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

Nineteen patients with severe essential hypertension or hypertension due to renal parenchymal disease were treated with intravenous clonidine. In 14 patients the elevated blood pressure was complicated by one or more crises: left ventricular failure in seven patients, encephalopathy in six, and subarachnoid hemorrhage, cerebral hemorrhage, dissecting aortic aneurysm, acute renal failure, and severe epistaxis, one episode each. Clonidine 0.15 or 0.30 mg, was given intravenously every 40 minutes until the diastolic blood pressure was decreased to 120 mm Hg or below. Blood pressure was taken every 10 minutes. Both systolic and diastolic blood pressure were reduced significantly after intravenous clonidine, the former by 96 mm Hg (P less than 0.001), the latter by 52 mm Hg (P less than 0.001) within a period of 40 minutes to 2 1/2 hours. The clonidine dose varied from 0.15 to 0.90 mg, mean 0.52 mg. Heart rate was decreased significantly by 20 beats/minute (P less than 0.001) by the drug. Serious side effects were not observed except for an episode of transient sinoatrial block. Renal function was not affected. Patients who were on chronic diuretic therapy prior to treatment with intravenous clonidine showed a significantly greater decrease in both systolic (P less than 0.01) and diastolic (P less than 0.001) blood pressure after the first clonidine dose. In one patient intravenous clonidine was not effective (i.e., blood pressure remained 200/150 mm Hg) in spite of a total clonidine dose of 0.9 mg. Two patients died, one from severe cerebral hemorrhage, the other from an extensive dissecting aortic aneurysm, but the fatal outcome was not related to clonidine.
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PMID:Evaluation of intravenous clonidine in hypertensive emergencies. 63 67

The main neuro-ontogenetic feature that characterizes chronic hypertonic encephalopathy lies in "acceleration" of the dynamics of natural evolution of the neuroontogenesis. It goes naturally at different levels of human brain organization in the second half of its ontogenesis manifesting on the whole by a decrease of the morphogenetic characteristics of the study parameters of the relatively young age marked by maximum diversity of morphofunctional performances of the brain. It should be emphasized that the later essential hypertension develops the less pronounced is the study complex of the neuro-ontogenetic manifestations of the pathology under consideration.
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PMID:[Hypertensive encephalopathy from the standpoint of the theory of age-related disorders of the nervous system]. 164 4

With 60 million Americans meeting criteria for either essential or secondary hypertension, elevated arterial pressures remain a major health problem. While efforts to find etiologies for essential hypertension continue, clinicians battle its effects on organ systems, including the nervous system. Hypertensive changes in the nervous system may be acute, chronic, or both. The intracerebral vasculature is commonly affected. Not infrequently, acute changes including hemorrhage, encephalopathy, and cerebral edema are superimposed on chronic changes of hyaline and fibrinoid arteriolosclerosis. Chronic vascular changes sacrifice vascular lumina. The resulting ischemia is responsible for cystic (lacunar) lesions and subcortical ischemic white matter lesions consistent with Binswanger's disease.
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PMID:The effects of hypertension on the nervous system. 206 1

Total and cerebral metabolism of catecholamines (CA) was examined in patients with associated chronic hypertonic encephalopathy and extrapyramidal disorders. It was discovered for the first time that there was an increase in noradrenaline in the blood and cerebrospinal fluid together with a lowering of the content of dopamine and major metabolite thereof along the pathway of oxidative deamination of homovanillic acid. CA metabolism was shown to correlate with the patients' age, duration and gravity of extrapyramidal disorders. It is suggested that the revealed metabolic disorders of CA--neurotransmitters which are likely to underlie the development of neurological deficiency and characteristic mental disorders occur as a result of the diverse complex of biochemical alterations and are related both to the complex mechanisms of the pathogenesis of essential hypertension and ischemic injury to the brain as well as to the localization in the brain of lacunar infarctions. The complexity of the pathogenic treatment of the disease is emphasized. The main approaches to the pharmacological correction of the revealed disorders are outlined.
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PMID:[Catecholamine metabolism in extrapyramidal disorders in patients with chronic hypertensive encephalopathy]. 217 86

