluoride, for which supplementation of infants is recommended, and of selenium in some countries, such as Finland and New Zealand, where maternal intakes are low. However, breast milk selenium contents have increased in these countries in recent years due to increased maternal selenium intakes. The concentrations of minerals and trace elements in infant formulas for full-term infants are generally higher than in human milk, and all appear to be more than adequate, with the possible exception of selenium, which may need to be increased in some formulas. Considerable changes in the mineral and trace element contents of formulas have been instituted in recent years in the light of improved knowledge of infant requirements. While the chemical forms of the macrominerals and some of the trace elements (iron, zinc, copper, and manganese) in milks are fairly well defined, the forms of many of the trace elements are unknown. Sodium, potassium, chloride, and iodine are believed to be almost totally absorbed from milks and infant formulas.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Minerals and trace elements in milk. 149 49

It is not known whether recombinant human erythropoietin has a direct, clinically apparent pressor effect in hemodialysis patients or whether hypertension developing or aggravated in these patients merely reflects increased hematocrit. We compared blood pressure after three different methods of partial correction of anemia in hemodialysis patients with similar baseline hematocrits (erythropoietin n = 12, intravenous iron alone n = 10, androgens n = 9). Shortly after the start of treatment and with a minimally increased hematocrit, the need for antihypertensive medication increased in the erythropoietin group. No such pressor effect was observed with iron or androgens. These data suggest a direct hypertensive effect of erythropoietin in some patients on hemodialysis.
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PMID:Blood pressure after three different forms of correction of anemia in hemodialysis. 151 88

Eleven anemic children and adolescents with a median age of 14 years (range six months-20 years) on chronic hemodialysis were treated with recombinant human erythropoietin (rHuEPO) intravenously three times a week for an average of 9.2 months. After eight weeks of therapy, hematocrit rose from 20.3 +/- 1.4% to 31.7 +/- 0.7% (0.20 +/- 0.01 to 0.31 +/- 0.007, p less than 0.001, mean +/- SEM). After reaching the target hematocrit of 30% to 33% (0.30 to 0.33), doses were adjusted individually. Blood transfusions were eliminated in all but one patient. All patients experienced an increase in appetite and energy level. Serum ferritin concentrations decreased in all patients who reached target hematocrit and seven required iron supplementation. Hypertension worsened in two patients and developed in two others. One patient's vascular access clotted. Dialysis efficiency and heparin requirements during dialysis did not change significantly. We conclude that rHuEPO is safe, effective, and should be recommended as treatment for anemia in children and adolescents on hemodialysis, but close monitoring for the development of hypertension and/or iron deficiency is necessary.
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PMID:Therapy of renal anemia in children and adolescents with recombinant human erythropoietin (rHuEPO). 154 82

Chronic renal failure is almost invariably accompanied by symptomatic anemia. It has been demonstrated that the primary cause of this anemia is inadequate production of erythropoietin by the diseased kidneys. The isolation of erythropoietin, followed by the cloning and expression of the human erythropoietin gene, made possible clinical trials of rHuEPO in uremic patients. rHuEPO produced dramatic increases in the hematocrit in almost all patients treated and also ameliorated many symptoms, such as lethargy, dizziness, and poor appetite, that had long been attributed to the effect of uremic toxins. Adverse effects of treatment with rHuEPO noted in the early clinical trials included hypertension, seizures, arteriovenous fistula or shunt thrombosis, and hyperkalemia. Further study of rHuEPO has shown that many of these side effects may be no more frequent in patients receiving rHuEPO than in other uremic patients not receiving rHuEPO. Reduction of the rHuEPO dosage and subcutaneous administration produce less rapid increases in the hematocrit and may lessen the incidence and severity of these side effects. rHuEPO therapy places great demands on both the body's iron stores and the capacity to rapidly transfer iron from storage sites to the erythroid progenitor cells. Thus, almost all patients treated with rHuEPO become iron deficient and require oral or parenteral iron replacement. Response to rHuEPO in uremic patients is diminished if the anemia is complicated by iron deficiency, inflammatory disorders, aluminum overload, or deficiency of folate or vitamin B12. rHuEPO therapy is safe and effective in the treatment of the anemia of chronic renal failure. The use of rHuEPO leads to enhanced quality of life and eliminates the need for red cell transfusions. In addition to hemodialysis patients, predialysis patients and those on CAPD benefit from and are candidates for rHuEPO therapy.
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PMID:Anemia of renal failure. Use of erythropoietin. 157 66

