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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Antihypertensive effect of enalapril (MK-421), an orally active non-sulfhydryl-containing converting enzyme inhibitor, was examined in stroke-prone spontaneously hypertensive (SHRSP) rats. The treatment was started at 14-15 weeks of age with tail blood pressure over 240 mmHg and was continued for 11 weeks. We used captopril as the reference drug. The dose of enalapril and captopril was 10 and 30 mg/kg per day, p.o., respectively. Enalapril showed a sustained antihypertensive effect from the 1st to the 11th week of the treatment. This antihypertensive effect was substantiated by the good increase in body weight; decrease in heart weight; decrease in incidences of vascular disease, nephrosclerosis, stroke and death. Enalapril treatment also prevented the increases in urine volume, and excretion of osmotically active solutes, Na, Cl and K with age. Captopril treatment showed about the same antihypertensive effect. No side effects were seen in the enalapril or captopril treated group. The antihypertensive potency of enalapril was about 3 times more than that of captopril. Enalapril and captopril slightly increased plasma renin concentration. Urinary excretion of PGE2 was not changed by enalapril or captopril treatment. These results clearly demonstrate the efficacy of long-term treatment with enalapril to prevent development of malignant hypertensive cardiovascular disease in SHRSP rats.
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PMID:Chronic effects of enalapril on blood pressure, stroke, plasma renin, urinary electrolytes and PGE2 excretion in stroke-prone spontaneously hypertensive rats. 299 88

PARD is a prospective study sponsored by the German Research Council with the aim to establish whether spontaneously enhanced platelet aggregation or changes of other hemostatic parameters are risk factors for new vascular occlusions in diabetic patients. 363 diabetic patients (aged 45-65, 232 men, 131 women) were observed for 5 years. Of the 232 men, 53 were on diet, 104 on oral antidiabetic drugs and 75 on insulin. Of 131 women 16 were on diet, 46 on oral antidiabetic drugs and 69 on insulin. At entry clinical examination and laboratory tests were performed, covering the known risk factors for cardiovascular complications. Hemostatic tests and clinical examination were performed at 3 months' intervals. The life status was followed for all patients. Endpoints were carefully defined. Until December 31, 1984, 42 patients died, 23 from cardiovascular disease and 19 from other causes. 13 patients suffered a myocardial infarction, 10 a stroke and 53 peripheral arterial occlusions. The occurrence of new vascular occlusions was significantly higher in those men with enhanced spontaneous platelet aggregation measured by PAT III angle alpha above 40 degrees at entry as compared to those with lower values. This was not the case for women. Other hemostatic parameters, which had also some relation to cardiovascular complications, in men were fibrinogen and F. VIII R:Ag. Established risk factors for which a significant relation to cardiovascular complications was observed in this study, were smoking, duration of diabetes, diastolic blood pressure, cholesterol, triglycerides and also HbA1. The results of the PARD-study have verified the hypothesis that spontaneous aggregation is a major risk factor for future vascular occlusions in diabetic men. They also lead to the hypothesis that high levels of F. VIII R:Ag and fibrinogen are further indicators of progressive vascular disease and may be useful as predictors of new vascular occlusions in combination with such established risk factors as smoking, duration of diabetes, diastolic blood pressure, cholesterol, and triglycerides.
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PMID:Spontaneous platelet aggregation and coagulation parameters as risk factors for arterial occlusions in diabetics. Results of the PARD-study. 310 11

Epidemiologic studies clearly link cigarette smoking with vasoocclusive cardiovascular disease. Postmortem studies provide evidence of accelerated atherogenesis in asymptomatic smokers. However, the rapid regression of cardiovascular risk within the first year of quitting smoking is difficult to explain solely in terms of vascular disease. Recent evidence indicates that plasma fibrinogen, which has been prospectively associated with the risk of ischemic heart disease, is elevated in smokers. Similarly, results from studies investigating thromboxane metabolite excretion in urine confirm those involving radiolabeled platelet turnover, suggesting that platelets are activated in the circulation of chronic smokers. Altered hemostatic function, either as a direct result of smoking or caused by smoking-induced vascular damage, may account for the more rapidly reversible component of cardiovascular risk observed in chronic smokers.
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PMID:Cigarette smoking and hemostatic function. 327 16

