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Query: UMLS:C0020538 (
hypertension
)
170,190
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A 38-year-old obese woman with concurrent hypothyroidism and pseudotumor cerebri was monitored with serial thyroid function tests and CSF pressure determinations during levothyroxine sodium replacement therapy. Following normalization of the patient's thyroid status, assessed by both clinical and chemical indexes (serum thyroxine level, 1.5 to 11.0 micrograms/dL; serum thyrotropin level, 128 to 1.5 micro units/mL), intracranial
hypertension
persisted for more than four months. After weight loss, acetazolamide therapy, and intermittent CSF drainage failed to produce remission, glucocorticoid therapy was associated with prompt, sustained resolution of the pseudotumor cerebri. Contrary to previous reports, this patient's clinical course suggests that
thyroid hormone
deficiency and pseudotumor cerebri are not causally related.
...
PMID:Pseudotumor cerebri and hypothyroidism. 684 97
Diabetes appears to cause a cardiomyopathy independent of atherosclerotic coronary artery disease and
hypertension
. Left ventricular papillary muscle function studies in rats made severely diabetic with streptozotocin have shown a slowing of relaxation and a depression of shortening velocity. However, the effects of insulin therapy on the myocardial mechanics of diabetic rats have not been studied. Therefore, rats diabetic for 6-10 weeks were treated with PZI insulin for 2, 6, 10, or 28 days and the mechanical performance of their left ventricular papillary muscles was compared to that of untreated diabetics and age-matched controls; cardiac contractile protein enzymatic activity was also measured. Neither 2 nor 6 days of therapy had any effects on the depressed cardiac muscle performance of diabetic animals, although plasma glucose concentration was restored to normal. By 10 days of therapy, recovery of mechanical performance was nearly complete, and by 28 days of therapy, complete reversal of the altered myocardial mechanics was observed. Crystalline insulin added to the bath (9 mU/ml) had no effect on myocardial mechanics in either diabetics or controls. A gradual recovery of actomyosin and myosin ATPase activity in the hearts of insulin-treated diabetic animals was also found, complementing the mechanical studies. In addition to demonstrating a gradual but complete reversibility of the abnormalities in papillary muscle function in diabetic rats (although control of hyperglycemia was less than ideal), this study confirms that this model of a cardiomyopathy is not a result of streptozotocin-induced cardiac toxicity. Additional data are provided indicating that depressed
thyroid hormone
levels in diabetic rats are not responsible for the mechanical changes observed.
...
PMID:Reversibility of diabetic cardiomyopathy with insulin in rats. 703 May 13
Diabetes mellitus is associated frequently with congestive heart failure in humans, even in the absence of associated coronary disease or
hypertension
. Nevertheless, the effects of the diabetic state on myocardial mechanics have not been studied. Accordingly, diabetes was induced in female Wistar rats by injection of streptozotocin (60 mg/kg). Left ventricular papillary muscles were studied 5, 10, and 30 weeks later and compared with controls. Relaxation was delayed significantly and velocity of shortening was depressed at all loads. However, the passive and active force-length curves, as well as the series elastic properties, were not altered. The changes in cardiac performance were found over a range of muscle lengths, stimulus frequencies, and bath concentrations of calcium, glucose, and norepinephrine. The duration of diabetes had no major effect on the mechanical changes observed. The possible influences of drug-induced cardiac toxicity, malnutrition, and altered
thyroid hormone
levels have been considered; the latter two factors could not be excluded completely from having some influence on the mechanical properties of diabetic cardiac muscle. Evidence is cited showing abnormalities in calcium uptake by sarcoplasmic reticulum and depressed actomyosin ATPase activity. Thus a cardiomyopathic state has been produced in the rat consequent to the induction of experimental diabetes mellitus. Various mechanisms for this entity have been suggested.
...
PMID:Altered myocardial mechanics in diabetic rats. 743 39
At the clinics of Uludag University Medical Faculty's Department of Obstetrics and Gynecology in Bursa, Turkey, clinicians compared data on 24 premature infants whose mothers had received oral ambroxol (1300 mg/day until delivery) with data on 58 premature infants whose mothers did not receive ambroxol to determine whether or not ambroxol reduced infant respiratory distress syndrome (RDS) by promoting fetal lung maturation. RDS occurred in 8% of the infants in the ambroxol group compared to 10% in the control group. The only RDS case to survive had received ambroxol. Sepsis was more common in the control group than the ambroxol group (13% vs. 4%). None of the infants had any concomitant disorder that would have contributed to fetal lung maturation. Ambroxol did not significantly change maternal liver and renal function results. In infant and maternal cases, the blood
thyroid hormone
levels were within the normal range. None of the mothers in either group developed a puerperal infection. Ambroxol did not cause any significant maternal or infant side effects. These findings suggest that ambroxol may prevent RDS and sepsis. Larger study groups and studies of groups with
hypertension
, diabetes, and multiple gestations are needed to determine whether ambroxol is a valuable alternative to steroids for prevention of RDS.
