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

The aim of the present work was to study the activity of a new antihypertensive drug, a synthetic furopyridine, cicletanine, upon hypertensive morphological lesions of the retina. The stroke-prone spontaneously hypertensive rat strain (SHR-SP), known to develop hypertensive retinopathy, was a particularly suitable material in this view. The experiment was carried out in 39 rats (SHR-SP/A3N Iffa Credo), initially at the age of 11 weeks, divided into 3 groups: one as control group, the other two treated orally with 100 and 150 mg/kg cicletanine, respectively. All rats had free access to tap water containing 1% NaCl. For 46 days, blood pressure, body weight and death rate were recorded, then the rats were sacrificed. The eyes were removed, the posterior pole collected and fixed with Trump's liquid for transmission electron microscopy. In the control group, the capillaries showed marked hypertensive lesions. Multivesicular bodies were found in the different layers, particularly in the innermost layers; photoreceptor impairments could also be observed. In contrast to this group, both cicletanine-treated groups showed only rare and minimal lesions.
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PMID:Cicletanine and hypertensive retinopathy. 209 Sep 85

A one-year prospective study of the complications of hypertension was carried out in the Medical Wards of the John F. Kennedy Hospital in Monrovia, Liberia. Of all medical admissions 15.6% (105 out of 672) were due to hypertension with its complications. Of the hypertensives, 72.4% (76 of 105) came from the lower socio-economic class. Heart disease with 55.2% (58 of 105) was the commonest complication. Next was stroke with 31.4% (33 of 105). Of the cases of heart disease, only one had suffered a myocardial infarction, the rest had congestive cardiac failure (CCF) without coronary heart disease. Severe hypertensive retinopathy was found in only four patients all of whom had severe uraemia. Hypertensive CCF constituted 41.1% (57 of 139) of all cases of CCF admitted to our hospital. All the complications and deaths were more common in males than in females and they were not uncommon in the young. Chronic renal failure, with 100% mortality, had the worst prognosis. 60.0% of the patients had not previously been diagnosed as hypertensive. There is an urgent need for health education in Liberia to inform the people of the dangers of uncontrolled hypertension and to encourage them to get their blood pressure measured periodically thus improving the early detection and initiation of antihypertensive treatment to prevent the complications of hypertension.
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PMID:Complications of hypertension in adult urban Liberians. 233 99

Stroke-Prone spontaneously hypertensive rat strain (SHR-SP) always develops hypertensive retinopathy. The aim of the present work was to study the activity of a new antihypertensive drug, a synthetic furopyridine: cicletanine, in retinal hypertensive morphological lesions. The experiment was performed in 39 rats SHR-SP/A3N Iffa Credo, 11 weeks old, divided into 3 groups: group 1 was the control group, groups 2 and 3 were orally treated with cicletanine (respectively 100 and 150 mg/kg). All the rats had free access to tap water containing 1 p. 100 NaCl. During 6 weeks, blood pressure, body weight and survival were recorded, then all the rats were sacrificed. The eyes were removed, the posterior pole collected and fixed with Trump liquid for transmission election microscopy. In the SHR-SP control group, each layer showed neural body and/or process lesions: in the ganglion cell layer, some ganglion cells realized cytoid bodies corresponding to a lysed cell with nucleus degeneration, most of the axons were destroyed. In the inner and outer plexiform layers, most of the contacts between processes were lost because of fibrinous deposits. Numerous synapses were destroyed in the outer plexiform layer. These findings might explain the numerous dense bodies in the inner rod segment and the vesiculation of the rod outer segment. The capillaries showed markedly hypertensive lesions. Whereas, in both treated groups, rare and animal lesions were observed. The fact that these lesions were so few and so unimportant after 6 weeks of treatment, as well as for the photoreceptors which remained unimpaired, is closely related to cicletanine therapy, since it was so even though the treatment had been started with an already high blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Malignant hypertensive retinopathy in spontaneously hypertensive stroke-prone rats. Effect of treatment with cicletanine]. 251 Jun 62