Polycythemia vera (PV) is one of the myeloproliferative diseases, and, as such, is an example of clonal hematopoiesis. The progeny of a single, abnormal, hematopoietic stem cell gain a growth advantage over their normal counterparts resulting in overproduction of red cells generally accompanied by overproduction of granulocytes and platelets as well. There are a variety of nonspecific symptoms at onset related to the increased red cell mass and hematocrit accompanied by the more specific manifestations of pruritus, erythromelalgia, and hepatic, portal, and mesenteric vein thrombosis. Splenomegaly and hypertension are common. The laboratory hallmark is an increased red cell mass. There is also often an increase in white cell count, platelet count, and leukocyte alkaline phosphatase along with other findings reflecting the increased rate of turnover of hematopoietic cells. The bone marrow biopsy generally displays hypercellularity involving all three cell lines and absent iron stores. The diagnosis of PV depends on excluding spurious polycythemia in which there is a high hematocrit but a normal red cell mass and secondary polycythemia in which there is an increased red cell mass in response to tissue hypoxia or the inappropriate production of erythropoietin, generally by a tumor. In addition, one should try to establish the diagnosis in a positive fashion by a combination of studies of the blood and bone marrow. Phlebotomy and occasionally plateletpheresis should be used as acute therapy. Chronic therapy is guided by the knowledge that patients treated with phlebotomy alone have an increased rate of thrombotic complications particularly in older patients and those with previous thrombotic disease. Myelosuppressive therapy can reduce the incidence of these complications, but is commonly associated with an increased incidence of second malignancies, particularly acute leukemia. At present, hydroxyurea is the myelosuppressive agent of choice. Antiplatelet agents have a limited role except in the palliation of the syndrome of erythromelalgia. Median survival is approximately 10 years. As implied above, the causes of morbidity and mortality vary with the mode of chronic therapy which has been employed, leukemia being more common after myelosuppressive therapy and thrombotic complications being more common after therapy with phlebotomy alone. Ten percent to 50% of patients move into a spent phase followed by postpolycythemic myeloid metaplasia, irrespective of previous therapy employed. Eventually, the major problems may be cytopenias and massive splenomegaly.
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PMID:Polycythemia vera. 158 7

References to individual trace minerals in hypertensive rats have been made; however, data on multiple minerals in SHR hypertensive rats is lacking. The purpose of this study was to investigate five trace minerals in normotensive, chronic renal and SHR hypertensive rats. Blood samples were drawn to measure serum levels of Ca, Fe, K, Mg, and Na. Serum K values were elevated in the chronic renal hypertensive animals. Iron levels were decreased in both the renal and SHR hypertensive animals. No difference was observed in levels of Ca, Mg, and Na between normotensive and chronic renal or SHR hypertensive rats. Further study of multiple trace minerals in experimental hypertension is recorded in order to extend these deviations.
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PMID:Minerals in renal and SHR hypertensive rats. 169 11

To explore the role of systemic hematocrit in the vascular adaptations which characterize desoxycorticosterone-salt hypertension, studies were performed in three groups of rats with uninephrectomy, desoxycorticosterone administration, and 1% saline in the drinking water. One group received recombinant human erythropoietin to increase hematocrit, and another group was subjected to phlebotomy and fed a low-iron diet to induce anemia. Control rats exhibited systemic and glomerular capillary hypertension, proteinuria, and substantial glomerular sclerosis at 8 wk. Erythropoietin modestly increased hematocrit and blood pressure and substantially aggravated glomerular capillary pressure, proteinuria, and glomerular sclerosis. In contrast, reduction of hematocrit with a low-iron diet significantly attenuated systemic and glomerular hypertension, proteinuria, and sclerosis. It was concluded that the pace of progression of glomerular injury can be limited by chronic reduction in hematocrit, which effectively ameliorates both systemic and glomerular hypertension in this model of salt-sensitive hypertensive renal disease.
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PMID:Anemia ameliorates progressive renal injury in experimental DOCA-salt hypertension. 176 13

