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)

In order to investigate the health and care of the urban elderly, self-administered anonymous questionnaires were sent to a sample randomly selected from the elderly 70 to 89 years of age, in 3 different areas (central, residential and suburban) in Wakabayashi-Ward in Sendai. Responses from 1,248 were returned by mail (response rate = 76.4%) and results were compared to the expected values estimated from the results of investigations conducted by the Ministry of Health and Welfare. 1) As for present addresses of the elderly, 94.2% were at home, 3.8% in hospitals, 0.7% in nursing homes, and 1.3% in other facilities. 2) Responses showed that 28.4% were suffering from hypertension, 5.6% from diabetes mellitus, 2.2% from strokes and liver diseases, with all of these percentages similar to the respective expected values. However, 12.7% were suffering from heart disease which was over twice the expected value. 3) Analysis of health habits showed that the percentages of the elderly who had "good sleep and rest", "nutritious meal", and "moderate exercise" were higher than expected. Only 2.3% did not practice good health habits, which was one sixth of the expected value. 4) As for meal habits of the elderly, 88.3% had three meals a day, and 33.7% made efforts to take less salty foods. 5) Dietary habits of the elderly indicated that 83.8% were frequent consumers of meat, fish and soybeans products, 62.3% vegetables, 51.0% sweet confectionery (significantly higher), 49.2% milk (significantly higher), 22.3% fried foods like tempura (significantly higher), and 22.3% salty vegetables (significantly lower).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Health status and care of the urban elderly]. 129 37

The relationship between placental and peripheral concentrations of pregnancy-associated plasma protein A (PAPP-A) was investigated, using specific radioimmunoassay techniques. At term, placental concentrations of PAPP-A were significantly lower in diabetic pregnancies; 1.9 +/- 0.2 micrograms/mg (mean +/- SE) placental protein as compared with controls (3.2 +/- 0.3). Similar findings were noted when results were analyzed per total placental weight. Patients with classes C-R (1.2 +/- 0.3) had significantly lower PAPP-A levels than in classes A, B (2.4 +/- 0.3 micrograms/mg protein, P = .02). Peripheral PAPP-A levels were measured in patients with chronic hypertension, toxemia, diabetes mellitus, and healthy controls. Overall, the distribution of PAPP-A values in patients with diabetes mellitus were different from controls. In addition, concentrations of PAPP-A in patients with classes B-D were significantly lower than in class A (P less than .001). In patients with chronic hypertension, some values of PAPP-A were lower than the tenth percentile, while patients with toxemia had a distribution which was similar to that of controls.
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PMID:Placental and circulating pregnancy-associated plasma protein A concentrates in normal and pathological term pregnancies. 242 40

No standard outcome measures exist to evaluate the effect of interventions intended to improve the quality of anesthesia care. The authors established a clinically practical definition of outcome, and used it to assess the effect of feedback of information about complications and the effect of pulse oximetry on the rate and severity of important anesthesia-related problems encountered in the operating room (OR) and recovery room (RR). On admission to the RR, the patient's anesthetist documented Recovery-Room-Impact Events (RRIE), defined as an "unanticipated, undesirable, possibly anesthesia-related effect that required intervention, was pertinent to recovery-room care, and did or could cause at least moderate morbidity." Following a control period with no feedback of data, intense feedback of grouped (anonymous) RRIE rates was provided. Later, pulse oximeters were introduced to all anesthetizing locations. Among 12,088 patients (71% of all RR admissions), 18% had at least one RRIE in the OR or RR. The most common RRIEs were hypotension (4.4%), arrhythmia (3.9%), hypertension (1.5%), intubation difficulties (0.8%), hypoventilation (0.8%), and hypovolemia (0.6%). Feedback of information produced no demonstrable change in the rate of RRIEs. Although significantly fewer patients experienced RRIEs (15.6% vs. 12.4%, P less than 0.0001), hypotensive RRIEs (5.2% vs. 3.8%, P = 0.0003), and hypovolemic RRIEs (0.88% vs. 0.42%, P = 0.0017) following the introduction of pulse oximetry in the OR, confounding factors prevent establishment of a cause-and-effect relationship. Quality assurance may require more direct intervention and individual feedback to be effective. Still, the RRIE measure requires minimal effort at low cost and encourages improved transmission of information at the time of admission to recovery-room care.
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PMID:Effects of information feedback and pulse oximetry on the incidence of anesthesia complications. 367 68