Sixteen patients with CT evidence of a single cerebral lacuna had no clinical findings to indicate stroke syndromes. All patients had systemic arterial hypertension; 12 (75%) had cardiographic evidence of left ventricular hypertrophy, ten (63%) had radiologic evidence of cardiomegaly, and ten (63%) had clinical signs of hypertensive retinopathy. All lacunas were located in the supratentorial region (seven in the anterior capsular limb, three in the caudate, two in the external capsule, two in the putamen, one in the corona radiata, and one in the thalamus). During the three-year follow-up period, seven had clinical lacunar stroke syndrome, three had cortical stroke, two had myocardial infarction, and one died suddenly of unknown cause.
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PMID:Neurologically asymptomatic patients with a single cerebral lacuna. 276 3

The prevalence of hypertension is particularly high in people of black African descent throughout the world, and the consequences of hypertension, such as hypertensive heart and renal disease and stroke, are also more common. But there is little consensus on whether hypertensive retinopathy follows a similar pattern. We determined the prevalence of hypertensive retinopathy and its relationships with resting and ambulatory blood pressure in a population study of Afro-Caribbeans and Europeans aged 40 to 64 years in London, UK. Retinal photographs of 651 participants were graded for hypertensive retinopathy. Age- and sex-standardized prevalence of retinopathy was 11% (95% confidence interval, 8% to 14%) in Europeans and 21% (95% confidence interval, 16% to 26%) in Afro-Caribbeans (P < .001), respectively. This ethnic difference in prevalence was greatest in normotensive women (8% in Europeans versus 20% in Afro-Caribbeans, P < .001). Resting systolic pressure was 8 mm Hg higher in normotensive Afro-Carribean compared with European women, but this could not fully account for the ethnic difference in the prevalence of retinopathy. Examination of the different relationships of age and resting and ambulatory blood pressures with hypertensive retinopathy showed that these relationships were strongest in European women and weakest in Afro-Caribbean women. We conclude that hypertensive retinopathy is more common in Afro-Caribbeans, particularly women, and that ethnic differences in resting blood pressure cannot fully account for this. The relatively weak relationship between resting and ambulatory blood pressures and retinopathy in Afro-Caribbeans suggests that factors other than blood pressure determine the high rates of hypertensive retinopathy in this group.
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PMID:Hypertensive retinopathy in Afro-Caribbeans and Europeans. Prevalence and risk factor relationships. 776 81

To assess the role of hypertension in asymptomatic cerebral lacunae, we evaluated cranial computed tomography in 76 untreated hypertensive patients, 173 hypertensive patients treated with antihypertensive drugs, and 69 age-matched normotensive control subjects who were more than 60 years of age and without a history of stroke. Cerebral lacunae were diagnosed by computed tomography as a hypodense lesion less than 15 mm in diameter seen on a single 10-mm scan section. The factors contributing to lacunae were determined by stepwise discriminant analysis. Single or multiple cerebral lacunae were revealed in 27.6% (21 of 76) of untreated hypertensive patients, 17.3% (30 of 173) of treated hypertensive patients, and 7.2% (5 of 69) of normotensive control subjects. Incidence of lacunae was significantly higher in hypertensive patients than normotensive control subjects. Stepwise discriminant analysis showed that the most strongly contributing factor for lacunae was the grade of hypertensive retinopathy in untreated hypertensive patients and mean blood pressure in treated hypertensive patients. Asymptomatic cerebral lacunae were frequently detected by computed tomography in elderly patients with essential hypertension. The severity and duration of hypertension correlate positively with this type of vascular complication in hypertension.
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PMID:Role of hypertension in asymptomatic cerebral lacunae in the elderly. 828 71

