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

The predictors of premature coronary atherosclerosis were examined in 203 patients (99 men aged less than or equal to 50 years, and 104 women aged less than or equal to 60 years) undergoing elective diagnostic coronary arteriography. Age, cigarette smoking, hypertension, obesity, diabetes, positive family history of premature coronary artery disease (CAD), and plasma levels of total cholesterol, triglyceride, lipoproteins (i.e., very low, intermediate-, low-, and high-density [HDL] lipoproteins and their subfractions [HDL2 and HDL3], and lipoprotein [a]) and apolipoproteins (apoA-1, apoA-2 and apoB, respectively) were examined using univariate analyses and multivariate logistic regression. In men, age (p less than 0.05), smoking (p less than 0.05), and plasma triglyceride (p less than 0.02) and apoA-1 (p less than 0.05) levels were independently associated with CAD. In women, smoking (p less than 0.001) and plasma apoB levels (p less than 0.04) were the strongest variables independently associated with CAD. It is concluded that the "nontraditional" risk factors (plasma apoA-1 and apoB levels) are better predictors of premature CAD than are plasma lipoproteins and that smoking is the strongest of the traditional nonlipid risk factors.
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PMID:Comparison of the plasma levels of apolipoproteins B and A-1, and other risk factors in men and women with premature coronary artery disease. 156 71

The relativity of the incidence rate of sudden death from coronary heart disease (CHD) among 2,990,816 people from 1985 to 1989 and the risk factor of cardiovascular disease was studied. The result showed that the crude incidence rate of sudden death from CHD was 12/100,000, standardized incidence rate 11.1/100,000 (according to the population in 1982), 9.5/100,000 (according to the population in 1964), was positive correlation with the mean level of blood pressure, prevalence rate of hypertension, total cholesterol in serum, Quetiele index of weight, rate of smoking, finding rate of abnormal ECG and prevalence rate of cardiovascular disease (r = 0.79-0.99, P less than 0.01); and was negative correlation with the level of HDL-TC (r = -0.81, P less than 0.01).
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PMID:[Study on relativity of sudden death from CHD to risk factor of cardiovascular disease]. 158 53

In this open study, 41 hypertensive patients with non-insulin dependent diabetes mellitus were treated with the combined alpha- and beta-adrenoceptor blocker amosulalol hydrochloride for 24 weeks, either alone or added to existing antihypertensive therapy. The effects on blood pressure, glucose and lipid metabolism were examined. Daily administration of 20 to 60 mg amosulalol caused a significant reduction in both systolic and diastolic blood pressure within 2 weeks. This effect was stable, lasting for the entire trial period. The mean systolic and diastolic blood pressure decreased from 174 +/- 13/92 +/- 9 mmHg at the beginning to 148 +/- 16/80 +/- 11 mmHg at the end of the trial. Heart rate was not affected. Plasma glucose and haemoglobin Alc levels showed a tendency to decrease without any statistical significance. Total and HDL-cholesterol and triglyceride levels also remained unchanged. Although 3 patients had complained of dizziness, all were easily manageable. The results indicate that amosulalol is effective in the treatment of hypertension in non-insulin dependent diabetics and does not affect glucose and lipid metabolism.
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PMID:Antihypertensive and metabolic effects of long-term treatment with amosulalol in non-insulin dependent diabetics. 158 38

Macroangiopathy of the lower extremities is one of the most frequent complications of diabetes and has a very adverse impact on the quality of life of the patients. It affects approximately as much as half the diabetics with the duration of the disease for more than 15 years. It is encountered in two forms. The first type of affection--obliterating atherosclerosis--reminds of affections of the arteries of the lower extremities in the non-diabetic population, although some differences in the site of affection, morphology of sclerotic changes as well as the spectrum of risk factors were found, when compared with obliterating atherosclerosis in non-diabetics. Risk factors of this form of macroangiopathy include cholesterol, triacylglycerols, reduced values of HDL-cholesterol, hypertension, fibrinogen, smoking and apparently also albuminuria. The second form of macroangiopathy--mediocalcinosis--is not associated with the mentioned risk factors of atherosclerosis but is probably the consequence of diabetic neuropathy. Contrary to atherosclerosis, it does not lead to the development of obliteration but has also an adverse effect on the function of blood vessels. Its incidence correlates with the duration and compensation of diabetes as well as deteriorated perception of vibrations. With regard to the high incidence of gangrenes requiring amputation, it seems rational to influence in diabetics all known risk factors of macroangiopathy although convincing results of long-term intervention studies are still lacking.
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PMID:[Characteristics of diabetic macroangiopathy of the lower extremities]. 159 8

