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

Five young, healthy male students performed two different psychophysical tests each lasting 1 min. The first test (A) consisted of mental arithmetic with digiting of results on a keyboard; the second test (G) consisted of playing an electronic game based on hand-eye coordination. Before and during each test, subjects remained seated with their thoraxes connected to an impedance cardiography monitor which gave, non invasively, beat-by-beat values of heart rate (HR), cardiac output (CO), stroke volume (SV) and left ventricle ejection time (VET). Systolic (SBP) and diastolic (DBP) arterial blood pressures were measured by means of a sphygmomanometer and total peripheral vascular resistance (TPR) and mean systolic ejection rate (MSER) were calculated. During test A, CO (A = +30%, G = +14%), HR (A = +26%, G = +2%) and SBP (A = +16%, G = +10%) increased more than during test G, while SV (A = +3%, G = +12%) and MSER (A = +11%, G = +14%) increased less and TPR (A = -13%, G = -7%) and VET (A = -7%, G = -2%) decreased more than in G. It was concluded that the analysis of a more complete cardiovascular profile may enhance distinctions among the behavioural stressors that induced different combinations in cognitive and sensory-motor responses.
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PMID:Differences in cardiovascular profiles induced by mental arithmetic and by hand-eye task. 770 30

Marital status and indices of social support are associated with mortality due to coronary heart disease and stroke. This association seems not entirely due to differences in recognised cardiovascular disease risk factors. The Western Sydney Stroke risk in the Elderly Study examined the relationship between marital status, living arrangements, widowhood and extent of social support, and risk factors for cardiovascular disease in men and women aged over 65 years. Unmarried men had the lowest mean HDL-C levels. Men living alone had the highest mean systolic blood pressures. The lower mean HDL-C levels and higher DBP levels seen among widows were not statistically significant after adjustment for differences in past medical history and education levels. The extent of social support was not associated with any significant differences in cardiovascular risk factor levels among men or women. We conclude that some of the increased risk of cardiovascular disease associated with socio-demographic factors among men in this age-group may be due to differences in primary cardiovascular disease risk factors. However, some of the mechanisms underlying risk of cardiovascular disease in this age-group remains obscure.
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PMID:Social support, marital status and living arrangement correlates of cardiovascular disease risk factors in the elderly. 774 15

Aim of this study was to evaluate the antihypertensive efficacy, tolerability, drug plasma levels and hemodynamic effects after long-term treatment with the slow release (SR) formulation of verapamil (240 mg od). After a wash-out period of two weeks, 96 subjects (39 M, 57 F; mean age: 55 +/- 8.4 years; recruited in 9 centers) with mild to moderate, uncomplicated hypertension received verapamil 240 mg SR od for 24 weeks. The following parameters were considered: systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), ECG, echocardiogram, routine blood and urine chemistries, drug plasma levels. In addition, hemodynamic parameters were assessed in 30 subjects. A significant decrease in SBP and DBP (p < 0.01) was observed already after 1 week of treatment and was evident during all the study. HR was significantly reduced after 4 weeks (p < 0.01). No changes of ECG and echocardiographic parameters occurred. A significant increase in drug plasma levels was measured after 12 and 24 weeks of treatment (p < 0.05), when compared to the values recorded after 1 week. After 24 weeks drug levels were slightly decreases, even if not significantly, when compared to the values observed at the 12th week. No significant changes of cardiac output (CO), cardiac index (CI), stroke volume (SV) were evident. Total vascular resistances (TVR) decreases significantly (p < 0.001) 80 subjects completed the study. These results confirm the antihypertensive efficacy and tolerability of SR formulation of verapamil and suggest that the effective mechanism by which it reduces blood pressure is the progressive reduction of TVR without a sympathetic reflex stimulation. This hemodynamic effect is achieved by small drug concentrations. In conclusion, SR formulation of verapamil allows a good therapeutic control in hypertensive subjects when it is administered od and, therefore, it can be considered a drug of first choice in the treatment of arterial hypertension.
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PMID:[Plasma levels and noninvasive hemodynamic profile of slow release verapamil (240 mg). A multicenter study]. 776 76