The serum concentration of placental protein 14 (PP14) was measured by radioimmunoassay in 129 apparently healthy pregnant women at 33-40 weeks, and the results were compared with those of 40 women with gestational hypertension either with or without proteinuria at similar weeks. In normal pregnancy, maternal serum PP14 levels decreased towards term. Therefore, the results were expressed as multiples of the normal median for each week. In gestational hypertension, the values were higher than normal (p less than 0.001): they were above the normal median in 32 (80%) cases (p less than 0.005), and above the normal 90th percentile in 15 (38%) cases (p less than 0.001). The presence or absence of proteinuria did not affect the result. Since recent findings suggest that PP14 is synthesized by late pregnancy decidua and not by the placenta, our results suggest that decidua may be affected in gestational hypertension.
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PMID:Is decidua affected in gestational hypertension? Indication by elevated PP14 levels. 373 49

A descriptive cross-sectional epidemiological survey of primary open-angle glaucoma (POAG) was carried out in the department of Marne, France, between October 1990 and May 1991. The aim of the study was to obtain socio-medico-demographic data on glaucoma patients who were treated for a period of one year or more. Fifty per cent of the ophthalmologists in the department of Marne participated in the study by having their patients complete an anonymous questionnaire at home. Eighty-five per cent of the 407 patients replied. This response rate to the investigation did not vary significantly (p > 0.90) with respect to the ophthalmologist. However, forgetting to distribute the questionnaires to the patients was variable from one physician to the other. The prevalence of POAG cases undergoing treatment was between 0.15 and 0.36% for the whole population; between 0.37 and 0.89% for patients over the age of 40 years; 0.67 and 1.67% after the age of 60. The same number of women and men are affected, but the risk is 1.33 times greater for men after the age of 60. The geographical distribution of the patients is identical to that of the general population. Sixty-two per cent of the patients take other drugs as well and this proportion increases with age (p < 0.0001); 24% of the subjects have hypertension and 10.6% are diabetic. Half of the patients have received anti-glaucoma therapy for 6 years or less; 94% take beta-blockers, 18% take miotics and 12% use adrenergic drugs. More women instil their eyedrops on their own (79% vs 57%; p < 0.0001). Ten per cent of patients have had glaucoma operations and this proportion increases with age (p < 0.03). The frequency of laser treatment is 20%. Glaucoma patients seem to be faithful to their ophthalmologist as 65% of them go to the same one for follow-up. Our study shows that this type of investigation is well received by the patients.
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PMID:[Epidemiological data on primary open-angle glaucoma and treatment in the department of Marne]. 836 Apr 20

Preeclampsia is characterized by maternal hypercoagulable state and intravascular coagulation, microthromboses in several organs, and impairment of uteroplacental circulation. Excessive fibrin deposition occurs in the placenta, suggesting that disorders of placental coagulation and fibrinolysis physiologic systems may have a role in hemostasis activation. Term placentas were collected from 17 hypertensive/preeclamptic women and from 17 healthy pregnant women, and processed for both histologic and hemostasis studies. Placental fibrinoid deposition was visualized by cresyl-violet staining and quantified by histomorphometric analysis. The content in hemostasis factors was measured on extracts from homogenized placentas treated by a nonionic detergent. The percentage of villi with fibrinoid deposits was higher in the diseased placentas than in controls: 13.2 +/- 11.2 versus 6.75 +/- 2.7% (p < 0.001) for the total amount of deposits; 4.8 +/- 6.7 versus 1.5 +/- 1.0% (p = 0.04) for perivillous fibrinoid deposits, which are considered as histologic markers of intraplacental fibrin. The content in type 2 plasminogen activator inhibitor (PAI-2) antigen was higher in the diseased placentas than in controls: 124 +/- 8 versus 104 +/- 6 ng/mg placental protein (p = 0.046); there was a negative correlation between PAI-2 antigen and thrombomodulin activity (r = -0.57, p = 0.02) in the diseased placentas. No significant differences were found between the two groups for placental procoagulant tissue factor and anticoagulant thrombomodulin activities, and for the content in plasminogen activators and PAI-1 antigens. Placental antifibrinolytic potential is increased in pregnancy-induced hypertension and preeclampsia. This change, and the association of the highest PAI-2 placental concentrations with the lowest concentrations of thrombomodulin, may contribute to the prethrombotic state and to the excessive placental perivillous fibrin deposition observed in these situations.
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PMID:Increased placental antifibrinolytic potential and fibrin deposits in pregnancy-induced hypertension and preeclampsia. 856 89