On the basis of radiocardiographic and radiocirculatory examination of the central and cerebral hemodynamics in 130 patients with dyscirculatory encephalopathy (DE) caused by essential hypertension and atherosclerosis, the authors have demonstrated that the development of DE is facilitated by disturbances of the central and peripheral hemodynamics. In turn, DE reduces the function of the autoregulatory mechanisms of the cerebral blood flow and leads to insufficiency of compensatory adaptive possibilities of the cardiovascular system. It is recommended that not only cerebral disorders but also the type (hyperkinetic, hypokinetic, eukinetic) of the blood circulation in these patients be taken into consideration in selecting the optimal method of treatment.
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PMID:[Status of cerebral and central hemodynamics in patients with dyscirculatory encephalopathy]. 395 86

Forty-one patients with dyscirculatory encephalopathy complicated by a transient impairment of the cerebral circulation were examined in a neurological department. A comparative analysis of the findings obtained during comprehensive study of the cerebral circulation showed that in the overwhelming majority of cases (37 out of 41), the results of isotope angiography and rheography coincided and corresponded to the clinical findings. To a certain degree these methods complemented each other: rheoencephalography was more informative in the diagnosis of cerebral atherosclerosis and essential hypertension while radioisotope angiography allowed a more accurate determination of the area affected.
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PMID:[Comparative evaluation of the diagnostic possibilities of radioisotope angiography and rheoencephalography in patients with vascular diseases of the brain]. 650 70

A group of patients with atherosclerosis and essential hypertension without clinically manifested signs of cerebral involvement was examined. The methods used included somatosensory evoked potentials, the assessment of the brachial muscles tone by passive sinusoidal movements of the upper arm and the determination of the curves of the isometric activation of the leg muscles during the stimulation of the feet by tactile and painful stimuli. Subclinical impairments of the muscular tone were elucidated. Patients with bilateral changes of the muscle tone show a high risk of the development of encephalopathy; those with unilateral alterations are at risk of developing a cerebral impairment of the corresponding side.
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PMID:[Electrophysiologic analysis of subclinical disorders of muscle tonus in atherosclerosis and hypertension]. 671 Dec 8

The principal risk factors conducive to the development of cardiovascular diseases in young and middle-aged subjects with chronic cerebrovascular insufficiency due to Stage I or II essential hypertension were under study. Thirty-four male patients with the initial manifestations of inadequate blood supply to the brain (IMIBS), 35 male patients with stages I or II dyscirculatory encephalopathy (DE), and 32 and 33 female patients with the same conditions, respectively, were examined. Hypertensive cerebral crises were significantly more frequent in DE patients of both sexes than in IMIBS patients, and a tendency to a longer standing of arterial hypertension was observed in DE patients as against those with IMIBS. The results of the examinations evidence that excessive body mass, hypokinesia and psychoemotional stress, as well as an 'accumulation' of risk factors were conducive to the development of DE in essential hypertension patients with IMIBS. Basing on the discriminant analysis of risk factors, the authors have developed a method for predicting the development of DE in patients with IMIBS of a hypertensive origin. Use of this method will essentially improve the efficacy of prophylactic and therapeutic measures in IMIBS patients.
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PMID:[The prediction of the development of circulatory encephalopathy in hypertension patients with the initial manifestations of brain blood supply insufficiency]. 785 79