The purpose of this study was to determine the prevalence of isolated systolic hypertension (ISH) and associated risk of major cardiovascular events. The Copenhagen City Heart Study is a prospective population survey with cardiovascular examinations at 5-year intervals. Blood pressure measurement was carried out as office blood pressure. ISH was defined as SBP > or = 160 mmHg and DBP < 90 mm Hg. The risk of stroke and myocardial infarction (MI) in association with ISH was assessed using a multivariate Cox regression model. Follow-up was carried out by means of the National Patients Register and Death Register. The 19,698 subjects were randomly selected after age stratification from an area of central Copenhagen. Subjects (n = 6621) were included if > or = 50 years, not on anti-hypertensive or cardiac medicine, and had no history of a previous stroke or MI. Initial cases of verified stroke or MI were recorded from 1976 to 1988. The prevalence of ISH showed an age-related increase from 3% in the 55-year olds to 13% in the 72-year olds. No sex difference was found. Relative risk of stroke corrected for other risk factors was 3.0 (95% CI 1.6-5.3) for women and 2.7 (1.8-4.3) for men. This was the highest relative risk among all hypertensive groups. Relative risk of MI corrected for other risk factors was 0.8 (0.3-2.0) for women and 1.6 (1.0-2.5) for men. Population attributable risk for stroke associated with ISH is up to 30%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Isolated systolic hypertension as a major risk factor for stroke and myocardial infarction and an unexploited source of cardiovascular prevention: a prospective population-based study. 778 98

The aims of this study were to determine: (1) the proportion of elderly hypertensive subjects currently attending a hospital hypertension clinic suitable for a trial of antihypertensive drug withdrawal, (2) the proportion of suitable patients who can be successfully withdrawn from drug therapy while receiving nonpharmacological advice, and (3) the factors associated with successful withdrawal. One hundred and five consecutive hypertensive subjects, 53% female, mean age 76 years (range 65-84 years) on pharmacological antihypertensive therapy for > 1 year were studied, of whom 78 (74%) had a clinic SBP < 175 mmHg and DBP < 100 mmHg. Subjects with recent myocardial infarction or stroke or with symptoms of ischaemic heart disease were excluded. Antihypertensive drug therapy was withdrawn in this group and nonpharmacological advice to lower BP was instituted. Clinic BP and weight were subsequently recorded monthly for 12 months in all subjects and at every three months in those who had a possible follow-up period of 24 months. The 24h ambulatory BP was measured at baseline and repeated one month off therapy; 24h urine electrolytes were also assessed at baseline and at 12 months or before restarting drug therapy. Seventy-four (70%) subjects had a potential follow-up of 12 months (four were withdrawn from the study) and 64 were available for two years of follow-up. Antihypertensive treatment was restarted if SBP > or = 160 mmHg and/or DBP > or = 90 mmHg on two consecutive visits. After 12 months, 20 (25%) of those withdrawn remained normotensive, the majority restarting therapy did so in the first three months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Possibilities for antihypertensive drug therapy withdrawal in the elderly. 785 30

The pharmacological treatment, mainly based on diuretics, of isolated systolic hypertension (ISH) has recently been shown to reduce the risk of stroke and coronary heart disease in the elderly. The purpose of this study was to compare the antihypertensive effect and tolerability of different drug regimens in elderly subjects with ISH (systolic blood pressure--SBP-- > or = 160 mmHg and diastolic blood pressure--DBP-- < 90 mmHg). A multicentre, randomized, controlled open trial was planned in the general practice setting. Four widely used treatment schedules were tested: hydrochlorothiazide 25 mg plus amiloride 2.5 mg (H+Am), nifedipine slow release 20 mg (N), atenolol 50 mg (At) and atenolol 25 mg plus chlorthalidone 6.25 mg (At+C). After a baseline evaluation, 308 patients (76.3% female, mean age 75.3 +/- 7.1 years) were randomized and followed up for 6 months. After 3 months the drug dosage was doubled if the systolic blood pressure goal (SBP < 160 mmHg and SBP reduction of at least 20 mmHg) had not been reached. Ninety-four subjects (30.5%) presented contraindications to beta-blockers. At the 3rd- and 6th-month visits all treatment groups, except At, showed a significant reduction in SBP compared to the control group; DBP showed no significant reduction in any group at any time. At the end of the follow-up the percentage of hypertensives who had reached the BP goal was 14.6% in the control group, 52.9% in H+Am, 54.8% in N, 28.6% in At and 52.2% in At+C.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Antihypertensive efficacy and tolerability of different drug regimens in isolated systolic hypertension in the elderly. 800 21

