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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

1. A study was conducted amongst 1247 treated hypertensive patients to determine the predictive power of untreated baseline and achieved treated blood pressures in the development of the complications of hypertension. In addition the relative importance of systolic and diastolic pressures was calculated. 2. Statistical analysis was done by calculating univariate differences in blood pressure between cases with and without complications. The higher the univariate distance, the greater the predictive power. 3. Blood pressures achieved during treatment were more important than baseline pressures for predicting stroke in both men and women, confirming the benefits of antihypertensive therapy in preventing strokes. 4. There was some evidence of prevention of myocardial infarction in men and of angina in women as a result of therapy. 5. There was no evidence to suggest that any one group of drugs, including beta-adrenoreceptor-blocking drugs and thiazides, conferred any extra benefit in preventing coronary heart disease. 6. The systolic blood pressures achieved during treatment predicted stroke better than diastolic pressure, but no consistent trends were found for coronary heart disease.
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PMID:Relation between prognosis and the blood pressure before and during treatment of hypertensive patients. 3 9

Within a group of 1026 men aged 47-54, cause-specific death-rates and the incidence of non-fatal myocardial infarction and stroke in treatment group of 635 hypertensive men (casual systolic B.P. greater than 175 or diastolic B.P. greater than 115 mm Hg on two occasions) treated at a hypertension clinic were compared with those in a control group of 391 men (causal systolic B.P. greater than 175 or diastolic greater than 115 mm Hg on only one occasion) who remained mainly untreated during their 4.3 years of follow-up. The predicted risk of coronary heart-disease (C.H.D.) at entry, calculated by a multiple logistic function, was slightly higher in the treatment group. Total death-rate during follow-up was significantly lower in the treatment group (3.3%) than in the control group (6.1%). The difference in death-rate for C.H.D. was of the same relative order (0.8% versus 1.5%), as was the incidence of non-fatal myocardial infarction (2.8% versus 5.4%), although none of the differences reached statistical significance. However, the pooled incidence of fatal and non-fatal C.H.D. was significantly lower in the treatment group (3.6%) than in the control group (6.9%). The results suggest that antihypertensive treatment might be effective in preventing or postponing C.H.D. in middle-aged men.
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PMID:Coronary heart-disease after treatment of hypertension. 7 94

A long-term clinical trial in micristin-treated patients suffering from organic arterial circulatory disturbances is reported. Problems of therapy monitoring by determination of the ASA level in plasma and of control of platelet aggregation are discussed. Acute cardiovascular complications (myocardial infarction, stroke, acute vascular occlusion, amputation and angiographically demonstrated progression) were observed. The observation time did not suffice to establish statistically significant differences between micristin therapy anticoagulant treatment and basic cardiovascular therapy. The results are suggestive of a more beneficial effect of anticoagulant treatment.
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PMID:[Prevention of cardiovascular complications in manifest arteriosclerosis by the use of Micristine]. 9 72

Two groups of 10 patients with left ventricular failure during the acute phase of myocardial infarction were studied. One group were given phentolamine, the other trinitrin. The infusion rate was regulated so that the heart rate was not increased by more than 10 beats per minute, and to obtain a pulmonary arterial diastolic pressure less than 18 mmHg with a mean systemic arterial pressure remaining greater than or equal to 80 mmHg. The dose of phentolamine was 5 +/- 3 mcg/kg/mn, but using trinitrin the initial optimal dose of 0.39 +/- 0.22 mcg/kg/mn had to be progressively increased during the first 24 hours. The haemodynamic study done before treatment and after an hour at the optimal infusion rate showed that, for a similar reduction in the pulmonary arterial diastolic pressure, the mean systemic arterial pressure was reduced less by trinitrin than by phentolamine, while the stroke work index was not appreciably altered by either drug. In patients with low systemic arterial pressure, trinitrin appears to be preferable and warrants use after the possible setting up of circulatory assistance by aortic counter-pulsation.
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PMID:[Comparison of the effects of phentolamine and trinitrine in the treatment of left ventricular failure during the acute phase of myocardial infarct]. 10 76

