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

Ca2+, Mg2+, K+, Na+ ATPase activities, and the changes in K, Na, Ca, cholesterol, its fractions and esters contents in the red blood cells of 95 patients with acute cerebral stroke were studied on day 1-3, 5-7, 19-21. Statistically significant differences were found in the enzyme activities, the levels of K, Na, Ca, cholesterol and its fractions and esters in the red blood cells of patients vs. healthy donors. These features were dependent on the nature of the stroke: reversible--irreversible, ischemic--hemorrhagic.
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PMID:[ATPase activity and erythrocyte levels of potassium, sodium, calcium and cholesterol and its fractions and esters in patients in the acute period of cerebral stroke]. 164 6

Hypertensive patients have lower cardiac outputs and stroke volumes, higher heart rates, and a markedly higher peripheral resistance than normotensive individuals at the same intensity of exercise. Even patients with mildly elevated resting blood pressures have a markedly increased myocardial oxygen demand during exercise; since demand is determined not only by the pressure load but also by the degree of ventricular hypertrophy, three therapeutic inferences may be drawn: (a) Endurance training offers hypertensive patients a means of lowering exercise heart rate, reducing the systolic blood pressure and myocardial oxygen consumption, and also improving physical work capacity. (b) Besides avoiding isometric exercise, due to possible excessive peaks of blood pressure, all patients should be evaluated by ergometric testing before beginning an exercise training programme. (c) If ergometry reveals a marked rise in blood pressure at low levels of exertion, then appropriate antihypertensive medication (beta-blockers, calcium antagonists) should be prescribed prior to training.
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PMID:Blood pressure response to exercise in normotensives and hypertensives. 166 31

Previous studies on isolated blood vessels indicate that acute withdrawal of extracellular magnesium ions ([Mg2+]o) induces calcium-dependent contractile responses, including coronary blood vessels. The present study, using isolated perfused rat hearts, was designed to assess whether low [Mg2+]o could result in cardiac failure and to gain some insight into the mechanism of action. The results show that both the myocardial oxygen consumption (by 29-38%) and oxygen tension in the coronary effluent decreased (by 18-26%) as the [Mg2+]o was decreased stepwise from 1.2 to 0.6, 0.3 and 0.0 mM. Linear-regression analysis of a plot of coronary flow versus the rate of oxygen consumption shows that there is a tendency for a rightward shift of this relationship in low [Mg2+]o and a leftward shift of the curve in elevated [Mg2+]o (4.8 mM). The experiments also show that with low [Mg2+]o, coronary flow declines 20-37%, and cardiac output and stroke volume fall 24-50% accompanied by 3- to 4-fold elevations in lactate production and eventual, irreversible cardiac failure. An interesting finding, of this study, is that the alpha-adrenoceptor constrictor agonist, phenylephrine (1-5 microM), was found to have effects very similar to low [Mg2+]o. This latter finding is consonant with our hypothesis that progressive lowering of extracellular, ionized magnesium initiates progressive coronary vasoconstriction, decreased tissue oxygenation and myocardial ischemia, which given time, in situ, in the intact host can lead to cardiac failure.
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PMID:Low extracellular magnesium results in cardiac failure in isolated perfused rat hearts. 166 20

The objective of treating patients with hypertension is not simply to reduce blood pressure but rather to prevent the associated morbidity and mortality. Recent assessments of clinical trials have shown that while the risk of stroke is consistently lower with antihypertensive therapy, the same degree of success has not been demonstrated for coronary artery disease (CAD). Although there are many explanations of why we have not done as well in preventing CAD, one possibility is that the therapy used in clinical trials, primarily thiazide diuretics and beta-adrenoreceptor blockers, has increased the patient's risk of developing coronary atherosclerosis or lethal arrhythmias. Four classes of antihypertensive agents are recommended for initial therapy--thiazide diuretics, beta-adrenoreceptor blockers, angiotensin-converting enzyme (ACE) inhibitors, and calcium entry blockers. The metabolic effects of thiazide diuretics include electrolyte disturbances (hypokalemia, hypomagnesemia, and hyponatremia), dyslipidemia (increased triglycerides), abnormalities of glucose metabolism (hyperglycemia, hyperinsulinemia, and peripheral insulin resistance), and hyperuricemia. beta-Adrenoreceptor blockers have many of the same metabolic adverse reactions. beta-Adrenoreceptor blockers without intrinsic sympathomimetic activity (ISA) also cause dyslipidemias (lowered high-density lipoprotein cholesterol and increased triglycerides) and abnormalities of glucose metabolism (hyperglycemia, hyperinsulinemia, and peripheral insulin resistance). beta-Adrenoreceptor blockers with ISA and third-generation beta-blockers with selective partial agonist activity (celiprolol and dilevalol) do not cause dyslipidemia and to date do not appear to induce abnormalities in glucose metabolism. ACE inhibitors may decrease triglycerides and increase high-density lipoprotein cholesterol, and captopril may improve insulin sensitivity. Calcium entry blockers are metabolically neutral.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Metabolic considerations in the choice of therapy for the patient with hypertension. 167 Nov 90