We set out to examine the prevalence of echocardiographically-determined left ventricular hypertrophy (LVH) in a hospital-based population of untreated elderly hypertensives and to study the relationship between left ventricular mass index and clinic and 24h ambulatory BP, urinary electrolyte and microalbumin excretion and ECG changes. We studied 52 untreated elderly hypertensives, mean age 76 years, with no evidence of stroke or heart disease. Subjects underwent 24h ambulatory BP recording together with 24h urine collection for electrolytes and microalbumin estimation. A standard ECG was examined for LVH by commonly used criteria. Subjects were examined by 2-dimensional guided M-mode echocardiography; left ventricular mass was calculated from the formula of Devereux and Riechek and corrected for body surface area (left ventricular mass index, LVMI). Mean LVMI was 168 +/- 39 g/m2 for men and 153 +/- 36 g/m2 for women; 43 (83%) subjects had LVH. LVMI was significantly related to clinic SBP (r = 0.27, P = 0.05), ambulatory daytime SBP (r = 0.27, P = 0.05), nighttime SBP (r = 0.41, P = 0.003) and nighttime DBP (r = 0.29, P = 0.04). LVMI was also related to the difference in mean SBP between day and night (r = -0.32, P = 0.02) and subjects with a day-night SBP difference of > or = 10 mmHg (n = 27) had significantly lower LVMI than those with a day-night SBP difference < 10 mmHg (141 +/- 32 g/m2 vs. 176 +/- 35 g/m2, respectively; P = 0.0005). Fifteen subjects had LVH by ECG criteria giving a sensitivity of 28% and specificity of 66%. LVMI was not related to urinary sodium, potassium or albumin excretion. This study shows that in elderly hypertensives it is measures of nighttime BP which are most closely related to LVMI and subjects with a greater nocturnal fall in BP have lower LVMI, presumably reflecting differences in 24h BP load.
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PMID:Clinical correlates of left ventricular mass in elderly hypertensives. 808 25

The role of hypertension in the increased rate of heart attack reported in vigorously active subjects was examined in a large prospective study of 7735 middle-aged men drawn from general practices in 24 British towns (The British Regional Heart Study). Analyses were restricted to 5694 men with no evidence of pre-existing ischaemic heart disease or stroke at screening, in whom there were 311 major ischaemic heart disease events after 9.5 years follow-up. Risk of major ischaemic heart disease events decreased significantly with increasing physical activity to levels of moderate/moderately vigorous activity, with a 50% reduction in risk compared with inactive men after adjustment for age, body mass index, smoking, heavy drinking, social class and blood cholesterol. However, at the highest level of physical activity (vigorous group) risk of major ischaemic heart disease events was increased above that seen in the moderate/moderately vigorous group (rr = 1.68, P = 0.05). When separated into normotensives (n = 3888) and hypertensives (n = 1806; SBP > or = 160 mmHg or DBP > or = 90 mmHg or on regular antihypertensive treatment), the increased risk of major ischaemic heart disease events in the vigorous group was only evident in hypertensive men. They showed more than a twofold increase in risk compared with the moderate and moderately vigorous group (rr = 2.7, P < 0.05). In normotensive men, risk was significantly lowered in those engaged in moderate activity with no further decline in rate of heart attack at increasing levels of physical activity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Physical activity, hypertension and risk of heart attack in men without evidence of ischaemic heart disease. 815 4

The prevalence of coronary events was 64.5/100,000 in the urban of shijia zhuang and it was higher than 23.8/100,000 in rural. Contrary to the coronary events, the prevalence of stroke in urban (159.6/100,000) was lower than that in rural (170.2/100,000). The paradox was studied with their relation to nutrition. The SBP and DBP levels, hypertension rate, serum cholesterol, BMI and dietary saturated fatty acid and cholesterol in urban were higher than that in rural. They were risk factors especially to coronary events. The urban inhabitants had high animal protein intake and higher serum amino acids and higher SO4 excreted in daily urine than that of the rural inhabitants. The result suggests that the higher animal protein intake may be preventive factor for stroke in urban inhabitants.
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PMID:[The relationship between nutrition and prevalence of coronary events and stroke in urban and rural areas of Shijiazhuang]. 820 Mar 14

In 148 Black and White men and women, laboratory measures of blood pressure (BP), heart rate, stroke volume (SV), cardiac output (CO) and total peripheral resistance (TPR) during baseline and 5 stressors were examined in relationship to ambulatory systolic (SBP) and diastolic (DBP) blood pressures at work. Baseline BP strongly predicted mean work levels in all groups. For White men and Black women, higher SV and CO responses to the active speech and averaged across all tasks predicted higher work SBP individually and also when added to a model based on baseline SBP, age, and diary information. For White women, higher SBP increases to the passive speech similarly predicted mean work SBP. For Black men, higher TPR response to the cold pressor test correlated with higher work SBP but did not improve a predictor model involving baseline SBP and age. Reactivity measures did not consistently contribute to prediction of work DBP.
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PMID:Race and gender comparisons: II. Predictions of work blood pressure from laboratory baseline and cardiovascular reactivity measures. 822 60


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