Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

By cholesterol feeding, atherogenic VLDL, beta-VLDL (IDL) and LDL increased more remarkably in SHRSP than in normotensive WKY, suggesting that hypertension may promote the productions of atherogenic lipoproteins. On the other hand, HDL significantly decreased in SHRSP, which was associated with the decrease in apoA-I and E in the HDL fraction. This indicates the decreases of two HDL subfractions, apoE HDL and apoA-I HDL, in SHRSP. These decreases of HDL subfractions in SHRSP may be closely related to the higher h-TGL activity in SHRSP than in WKY, and could be a trigger of the excess production of atherogenic lipoproteins.
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PMID:Effect of cholesterol feeding on the compositions of plasma lipoproteins and plasma lipolytic activities in SHRSP. 177 30

The UK Prospective Diabetes Study (UKPDS) is a multi-centre, prospective, randomised, intervention trial of 5100 newly-diagnosed patients with Type 2 (non-insulin-dependent) diabetes mellitus which aims to determine whether improved blood glucose control will prevent complications and reduce the associated morbidity and mortality. Newly presenting Type 2 diabetic patients aged 25-65 years inclusive, median age 53 years, median body mass index 28 kg/m2 and median fasting plasma glucose 11.3 mmol/l, were recruited and treated initially by diet. Ninety five percent remained hyperglycaemic (fasting plasma glucose greater than 6 mmol/l) and were randomly allocated to different therapies. In the main randomisation, those who were asymptomatic and had fasting plasma glucose under 15 mmol/l were allocated either to diet policy, or to active policy with either insulin or sulphonylurea aiming to reduce the fasting plasma glucose to under 6 mmol/l. Over 3 years, the median fasting plasma glucose in those allocated to diet policy was 8.9 mmol/l compared with 7.0 mmol/l in those allocated to active policy. The Hypertension in Diabetes Study has been included in a factorial design to assess whether improved blood pressure control will be advantageous. Patients with blood pressure greater than or equal to 160/90 mm Hg were randomly allocated to tight control aiming for less than 150/85 mm Hg with either an angiotensin-converting enzyme inhibitor or a Beta-blocker or to less tight control aiming for less than 200/105 mm Hg. The endpoints of the studies are major clinical events which affect the life and well-being of patients, such as heart attacks, angina, strokes, amputations, blindness and renal failure. To date, 728 patients have had at least one clinical endpoint. Surrogate endpoints include indices of macrovascular and microvascular disease detected by ECG with Minnesota Coding, retinal colour photography and microalbuminuria. The studies also aim to evaluate potential risk factors for the development of diabetic complications such as smoking, obesity, central adiposity, plasma LDL- and HDL-cholesterol, triglyceride, insulin, urate and other biochemical variables. The studies are planned to terminate in 1994, with a median follow-up of 9 years (range 3-16 years) for the glucose study and 5 years (range 2-6 years) for the hypertension study.
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PMID:UK Prospective Diabetes Study (UKPDS). VIII. Study design, progress and performance. 177 53

The results of treadmill exercise stress test (TMX) for ischaemia is based on ST-segment depression. Patients with positive test may or may not be symptomatic. This study examines if there are any differences between these two groups of patients. A total of thirty-nine patients with coronary artery disease and positive TMX results in 1988 was studied. There were 16 patients with chest pain and 23 without. They were followed-up for a mean period of 16.9 and 15.2 months respectively. The following factors were found not to be statistically significant between these two groups of patients: age, sex, race, height, weight, history of hypertension, diabetes mellitus or smoking, indication for the test, use of drugs, total and HDL-cholesterol, exercise duration and the initial double product. The difference between the maximal double product of the two groups was statistically significant (p = 0.004). In the follow-up period, in the group of patients with silent myocardial ischaemia, one had a cardiac event and one underwent revascularisation. While in the symptomatic group, two had cardiac events and seven underwent revascularisation. There were no deaths in either group. The difference in overall outcome was significant statistically (p = 0.002). Therefore, patients with silent myocardial ischaemia have a higher maximal double product in TMX; hence a higher maximal workload and a less adverse outcome compared to symptomatic patients.
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PMID:Silent myocardial ischaemia: the Tan Tock Seng experience. 178 83

