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

This study analyzed blood pressure in hemodialysis patients treated with epoetin beta in multicenter trials. Antihypertensive drugs were prescribed as usual. Placebo-controlled trials compared epoetin (100 to 150 U/kg; N = 151) with placebo (N = 78) for 82 days. Hemoglobin (108 +/- 18 versus 75 +/- 14 g/L) (mean +/- SD) and diastolic blood pressure (84 +/- 14 versus 78 +/- 15 mm Hg) were greater (P less than 0.05) after epoetin. Clinically important increases in blood pressure (increases in diastolic blood pressure greater than or equal to 10 mm Hg and/or drug therapy) were more frequent with epoetin (58 versus 37%; P = 0.005). A dose-response trial compared epoetin, 25 U/kg (N = 42), 100 U/kg (N = 40), and 200 U/kg (N = 39) for 138 days. Increases in hemoglobin were dose dependent, but clinically important increases in blood pressure were not. In analyses of all patients treated with epoetin (N = 272), no baseline or final level of hemoglobin, or rate of hemoglobin rise, was a threshold for a rise in blood pressure. Patients requiring antihypertensive drugs or having uncontrolled hypertension (diastolic blood pressure greater than 90 mm Hg) at baseline had decreases in blood pressure (P less than 0.05) with antihypertensive therapy. Thus, compared with placebo, 21% of patients had clinically important increases in blood pressure during amelioration of anemia. The baseline or final levels of hemoglobin, the extent or rate of hemoglobin rise, or uncontrolled hypertension or antihypertensive drug use at baseline were not confirmed as risks. Antihypertensive drug therapy was important for blood pressure control.
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PMID:Blood pressure in hemodialysis patients during amelioration of anemia with erythropoietin. 175 94

The measurement of small but abnormal amounts of albumin in urine is important in evaluating kidney disease in people with diabetes mellitus, hypertension, or possible adverse health effects from exposure to nephrotoxins. Routine laboratory methods for measuring albumin are not sensitive enough to measure the amounts that are significant in urine (less than 30 mg/L). In our laboratory we used three immunoassays for measuring urinary albumin: enzyme-linked immunosorbent assay (EIA), radioimmunoassay (RIA), and immunoturbidimetric assay (IT). We calculated the CVs of the three methods, investigated potential interfering substances at three times their normal concentrations, and stored urine under different conditions to find the best way to protect the sample until assay. The potential interferents we checked were transferrin, urea, beta 2-microglobulin, retinol-binding protein, creatinine, kappa and lambda light chains, IgG, hemoglobin, ketone, and glucose. The stability study involved two study temperatures (-20 and -70 degrees C) and four treatments (centrifuging or filtering, before or after storage). We found the following: the RIA had the lowest CV; the results from the interference study showed no interference from normal physiological concentrations of the substances investigated; storage at -70 degrees C regardless of the treatment should be adequate to prevent loss of albumin immunoreactivity.
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PMID:Considerations when measuring urinary albumin: precision, substances that may interfere, and conditions for sample storage. 176 88

Alacepril is a new angiotensin-converting enzyme (ACE) inhibitor that possesses sympatho-inhibitory action. We evaluated the effect of alacepril on blood pressure and progression of diabetic nephropathy in hypertensive type II diabetics in an open multicenter trial. Eighty-nine type II diabetics with mild hypertension were treated with 50 mg of alacepril daily and observed for 12 weeks. Blood pressure was reduced significantly at 4 weeks; this reduction continued throughout the study. Urinary excretion of albumin also was reduced significantly at 12 weeks. Glycosylated hemoglobin (HbA1c) and serum total cholesterol showed significant reduction with alacepril. We confirmed the beneficial effect of alacepril on blood pressure and diabetic nephropathy, and found that glucose and lipid metabolism improves in the diabetic state with this ACE inhibitor.
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PMID:Beneficial effect of alacepril, a new angiotensin-converting enzyme inhibitor on albuminuria and glycemic state: an open multicenter trial. Alacepril Study Group. 177 32