A noninvasive technique, i.e., the intravenous injection of a bolus of 99mTc, allows one to visualize the wall motion and the stroke volume distribution of the left ventricle after myocardial infarction. Thus, in the first weeks after infarction, it is possible 1) to answer the question of the function of the involved wall segment, 2) to detect early complications, 3) to follow-up the course 4) to estimate the patient's functional status for treatment more accurately and 5) to control the result of treatment. Furthermore, one can calculate the ejection fraction, demonstrate other zones of reduced systolic function and evaluate the degree of congestion in the lung and involvement of the right ventricle. The study is based on 42 examinations in 35 patients with proven myocardial infarction. Only three patients presented normal systolic wall motion. In the remaining 32 patients there was hypokinesia of the infarcted segment partly combined with some temporary dyskinesia during ventricular contraction or with localized akinesia. Three patients had an aneurysm, two a ventricular septal defect and 19 some degree of mitral reflux, in seven congestive heart failure was present. Certain technical requirements are essential for this noninvasive technique. They are discussed in detail. Examples of wall motion and stroke volume distribution of a normal left ventricle, anterior and posterior infarction and an aneurysm are illustrated.
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PMID:[Noninvasive demonstration of wall movement and stroke volume distribution of the left ventricle after myocardial infarction (author's transl)]. 13 Oct 77

Clinical, experimental and pathologic studies strongly indicate that hypertension is a major factor in coronary heart disease, sudden death, stroke congestive heart failure and renal insufficiency. The deleterious effect of the elevated blood pressure on the cardiovascular system appears to be due mainly to the mechanical stress placed on the heart and blood vessels. Humoral factors and vasoactive hormones such as angiotensin, catecholamines and prostaglandins may play a role in the pathogenesis of hypertensive cardiovascular disease but this role has not yet been defined and is probably secondary. Hypertension and the resulting increase in tangential tension on the myocardial and arterial walls, leads to the development of hypertensive heart disease and congestive heart failure as well as hypertensive vascular disease that affects not only the kidneys but also the heart and brain. Hypertensive vascular disease involves both large and small arteries as well as arterioles and is characterized by fibromuscular thickening of the intima and media with luminal narrowing of the small arteries and arterioles. The physical stress of hypertension on the arterial wall also results in the aggravation and acceleration of atherosclerosis, particularly of the coronary and cerebral vessels. Moreover, hypertension appears to increase the susceptibility of the small and large arteries to atherosclerosis. Thus the patient with hypertension is a candidate for both hypertensive and atherosclerotic vascular disease of the coronary and cerebral vessels leading to occlusive disease of both the large and small arteries and resulting in myocardial infarction and stroke. Other major complications of hypertensive vascular disease include rupture and thrombotic occlusion of blood vessels, especially in the brain. Disease of the arterial media, which begins in childhood with the deposition of calcium in the vessels, may be an important cause of arterial hypertension. This form of hypertension may manifest itself in adults as arteriosclerotic hypertension and lead to cardiovascular complications very similar to those of essential hypertension. The relation of arteriosclerotic hypertension to nutritional factors, including dietary salt intake, deserves study.
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PMID:Role of hypertension in atherosclerosis and cardiovascular disease. 13 91

Comprehensive ascertainment of all possible new cases of stroke appearing between January 1, 1970 and June 30, 1971, and admitted to three major hospitals in Winnipeg, Manitoba, has been achieved by reviewing the Manitoba Health Services Commission claim reports. The medical records of these cases were reviewed, pertinent data were abstracted, and rigid criteria for diagnosis were followed. Also, data were obtained from death certificates, autopsy reports and long-term hospital records. A total of 606 ascertained cases (410 infarction, 137 hemorrhage, and 59 undetermined type) were matched for age, sex, residence and year of admission with 606 controls from admissions for other than cardiovascular and cerebrovascular disorders. The data were analyzed for elucidating the possible risk factors for infarction (INF) and hemorrhage (HGE). The findings suggested that hypertension was the main risk factor in hemorrhage, whereas in infarction, along with hypertension, other factors such as diabetes, heart enlargement in chest x-ray, ECG abnormalities, and smoking were suggested as risk factors. There was an association also between infarction, on one hand, and the history of receiving anticoagulants, diuretics, and medications for the heart, and the occurrence of myocardial infarction, on the other hand. These features indicate that infarction and ischemic heart disease have similar risk factors. Hemoglobin and hematocrit were higher in infarction cases than in their controls only when measured at stroke admission. No difference was revealed when they were measured prior to stroke. Their association with infraction therefore may be secondary to other factors and of no significance for its risk.
Stroke
PMID:Relative role of factors associated with cerebral infarction and cerebral hemorrhage. A matched pair case-control study. 13 18