The evidence is growing that not only total cholesterol, but also HDL cholesterol is an important predictor of coronary heart disease. In the Framingham Study, the total cholesterol/HDL cholesterol ratio gave the best prediction for the coronary heart disease risk. With data of the Netherlands Monitoring Risk Factor Project it was investigated to what extent persons with a high ratio (greater than or equal to 7) were identified when the criteria of the Netherlands Cholesterol Consensus were applied. Between 1987 and 1989 total and HDL cholesterol were determined in about 22,000 men and women aged 20-59. Twenty per cent of the men had hypercholesterolaemia (total cholesterol greater than or equal to 6.5 mmol/l). Of the hypercholesterolaemic men, 60 per cent did not have a high total/HDL cholesterol ratio. Eighteen per cent of the women were hypercholesterolaemic. Of all hypercholesterolaemic women, 80 per cent did not have a high total/HDL cholesterol ratio. Therefore, it is important that after a first screening on total cholesterol, HDL cholesterol is measured at the second cholesterol determination. Subsequently, a decision about treatment should be made, based on the total/HDL cholesterol ratio and the presence of other risk factors (hypertension, smoking, obesity, diabetes and a family history of cardiovascular disease.
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PMID:[The importance of HDL-cholesterol level determination in the classification of persons at increased risk of coronary heart disease]. 160 47

Diagnosis of hypertension is based on a classification of blood-pressure values, determined by multiple blood-pressure measurements over a period of several weeks or months. However, possibility of a so-called 'white coat effect' has to be considered, i.e. a marked increase of blood-pressure values in the presence of medical persons. Multiple control-measurements by the patient himself or an ambulatory day profile may clarify the situation in suspicious cases. In the case of pure 'white coat' hypertension, no further investigation is necessary, since cardiovascular complications only correlate with the 'usual' ambulatory blood pressure. Persons with borderline (141-159/91-94 mmHg and intermittently lower, according to the WHO) or established hypertension usually present with further cardiovascular risk factors, like lack of physical exercise, smoking, hypercholesterolemia (elevated total cholesterol/HDL-cholesterol), alone or accompanied by hypertriglyceridemia, disturbed tolerance of glucose or diabetes mellitus, or hypertrophy of the left ventricle. Therefore, in borderline as well as in established hypertension these additional risk factors have to be evaluated. Considering left ventricular hypertrophy electrocardiogram and chest X-ray are insensitive with regard to diagnosis and prognosis of this important and serious risk factor. Echocardiography that can meet both these criteria is for capacity reasons still limited to selected cases. In contrast to the investigation of the risk profile, only few patients will profit from an investigation of etiology of hypertension. It should be tailored to individual features and after thorough evaluation of all consequences, such as costs for the patient, chances for a positive result and possible therapeutical consequences. Usually, careful history taking, clinical investigation and routine laboratory provide an appropriate basis for further rational investigative procedures. Hypertension is a common and important risk factor. The challenge for the public health is great because prognosis can markedly be influenced by early diagnosis and therapy. Insufficient distinction between efficient diagnostic and therapeutical efforts and those that may be superfluous may not only influence psyche and somatic well-being of the patient but also socio-economic balance.
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PMID:[Rational assessment procedure in hypertension]. 160 89

The influence of obesity on the development of ischemic heart disease (IHD) was studied in 103 diabetic patients over 65 years of age. The patients were divided into three groups on the basis of their body mass index: lean, less than 20; normal, 20-25; obese, greater than 25. The incidence of IHD was significantly (p less than 0.01) higher in the obese group than in the other groups (43.2 vs. 18.8 and 16.3%). The age, sex distribution, duration and control of diabetes mellitus, methods of diabetic therapy, and prevalence of hypertension, hyperuricemia and smoking were not significantly different in the three groups. The level of serum triglyceride was higher and that of high-density lipoprotein cholesterol (HDL-C) was lower in the obese group than in the other groups, but the prevalence of IHD was significantly higher in the obese patients without hypertriglyceridemia and/or low HDL-C than in the normal group (p less than 0.05). These results suggest that obesity is a risk factor for development of IHD in elderly diabetic patients independently of other known risk factors.
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PMID:Role of obesity in development of ischemic heart disease in elderly diabetic patients. 162 45

