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

Measurement of serum total cholesterol (TC) and high-density lipoprotein-cholesterol (HDL-C) is recommended in the comprehensive evaluation of hypertensive patients. The prevalence of hypercholesterolemia is higher in hypertensive compared to normotensive individuals and the cardiovascular risk associated with high blood pressure is increased when hypercholesterolemia is present. Diuretics and/or beta blockers may increase TC, triglyceride (TG), and very low-density lipoprotein-cholesterol (VLDL-C) levels and/or reduce HDL-C levels, but it is not certain if these changes in blood lipids and lipoproteins decrease the benefits of the blood pressure reduction that they produce. Blood pressure and blood cholesterol levels may be reduced through dietary modification and low-fat diets blunt the changes in lipids and lipoproteins induced by diuretics or beta blockers. Despite these changes, many hypertensive patients require lipid-lowering drugs to reduce low-density lipoprotein-cholesterol (LDL-C) levels to an acceptable range. Lipid lowering drugs may produce bothersome side effects and/or increase the cost of medical therapy considerably. However, several lipid lowering drugs have been shown to reduce primary CHD incidence in middle-aged men with hypercholesterolemia.
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PMID:Management of hypercholesterolemia in the hypertensive patient. 266 24

Treatment of mild to moderate hypertension does not result in any obvious reduction in the frequency of coronary heart disease (CDH) whereas the frequency of cerebrovascular disease is reduced. Platelet activation assumes a central role in the development of arteriosclerosis which is presumed to be the basis of coronary heart disease. Platelet activation may occur at sites of damaged endothelium (eg in the arteriosclerotic plaque) and by means of influencing specific thrombocyte receptors. The receptors may also be activated in vitro, which may be utilized experimentally. By means of stratification of material from the literature, it appears possible that patients with high mean arterial blood pressures (MAP) (over approximately 120 mmHg) have an increased tendency to platelet aggregation for ADP and adrenalin. This hyper-aggregability appears to be related to the blood pressure as it is normalized when MAP is reduced by treatment to values around 120 mmHg. If MAP is under 120 mmHg already, no further decrease in the tendency to platelet aggregation occurs. Some investigations suggest an effect on ischaemic heart disease on treatment of the most hypersensitive patients. The observations quoted in the present article are in agreement with the theory that thrombocyte aggregation may be of significance for development of CDH.
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PMID:[Platelet function, hypertension and ischemic heart disease]. 267 54

Since the early 1900s, coffee has been implicated as having adverse effects on human health. Recent attention has focused on coffee's relation to CHD, but because of conflicting results of epidemiologic studies on coffee and CHD mortality, attention has turned to the effects of coffee and caffeine on individual CHD risk factors. Coffee's effect on serum lipids does not appear to be due to caffeine. If in fact an adverse effect on lipids exists, it may be related to other factors including biochemical constituents other than caffeine, hardness of the water used in preparation, and the method of preparation, filtered coffee having no effect. The data are fairly convincing that chronic coffee ingestion does not induce hypertension, although acute consumption produces a small, short-lived increase in BP. The least well understood effect of coffee is its potential to induce cardiac arrhythmias, including potentially lethal ventricular ectopy in certain individuals. More work is needed in this area of arrhythmias before any concrete recommendations can be made. Until more convincing evidence against coffee is compiled, it appears that, at least in moderate amounts in otherwise healthy persons, coffee is a safe beverage.
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PMID:Coffee and coronary heart disease: a review. 268 80

Prevalence rate of hypertension in Tianjin is one of the highest in China, so we had done a series of epidemiological study of hypertension in Tianjin. Tianjin is one of the biggest cities in China with 8 million population. Prevalence rate of hypertension (1985) is 9.24% borderline 2.94%, total 12.18%. Incidence rate (1984) 0.66% & 0.14% (borderline). Prevalence rate: male 8.3%, female 10.2%; urban area 10.7%, rural area 5.7%. It increased in recent 20 years. Mortality rate of cardio- & cerebro-vascular diseases in Tianjin is also one of the highest, in China. Hypertension is one of the risk factors of CHD in Tianjin. Prevalence rate of hypertension increases with age. It is higher in drinkers than non-drinkers, higher in smokers than non-smokers. It is higher in the overweight group and in the group with family history of hypertension. High Na intake is one of the risk factors, it seems synergistic with family history. B. P. is lower in summer. It negatively correlates with atmospheric temperature and humidity.
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PMID:[Serial epidemiological study of hypertension in Tianjin]. 278 54

In the Warsaw Pol-MONICA area, which is inhabited by 274,000 people of ages 25-64, trends in total mortality showed increases similar to those for the whole of Poland. In Warsaw, mortality from cardiovascular disease in men and from ischaemic heart disease (IHD), myocardial infarction (MI), and cerebrovascular disease in both sexes decreased from 1976 to 1986, whereas trends for these diseases were increasing for the whole of Poland. Within the last 11 years, the MI attack rate and case-fatality rate increased in Warsaw. In the Warsaw male population, an increase in the majority of CHD risk factors was also observed. Age-adjusted mortality rates, MI attack and incidence rates, and stroke attack rates in Warsaw were all higher in men than in women. The mean values of HDL cholesterol and LDL cholesterol, Quetelet's index, and prevalence of hypercholesterolaemia in Warsaw were higher in women than in men, whereas the mean values of triglycerides, diastolic blood pressure, and number of cigarettes smoked as well as prevalence of hypertriglyceridaemia, hypertension, and smoking were higher in men.
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PMID:Epidemiology of cardiovascular diseases in Warsaw Pol-MONICA area. 280 93

