Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Renal transplantations were performed using stroke-prone spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY) as kidney donors and bilaterally nephrectomized F1 hybrids, bred from SHR x WKY parents as renal graft recipients. Recipients of renal grafts from adult, naive SHR but not from adult normotensive WKY kidney donors developed post-transplantation hypertension. Permanent blood pressure normalization by antihypertensive treatment in adult SHR kidney donors, as well as the young, prehypertensive age of SHR kidney donors reduced but did not prevent the development of post-transplantation hypertension. Increasing renal perfusion pressure in WKY kidney donors (chronic 2-kidney 1-clip renovascular hypertension) also resulted in post-transplantation hypertension in recipients of the non-clipped kidneys. Blood pressure remained normal in recipients of renal grafts from young WKY kidney donors. These data suggest that SHR kidneys carry a genetic defect which can give rise to post-transplantation hypertension and which therefore may also play a role in the development of hypertension in naive SHR. In addition, secondary hypertension-induced renal damage may also contribute to post-transplantation hypertension in recipients of renal grafts from hypertensive donors.
 ...
PMID:Post-transplantation hypertension in recipients of renal grafts from hypertensive donor rats. 179 3

The preventive effects of carteolol, a beta-adrenoceptor antagonist, on secondary lesions were pathophysiologically examined in stroke-prone spontaneously hypertensive rats (SHRSP) from 8 to 30 weeks of age. Carteolol was added to the drinking water in doses of 0.005% (8 to 18 weeks of age) to 0.01% (19 to 30 weeks of age) (3.8 and 6.0 mg/kg/d, respectively). These animals gained significantly more weight than the untreated control SHRSP, and their heart rate reduced from 14 weeks of age. Suppression of blood pressure rise was not definite, however, histology revealed prevention of the development or aggravation of secondary hypertension-related lesions, such as myocardial fibrosis, proliferative arteriolitis, necrotic arteriolitis and renal glomerular lesions. A decrease in non-esterified fatty acids in the serum was evident. Thus, carteolol has cardiac as well as renal protective effects, in the SHRSP.
 ...
PMID:Systemic effects of carteolol, a beta-adrenoceptor antagonist in stroke-prone spontaneously hypertensive rats. 197 5

The prevalence, reversibility, and mortality of secondary hypertension among 3783 patients with moderately severe nonmalignant hypertension attending the Glasgow (Scotland) Blood Pressure Clinic were assessed. Underlying causes of hypertension were found in 297 patients (7.9%). Eighty-seven patients (2.3%) were considered to have a potentially reversible cause for their hypertension, including the oral contraceptive pill (38 patients), renovascular disease (27 patients), and primary hyperaldosteronism (ten patients), but of these only 33 patients (0.9% of total clinic population) were cured by specific intervention. Two hundred ten patients (5.6%) had irreversible renal parenchymal disease and significantly higher mortality than men and women with other causes of hypertension. Excess deaths in the renal group were attributed to renal failure (International Classification of Diseases [ICD] 580 to 589) and vascular causes (ICD 390 to 458) but not to cancer (ICD 140 to 208; 235 to 239) or other nonvascular disease. These results suggest that investigation of hypertension for an underlying cause will reveal a small number of patients with treatable disorders, of whom only a few will be cured by specific intervention, and a moderate number with irreversible disease who are at high risk of myocardial infarction and stroke.
 ...
PMID:Secondary hypertension in a blood pressure clinic. 360 86

The mortality of 3783 non-malignant hypertensive patients attending the Glasgow Blood Pressure Clinic between 1968 and 1983 and followed for an average of 6.5 years was compared with that in three control groups: the general population of Strathclyde a group of 15 422 subjects aged 45-64 years and screened in Renfrew and Paisley between 1972 and 1976, and a group of hypertensives seen in a blood pressure clinic based on general practice in Renfrew. Average blood pressure for men at entry to the Glasgow Clinic was 181/111 mmHg falling to 158/96 mmHg during treatment. Corresponding values for women were 185/109 mmHg and 161/96 mmHg. Seven hundred and fifty clinic patients (451 males) died during follow-up, the commonest causes of death in both sexes being myocardial infarction and stroke. All-cause age-adjusted mortality (deaths per 1000 patient-years) was 41.4 for men and 22.1 for women. At all ages in both sexes and for all levels of initial blood pressure mortality was less in patients whose blood pressure was reduced most. Without a randomized control group it is not certain that lower mortality in those with well controlled blood pressure was due to treatment, although this is the most likely explanation. Cigarette smoking, a history of myocardial infarction, angina or stroke, retinal arterio-venous nipping, raised blood urea, an abnormal electrocardiogram (ECG) and secondary hypertension were associated with increased risk, but heavy alcohol intake, obesity, haematocrit greater than 45%, hypokalaemia and social class were not. Life table analysis showed that, despite some reduction of mortality by treatment, the relative risk to men and women in the clinic remained two- to five-times that of the general population. The benefits of treatment were not such as to restore normal expectation of life even when blood pressure was well controlled. Excess mortality in the clinic could not be explained by difference of smoking habit or social class. This suggests that there is in the hypertensive patients of the Glasgow Clinic an element of irreducible risk, that treatment may be beneficial in some respects but harmful in others, or that patients at particularly high risk are selectively referred to the clinic.
 ...
PMID:Mortality in patients of the Glasgow Blood Pressure Clinic. 371 57