The increase of urinary albumin excretion has a predictive value for cardiovascular disease in insulin-dependent and non insulin-dependent diabetics. To study the relationship between urinary albumin excretion and serum lipids, 380 non insulin-dependent diabetics, 40 to 75 yr old, with urinary albumin excretion from 0 to 200 mg/l, and normal serum creatinine (less than 150 mumol/l), were surveyed. Urinary albumin excretion, was related positively to age (r2 = 0.014; p = 0.02), to systolic blood pressure (r2 = 0.073, p = 0.0001) and diastolic blood pressure (r2 = 0.052, p = 0.0001); a negative correlation existed with HDL-cholesterol (r2 = 0.043, p = 0.0001) and Apoprotein A1 (r2 = 0.044, p = 0.0001). A stepwise regression analysis was performed and resulted in three independently contributing variables related to urinary albumin excretion: First systolic blood pressure (F = 36), second Apoprotein A1 (F 24), third hemoglobin A1C (F = 6). The presence of hypertension or insulin therapy did not modify these findings. In conclusion, serum lipid seems an important determinant of urinary albumin excretion in non insulin-dependent diabetics.
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PMID:Serum lipids and urinary albumin excretion in non insulin-dependent diabetics. 162 84

The aim of the study was to evaluate the direct influence of lipid parameters (total and HDL-cholesterol, triglycerides and total lipids) on the rheologic-coagulative pattern. We studied blood rheological properties--blood (BV), plasmatic (PV), and seric (SV) viscosity, whole blood (WBF) and red cell (RCF) filterability--and some coagulative factors--fibrinogen (Fib), levels of clotting factor VII (fVIIc) and VIII (fVIIIc) activity--in 156 men aged 40-54 years; 87 patients had type II hyperlipoproteinemia (46 type IIa and 41 type IIb) and 69 were normolipemic controls. Smokers, patients with arterial hypertension, diabetes mellitus or cardiovascular clinical manifestations were excluded. Type IIb hyperlipoproteinemic patients had increased blood viscosity (shear rate 225 sec-1, p. less than 0.01), which was positively correlated with triglycerides and fibrinogen concentration. Levels of fibrinogen, fVIIc and fVIIIc activity did not differ significantly in hyperlipemic patients and controls, although fVIIc activity and fibrinogen were both positively related with lipid parameters. These data suggest that, in absence of other major risk factors, the alterations of the rheologic-coagulative pattern are mainly dependent on the severity of the lipid disorder.
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PMID:[The relationships between the lipoprotein profile and rheological-coagulation parameters in patients with hyperlipoproteinemia type II]. 162 10

Plasma glucose and insulin responses to an oral glucose challenge and fasting plasma lipid and lipoprotein concentration were compared in 25 normal individuals and 53 patients with high blood pressure. Patients with hypertension were further subdivided into two groups--normal electrocardiogram (EKG) (n = 24) or abnormal EKG (n = 29)--using the Minnesota code criteria. Patients with hypertension and an abnormal EKG had significantly higher plasma glucose and insulin concentrations following oral glucose than did the control population. Furthermore, plasma triglyceride (TG) concentration was higher and high density lipoprotein cholesterol concentration lower then normal in hypertensive patients with an abnormal EKG, and the ratio of total to HDL cholesterol was higher in this subgroup. Values for patients with high blood pressure and a normal EKG were intermediate. Insulin-mediated glucose uptake was also measured in a subset of patients with hypertension and either a normal (n = 18) or abnormal (n = 17) EKG. When these two subgroups were compared, those with high blood pressure and an abnormal EKG were significantly more insulin resistant than patients with hypertension and a normal EKG. In addition, they also had higher plasma glucose and insulin responses to oral glucose, higher fasting plasma triglyceride and cholesterol concentrations, and an increase in the ratio of total to HDL cholesterol. Thus, patients with high blood pressure have abnormalities of glucose, insulin, and lipid metabolism when compared to a nonhypertensive control group, and the magnitude of these metabolic defects is significantly greater in patients with high blood pressure who have EKG evidence of coronary heart disease.
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PMID:Insulin resistance and abnormal electrocardiograms in patients with high blood pressure. 163 16


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