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

A 1987 questionnaire sponsored by the Health and Welfare Ministry concerning the clinical subsets and severity of systemic lupus erythematosus (SLE) was distributed to 93 medial facilities. A clinical analysis of the outcome and treatments was accomplished on one thousand six hundred and fourteen SLE patients fulfilling ARA criteria. The outcome was evaluated into 6 categories, namely; complete remission, incomplete remission, no change, gradual worsening, rapid worsening and unknown. Treatments included (1) anti-inflammatory drugs, (2) initial dose of prednisolone (PSL) below 29 mg/day, (3) initial dose of PSL from 30 to 59 mg/day, (4) initial dose of PSL above 60 mg/day, (5) pulse therapy, (6) immunosuppressants, (7) plasmapheresis, and (8) hemodialysis. Statistical significances were determined with ridit analysis. The severity of the disease for 1,614 SLE patients was evaluated by the judgement of each medical facility independently, separating it into 3 grades. As a result, 16.8% was evaluated as severe, 54.6% was evaluated as moderate, and 28.6% was evaluated as mild. Clinical subsets were divided into 3 categories according to the outcome; (1) those with high complete remission rates (serositis, convulsion, oral ulcers, unconsciousness, hemolytic anemia and so on), (2) those with high incomplete remission rates (lupus nephritis, digital gangrene, hypertension, peripheral neuropathy, erythema, Raynaud's phenomenon and so on), and (3) those with high rates of no change or worsening (aseptic bone necrosis, pulmonary hypertension, pneumonitis, chronic renal failure and so on). SLE patients with persistent proteinuria below 3.4 g/day, pulmonary hypertension, or pneumonitis treated with large doses of PSL such as an initial dose of PSL above 60 mg/day and/or pulse therapy had a significantly higher remission rate than those treated with small dosages of PSL. Hereafter, the establishment of modes of treatments for increasing the remission rates of intractable clinical subsets in highly desired.
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PMID:[Studies on clinical subsets and severity of systemic lupus erythematosus based on a 1987 questionnaire conducted in Japan--clinical analysis of the outcome and treatments in clinical subsets]. 160 13

Changes in carbonic anhydrase (CA) activity have been associated with metabolic diseases like diabetes mellitus and hypertension. To explore the exchange of H+ for Na+ and 22Na+, the sodium pool, CA activity and H2O content in erythrocytes from the two groups of diabetic chronic renal failure (CRF) patients with and without hypertension before dialysis were studied. The results were compared with those from the normotensive controls. The CA activity was determined spectrophotometrically, the sodium pool by ouabain insensitive 22Na+ influx and the percent H2O content gravimetrically. The 22Na+ influx in CRF patients with hypertension was significantly higher (p less than 0.025) than in the normotensive CRF patients and the controls. The levels of CA activity (U/min/mL) and the percent H2O content were significantly different in the hypertensive and the normotensive CRF patients from the control group (2.24 +/- 0.69 and 67.11 +/- 1.33, 1.95 +/- 0.63 and 66.43 +/- 1.51, 1.44 +/- 0.07 and 63.61 +/- 1.72, respectively). The present study implies a relationship between the 22Na+ influx and CA activity in CRF patients with hypertension. The variation of CA activity may thus result in changes in H+ production and ultimately in the intracellular Na+ pool.
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PMID:Erythrocyte carbonic anhydrase: a major intracellular enzyme to regulate cellular sodium metabolism in chronic renal failure patients with diabetes and hypertension. 161 Mar 83

The epidemiology, clinical symptomatology, diagnosis and management of acute and chronic lead intoxication are reviewed. While acute lead intoxication has become rare, the elevated environmental lead burden is thought to play a causal role in hypertension. Lead may also be linked with neuropsychological disorders of children and possibly even chronic renal failure. The epidemiological and experimental evidence for this hypothesis is critically discussed.
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PMID:Lead intoxication--new insights into an old problem. 161 43

We report the case of an elderly black woman with a 20-year history of insulin-independent diabetes mellitus (IDDM), chronic renal failure, hypertension, proliferative retinopathy, and classical histologic features of diabetic glomerulosclerosis on renal biopsy. Repeat determinations of urinary albumin excretion rates failed to disclose significant microalbuminuria. This presentation should remind the clinician that a small minority of patients with IDDM of long duration may have severe diabetic glomerulosclerosis and renal insufficiency without detectable microalbuminuria.
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PMID:Diabetic glomerulosclerosis and chronic renal failure with absent-to-minimal microalbuminuria. 162 84