The role of hypertension in cardiovascular disease was studied in the hypertensive coarcted monkey during the feeding of an atherogenic and nonatherogenic diet. During the 15-month period of observation, half of the hypertensive coarcted monkeys developed cardiovascular disease which included heart failure, ischemic heart disease, stroke, and sudden death. There were no cardiovascular complications in the control normotensive monkeys except for one cholesterol-fed animal. The incidence of ischemic heart disease and sudden cardiac death was higher in monkeys with both hypertension and hypercholesterolemia than in those with hypertension or hypercholesterolemia alone. Postmortem studies revealed that the former monkeys had both hypertensive and atherosclerotic heart disease, whereas the monkeys with hypertension or hypercholesterolemia had either hypertensive or atherosclerotic heart disease. Hypertensive heart disease was characterized not only by hypertrophy of the left ventricle but also by focal myocardial degeneration and fibrosis and by focal thickening and narrowing of the small coronary arteries, particularly the sinus node artery and the atrioventricular node artery. The finding of transmural myocardial infarction in two monkeys with patient coronary arteries suggests a possible role of coronary artery spasm in ischemic heart disease in hypertension. The cerebral vascular complications of hypertension included hypertensive encephalopathy, transient "ischemic" attacks, and hemorrhagic stroke. The complications were associated with severe hypertension and with hypertensive vascular disease or hypertensive and atherosclerotic vascular disease of the cerebral arteries.
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PMID:Role of hypertension in ischemic heart disease and cerebral vascular disease in the cynomolgus monkey with coarctation of the aorta. 14 28

Three hundred and eighty-nine subjects, ages 21-55, with diastolic blood pressures between 90 and 115 mm Hg were studied prospectively for 7-10 years in a controlled intervention trial to determine whether pressure lowering reduces the incidence of cardiovascular complications and death. The assignment to therapy, either a combination of a diuretic and rauwolfia serpentina, or an identical placebo, was random. Adverse effects required termination in only 23 (5.9%) cases. Diastolic blood pressure (DBP) was reduced an average of 10 mm Hg (systolic equals 16 mm Hg) in the active treatment group with no change in the placebo group. The major end points of death, myocardial infarction, and stroke totaled 17 and were nearly equally divided between treatment and placebo. Other manifestations of coronary disease were also equally distributed. Complications such as electrocardiographic hypervoltage, left ventricular hypertrophy, radiogrpahic cardiomegaly, and retinopathy occurred in the placebo group at a rate of 53.1 per 100 subjects compared to 23.8 per 100 in those on active drugs. Treatment failure occurred in 24 placebo-treated cases and none of the active group. The overall effectiveness of pressure lowering in reducing these complications and treatment failure was 60%. It is concluded that given the lower level of excess risk in mild uncomplicated hypertension, and the failure of active drug therapy to protect against coronary disease, systematic follow-up without drugs while attempting hygienic intervention and control of other risk factors may be a reasonable alternative for this large group.
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PMID:Treatment of mild hypertension: results of a ten-year intervention trial. 14 29

The families of 13 children who had presented hyperlipoproteinemia at birth were studied. Total cholesterol, LDL cholesterol, triglycerides and electrophoresis of LP were performed. The parameters studied were divided in three groups: a) Inespecific indicators (alpha-LP, betas/alphas relation). b) Indicators of the beta-LP group (total and LDL cholesterol and beta-LP). c) Indicators of the prebeta-LP group (TG, prebeta-LP and prebeta-1). In all cases at least one of the parents had hyperlipoproteinemia. All the parents, but one, showed alterations in the same group of indicators as their children. Obesity, diabetes mellitus, arterial hypertension, coronary insufficiency, myocardial infarction and cerebrovascular accident where observed in the families of the hiperlipidemic parents, but not on those of the normolipemic parents.
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PMID:[Hyperlipoproteinemia in children. Correlation between changes in the parents and newborn infant]. 18 99


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