...
PMID:Antenatal ambroxol usage in the prevention of infant respiratory distress syndrome. Beneficial and adverse effects. 755 58
A report is given on a 28 years old women with congenital aplasia of the thyroid gland. She was substituted with thyroxine (300 micrograms per day). Her first pregnancy was complicated by gestational
hypertension
and pre-eclampsia. Delivery was by forceps. During the first trimester of her second pregnancy, bleedings occurred. The thyroid-stimulating hormone level (TSH-level) was increased (18.3 microU/ml). The patient did not show clinical signs of manifested hypothyroidism. The thyroxine dosis was increased. Bleedings disappeared. Labour was terminated and induced. Labour intra partum was hypoactive. The delivery was again by forceps. The newborn did not show any signals of hypothyroidism. Dysfunction of thyroid gland is associated with reduced fertility. Hypothyroidism in pregnancy is associated with an adverse outcome in fetal health as well as an increase in obstetric complications. Thyroid hormones play a vital role in fetal development and maturation of brain. Women with a hypothyroidism have a lower rate of pregnancy and a higher rate of spontaneous miscarriages compared to a normal population. Recognition and treatment of thyroid disorders in reproductive age occur before conception. Iodoprophylaxis is necessary for prevention of congenital hypothyroidism (cretinism). Iodoprophylaxis is necessary to prevent endemic goiter in pregnancy. Euthyroid goiter is an indication for a combined treatment with jodid and levothyroxine. Treatment should be individualized. Assessment of efficacy of treatment is based on measurement of TSH- and free
thyroid hormone
(fT4)-levels.
...
PMID:[The course of pregnancy in congenital thyroid gland aplasia. Case report with special reference to maternal hypothyroidism]. 797 62
Hypertension
is more common in hypothyroidic patients than in euthyroid controls in older age groups. Treatment of the thyroid deficiency alone lowers blood pressure in most patients. Hemodynamically, cardiac output is reduced and total peripheral resistance is elevated. The latter probably is secondary to an increase of sympathetic nervous tone and a relative increase in alpha-adrenergic response. In hyperthyroidism, elevation of diastolic blood pressure is uncommon. Systolic hypertension is more common in younger age groups. Treatment of the hyperthyroidism alone lowers systolic blood pressure in most patients. An increase in cardiac output and a decrease in total peripheral resistance accompany the hyperthyroidism. Potentiation of catecholamine action by an excess of
thyroid hormone
has been invoked as an explanation, because
thyroid hormone
excess is accompanied by increased beta-adrenergic receptors in some tissue, including heart.
...
PMID:Hypertension in thyroid disorders. 807 Apr 28
1. Thyroid hormone (L-thyroxine, 10(-10) mol/l) incubated in vitro with human erythrocyte membranes induced the release of a soluble calmodulin-like material, the 3':5'-cyclic nucleotide phosphodiesterase-stimulating activity of which was at least six-fold greater than its concentration measured by a specific calmodulin radioimmunoassay. 2. The material had the characteristics of calmodulin in that it stimulated both phosphodiesterase and erythrocyte Ca(2+)-ATPase activities, cross-reacted with and was neutralized by anti-calmodulin antibody, was adsorbed by phenothiazine-Sepharose and was heat-stable. Control supernatant from the incubation of membranes in the absence of thyroxine contained calmodulin, the bioactivity of which was not enhanced beyond that predicted from radioimmunoassay. Subsequent addition of thyroxine did not increase calmodulin bioactivity. Calmodulin-agarose removed calmodulin-enhancing activity from the supernatant. 3. Thus, the enhancing factor(s) appears to interact directly with calmodulin. These observations indicate that
thyroid hormone
promotes the release from human erythrocyte membranes of a soluble factor (or factors) which binds to calmodulin and significantly increases its bioactivity. This enhancing activity is similar to that of a calmodulin activator described in a rat model of
hypertension
(S.-L. Huang et al., J Clin Invest 1988; 82: 276-81).
...