A survey was carried out on 59 males and 146 females aged 60 years and above from a special clinic for the elderly in Bangkok. All of these subjects had no major complaints of ill health and, judging by their appearance, they seemed to be apparently healthy. 6.8% of the males and 11% of the females were found to be over-nourished. Less than 15% of all the individuals under investigation were suffering from hypertension, hyperglycaemia and hyperuricaemia. 35% of the males but only 13% of the females were anemic. The lipid status of the females was generally worse with statistically higher median values for total cholesterol, LDL-cholesterol and triglycerides than the males. There was no significant difference in the variation of HDL-cholesterol between the sexes. High vitamin C, B2 and B6 deficiency rates were observed in both the males and the females.
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PMID:Anthropometry, lipid- and vitamin status of 215 health-conscious Thai elderly. 179 50

We studied 344 children (174 girls and 170 boys) between the ages of 6 and 15 years (average age 11 years 9 months) chosen on the basis of a positive family anamnesis for dismetabolic and/or precocious cardiovascular pathologies, and also on the basis of objective data obtained at medical examinations, such as obesity and hypertension. These subjects underwent blood tests for glycaemia, total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Children with total cholesterol levels above 170 mg/dl were considered to be hypercholesterolemic. 127 young people (65 girls and 62 boys) turned out to have excessively high cholesterol levels with an average level of 195.71 +/- 23.11 mg/dl and average LDL level of 127.05 +/- 25.08 mg/dl. 217 subjects (109 girls and 108 boys) turned out to be within the norm with total cholesterol level of 137.76 +/- 23.04 mg/dl and LDL cholesterol 75.59 +/- 22.89 mg/dl. We found a greater difference between the average values of LDL cholesterol and those of total cholesterol (40.5% compared to 29.61%), which shows that even at pediatric ages the LDL cholesterol concentration is the factor which best indicates the risk level for atherosclerotic development.
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PMID:[Cholesterol screening in a pediatric population at atherosclerotic risk]. 180 15

3 about-to-be marketed progestogens (desogestrel, gestodene, and norgestimate) are discussed in terms of their structural characteristics and metabolism, biological activity, effects on carbohydrate and lipid metabolism, and effects on coagulation. There appears to be little difference in clinical efficacy between the new progestogens and those currently available in the US. What difference, there is to be that the androgenic metabolic effects are minimized with the new progestogens. It is though that a comparison of the clinical benefits of these agents would be difficult. Synthetic progestogens are used in oral contraceptives (OC) in order to inhibit ovulation. In combination with estrogen, they can have antiestrogenic properties. Steroid dose and potency in OCs is noted as an important consideration in comparing progestogens. The new progestogens, like the US-marketed DL-norgestrel and levonorgestrel, are gonanes, which like estranes are structured with the absence of a methyl group between rings A and B and the presence of an ethinyl group in position 17 alpha. Each is different metabolically. Studies of the biological activity of these new progestogens are difficult to compare because of labeling, dose, experimental methods, measurement errors, and the inclusion of the estrogen component, which is known to be contributory to the side effects. Only potency can be compared and gestodene has the strongest effect on inhibiting ovulation an transforming the endometrium into secretory endometrium. All have little estrogenic effects an are weak antiestrogens, with little androgenic activity as measured by the increase in seminal vesicle or prostatic weight of laboratory animals. Circulatory bonding is found in various forms. Although not clinically demonstrated, it is possible that gestodene, which is a competitive inhibitor to aldosterone, may be useful to those with hypertension. Because of the marked increase in circulating concentrations of SHBG of gestodene and desogestrel, it may be useful to those with hirsutism upon additional clinical testing. The selected review of studies on the effects of the new progestogens on carbohydrate and lipid metabolism, including the HDL and LDL cholesterol levels, suggests small effects of questionable clinical significance. Based on clinical trials of gestodene in Europe, there appears to be no greater incidence of thromboembolic activity or effects on coagulation an fibrinolysis than previously reported.
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PMID:Characteristics of the new progestogens in combination oral contraceptives. 183 25

Atherosclerosis is the main cause of mortality in diabetic patients, and the incidence of coronary heart disease is increased in the presence of microalbuminuria. The mechanisms of this association are not known and could involve genetic factors (predisposition to hypertension), renal disease and dyslipidemia. An increase in plasma triglyceride and apoprotein B levels, a decrease in plasma HDL cholesterol, qualitative abnormalities of VLDL and HDL are related to cardiovascular risk in diabetic patients. All these factors are worsened by nephropathy. Lipoproteins abnormalities could be involved in the progression of renal injury. In microalbuminuric patients, it seems important to reduce glomerular hyperfiltration and to normalize glycemia and blood pressure in order to prevent impairment of renal injury and dyslipidemia induced by nephropathy. Early treatment of lipoprotein abnormalities could decrease the incidence of cardiovascular complications.
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PMID:[Association of atherosclerosis and nephropathy in diabetes mellitus. Role of lipid anomalies]. 183 72