1. Comparisons of the effects of 4 and 16 weeks of exercise were made on; cardiac output, stroke volume, heart rate, left intraventricular systolic and diastolic pressures, dP/dt, and heart calcium in the Bio 14.6 cardiomyopathic and F1 B hamsters. 2. In the cardiomyopathic hamster the cardiac output, stroke volume, left intraventricular systolic pressure and dP/dt, which were all depressed in the age related sedentary animals, were increased by both periods of exercise. The left intraventricular diastolic pressure which was elevated was likewise decreased by both exercise periods. Only the 16 week exercise period decreased the resting heart rate. 3. In the normal F1 B hamster, both periods of exercise increased the cardiac output and stroke volume while the left intraventricular systolic pressure was decreased. Only the 16 week exercise decreased the resting heart rate and left intraventricular diastolic pressure and increased the left ventricular dP/dt. 4. Both periods of exercise increased the total heart calcium in the Bio 14.6 hamster while the heart calcium in the F1 B was increased only by the 16 week exercise period.
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PMID:Comparison of exercise effects on the hemodynamics of the Bio 14.6 cardiomyopathic hamster. 167 84

The genomic loci of four distinct phospholipase C genes (PLC-beta, PLC-gamma I, PLC-delta and PLC-gamma II) were examined for restriction fragment length polymorphisms (RFLPs) between the genomes of three normotensive [Sprague-Dawley, Donryu and Wistar-Kyoto (WKY)] and two closely related hypertensive [spontaneously hypertensive (SHR) and SHR stroke-prone (SHR-SP)] rat strains. The RFLPs observed between SHR and WKY were classified into three types. Type I RFLPs are those observed at 4.3 kilobase (kb) and 1.9 kb by AvaI digestion for PLC-gamma probe and at 1.9 kb by AccI digestion for PLC-beta probe, where RFLP banding patterns are conserved in two hypertensive (SHR and SHR-SP) and one normotensive (Sprague-Dawley) strains. Type II RFLPs are those observed by AccI, BamHI, EcoRI and PstI digestions for PLC-beta probe, where RFLP pattern observed in SHR is shared by one normotensive (Sprague-Dawley) strain but not by SHR-SP, WKY or Donryu rats. Type III RFLPs are those detected at 6.3 kb band by Bg/II digestion for PLC-beta probe and at 1.0 kb by BamHI digestion for PLC-gamma II probe, where RFLP pattern observed in SHR is shared by two normotensive rats other than WKY. No RFLP was found for PLC-gamma I probe after testing 13 restriction enzymes. Since PLC plays a pivotal role in regulating the intracellular calcium concentration and the intracellular signal transduction, these RFLPs may offer a valuable tool for the analysis of genomic predisposition for hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Phospholipase C genes display restriction fragment length polymorphisms between the genomes of normotensive and hypertensive rats. 167 27

The hemodynamic consequences of blockade at both beta-adrenoceptors and slow calcium channels is of therapeutic importance for patients with angina pectoris. The hemodynamic interaction of a new cardioselective beta blocker, celiprolol, and nifedipine was examined in an acute hemodynamic study using three prospectively matched groups with angiographically confirmed coronary artery disease (n = 10/group). Patients were randomly allocated to intravenous celiprolol (8 mg), sublingual nifedipine (20 mg), or their combination. Rest and exercise (supine bicycle) hemodynamics were determined before and following each therapy. At rest, celiprolol did not alter pumping function; nifedipine reduced diastolic blood pressure and systemic vascular resistance index (SVRI), with a small increase in heart rate. Combination therapy reduced systemic arterial pressure and SVRI; heart rate and cardiac stroke volume index increased. During exercise celiprolol tended to reduce heart rate and cardiac index; nifedipine reduced exercise SVR and cardiac stroke work indices. Combination therapy reduced all components of blood pressure; cardiac stroke work and SVR indices fell. These hemodynamic data suggest that beta blockade with celiprolol may result in a slight depression of cardiac pumping during exercise; however, such effects are offset by the vasodilating actions of nifedipine (reflex sympathetic action offsetting cardiodepression). Thus the acute hemodynamic effects of this combination were seemingly safe in these patients; the longer term effects during maintained therapy should be further assessed.
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PMID:Hemodynamic interactions of a new beta blocker, celiprolol, with nifedipine in angina pectoris. 167 61