PMID:Thyroid hormone stimulates release of calmodulin-enhancing activity from human erythrocyte membranes in vitro. 838 86
The heart is a major target organ for
thyroid hormone
action, and marked changes occur in cardiac function in patients with hypothyroidism or hyperthyroidism. Triiodothyronine (T3)-induced changes in cardiac function can result from direct or indirect T3 effects. Direct T3 effects result from T3 action in the heart itself and are mediated by nuclear or extranuclear mechanisms. Extranuclear T3 effects, which occur independently of nuclear T3 receptor binding and increases in protein synthesis, influence primarily the transport of amino acids, sugars, and calcium across the cell membrane. Nuclear T3 effects are mediated by the binding of T3 to specific nuclear receptor proteins, which results in increased transcription of T3-responsive cardiac genes. The T3 receptor is a member of the ligand-activated transcription factor family and is encoded by cellular erythroblastosis A (c-erb A) genes. T3 increases the heart transcription of the myosin heavy chain (MHC) alpha gene and decreases the transcription of the MHC beta gene, leading to an increase of myosin V1 and a decrease in myosin V3 isoenzymes. Myosin V1, which is composed of two MHC alpha, has a higher myosin ATPase activity than myosin V3, which contains two MHC beta. The globular head of myosin V1, with its higher ATPase activity, leads to a more rapid movement of the globular head of myosin along the thin filament, resulting in an increased velocity of contraction. T3 also leads to an increase in the speed of diastolic relaxation, which is caused by the more efficient pumping of the calcium ATPase of the sarcoplasmic reticulum (SR). This T3 effect results from T3-induced increases in the level of the mRNA coding for the SR calcium ATPase protein, leading to an increased number of calcium ATPase pump units in the SR. Overall, T3 leads to an increase in ATP consumption in the heart. In addition, less chemical energy of ATP is used for contractile purposes and more of it goes toward heat production, which causes a decreased efficiency of the contractile process in the hyperthyroid heart. The pathophysiologic basis for myxedema is the opposite of that discussed for the hyperthyroid heart. In addition to decreased direct effects of
thyroid hormone
in cardiac myocytes, indirect effects occur through decreases in peripheral oxygen consumption and changes in hemodynamic parameters. Myofibrillar swelling with loss of striation and interstitial fibrosis occurs on histologic examination of hypothyroid hearts. In addition, accumulation of mucopolysaccharide substances (Glycosaminoglycans) can be demonstrated. On electron microscopic examination, mitochondria show disruption and lipid inclusion. Cardiac papillary muscle obtained from animals with hypothyroidism shows a depression of the force velocity curve and reduced rate of tension development, indicating significant contractile abnormalities. In patients with hypothyroidism, a true enhanced incidence of
hypertension
(increased peripheral vascular resistance) has been found. In addition, hypercholesterolemia and impairment of fatty acid mobilization are associated with myxedema and present additional risk factors for the development of atherosclerotic cardiovascular disease.
...
PMID:[Cardiovascular effects of thyroid hormones]. 906 69
The aim of this study was to evaluate the relationship between subclinical hypothyroidism and/or autoimmune thyroid disease and coronary heart disease (CHD). Ninety seven patients diagnosed as having CHD by a coronary angiography (CHD group) and 103 healthy subjects matched for age, sex and body mass index (control group) were included in the study. Thyroid function, thyroid autoantibodies and serum lipid concentrations were measured in the CHD and control groups. The CHD group exhibited significantly decreased serum free T3 (FT3) and free T4 (FT4) levels, and significantly increased serum TSH levels as compared with the control group, indicating a significant decrease in thyroid function in the CHD patients. Serum high density lipoprotein cholesterol (HDL-C) levels were significantly decreased in the CHD group. The incidence of subclinical hypothyroidism and thyroid autoantibodies was similar in both two groups. These observations were also true of women even after those who had diabetes mellitus (DM),
hypertension
(HT) and a smoking habit were excluded. This was not the case, however, in men without DM, HT, or a smoking habit. Patients with CHD had significantly lower serum levels of HDL-C than the control subjects, regardless of gender (P < 0.01). In the group with CHD, there was no difference between the serum lipid levels in patients with subclinical hypothyroidism and those with normal thyroid function. Female patients with CHD had significantly lower serum levels of
thyroid hormone
and HDL-C, but their subclinical hypothyroidism or thyroid autoimmunity did not seem to be related to the development of CHD.
...
PMID:Decrease in serum levels of thyroid hormone in patients with coronary heart disease. 907 5
The
thyroid hormone
deficiency on cardiovascular function can be characterized with decreased myocardial contractility and increased peripheral vascular resistance as well as with the changes in lipid metabolism. 42 patients with cardiovascular disease (mean age 65 +/- 13 yr, 16 males) were investigated if iodine insufficiency can play a role as a risk factor for the cardiovascular diseases. The patients were divided in 5 subgroups on the ground of the presence of
hypertension
, congestive heart failure, cardiomyopathy, coronary disfunction and arrhythmia. Urine iodine concentration (5.29 +/- 4.52 micrograms/dl) was detected with Sandell-Kolthoff colorimetric reaction. The most decreased urine iodine concentration was detected in the subgroups with arrhythmia and congestive heart failure (4.7 +/- 4.94 micrograms/dl and 4.9 +/- 4.81 micrograms/dl, respectively). An elevated TSH level was found by 3 patients (5.3 +/- 1.4 mlU/l). An elevation in lipid metabolism (cholesterol, triglyceride) associated with all subgroups without arrhythmia. In conclusion, the occurrence of iodine deficiency in cardiovascular disease is frequent. Iodine supplementation might prevent the worsing effect of iodine deficiency on cardiovascular disease.
...
PMID:[Iodine deficiency in cardiovascular diseases]. 975 26
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