Hypertension in pregnancy is defined by a systolic blood pressure > or = 140 mm Hg and a diastolic blood pressure of > or = 90 mm Hg or by a rise in blood pressure of systolic > or = 30 mm Hg and diastolic > or = 15 mm Hg. High blood pressures are found in 5-10% of all pregnancies. The outcome of pregnancy is influenced by the fact whether there occurs a proteinuria in addition to hypertension. While the prognosis of an isolated hypotension is good, the combination of hypertension and proteinuria leading to preeclampsia is the primary cause of maternal death in many countries and is responsible for 20-25% of perinatal mortality. A simple classification divides between chronic hypertension, preeclampsia, preeclampsia superimposed on chronic hypertension and transient hypertension. With chronic hypertension pregnancy outcome is determined by a preexisting nephropathy and the occurrence of a superimposed preeclampsia. Preeclampsia and superimposed preeclampsia are pregnancy induced multiorganic diseases, endangering both the mother and the fetus. Transient hypertension is a benign pathology, which occurs toward the end of pregnancy usually on the basis of a latent essential hypertension, which is laid open through pregnancy. While a severe chronic hypertension in pregnancy must be treated to prevent a hypertensive maternal encephalopathy, a less severe chronic hypertension should not be treated as the risk of a superimposed preeclampsia and the maternal and fetal outcome cannot be influenced by antihypertensive therapy. The incidence of preeclampsia is 3-5% in nulliparae and 0.5% in multiparae. Preeclampsia is a severe and dangerous pathology with an unknown etiology. Pregnancy termination is the only causal therapy. At present it is still recommended to terminate a severe preeclampsia after stabilizing the mother, irrespective of gestational age. In less severe preeclampsia occurring before 32 weeks of gestation, termination of pregnancy can be postponed under intensive monitoring and a prophylaxis with magnesium sulfate in order to accelerate the fetal lung maturation with glucocorticoids. A conservative management in the case of a HELLP-syndrome (Haemolyis, Elevated Liver enzymes, Low Platelets), which is a very severe form of preeclampsia, is not recommended because it hasn't been validated in prospective controlled studies. The most dangerous complication of preeclampsia is eclampsia, which is defined by general tonic-clonic convulsions before or after birth. The most effective prophylaxis of eclamptic attacks is the intravenous therapy with magnesium sulfate. A primary prohylaxis for preeclampsia doesn't exist. Treatment with low-dose aspirin in high-risk patients, i.e. after a severe preeclampsia, in cases of chronic hypertension, in cases of nephropathy and in cases with antiphospholipid-syndrome++ can be recommended. The prophylactic use of low-dose heparin, which has lead to a significant decreased incidence of preeclampsia in retrospective analysis, is now the object of a randomized, controlled trial in our hospital. All women who suffered from a preeclampsia should have a check-up after 3-6 months. Preexisting pathologies are found in up to 40% of patients, mostly in multiparae, i.e. chronic hypertension, nephropathy, endocrine pathologies, anomalies of blood coagulation and antiphospolipid-syndrome.
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PMID:[Hypertensive disorders in pregnancy]. 1054 28

Hypertension is a major public health problem both in the developing and developed countries of the world and if untreated, can lead to various fatal complications like cerebral stroke, encephalopathy, ischaemic heart disease (IHD), renal failure and sudden cardiac death, etc. In the present study, a comparative evaluation was made between angiotensin-II receptor antagonists like losartan potassium (50 mg daily) and angiotensin converting enzyme (ACE) inhibitors like enalapril maleate (5 mg daily) in 100 patients (50 males and 50 females having 25-50 years of age) of mild to moderate essential hypertension with diastolic blood pressure (DBP) 90-109 mmHg. Both the drugs were tried as monotherapy for their clinical efficacy, safety, tolerability and adverse effect profile in this open trial. Losartan potassium lowered the DBP to <90 mmHg in 62% of the patients at the end of 8 weeks compared to 40% in the enalapril group. Percentage of side effects with losartan was 20 and 50 with enalapril. It is concluded that both the drugs are effective antihypertensive agents and cause significant and comparable fall in systolic blood pressure (SBP) and DBP in patients of mild to moderate essential hypertension. But losartan potassium has been found to be more effective with fewer side effects when compared to enalapril maleate.
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PMID:A comparative evaluation of therapeutic effects of once a day dose of losartan potassium versus enalapril maleate in mild to moderate essential hypertension. 1202 7


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