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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hypertensive emergencies present a difficult problem of management. Although many treatment regimens have been described over the years, their application has presented problems of adverse effects and all have required detailed and intensive supervision of patients. After favourable results obtained in a preliminary study using a combination of parenteral chlorpromazine and frusemide, a 5-year prospective study was conducted using this treatment to produce rapid reduction in blood pressure in patients with acute onset severe hypertension (blood pressure greater than 225/130 mmHg). The patients involved covered a wide range from 22 to 74 years (mean 47 years) and, on subsequent or previous investigation, were all considered to have essential hypertension. Twenty-seven patients were treated successfully with a single administration of the regimen. Two women required a second treatment before adequate control of blood pressure was achieved and 1 man died of extensive dissecting abdominal aortic aneurysm before the effects of the therapy could be fully assessed. The reduction in blood pressure was gradual but progressive over 4 hours and the pattern of response was uniform. No significant adverse effects related to the treatment were found. Only basic measurement of pulse and blood pressure was considered necessary and so this regimen of therapy is suitable for general use even when sophisticated monitoring facilities are not available and staff levels are limited.
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PMID:Parenteral chlorpromazine and frusemide: safe and effective treatment for hypertensive emergencies. 373 25

In many reports, the prevalence of target organ damage in renovascular hypertension (RVH) appears to be higher than in essential hypertension (EH). Since in most studies the renal artery stenosis is part of a diffuse atherosclerotic disease, it is not known whether these complications are due to RVH itself or to the vascular disease. We have undertaken a case control study of 92 patients divided into two groups (46 in each), one with RVH and the other with EH and abdominal aortic aneurysm, with a comparable degree of diffuse atherosclerotic vascular disease. The vascular state of the extracranial carotid arteries and abdominal and inferior limb districts was investigated with angiography and sonography. The prevalence of left ventricular hypertrophy (LVH) and ischemic heart disease (IHD) were assessed by electrocardiography. Serum creatinine and urinary protein excretion were employed in the renal evaluation. While the analysis of the results confirmed an even diffusion of atherosclerotic vascular disease between the two groups, a significant difference was found in the prevalence of heart and renal damage. LVH was present in 32.6% of RVH patients versus 10.8% in EH (P = .02). Serum creatinine > 1.4 mg/dL was found in 50% of RVH and in 23.9% of EH, (P = .01). The prevalence of proteinuria in RVH was also higher although not reaching the statistical significance. The results suggest that, in patients with comparable degrees of atherosclerotic vascular disease, RVH is responsible for the higher prevalence of target organ damage in this condition compared to those with EH.
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PMID:Comparison of target organ damage in renovascular and essential hypertension. 893 30

The objective of the present study was to determine the viscoelastic properties of the common carotid artery in 35 patients with aortic aneurysm before surgery (AAA) (age 71 years, range 61-84), in comparison with 48 patients with essential hypertension (HT: 50 years, range 24-88) and 44 normotensive subjects (NT: 44 years, range 23-85). The second objective was to establish the relations between common carotid artery (CCA) viscoelastic properties and histologic lesions observed on AAA segments, obtained after surgery. CCA diameter was larger and distensibility smaller in AAA patients than in HT and NT. Distensibility of the aortic aneurysm was smaller than that of upstream 'normal' aorta, itself being smaller than control aortas. AAA wall lesions were extensive, associating adventitial and medial fibrosis, elastolysis, smooth muscle rarefaction, neovascularization, inflammation and plaques. The grade of these lesions was not correlated with the mechanical properties of the aorta and CCA; however, they could explain their qualitative alterations. AAA is characterized by severe stiffening and dilatation of large arteries distant from the aneurysm location. Whether this pattern of arterial phenotype is explained by the increase in stiff material (collagen) and the rarefaction of distensible material (smooth muscle and elastin) remains to be determined.
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PMID:[Associations between viscoelastic properties of large arteries and their extracellular matrix composition in abdominal aortic aneurysms in humans]. 1021 30