Reduction of morbidity and mortality has been the aim of drug treatment for hypertension since its beginning in the 1950s. Its efficacy has been tested in many trials. An outstanding result of these trials has been their clear success in preventing stroke and stroke-related deaths and in decreasing the incidence of congestive heart failure (CHF) and renal disease. A similar success has not been achieved in reducing coronary heart disease endpoints. Diuretics and beta-blockers played a central role in these studies; however, their adverse effects on lipid metabolism have been cited as a possible explanation for the failure of antihypertensive therapy to affect coronary heart disease (CHD). Recently, the extent and significance of these lipid changes has been put into perspective, and new insights into the role of carbohydrate metabolism and insulin resistance in hypertension have emerged. The same drugs which adversely affect lipid metabolism also adversely affect carbohydrate metabolism, and more is becoming known about these mechanisms and their role in hypertension and its sequelae. Other classes of antihypertensive drugs such as the calcium antagonists, angiotensin converting enzyme (ACE) inhibitors, and alpha 1-antagonists do not share these adverse effects. It has become increasingly clear that effective antihypertensive therapy includes both the lowering of blood pressure and containment of the abnormalities that accompany the hypertensive state.
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PMID:Metabolic consequences of treating hypertension. 168 Mar 46

The effects of combined alpha/beta adrenoceptor blockade and of beta-receptor/slow channel calcium blockade on systemic and pulmonary hemodynamics and on adrenergic activity were compared in two matched groups of men suffering from ischemic heart disease and grade 1 to 2 hypertension. They were studied at rest supine and during ischemia-inducing exercise in the seated posture using invasive percutaneous techniques. Sixteen patients received 200 mg labetalol as a single oral doses, 15 received 100 mg metoprolol plus 10 mg nifedipine. Both regimens reduced pressures in the systemic and pulmonary circulation under all conditions. At rest, stroke volume and cardiac output slightly decreased after labetalol and increased after metoprolol/nifedipine. During exercise the changes induced by the two regimens were virtually identical; heart rates and vascular resistances were reduced, stroke volume increased, cardiac output was not significantly changed. Plasma renin activity was lowered by labetalol, unchanged by metoprolol/nifedipine. Plasma adrenaline increased after metoprolol/nifedipine only, noradrenaline with both regimens. Both combinations significantly lowered stroke work and the rate pressure product and had similar beneficial effects on the onset and the duration of angina. It is concluded that both combinations significantly reduce blood pressures and attenuate or offset the potential adverse hemodynamic effects of beta-receptor blockade alone without loss but rather enhancement of antianginal efficacy.
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PMID:Acute effects of combined alpha/beta-adrenoceptor blockade v combined beta-receptor and slow channel calcium blockade in ischemic heart disease complicated by hypertension. Hemodynamic and adrenergic responses. 168 21

This study was undertaken in order to investigate the newly discovered spontaneously hypertensive rat (SHR)-specific restriction fragment length polymorphism (RFLP) at the genomic locus of (poly)phosphoinositide-specific phospholipase C (PLC)-delta at a DNA sequence level. Our aim was to clone the PLC-delta complimentary DNA (cDNA) from SHR and analyse the genomic DNA obtained from two hypertensive rat strains such as SHR and its stroke-prone substrain (SHR-SP) and three normotensive rat strains such as Sprague-Dawley, Donryu and Wistar-Kyoto (WKY) by preparing an aortic cDNA library of SHR, hybridization cloning of PLC-delta cDNA and an analysis of the genomic DNA by polymerase chain reaction. By digesting with restriction enzyme XhoI, we discovered an RFLP band displaying only in SHR and SHR-SP, not in Sprague-Dawley, Donryu and WKY rats. DNA sequencing of PLC-delta cDNA cloned from an aortic cDNA library of SHR revealed a total of three SHR-specific point mutations, two of which resulted in amino acid substitutions. The first point mutation (A to T) was detected at the XhoI site, changing a threonine(ACG) to a serine(TCG), and the second point mutation (A to G) was discovered in the vicinity of the first one, changing an isoleucine(ATA) to a methionine(ATG). This is the first demonstration of the mutations in the SHR genome changing amino acid sequences. These amino acid substitutions, situated in the putative catalytic X domain of PLC-delta, may be the major cause of the augmented PLC activity observed in the SHR, possibly leading to hypertension-related phenonemoma such as abnormal calcium homeostasis and increased intracellular calcium ion concentrations.
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PMID:Phospholipase C-delta gene of the spontaneously hypertensive rat harbors point mutations causing amino acid substitutions in a catalytic domain. 168 14


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