Twenty-three anemic children with end-stage renal failure (ESRD), aged 0.1-19.0 years (X +/- SD, 8.3 +/- 5.7 years), were treated with intravenous recombinant human erythropoietin (rHuEPO). Eleven were on conservative treatment and their estimated glomerular filtration rate (EGFR) was 11.8 +/- 3.8 ml/min/1.73 m2; 7 were on continuous ambulatory peritoneal dialysis (CAPD) and 5 on chronic hemodialysis. rHuEPO was given once a week in predialysis and CAPD children and thrice weekly in patients on hemodialysis. The initial dose of 50 U/kg/week was increased gradually up to a target hemoglobin of 10-12 g/dl. After 4.3 +/- 1.3 months of treatment, hemoglobin increased from 7.4 +/- 1.3 to 10.7 +/- 1.4 g/dl (p less than 0.001). An hemoglobin concentration of 11.4 +/- 0.9 g/dl was maintained with a rHuEPO dose of 289 +/- 86 U/kg/week. The response was similar in predialysis, CAPD, and hemodialysis children. No change in renal function was observed in predialysis children, EGFR being 11.8 +/- 3.8 and 10.8 +/- 1.7 ml/min/1.73 m2, before and after rHuEPO therapy. All children improved appetite, physical activity, and the sense of well-being. Four developed mild hypertension that was easily controlled with antihypertensive therapy. Heparin dose had to be increased during the hemodialysis sessions to avoid clotting of the filter. Serum calcium increased from 9.9 +/- 0.9 to 10.5 +/- 0.9 mg/dl (p less than 0.001). Serum aluminium levels also increased from 65 +/- 17 to 100 +/- 15 micrograms/l, p less than 0.01. A linear correlation (r = 0.58, p less than 0.01) between aluminium levels and rHuEPO dose was found.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Anemia of chronic renal failure: treatment with erythropoietin. 177 93

During 15 months all the patients with retinal or vitreous hemorrhages diagnosed in departments of ophthalmology or internal medicine in Bamako (Mali) were submitted to an aetiological assessment. Only patients with hemorrhages caused by a general aetiology were included in the study. 64 cases were selected according to these criteria. Hemoglobinopathies were involved in 14.1% of cases, high blood pressure in 31.8%, diabetes mellitus in 10.9% and miscellaneous causes in 15.6%. In 26.6% of cases an association between several of these aetiologies was observed. SC hemoglobin was the most frequent and the most serious. AS and AC traits were involved in 2 retinal hemorrhages' cases. AS and AC traits' responsibility in ocular hemorrhages associated with diabetes mellitus or high blood pressure was doubtful. A frequent association of sickle cell trait and high blood pressure was noticed. One case of Eales syndrome is reported during a diabetes mellitus-AS trait. All the patients were submitted to a treatment by pentoxifylline. Moreover 5 patients were treated by a laser coagulation and 2 patients by cryoapplication. The interest of the hemoglobin electrophoresis for the aetiologic assessment of retinal and vitreous hemorrhages is stressed.
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PMID:[Retino-vitreous hemorrhage in hemoglobinopathies]. 177 9

The present study was conducted in order to examine epidemiologic factors related to physical locomotion ability among the aged in an area with long life expectancy, a village in Okinawa Prefecture. Medical examinations and interviews were performed for 756 inhabitants aged 65 years and older, who were classified into 2 groups of physical locomotion ability, a high group and a low group. According to the results after multiple logistic regression analysis, the following factors showed positive relation to physical locomotion ability: age, working status, food intake frequencies (fish, eggs and green vegetables), skinfold thickness, grip strength and serum albumin. However, no statistical associations were observed between physical locomotion ability and other factors such as sex, smoking status, alcohol intake, hypertension, Quetelet's index, serum total cholesterol or and hemoglobin.
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PMID:[Epidemiologic study on factors related to physical locomotion ability among the aged]. 179 39