Clinical, biochemical, radiological and echo-cardiographic (echo) evaluation was done prospectively in 50 patients of untreated end stage chronic renal failure (CRF). While clinically congestive cardiac failure (CCF) was diagnosed in 24%, low ejection fraction on echo was found in only 16%. Echo in these cases showed evidence of cardiac chamber dilatation in most (mean LVID (D) 54.1 +/- 6.51 and (S) 36.4 +/- 6.9 mm, but parameters of cardiac functions were normal in most. Mitral annular calcification (MAC) was detected on echo in 26%. On comparing patients with MAC (Group I) and those without MAC (Group II), the aetiological factor found more frequently in Group I was diabetes (61.5% vs 35.1%, P less than 0.05). Clinical features such as older age (mean age 54 years vs 45.5 years), severe hypertension, and grade IV and above murmur (15.2% vs none) were more common among group I patients. However, the difference was not statistically significant. Parameters of calcium metabolism were similar in the two groups. Conduction disturbances (30.7% vs 5.4%) were significantly more common in Group I (P = 0.05). The mitral regurgitation due to MAC was of no haemodynamic significance. Complications of MAC syndrome were rare.
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PMID:Mitral annular calcification in untreated chronic renal failure. 162 45

Symptomatic pericardial effusion (PE) occurred in two of our patients with chronic renal failure (CRF) who had taken minoxidil for control of their hypertension. One of them died from the effects of cardiogenic shock due to cardiac tamponade. The 2 patients had taken minoxidil for over 3 months. Other patients who had CRF had not developed symptomatic PE while being treated with other anti-hypertensive agents. Our experience conforms with reports from elsewhere that minoxidil may cause PE. Therefore, patients with CRF who need minoxidil as an anti-hypertensive agent should be examined regularly for clinical evidence of PE.
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PMID:Pericardial effusion associated with minoxidil therapy: case reports. 163 46

In 8 non-dialysed patients with chronic renal failure (PNN) and hypertension (NT)-(PNNT group) sodium-potassium pump activity (PSP) and intra-erythrocyte sodium (NaE) and potassium (KE) concentration were measured. No differences were found in PSP, NaE and KE between group PNNT and healthy volunteers (Z). These results do not support an importance of the role of the so-called endogenous PSP inhibitor in the pathogenesis of NT in patients with PNN.
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PMID:[Activity of the sodium-potassium pump and values of sodium and potassium in erythrocytes in patients with non-dialyzed renal failure and arterial hypertension treated conservatively]. 166 26

This report presents 72 cases with mitral annulus calcification. The diagnosis was made by echocardiogram. There were 21 males and 51 females, aged from 38 to 93 (mean 71). The associated clinical findings in these 72 patients included: hypertension, 28 cases; valvular aortic stenosis, 3 cases; hypertrophic cardiomyopathy, 7 cases; chronic renal failure, 14 cases; congestive heart failure, 29 cases, calcified aortic valve, 27 cases; mitral regurgitation, 46 cases; cerebral infarct, 19 cases; peripheral arterial embolism, 2 cases. Their electrocardiographic findings included: atrial fibrillation, 25 cases; conduction defects, 21 cases; sick sinus syndrome, 3 cases (one case required permanent pacemaker implantation). We conclude that mitral annulus calcification is not a senile change only, and that it also results in some complications such as: mitral regurgitation, cerebral embolism, peripheral arterial embolism, atrial fibrillation and conduction defects. Echocardiography is a useful diagnostic tool in the evaluation of patients with mitral annulus calcification.
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PMID:[Mitral annulus calcification: clinical observation on 72 patients]. 167 8

The efficacy, safety, and pharmacokinetics of carvedilol were investigated in an open trial performed on six patients with hypertension and chronic renal failure requiring hemodialysis. The plasma level of unchanged carvedilol after a single dose of 10 mg reached a peak 1-5 h after administration both on days with and without hemodialysis. The drug was gradually metabolized thereafter and had almost disappeared from the plasma after 24 h. Blood pressure was lowered by carvedilol both on days with and without hemodialysis. No carvedilol passed through the dialysis membrane. During the 4-week administration period of carvedilol at 10 mg/day, assessment of plasma samples taken just prior to early morning administration demonstrated no drug accumulation. Blood pressure was well controlled during the administration period. Tolerance to the antihypertensive effect was not observed. Heart rate was not significantly changed at any time. There were no side effects in any of the patients during the trial, and laboratory parameters remained unchanged. These results indicate that carvedilol is a safe and effective antihypertensive agent for use in patients on chronic hemodialysis.
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PMID:Pharmacokinetics and efficacy of carvedilol in chronic hemodialysis patients with hypertension. 172 82

Calcium-entry blockers exert several characteristic effects on the kidney that potentiate their antihypertensive effect. Long-term therapy with nitrendipine, a dihydropyridine derivative, lowers blood pressure while maintaining renal hemodynamics within limits similar to pretreatment values in essential hypertension with normal renal function. This is accompanied by a persistent natriuretic effect that probably facilitates its antihypertensive action and is not followed by changes of the renin-angiotensin-aldosterone system. Preliminary data also seem to indicate that nitrendipine could be safely used in patients with arterial hypertension and chronic renal failure.
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PMID:Renal effects of nitrendipine. 172 95


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