Isolated vascular risk factors (e.g. hypercholesterolemia, hypertension, etc) are not commonly found in high risk patients. In fact, more often, constellations of risk factors are detected, giving rise to a so-called polymetabolic syndrome. Among the associated factors, insulin-resistance with altered carbohydrate tolerance, hypertriglyceridemia, hypertension and reduced HDL-cholesterol levels are most often described. Recent epidemiological studies underline the possible genetic basis of this syndrome, as shown in the highly consanguineous Utah population. The major determinant of the syndrome seems to be insulin-resistance. Development of hypertension within this syndrome may be linked to hyperinsulinemia, with increased intracellular Ca++ and/or obesity. The reduction of HDL-cholesterol may be secondary to the hypertriglyceridemia, again secondary to hyperstimulation, most likely from hyperinsulinemia. In the polymetabolic syndrome frequent alterations in the hemocoagulative system, mainly hyperfibrinogenemia/reduction of fibrinolysis, are recognized. Recently a circulating antagonist of fibrinolysis, PAI-1 has been described: PAI-1 levels are significantly correlated to those of plasma triglycerides. Regulation of fibrinogenemia is, instead, more complex and may only be partly linked to an increase of circulating lipids/lipoproteins. Development and stabilization of the syndrome, with the consequent vascular alterations, may be effectively prevented or treated by diet, and also by specific drugs. The choice is addressed to drugs reducing insulin-resistance and/or plasma triglycerides, possibly also raising HDL-cholesterol and reducing fibrinogen; among the possible options, bezafibrate seems to exert the largest number of effects.
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PMID:[The physiopathology and pharmacological approach to multiple metabolic and blood coagulation syndromes, the characteristics of atherogenesis]. 184 8

We have designed a preventive medical examination program for workers of an electric company in Santiago, Chile. The first stage, directed mainly to identification of cardiovascular risk factors was completed in 1987. 1006 males and 163 females with mean age 45 +/- 9.4 years (range 22-65) were screened. High blood pressure mainly of mild degree was detected in 17.6% of subjects (57% of them were new cases). Total cholesterol above 220 mg/dl and HDL cholesterol below 40 mg/dl were present in 33% and 22%, respectively. Obesity (body weight > 120% of ideal weight for height) was present in 19%, and body mass index was above 27 in 25% of subjects. 23% of males and 31% of females smoked 1 or more cigarettes a day and 2% had an abnormal non-fasting glucose level. A total of 750 workers have at least 1 risk factor that should be corrected. No cases of cancer were detected by Papanicolaou and mammography. A positive correlation was found among LDL cholesterol, age and triglyceride levels and HDL was negatively correlated to triglycerides, blood glucose and obesity. A multivariate analysis of these factors revealed that only age was related to LDL levels and triglycerides to HDL levels. This health prevention program may help a significant number of asymptomatic workers by detecting risk factors that need correction in order to decrease mortality and morbidity in this population.
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PMID:[Preventive medical examination in asymptomatic workers: design and initial outcome of an institutional program]. 184 64

Increased cholesterol levels above 200 mg/dl, LDL levels above 130 mg/dl and total cholesterol/HDL ratio above 4.5 in males and above 5.0 in females are recognized as indicators of increased risk of atherosclerosis. Risk associated to increased triglyceride levels (above 200 mg/dl) must be judged in relation to associated factors such as family history of coronary heart disease, presence of remnants (type III hyperlipidemia), presence of Lp(a), increased levels of Apo B, reduced levels of HDL2 or Apo A1. VLDL and chylomicron remnants and Lp(a) have an atherogenic power in vitro 2 to 4 times that of LDL. There is a correlation between hypertriglyceridemia and reduced HDL2 and Apo A1 levels. Hypertriglyceridemia is frequently associated to other risk factors like diabetes, obesity, hyperinsulinism, and high blood pressure. Finally, VLDL may elevate levels of plasma plasminogen inhibitor. Thus, hypertriglyceridemia should be investigated when, evaluating risk of atherosclerosis.
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PMID:[Cholesterol and triglycerides in atherosclerosis: epidemiologic and physiopathologic considerations]. 184


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