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)

Hypertension affects 58 million Americans. Dentists frequently encounter patients who are using one or more antihypertensive medications. This study evaluates the incidence of active duty soldiers dispensed antihypertensive medications at a large military installation. Lisinopril was the most frequently prescribed antihypertensive medication during a 2-month period in 1997 and was followed by hydrochlorothiazide, amlodipine, propranolol, felodipine, verapamil, atenolol, diltiazem, terazosin, clonidine, nifedipine, and metoprolol. These 12 drugs accounted for 93.46% of all antihypertensive medications dispensed. In this study, the percentage of active duty soldiers dispensed any antihypertensive medication was 1.51% (30 different medications were dispensed); 0.16% of all soldiers younger than age 30 and 1.25% of all soldiers older than age 30 were prescribed 1 of the 12 most commonly prescribed antihypertensive agents. Considering the same top-12 antihypertensive agents, the percentage of male soldiers younger than 30 who received a prescription was 0.24% and the percentage of male soldiers older than 30 who received a prescription was 4.3%. The percentage for males older than 40 receiving 1 of the 12 medications listed above was 12.05%. Similarly, the percentages for females were 0.27% for younger than 30, 1.87% for older than 30, and 3.51% for older than 40. Active duty males older than age 30 were more than twice as likely to be prescribed an antihypertensive agent than females in the same age group. Male active duty soldiers older than age 40 were more than 50 times more likely to be prescribed an antihypertensive agent than active duty males younger than 30.
Mil Med 1999 Oct
PMID:The incidence of active duty dental patients taking antihypertensive medications. 1054 31

In this study an all-male population of 256 U.S. Army basic trainees and 98 armor officer basic course students were surveyed concerning extent of use, knowledge of, and factors contributing to the use of smokeless tobacco (ST). The survey was administered at a dental clinic at Fort Knox, Kentucky. The data were analyzed using the SPSS computer software program. Results showed that more than 17% of this population were either occasional or regular users of ST. Nearly 24% had tried ST and more than 9% were former users. Exactly one-half had not tried ST. A typical user was white, had started ST use at age 14, had used it for 4 years, and was most likely to use snuff or dip. Higher educational level achieved was associated with increased likelihood of ST use. Nearly 22% of college graduates used ST, whereas only 15.3% of high school graduates or those with some college were users. Knowledge about the potential health effects of ST was generally high or moderately high, except for its ability to cause hypertension. This was true for both high school and college graduates, although college graduates were somewhat more informed. Few in this population had a personal attitude of approval toward ST use, and very few perceived that either their parents or their superiors in the military approved of ST use. Perceived attitude of approval was highest from friends and peers. The principle reasons for starting ST use were use by friends and curiosity about taste and effects. Influence from public figures, such as athletes, and from advertising was minimal. Enjoyment of flavor and taste was found to be the main reason for continued ST use. Health professionals were identified by the majority of respondents as the single most important information source on ST. Relatively few (27%), however, stated that their dentist or hygienist had ever discussed ST with them.
Mil Med 1996 Jan
PMID:Survey of smokeless tobacco use in basic trainees and armor basic course officers. 1108 50

Although medical survey studies often rely on self-reported symptoms to establish the presence or absence of clinical conditions in respondents, recent findings suggest that surveys that assess a broad range of symptoms may have limited sensitivity in detecting specific clinical conditions such as hypertension. The present study evaluated the accuracy of a blood pressure history survey mailed to 800 men and women who had received treatment at a military medical facility in the previous year. Compared with their medical records, patient reports of a previous diagnosis of hypertension exhibited an overall accuracy of 94.2%. This high level of overall accuracy was associated with equally high proportions of correct identifications of high blood pressure histories (sensitivity = 95.4%) and normal blood pressure histories (specificity = 92.4%). Our findings indicate that the Ohio Blood Pressure History Survey is a highly accurate measure of hypertension history among active and retired military personnel.
Mil Med 2001 Mar
PMID:Identifying hypertension using the Ohio Blood Pressure History Survey. 1126 26