Diuretics have traditionally been the keystone of antihypertensive therapy. A variety of clinical trials, designed to examine the benefit of blood pressure reduction in decreasing morbidity and mortality from hypertension-related cardiovascular disease, have surprisingly failed to show a decrease in coronary artery disease death rate, although other forms of vascular disease were impressively reduced. These trials have consistently used diuretics as the initial therapeutic choice. Such observations have stimulated a reevaluation of the "stepped-care" approach and a critical appraisal of diuretic effects. This review examines the efficacy of diuretics in reducing blood pressure and attempts to identify individuals most likely to respond to these agents. The side effects of diuretic therapy are reviewed in hemodynamic, cardiac, metabolic, and symptomatic terms, but because some of these aspects of diuretic or antihypertensive therapy are detailed elsewhere in this monograph, the present discussion focuses on cardiac, metabolic, hemodynamic, and symptomatic effects. Finally, alternative therapeutic options and guidelines for therapy are outlined.
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PMID:Diuretics and their side effects. Dilemma in the treatment of hypertension. 328 Apr 87

The factors responsible for atherosclerosis in renal transplant recipients are not known. In the present study, cardiovascular disease was investigated in 403 patients who received 464 kidney transplants during a 10-year period. Among those who had no clinical evidence of vascular disease at the time of transplantation, atherosclerotic complications developed in 15.8 percent during the post-transplant follow-up period (46.1 +/- 36.2 months). Pre- and post-transplant vascular diseases were closely linked. However, after taking pre-transplant vascular disease into account, multivariate analysis showed that a number of known risk factors (age, sex, diabetes, cigarette smoking, hypertension, and serum cholesterol) were independently associated with post-transplant vascular disease. In addition, the number of acute rejection episodes (all treated with high doses of corticosteroids) was also independently linked to vascular disease. These results suggest that an increased prevalence of known risk factors, and events linked to allograft rejection, explain the high incidence of cardiovascular disease in renal transplant recipients.
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PMID:Risk factors for accelerated atherosclerosis in renal transplant recipients. 328 17

A large and rapidly growing quantity of information gained from both clinical and experimental observation strongly indicate that perturbations of the immune system can contribute to the pathogenesis of vessel injury and thrombosis. This is, in part, because the immune system functions to amplify and diversify the host response to a given stimulus often resulting in activation of associated pathways such as the hemostatic system and modulation of endothelial cell function. Studying the pathogenesis of arteriosclerosis and its complications, as well as other vascular disease, from an immunologic or immunopathologic perspective may provide a better understanding of why some some individuals appear to be at greater risk of cardiovascular disease than others, a more precise identification of the mechanisms leading to the expression of increased risk, and because of the structural specificity implicit in immunologic reactions, identification of those environmental factors responsible for inciting such immunologic perturbation. It is conceivable that identification of at least some of the risk factors associated with the 50% of deaths from heart attack that are not associated with known risk factors may be achieved through a consideration of the role of immunologic mechanisms in the pathogenesis cardiovascular disease.
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PMID:Immunologic aspects of vessel injury and thrombosis. 331 May 35

This report reviews the present status of cardiovascular surgery in West Africa and highlights some of the constraints of development in this field.Rheumatic heart disease is still endemic in the tropics, where it constitutes about 20 percent of all cases of cardiovascular disease (CVD) in Nigeria. Endomyocardial fibrosis is a disease of unknown etiology accounting for 10 to 20 percent of cases. Purulent pericarditis is a common complication of pyomyositis and osteomyelitis found in 5 percent of patients. Chronic constrictive pericarditis is a sequela of infective pericarditis found in 5 percent of all cases of CVD. Calcification is found in 30 percent of cases and pericardiectomy can be performed successfully without cardiopulmonary bypass. Infective endocarditis is equally rare, occurring in 2.5 percent of cases; it is a common source of septic emboli to coronary artery and a very difficult disease to treat in the West African environment.Ischemic heart disease is relatively uncommon, accounting for less than 0.5 percent of patients. The rarity of the disease in black Africans has been attributed to dietary habits and environment rather than to racial and psychosocial factors. Congenital heart disease accounts for 5 percent of all cases of CVD in this review. Ventricular septal defect and patent ductus arteriosus are the most common acyanotic defects, while tetralogy of Fallot and transposition of the great arteries are the most common cyanotic defects.Vascular diseases are uncommon in this series, with traumatic injuries accounting for most of the cases. Abdominal aortic aneurysms, peripheral occlusive vascular disease, and atherosclerotic aortic aneurysms are quite rare. This review further confirms the rarity of deep venous thrombosis and pulmonary embolism in Africans.
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PMID:The status of cardiovascular surgery in West Africa. 331 74