The study was conducted to provide reference values of anthropometry and dietary intakes of elderly Chinese aged greater than or equal to 70 years and to investigate differences between urban and rural groups. A total of 441 subjects comprising 260 urban elderly (126 men and 134 women) and 181 rural elderly (83 men and 98 women) participated in the anthropometric study. One hundred subjects (50 men and 50 women) from both urban and rural locations were selected randomly from the anthropometric cohort for dietary survey using the method of diet recall. For both men and women, the urban elderly had significantly higher intakes of protein, fat, calcium, iron, retinol, thiamin, riboflavin and nicotinic acid than did the rural elderly. Significant sexual differences were also observed: men had higher intakes of total energy and three macronutrients than women. Both regional and sexual differences in anthropometry (but not blood pressure) seemed to be consistent with the results of the dietary survey. Positive correlations were found between systolic blood pressure and the ratio waist:hip circumference for both men and women. As a marker of adipose tissue distribution, it seemed that this ratio was more predictive of high blood pressure than body-weight.
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PMID:Anthropometric and dietary survey of elderly Chinese. 177 65

The beneficial effects of combined estrogen-progestin-containing oral contraceptives (OCs) include prevention of pregnancy (less than 1 failure out of 100 regular users); the prevention of ectopic pregnancy; the reduction of preeclampsia (2.4 times lower risk compared with barrier methods); and reduction of pelvic inflammation to about one-half. The effects on menstruation include the reduction of sideropenic anemia (by lowering the incidence and duration of menstruation, OCs reduce the loss of iron to 50% or to as much as 33%); dysmenorrhea by 40% (symptoms receded in 90% of users); and premenstrual syndrome by 30%. OCs exert a favorable effect on menstrual epilepsy; reduce sports-related accidents in the premenstrual and menstrual periods; and reduce intermenstrual bleeding. The protection from cancer includes the lowering of endometrial cancer risk (every 2 years of use reduces the risk by 38%, 12 years of use by 70%, and the beneficial effects last 3-15 years); reduction of the risk of the ovarian cancer (already 3-6 months of use reduces the risk by 30%, and more than 5 years by 50% in women under 50 years of age with a longterm effect of 10 years or more, which drops sharply in women over 60 who are mostly at risk). Among other beneficial effects, they reduce benign mastopathy by 50-75%; reduce the risk of follicular ovarian cysts to 50% and the risk of corpus luteal ovarian cysts to 1/5; and they lessen bone loss which favorably affects osteoporosis. Low-dose OCs minimize the well-known risks of thrombotic and cerebrovascular accidents, myocardial infarction, hypertension, altered carbohydrate metabolism, gallbladder diseases, and liver cancer. A new OC with 30 mcg of ethinyl estradiol was tested with daily doses of 150 mcg of desogestrel. The high density lipoprotein (HDL) either increased or did not change with desogestrel: the HDL2 subfraction that protects from atherosclerosis did not change, and probably the HDL3 raised the HDL level.
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PMID:[Favorable effects of oral estrogen-progestin contraception]. 181 41

To reveal cardiovascular abnormalities, a screening was made in Tuva, which covered 1481 nomadic stock breeders, 1041 settled natives and 1081 migrants. The incidence of arterial hypertension (AH) was 33.5% among the nomadic stock breeders and 17.2% among the settled Tuva habitants and migrants. No impact of obesity and dyslipoproteinemia on the incidence of AH was found in the nomadic stock breeders. There was a direct correlation between the incidence of AH and alcoholization and an inverse correlation between its incidence and smoking in nomadic stock breeders aged 50-59 years. The hairs from the nomadic stock breeders exhibited elevated levels of aluminium, chromium, manganese, iron, and vanadium, which is not attributable to higher levels of these compounds in the meat of domestic animals.
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PMID:[Epidemiology of arterial hypertension and various characteristics of mineral metabolism among nomadic stock breeders in Tuva]. 181 43


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