35 cases of pregnancy-induced-hypertension (PIH) and 125 controls taken on nonconsecutive days from 792 deliveries during the period June-August 1988 at the University Teaching Hospital, Lusaka, Zambia, were analyzed for mean arterial pressure (MAP), and contributing factors. Data were taken from delivery logs and patients' antenatal cards. The cases were women diagnosed with PIH or a history of seizures. Controls were the 5 preceding deliveries with adequate data. Results for MAP were presented as a matrix showing good outcome controls, poor outcome controls, and cases, by MAP at antenatal visits 1-4, with numbers of women in groupings by MAP ranges. There were more high MAP values for cases than for controls. Over 25% of both groups were women aged 17-19. 64.7% of cases were primigravida, compared to 43% of controls. Data on weight gain were not consistently available, but a higher proportion of cases gained 20 pounds than controls. Most women gained 0 or 1-10 pounds. 44% of cases and 41% of controls had hemoglobin 10 mg/dl. There were 4 positive VDRLs among 34 women tested. 4% of the control infants were stillborn; 7% died in hospital. Among the cases there were 1 fetal death, 2 stillborns, 4 hospital deaths, 20% pregnancy loss overall. Apgar scores were lower among cases, with 25% 4-6, compared to 3.3% of controls. These results did not indicate that MAP would be useful in comparison with blood pressure and other risk factors in monitoring pregnant women for PIH.
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PMID:Parameters of normotensive women and women with pregnancy induced hypertension (PIH) in Lusaka. 179 36

From January 1988 to September 1990 14 uremic patients in CAPD underwent EPO therapy in the Nephrology and Dialysis Unit of the "E. Agnelli" Hospital in Pinerolo. Intravenous routes were used in 5 patients and subcutaneous routes in the remaining 9 patients, with a unified dose of 4000 IU/three times a week. Both methods were equally efficacious in achieving the set target: partial correction of anemia together with an improvement in the patients' well-being. The most frequent side-effect was increased blood pressure, above all in those patients with pre-existing hypertension. Satisfactory control was achieved by adjusting anti-hypertensive therapy. Low EPO doses, administered via a subcutaneous route once and twice a week (mean dose: 61.6 +/- 35.8 IU/kg/week), allowed hemoglobin values to be maintained at previous levels. On these grounds the method could also be used for patients in hemodialysis.
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PMID:[Utilization of EPO in CAPD]. 181 35

Sixty four cases of retinal and vitreous hemorrhages are reported during a 15 months prospective study in Bamako. Main diseases associated with hemorrhages are high blood pressure (56% of cases), hemoglobinopathies (33%) and diabetes mellitus (23%). In 28% of cases several aetiologies are connected. SC hemoglobin is a frequent aetiology of vitreous hemorrhage (40%). Hemoglobin AS and AC, generally asymptomatic, are also liable to hemorrhages. Terson and Eales syndromes, Werlhof disease, hemophilia and AIDS are most uncommon. In 8% of cases there is not any aetiology.
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PMID:[General causes of retinal and vitreous hemorrhages in Mali]. 181 88

We analyzed the serum concentrations of lipids and lipoproteins and the prevalence of other risk factors in a case-control study of 304 consecutive Chinese patients with acute stroke (classified as cerebral infarction, lacunar infarction, or intracerebral hemorrhage) and 304 age- and sex-matched controls. For all strokes we identified the following risk factors: a history of ischemic heart disease, diabetes mellitus, or hypertension; the presence of atrial fibrillation or left ventricular hypertrophy; a glycosylated hemoglobin A1 concentration of greater than 9.1%; a fasting plasma glucose concentration 3 months after stroke of greater than 6.0 mmol/l; a serum triglyceride concentration 3 months after stroke of greater than 2.1 mmol/l; and a serum lipoprotein(a) concentration of greater than 29.2 mg/dl. We found the following protective factors: a serum high density lipoprotein-cholesterol concentration of greater than 1.59 mmol/l and a serum apolipoprotein A-I concentration of greater than or equal to 106 mg/dl. The patterns of risk factors differed among the three stroke subtypes. When significant risk factors were entered into a multiple logistic regression model, we found a history of hypertension, a high serum lipoprotein(a) concentration, and a low apolipoprotein A-I concentration to be independent risk factors for all strokes. The attributable risk for hypertension was estimated to be 24% in patients aged greater than or equal to 60 years. In this population, in which cerebrovascular diseases are the third commonest cause of mortality, identification of risk factors will allow further studies in risk factor modification for the prevention of stroke.
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PMID:Hypertension, lipoprotein(a), and apolipoprotein A-I as risk factors for stroke in the Chinese. 192 51


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