Pathophysiology, outcome and some therapeutic problems of hypertension were described. Frequency of secondary hypertension and its underlying diseases in a hypertensive population greatly varied by study population. In the adult general population (Hisayama study) it was estimated to be 3.8%. Significance of various tests was evaluated in the diagnosis of renovascular hypertension and primary aldosteronism. Consideration of sodium balance in the evaluation was very necessary. The usefulness of captopril test was emphasized. Blood pressure was tended to decrease in upright posture and ambulation in cases with essential hypertension responding to acute sodium depletion by a significant reduction in blood pressure. In the observation of diurnal rhythm of urinary sodium excretion, the peak phase appeared about 3 hours earlier in essential hypertension than in normal control and 5 to 6 hours later in primary aldosteronism and Cushing syndrome. Sympathoadrenal function was activated in young borderline hypertensives but not in middle-aged ones. Outcome of hypertension accompanying diabetes mellitus was poor. Cardiovascular disease and renal failure occurred much frequently. Significance of hypertension as a risk factor of cardiovascular disease was described based on the data obtained through prospective epidemiological study (Hisayama Study). Hypertension was significantly correlated with stroke but not with myocardial infarction. Serum cholesterol level did not significantly correlate with both stroke and myocardial infarction. Reduction in stroke incidence in recent years was described in relation to the changes in risk factors of cardiovascular diseases. Pathophysiology and outcome of malignant hypertension (KW III-IV) were described in relation to underlying disease.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Pathophysiology and outcome of hypertensive subjects. 389 32

One hundred and thirty-five patients with malignant hypertension seen over a period of 11 years (1979 to 1989) at a referral hospital were analyzed to characterize the clinical features and etiology of this disease. Ninety male and 45 female patients with an average age of 38.2 +/- 1.4 years were studied. Malignant hypertension was the presenting feature in 68 patients. The etiology included essential hypertension in 88 patients and a secondary cause in 47 patients. Secondary causes included a renovascular etiology in 20 patients, renal parenchymal disease in 19, pheochromocytoma in 6 and Conn's syndrome and adrenal carcinoma in one patient each. Among the 20 patients with renovascular hypertension, Takayasu's arteritis was seen in 15 (75%). The mean age of patients with essential hypertension was 41.7 + 1.14 years while the mean age in patients with secondary hypertension was 33.2 + 1.96 years. Duration of preexisting hypertension was longer in essential hypertensives (2.42 + 0.45 years) than in patients with secondary hypertension (1.27 + 0.41 years, p < 0.05). Raised serum creatinine was seen in 93 patients. Seventy-seven patients had left ventricular hypertrophy on ECG. Ninety-six patients were followed for a period ranging from 18 months to 10 years (mean 32 months). Sixteen patients died during hospital stay while 6 patients died during the follow-up period. The deaths were related to the effects of uncontrolled hypertension including, renal failure (11), stroke (6), congestive cardiac failure (3) and myocardial infarction (1).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Malignant hypertension in north west India. A hospital based study. 783 Mar 25