The results of large epidemiological studies dealing with the prognosis and unfavourable outcome of essential hypertension, clearly show that the pharmacological reduction of the elevated blood pressure of hypertensive patients significantly reduces the risk of at least some major cardiovascular complications. Satisfactory antihypertensive efficacy reflects, nevertheless, merely a minimal requirement for a modern antihypertensive drug. Additional pharmacological properties, which counteract the typical concomitant diseases like CHD, heart failure and other cardiovascular complications would be desirable. In this respect, the oral CE-inhibitors captopril and enalapril offer an exciting new approach to the treatment of arterial hypertension. As the most predictive international studies on prevention of hypertension were conducted before CE-inhibitors were available, the present review evaluates the pharmacological profile of this new class of antihypertensive compounds in the light of previously available baseline drugs, including the calcium channel antagonists. Until now, captopril and enalapril have been the best investigated and documented representatives. Besides new experimental results concerning the molecular mechanism of these drugs, clinical and experimental approaches to verify protective effects on the cardiovascular and the renal system are addressed. These offer a rational basis for the preferential treatment of hypertensive patients with reduced renal function, diabetes and chronic heart failure. In addition, some distinct advantages of enalapril over captopril, resulting mainly from the long-term reduction of high blood pressure, are discussed.
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PMID:[Differential therapeutic topics in antihypertensive therapy. What can angiotensin-converting enzyme inhibitors accomplish?]. 285 Jun 83

The major findings of a review of the literature on platelet aggregation in hypertensive human subjects and the effects of antihypertensive agents were as follows: (1) There is an increased platelet aggregatory response to epinephrine and ADP in hypertensives with MAP greater than 120 mmHg. (2) Treatment with propranolol decreases the aggregatory response to ADP, but it may enhance the response to epinephrine. (3) Treatment with calcium blockers in normotensives decreases the aggregatory response to epinephrine. Further work needs to be done to answer the questions raised by this review. Since the major goal, yet unachieved, of antihypertensive therapy is reduction of the incidence of CHD, the anti-thrombotic or thrombotic potential of antihypertensive agents must be known. Future clinical trials of drug therapy for hypertension should be designed to include at least a determination of platelet aggregation in response to both ADP and epinephrine.
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PMID:Platelet aggregation in hypertension and the effects of antihypertensive treatment. 289 88

Altogether 56 patients with occlusive abdominal aortic lesions and concomitant CHD were examined by radionuclide ventriculography on a nuclear stethoscope. Suppression of left ventricular systolic and diastolic function was noted in the patients with CHD and arterial hypertension. Investigations of cardiohemodynamics using the above method made it possible to identify patients with limited functional cardiac reserve, to predict possible myocardial complications, and to take preventive measures before, during and after reconstructive interventions on the abdominal aorta.
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PMID:[Evaluation of pump function of the heart in patients with occlusive diseases of the abdominal aorta and ischemic heart disease based on radionuclide ventriculography]. 290 42

A total of 96 males aged 80 to 92 (98% of the persons of this age and sex residing in October 1, 1983, in one of the administrative districts in Leningrad) were examined at home by standardized methods. Arterial pressure (AP) was measured and ECG at rest was recorded; 73 persons living an active life were interviewed using a WHO questionnaire with regard to angina pectoris of effort. The blood lipid composition was studied in 54 persons. Systolic arterial hypertension (AP greater than or equal to 160 mm) was found in 65.6%, AP greater than or equal to 190 mm in 21.9%, isolated diastolic arterial hypertension was not detected, together with systolic hypertension it was observed in 10.4%. The blood lipid composition in males over 80 was characterized by rather low total cholesterol and triglyceride levels and quite a low atherogeneity rate (3.3 +/- 0.26 U). Epidemiological CHD diagnosis was established in 45.7% of the persons examined including myocardial infarction in the anamnesis in 16.7%. The results obtained indicate to more frequent associations of CHD with a high AP and tendencies to an atherogenic shift of the blood lipid fractions.
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PMID:[Ischemic heart disease, arterial pressure and the lipid composition of the blood in men over 80 in Leningrad (epidemiological survey data)]. 293 48

Electro- (12 and 35 ECG leads) and vectorcardiographic (3 orthogonal leads) examination of 75 patients with arterial hypertension and left-ventricular hypertrophy (LVH), 28 of which also had documented stenosis of one or more coronary arteries, was carried out using an automatic system of graphic registration and quantification of ECG-35 and VCG parameters. Electro- and vectorcardiographic signs of "pure" LVH and LVH accompanied by CHD relevant for their differential diagnosis were established. The principal singled out difference criteria include NQ (Q registration zone) and SQRSxyz (space QRS loop area), while Q (Q-wave sum), H0QRSxyz 0.08-0.10 s (QRS end vector azimuth), Gxyz (space ventricular gradient) and V0Gxyz (ventricular gradient elevation) are complementary, determined by the degree of the principal parameter shifts.
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PMID:[Approaches to electro- and vectorcardiographic differentiation of the signs of focal and cicatricial myocardial lesions in left-ventricular hypertrophy]. 293 52


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