The development of hypertension is associated with the presence of cardiovascular structural alterations. The principal target organs of hypertensive disease are the heart, brain, kidney and eye. Although left ventricular hypertrophy is an initially useful and well tolerated adaptive mechanism because it tends to reduce wall stress, it may subsequently lead to impaired cardiac function and even heart failure. Vascular structural alterations include reduced compliance, the appearance of atheromatous lesions in the large arteries, and hypertrophy or remodelling of small artery walls, and may be involved in the onset of retinal, renal and brain lesions. Technological progress now enables us to evaluate cardiovascular structural alterations early on as well as to monitor their natural history and the modifications induced by antihypertensive therapy. There is no question as to capacity of antihypertensive therapy to reduce the incidence of stroke, heart failure, renal failure and severe hypertensive retinopathy. Although a number of drugs are able to lower blood pressure, ACE-inhibitors and calcium entry blockers more effectively bring about the regression of left ventricular hypertrophy and, probably, also the retrocession of structural alterations in small resistance arteries; they seem to have a beneficial effect on structural alterations in large arteries as well. Although the regression of left ventricular hypertrophy could be associated with an improved prognosis, no data are available yet on the prognostic significance of the presence and regression of vascular structural alterations.
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PMID:[The organ damage in arterial hypertension]. 856 78

Left ventricular hypertrophy (LVH) is an independent cardiovascular risk factor. It has not been established, however, whether left ventricular geometry is an independent predictor of extracardiac target organ damage in essential hypertension. Study groups were classified according to relative wall thickness: 27 patients with concentric LVH and 50 patients with eccentric LVH. Age and left ventricular mass indexes of two groups were matched. As indexes of extracardiac target organ damage, retinal funduscopic grade, and serum creatinine level were measured. The severity of hypertensive retinopathy and the renal involvement were more severe in patients with concentric LVH than in patients with eccentric LVH. Extracardiac target organ damage was consistently higher in patients with concentric LVH than in those with eccentric LVH. Systemic hemodynamics paralleled ventricular geometric patterns, with higher peripheral resistance and lower aortic compliance in patients with concentric LVH, whereas end-diastolic volumes and stroke volumes were higher in patients with eccentric LVH than in patients with concentric LVH. In addition, total peripheral resistance was related to retinal fundoscopic grade (r = 0.41, P < .01), and serum creatinine level (r = 0.28, P < .05). Even in the presence of an identical degree of LVH, echocardiographically determined left ventricular geometry may provide a further independent stratification of extracardiac target organ damage in essential hypertension.
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PMID:Left ventricular geometry as an independent predictor for extracardiac target organ damage in essential hypertension. 979 33

Systemic hypertension is a common condition associated with significant morbidity and mortality. Hypertension confers cardiovascular risk by causing target-organ damage that includes retinopathy in addition to heart disease, stroke, renal insufficiency and peripheral vascular disease. The recognition of hypertensive retinopathy is important in cardiovascular risk stratification of hypertensive individuals. This review reevaluates the changing perspectives in the pathophysiology, classification and prognostic significance of fundal lesions in hypertensives.
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PMID:Hypertension and the eye: changing perspectives. 1242 Jan 90

Hypertensive retinopathy has long been regarded as a risk indicator for systemic morbidity and mortality. New population-based studies show that hypertensive retinopathy signs are strongly associated with blood pressure, but inconsistently associated with cholesterol and other risk factors of atherosclerosis. Mild hypertensive retinopathy signs, such as generalized and focal retinal arteriolar narrowing and arteriovenous nicking, are weakly associated with systemic vascular diseases. Moderate hypertensive retinopathy signs, such as isolated microaneurysms, haemorrhages and cotton-wool spots, are strongly associated with subclinical cerebrovascular disease and predict incident clinical stroke, congestive heart failure and cardiovascular mortality, independent of blood pressure and other traditional risk factors. These data support the concept that an assessment of retinal vascular changes may provide further information for vascular risk stratification in persons with hypertension.
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PMID:Hypertensive retinopathy signs as risk indicators of cardiovascular morbidity and mortality. 1614 91


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