Previous studies have suggested the presence of quantitative trait loci (QTLs) influencing blood pressure on rat chromosomes 2 and 13. In this study, we mapped the QTLs in F2 rats derived from a cross of the spontaneously hypertensive rat and the Wistar-Kyoto rat and analyzed the effect of the QTLs on blood pressures measured longitudinally between 12 and 25 weeks of age. We analyzed 16 polymorphic markers spanning 147.3 cM on chromosome 2 and 13 markers spanning 91.6 cM on chromosome 13. Both chromosomes contained QTLs with highly significant effects on blood pressure (peak logarithm of the odds [LOD] scores, 5.64 and 5.75, respectively). On chromosome 2, the peak was localized to a position at anonymous marker D2Wox7, 2.9 cM away from the gene for the sodium-potassium ATPase alpha 1-subunit. On chromosome 13, the major peak coincided with the marker D13Mit2, 21.7 cM away from the renin gene, but there was a suggestion of multiple peaks. The effect of the QTL on chromosome 2 was seen throughout from 12 to 25 weeks of age, whereas interestingly, the effect for the QTL on chromosome 13 was maximal at 20 weeks of age but disappeared at 25 weeks of age, presumably because of the effect of either epistatic factors or environmental influences. The findings provide important information on QTLs influencing blood pressure on rat chromosomes 2 and 13 that will be useful in localizing and identifying the causative genes and emphasize the importance of age being taken into account when the effects of individual QTLs on a trait that shows significant age-related changes are being analyzed.
Hypertension 1996 Dec
PMID:Analysis of quantitative trait loci for blood pressure on rat chromosomes 2 and 13. Age-related differences in effect. 895 8

To elucidate if genetic variants in the bradykinin B2 receptor (B2) gene occur that could affect receptor expression and function, we screened for mutations in the promoter and in the coding region of the human B2 gene. In our initial study we analyzed 92 consecutive, unrelated subjects (including 25 patients with hypertrophic cardiomyopathy, 18 patients with dilated cardiomyopathy (DCM), 25 patients with hypertension, 18 patients with coronary heart disease, and 6 patients with valvular heart disease) using nonradioactive polymerase chain reaction-single-strand conformation polymorphism analysis as mutation screening method. We detected eight as yet unknown polymorphic sites in the promoter region of the B2 gene (-845 C/T, -704 C/T, -649 insG, -640 T/C, -536 C/T, -412 C/G, -143 C/T and -78 C/T) with allele frequencies between 0.5 and 13%. One of them (-412 C/G) destroys a Sp1 binding site and abolishes protein binding to this Sp1 site in human umbilical vein endothelial cells and human vascular smooth muscle cells. In the protein-coding region one new coding variant (T21M) with the potential to create a truncated receptor isoform was detected. We determined the frequency of the promoter variant at position -412 (C --> G) and the newly identified coding variant (T21M) in extended samples of 69 patients with HCM, 163 patients with DCM, 109 patients with hypertension, and 173 healthy anonymous blood donors. The promoter variant (-412 C/G) was found in one blood donor and the T21M mutation was not found in the control population. Therefore, it appears that these mutations are rare events and the determination of clinical significance will be a demanding task in the future.
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PMID:Screening the human bradykinin B2 receptor gene in patients with cardiovascular diseases: identification of a functional mutation in the promoter and a new coding variant (T21M). 988 Feb 21

Small (three to five members) group teleconferences led by consultants were used as one part of educational follow-up to individual medical audit studies in hypertension. The original studies were carried out in the offices of 51 private practice physicians. A number of techniques were used to improve physician acceptance of the teleconference method. Before the teleconference, participants received biographical information about the consultant as well as an outline describing how the call was to be structured. In practice, a varied format was used, beginning with questions from the physicians, followed by the consultant's discussion of study results, and ending with a period during which the physicians had an opportunity to raise additional questions. Evaluation of the calls showed that most physicians thought their study results had been kept anonymous by the consultant. Most thought the length of time (usually one hour) was satisfactory, and most agreed that they learned both from the consultant and other group members. Of all the educational components in the audit study (record review results, articles, or patient education materials), the telephone conference by far received the highest acceptance score.
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PMID:Small group teaching via telephone in continuing medical education. 1026 8

Participants in controlled feeding studies must consume all study foods and abstain from all other foods. In outpatient studies in which adherence may be compromised by free-living conditions, promoting, documenting, and monitoring dietary adherence are necessary. In the Dietary Approaches to Stop Hypertension (DASH) trial, a thorough participant screening process, an orientation session, and a run-in feeding period before randomization aided in the selection of participants who would most likely adhere to the demands of the study protocol. Throughout the feeding period, various educational and motivational techniques were used to encourage DASH participants to adhere to the dietary protocol. Both objective and subjective methods documented excellent participant adherence. Daily monitoring of individual adherence was based on meal attendance, body weight measurements, and daily diaries. Urinary sodium, potassium, phosphorus, and urea nitrogen values and an anonymous poststudy survey were used to evaluate adherence at the end of the study. Most DASH participants adhered to the feeding regimen by consuming only study foods and no other foods. When adherence lapsed, participants generally cited the lack of menu variety as a reason. Successful participant adherence to the constraints of an outpatient controlled feeding study is possible with carefully selected participants and a variety of adherence-promoting strategies incorporated into the study protocol.
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PMID:Dietary adherence in the Dietary Approaches to Stop Hypertension trial. DASH Collaborative Research Group. 1045 Feb 98


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