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Query: UMLS:C0085580 (essential hypertension)
 14,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a group of 34 men aged 30-59 years with essential hypertension of a mild or moderate degree the authors evaluated the behavior of the left ventricular ejection fraction and the rate of shortening of the circumferential fibre, using radionuclide ventriculography during exercise. The results were compared with a control group of 19 subjects lacking signs of cardiovascular disease. Asymptomatic hypertonic patients without signs complicating IHD have on average a small statistically insignificant reduction of values of the ejection fraction at rest and of the shortening of the circumferential fibre. However, they respond to a load by a significantly lower rise of the resting values than the control group. In 12% of the patients the authors found an abnormal reaction of the ejection fraction, i.e. a decline as compared with original values. The above differences can be ascribed to a reduction of left ventricular systolic function during chronic overload as a result of arterial hypertension. This functional reduction is not related to the values of the systolic or diastolic pressure at rest nor to the duration of hypertension.
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PMID:[Left ventricular systolic function during exertion in persons with mild and medium levels of hypertension]. 262 36

The pathophysiology and course of hypertensive cardiovascular disease in the black population differ significantly from those of nonblacks. The hemodynamic and endocrine profiles are different, consequences of hypertension are more severe in blacks, and black patients are often less responsive to standard antihypertensive treatment. Safe and efficacious treatment can be achieved when drug therapy is directed at the specific underlying pathophysiologic abnormality in black patients. By closely matching cardiovascular pathophysiologic findings in a given patient with the pharmacologic effects of an antihypertensive agent, blood pressure can often be controlled with fewer adverse effects. In addition, blood flow to target organs and their function can be maintained or improved. Calcium channel blockers are especially well suited for the treatment of essential hypertension in black patients.
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PMID:Management of essential hypertension in the black patient: profiling as the initial approach to treatment. 265 78

Numerous studies over the past few years have indicated that mechanisms of pressure elevation are not uniform in all patients with essential hypertension. Simple clinical findings such as age, sex, body habitus, and race often allow us to define the predominant pathogenetic mechanism. Not only is the hemodynamic and biochemical pattern of essential hypertension different in patient subgroups, but manifestations of target organs and therefore the risk of cardiovascular disease also vary distinctly from one group to another. Identifying the predominant hemodynamic, biochemical, and target organ disease pattern in a given patient will help the physician to select more specific antihypertensive therapy and thereby, it is hoped, prevent or reverse target organ disease and improve the quality of life.
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PMID:The heterogeneity of essential hypertension: hemodynamic aspects. 329 2

Essential hypertension (EHT) is one of the most common risk factors for cerebrovascular and cardiovascular disease (CVD), which in turn are among the most common causes of death and disability in developed countries. Drug treatment of EHT has proven effective in lessening the risk of CVD, but has attendant risk of side effects, some of which are of risk to the CV system. Thus, increasing attention is being paid to non-drug treatment of EHT, which includes changing the daily intake of such electrolytes as sodium (Na), potassium (K), calcium (Ca), and magnesium (Mg). Decreasing Na intake to control blood pressure (BP) is well established. On the basis of epidemiologic and experimental studies, increasing K and/or Mg intakes, and increasing of decreasing Ca intakes, have each been proposed to have beneficial effects of BP. Presented here is a review of the background data supporting the rationale for adding Mg to the anti-hypertensive regimen. There is evidence that Mg can exert a favorable effect in EHT, particularly when used in combination with K during diuretic therapy.
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PMID:Magnesium and hypertension. 330 83