The aim of this study was to determine the pattern of myocardial infarction (MI) incidence with regard to age, gender, infarction site, and the most important risk factors. All 3,454 patients hospitalized in coronary care units of Clinical Hospital Split between 1989 and 1997 were analyzed. In the 3-year period preceding the war, from 1989 to 1991, 1,024 patients were hospitalized because of MI. During the 3 years of full war activities, from 1992 to 1994, there were 1,257 patients (significantly more; p < 0.05). And in the 3-year period after the war, from 1995 to 1997, there were 1,173 patients. In the war period, there were 151 (12%) patients younger than 45 years of age (p < 0.05); of that number, 143 (95%) were men (significantly more than in the other two periods; p < 0.05) and 8 (5%) were women. In the period preceding the war, there were 66 (6.5%) patients younger than 45 years: 60 (91%) men and 6 (9%) women. In the period after the war, those numbers were 88 (7.5%), 81 (92%), and 7 (8%), respectively. The patients younger than 45 years (305) more often had MI of an inferior than an anterior site (49% vs. 28%; p < 0.001), whereas there was no difference in patients older than 45 years (36% vs. 37%; p > 0.05). The patients older than 45 years had significantly greater hospital mortality (21% vs. 4%; p < 0.001) and were more likely to have hypertension (51% vs. 15%; p < 0.001) as well as hypercholesterolemia (54% vs. 14%; p < 0.001). Smokers prevailed among those younger than 45 years (75% vs. 51%; p < 0.001). The number of hospitalized patients with MI was greatest during the war period. It included a significant increase in the incidence in men younger than 45 years (12% vs. 7%; p < 0.05), with smoking as the most important risk factor, especially for infarctions of inferior sites.
Mil Med 2001 May
PMID:Trends in myocardial infarction in Middle Dalmatia during the war in Croatia. 1137 Feb 6

To establish a practical weight management program for mariners in the Japan Maritime Self-Defense Force (JMSDF) Fleet Escort Force, the relationship between morbidity and body mass index (BMI) was studied. To estimate morbidity, 10 medical problems were used as indices (hyperlipidemia, hyperuricemia, diabetes mellitus, lung disease, heart disease, upper gastrointestinal tract disease, hypertension, renal disease, liver disease, and anemia). A curvilinear relationship was found between morbidity and BMI, in which a BMI of 17.5 was associated with the lowest morbidity. This curvilinear pattern was more complex than a curve reported previously for Japanese civilians. Using the present curve and aiming for a BMI of 17.5 will help in the design and implementation of a practical management program for health promotion in the JMSDF.
Mil Med 2001 Aug
PMID:Relationship between morbidity and body mass index of mariners in the Japan Maritime Self-Defense Force Fleet Escort Force. 1151 16

The Japan Maritime Self-Defense Force (JMSDF) requires all personnel assigned to Iwo Jima to undergo a preassignment medical examination. The efficacy and benefit of this mandatory examination has not been evaluated objectively in depth. Our purpose was to review the health status of JMSDF personnel assigned to Iwo Jima and to evaluate the correlation of the preassignment medical examination to their current health status for the study period. We divided the participants into two groups. Group Y was composed of JMSDF personnel receiving a preassignment medical examination, and group N was composed of those personnel who did not receive the examination. After the annual health examination, health status was evaluated using objective criteria. We found little statistically significant difference among group Y and group N participants. However, proportionally more patients currently receiving care for or diagnosed with hypertension, hyperuricemia, or severe obesity were identified as being members of group N than group Y. We have demonstrated that the preassignment medical examination may contribute to predicting the health status of potential Iwo Jima personnel and may contribute to controlling the cost of care associated with these specific diagnoses by limiting the assignment of at-risk personnel.
Mil Med 2001 Aug
PMID:Preassignment examination for personnel on Iwo Jima. 1151 25