This report describes the nuclear cardiology procedures available for use as diagnostic techniques in patients with definite or suspected cardiovascular disease. The usefulness of myocardial imaging, radionuclide angiocardiography, and other radionuclide cardiovascular imaging techniques is classified within specific disease states. The clinical utility of each technique is graded from I to IV, depending on the clinical importance of the technique (I equals most important; IV equals not indicated). A grade of V is given for methods now considered to be in their research phase. The usefulness of these methods is discussed in patients with acute ischemic heart disease, chronic ischemic heart disease, valvular heart disease, pulmonary vascular disease, and hypertensive heart disease. Selected references are provided.
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PMID:Guidelines for clinical use of cardiac radionuclide imaging, December 1986. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Cardiovascular Procedures (Subcommittee on Nuclear Imaging). 349 Sep 32

Idiopathic pulmonary fibrosis (IPF) and pulmonary fibrosis associated with a collagen vascular disorder (PF-CVD) are chronic inflammatory lung disorders which may be characterized in various subgroups of patients by increased numbers of macrophages, neutrophils, lymphocytes, and/or eosinophils. Previous studies have suggested that the cell populations recovered with bronchoalveolar lavage (BAL) may be important in predicting disease progression and response to therapy. We evaluated this hypothesis in 27 patients by determining if the cell populations recovered with BAL differed between patients who improved, remained stable, or worsened in their pulmonary functions (as defined by at least a 15 percent change in forced vital capacity) over a six-month observation period. The findings suggested that BAL eosinophilia may be a marker of progressive lung disease in patients with IPF and PF-CVD.
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PMID:Prognostic role of eosinophils in pulmonary fibrosis. 359 49

To support our contention that the Wistar-Furth rat is resistant to mineralocorticoid hypertension, we assessed the effects of deoxycorticosterone (DOC) administration or renal artery stenosis on the development of hypertension in the Sprague-Dawley and Wistar-Furth rat strains. Weekly administration of mineralocorticoid in the form of DOC pivalate resulted in rapid, severe hypertensive cardiovascular disease in Sprague-Dawley rats. Within 5 weeks the mean conscious systolic blood pressures in steroid-treated and control rats were 186 +/- 4 and 118 +/- 5 mm Hg, respectively. In contrast, blood pressures of Wistar-Furth rats were only moderately elevated, even after 10 weeks of DOC pivalate administration (136 +/- 2 vs 116 +/- 2 mm Hg for controls). Furthermore, none of the steroid-treated Wistar-Furth animals exhibited cardiovascular lesions. In parallel studies, littermates of these rat strains were subjected to renal artery stenosis and blood pressures were determined weekly in conscious rats. Silver clip constriction of the left renal artery, in the presence of the contralateral kidney, resulted in a rapid, sustained elevation of blood pressure in both Sprague-Dawley and Wistar-Furth rat strains (177 +/- 4 and 176 +/- 5 mm Hg, respectively). Corticosteroid levels were also determined in DOC-treated Sprague-Dawley and Wistar-Furth rats. The regimen employed resulted in a 10-fold increase in DOC levels as compared with controls, and the levels achieved were comparable in both strains. Thus, the Wistar-Furth rat appears to be selectively resistant to mineralocorticoid hypertensive vascular disease and thus affords a model for studying mechanisms of steroid hypertension.
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PMID:Resistance to mineralocorticoid-induced hypertensive vascular disease. 361 Feb 93


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