Stress has been identified as contributing to the development of cardiovascular disease. The pathophysiologic link between stress and disease still remains unclear. Because experimental stress testing in the laboratory permits the examination of the underlying mechanism for stress-induced blood pressure, analyses of cardiovascular reactivity during emotional stress could be of particular clinical importance. The analyses of pooled data during the past 6 years (n = 298, age from 20 to 60 years, normotensive subjects as well as patients with borderline and mild essential hypertension) reveal that stress-induced changes in stroke volume and especially in total peripheral resistance are crucial parameters to analyze the hemodynamic stress response. However, neither those simple nor complex response patterns such as "hot reactor" describe clinically distinct subgroups of persons. When physiologic testing was repeated in hypertensive patients after effective long-term antihypertensive therapy with clonidine, oxprenolol, nitrendipine, or enalapril, no attenuation of the stress-induced increase in blood pressure was found in any of these groups. However, heart rate reactivity and stress-induced changes in total peripheral resistance were altered significantly by oxprenolol and nitrendipine. The beta-adrenoceptor blocker decreased heart rate reactivity and increased reactivity of peripheral resistance; the calcium antagonist decreased stress-induced changes in peripheral resistance and increased the heart rate response. The centrally acting sympatholytic regimen and the angiotensin-converting enzyme inhibitor had no impact on the hemodynamic response pattern during emotional challenge.
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PMID:Hemodynamic response patterns to mental stress: diagnostic and therapeutic implications. 339 40

The risk of cardiovascular disease for children in the upper percentiles of the blood pressure distribution for age has not been determined. In this study echocardiographic evaluation was conducted at age 15 years in eight children tracking in the 89 +/- percentile for systolic blood pressure since age 8 years, and compared with nine children tracking in the 28 +/- 3 percentile over the same period. No significant differences were observed for left ventricular size, septal or posterior wall thickness or relative wall thickness using raw data, after adjustment for body mass index or after regression analysis using systolic blood pressure as the dependent variable. In contrast, stroke volume, cardiac output and left ventricular fractional shortening were greater in the high blood pressure group after adjustment for body mass index (P = 0.006, 0.075 and 0.08, respectively). These results suggest that changes consistent with previously reported findings in adults with essential hypertension (i.e. and increase in cardiac performance with normal peripheral resistance) are also early findings in adolescents tracking with high blood pressure.
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PMID:Cardiac status of adolescents tracking with high and low blood pressure since early childhood. 347 11

We measured systemic hemodynamic, volume, and endocrine findings in 100 hypertensive women matched to 100 men by mean arterial pressure, age, race, and body surface area. Women had a higher resting heart rate, cardiac index, and pulse pressure and lower total peripheral resistance (all p less than 0.01) than men with the same pressure level. Isometric stress caused an increase in arterial pressure that was almost 50% higher in men than in women. The sexual difference in cardiovascular findings was significant before but not after menopause. For any level of arterial pressure, total peripheral resistance (and therefore the risk of hypertensive cardiovascular disease) was lower in women than in men. We conclude that premenopausal women are hemodynamically younger than men of the same chronologic age. Our study identifies a pathophysiologic mechanism for the clinical and epidemiologic finding that essential hypertension is less lethal in women than in men.
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PMID:Disparate cardiovascular findings in men and women with essential hypertension. 360 94

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)
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PMID:Pathophysiology and outcome of hypertensive subjects. 389 32

The literature on the behavioural treatment of primary hypertension, reduction of Type A behaviour, and psychological interventions during acute coronary care and rehabilitation after a myocardial infarction are selectively reviewed. There is growing evidence that relaxation and stress management can lower blood pressure by useful amounts in mild primary hypertension although the mechanisms underlying these reductions are unclear. Type A behaviour has been reduced in patients following a myocardial infarction and this led to reduced morbidity. Other interventions following myocardial infarction, both when the patient is in hospital and after discharge have produced at best only modest benefits and are, therefore, not widely applicable. Future research in rehabilitation should be directed at reducing the disabilities of patients with clearly identifiable problems that stem from their response to cardiovascular disease.
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PMID:Psychological interventions in cardiovascular disease. 390 5

In a group of 300 patients with essential hypertension, grades I and II (WHO), the medicamental treatment and the relation of blood pressure before and during their stationary treatment at a clinic for rehabilitation of cardiovascular disease were explored. 23% of the patients were admitted to the clinic without any antihypertensive treatment. Only 18% of the patients had been treated before according to the general directions with beta-receptor-blockers and/or diuretics (so-called basic therapy). These percentages remained almost constant during the period of observation from 1977 to 1979. According to the relation of blood pressure a change of medicaments to the so-called basic therapy was necessary in 59% of the cases. In 11% of the patients an adequate reduction of weight made medicamental treatment unnecessary.
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PMID:[High blood pressure is still being inadequately treated]. 611 71


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