Renovascular hypertension is one of the most common causes of secondary hypertension. Its early diagnosis is particularly important, firstly because it is one of the few potentially reversible causes of chronic renal failure. In many centers, including our own, renal angioplasty (PTA) or surgery is the treatment of choice for patients with renovascular hypertension. The aim of the study was the evaluation of the early and late results of PTA versus renovascular surgery. The diagnostic procedures and clinical course of renovascular hypertension were also analyzed. Among patients with renovascular hypertension treated in our Department during the 1981-1993 years, 89 patients (46 men, 43 women) were diagnosed and having renovascular hypertension (3% of all hypertensive patients). The average duration of hypertension in this group was 5 years. High incidence of accelerated hypertension (18%) and cardiovascular complications were observed: myocardial infarction in 20.2% of cases and stroke in 4.5%. The presence of renal failure was found in 22.5% of cases, hypokalemia in 11.2%, 38.3% of patients had changes in other arteries. Renal angioscintigraphy and captopril renal scintigraphy were performed in accordance with renal arteriography in 80% of patients. Arteriography showed unilateral renal artery stenosis in 78.7% of patients and bilateral - in 21.3%. The most common cause of renovascular hypertension in our material was atherosclerosis (65.2%). Fibromuscular dysplasia and Takayasu arteritis were diagnosed less frequently (25.8% and 9.0% respectively). Forty four patients were treated with PTA, 15 underwent surgical revascularization and 11 - unilateral nephrectomy. Early beneficial therapeutic effect (normalization or improvement of blood pressure control) was observed in 88.6% for PTA and 66.7% for surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Renovascular hypertension--clinical observations and long-term follow-up]. 787 Dec

Patients with mild to moderate hypertension require only a simple schedule of investigations, especially if there is a history of stroke or hypertension in first degree relatives. Tests are necessary to profile other cardiovascular risk factors and to detect target organ damage with only limited screening for secondary hypertension. Careful history, physical examination, repeated blood pressure measurements over months and measurements of body mass index, random cholesterol, routine blood chemistry and urinalysis using impregnated paper strips are all that are required. More detailed investigations can be reserved for special groups such as those with peripheral vascular disease or abnormal renal function before or after treatment with angiotensin converting enzyme inhibitors or significant proteinuria or hypokalaemia. Patients with essential hypertension who are smokers with lipid abnormalities may go on to develop superimposed renovascular disease. Severe hypertension at any age and especially if there is a reliable negative family history also merits special consideration. Resistance to antihypertensive treatment is more often due to non-compliance or non-steroidal anti-inflammatory drug use or alcohol abuse than to underlying secondary causes.
 ...
PMID:Hypertension: investigation, assessment and diagnosis. 820 68

Among cardiovascular diseases, hypertension, angina pectoris, acute myocardial infarction and ischemic stroke present a circadian pattern with a greater incidence of unfavourable events between awakening and noon. Chronotherapy aims to use drugs that release their active principles at different times during the day, according to biological needs. In chronotherapy of cardiovascular diseases, a particular attention has been paid to slow-release drugs that assure a 24 hours therapeutic effect with once a day administration. In primary hypertension well controlled by monotherapy (dipper hypertensives), the morning administration of long-acting beta-blockers and calcium antagonists has shown to control blood pressure over 24 hours, whereas ACE-inhibitors have proved more effective when administered at evening. In secondary hypertension (non dipper hypertensives) the administration of calcium antagonists is more effective at evening. Patients with severe hypertension need polytherapy. In that case, at least one of the antihypertensive drugs should be given at evening to lower night blood pressure values, which are particularly elevated also during sleep, and so to prevent an excessive blood pressure rise on awakening. In chronic monotherapy of ischemic heart disease, long-acting beta-blockers and calcium antagonists have shown to be equally effective when they are administered at morning, whereas slow-release nitrates, which need a nitrate-free interval, are to be administered either at morning or at evening, according to the expected time of onset of anginal pain. ASA seems to reduce the morning incidence of acute myocardial infarction, while tissue-type plasminogen activator presents a circadian variation of its thrombolytic activity with a higher efficacy between noon and midnight.
 ...
PMID:[Application of chronotherapy to cardiovascular diseases]. 979 79

Hypertension in pregnancy is generally defined as either an absolute BP > 140/90 mm Hg or a rise in systolic BP > or = 25 mm Hg and/or diastolic BP > or = 15 mm Hg from pre-conception or 1st trimester BP. Hypertension in pregnancy is classified as: a) Chronic--essential or secondary hypertension, b) De novo--pre-eclampsia or gestational hypertension, and c) Pre-eclampsia superimposed on chronic hypertension. Pre-eclampsia is a multisystem disorder in which hypertension is but one sign. The major maternal abnormalities occur in kidneys, liver, brain and coagulation systems. Impaired uteroplacental blood flow causes fetal growth retardation or intrauterine death. There is general agreement that BP > or = 170/110 mm Hg should be lowered rapidly to protect the mother against risk of stroke or eclampsia. There is dispute concerning the level at which lesser degrees of hypertension should be treated, and lowering BP is treating only one aspect of pre-eclampsia. Delivery remains the definitive management.
 ...
PMID:Management of hypertension in pregnancy. 1042 12


1 2 3 4 5 Next >>