The cost of treating hypertension represents a substantial percentage of total pharmacy expenditures at medical centers and by managed care organizations in the United States. The present study evaluated improvements in blood pressure control and cost savings achieved by switching 543 hypertensive patients from nifedipine gastrointestinal therapeutic system (GITS) to amlodipine and concurrently instituting an educational program directed at prescribers, nursing and pharmacy staff, and patients and family members. Before the switch, 543 patients were being treated with nifedipine GITS: 259 with 30 mg/d, 209 with 60 mg/d, and 75 with 90 mg/d. The total annual cost of primary antihypertensive therapy for this patient population was $184,698. All patients were switched from nifedipine GITS to 5 mg of amlodipine. The pharmacist saw patients at the time of the switch and at 2, 4, and 6 to 8 weeks after the change in antihypertensive therapy. Patients who did not achieve systolic blood pressure < or = 140 mm Hg or diastolic blood pressure < or = 90 mm Hg by 6 to 8 weeks after the switch were titrated to 10 mg/d amlodipine. After the conversion, 417 patients were receiving amlodipine 5 mg/d and 126 patients were ultimately titrated to 10 mg/d. Measurements made during the first 6 to 8 weeks of treatment indicated that amlodipine therapy significantly reduced blood pressure. Overall, amlodipine produced further mean reductions in blood pressure, from 140/82 to 130/76 mm Hg (p < 0.00005). The mean reduction from the time of the switch to 6 to 8 weeks was from 138/81 to 129/74 mm Hg for the patients who received 5 mg/d amlodipine (p < 0.00001) and from 147/85 to 133/79 mm Hg for the patients ultimately titrated to 10 mg/d amlodipine (p < 0.05). The total annual cost for primary antihypertensive therapy after the conversion was $136,854. We observed that conversion from nifedipine GITS to amlodipine enhanced blood pressure control and saved $47,844 in the annual cost of primary antihypertensive medication. For the 543 patients undergoing the switch, annual cost savings was $47,844. When the cost of additional antihypertensive agents discontinued after the switch to amlodipine was added to the analysis, the net annual cost savings increased to $49,578, a 27% reduction in yearly drug costs.
Mil Med 2001 Oct
PMID:Pharmacist-managed hypertension therapy conversion. 1160 36

This is a case report of a reservist who presented for a physical examination with hypertension. It was discovered that the reservist was unknowingly taking large doses of Ephedra sinica, or ma huang, a Chinese herbal supplement, for body-building. One of the ingredients in ma huang is ephedrine, an active alpha- and beta-adrenergic stimulant that produces increases in heart rate, blood pressure, and cardiac output. Ma huang has been reported to cause hypertension, hepatitis, nephrolithiasis, and sudden death in healthy, normotensive people. Ma huang will produce a positive urinary drug screen for stimulants and can be a drug of abuse. A recommendation is made to screen for dangerous supplement use before physical readiness training and to stop the supplement for 1 month before beginning any exercise program.
Mil Med 2002 Jun
PMID:A mysterious blood pressure increase in a drilling Naval reservist. 1209 92

Because current methods of tracking hypertension are time-consuming and expensive, the prevalence of hypertension in retired military populations is often unknown. Tracking military retiree hypertension is important because it can help to conserve scarce resources and save lives by preventing strokes and other diseases. Intended as a case study, an alternative method of tracking hypertension using pharmacy records and ambulatory data system records to confirm diagnosis of hypertension was used to determine the prevalence of hypertension in a retired military population (ages 40-85 years). The results indicated that matching pharmacy data with ICD9 401 diagnosis data and medical records is a more efficient method of tracking hypertension.
Mil Med 2003 May
PMID:A descriptive analysis of hypertension and affiliated therapies in a military retiree population (ages 40-85 years) at Camp Lejeune, North Carolina. 1277 83

The purpose of this study was to assess baseline physiological arousal in women veterans with posttraumatic stress disorder (PTSD) in a nonresearch setting. Heart rate, blood pressure, sublingual temperature, and weight were obtained from a retrospective chart review of the medical records of 92 women veterans with and without a diagnosis of PTSD who were seen in an outpatient Veterans Affairs medical center. Women veterans with PTSD had statistically significantly higher mean baseline heart rates compared with women veterans without PTSD. The two groups did not differ statistically in blood pressure measures, sublingual temperature, or body mass index. Based on our analyses, this difference is not likely to be an artifact of age, race, body mass index, smoking status, or medication. The mean resting heart rate of women with PTSD was 83.9 beats per minute; it was 77.5 beats per minute in those without PTSD. This elevation in heart rate among women veterans with PTSD suggests an increase in baseline physiological arousal compared with women veterans without PTSD. Faster resting heart rate has been shown to be associated with a higher risk of developing hypertension and a greater incidence of cardiovascular morbidity and mortality in non-PTSD samples. Further research is needed to determine the physiological effects of PTSD in women.
Mil Med 2004 Apr
PMID:Physiological arousal among women veterans with and without posttraumatic stress disorder. 1513 35


<< Previous 1 2 3 4 Next >>