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Sample records for hypertensive men presenting

  1. Ambulatory blood pressure and Doppler echocardiographic indexes of borderline hypertensive men presenting an exaggerated blood pressure response during dynamic exercise

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    Herkenhoff F.L.

    2001-01-01

    Full Text Available Borderline hypertension (BH has been associated with an exaggerated blood pressure (BP response during laboratory stressors. However, the incidence of target organ damage in this condition and its relation to BP hyperreactivity is an unsettled issue. Thus, we assessed the Doppler echocardiographic profile of a group of BH men (N = 36 according to office BP measurements with exaggerated BP in the cycloergometric test. A group of normotensive men (NT, N = 36 with a normal BP response during the cycloergometric test was used as control. To assess vascular function and reactivity, all subjects were submitted to the cold pressor test. Before Doppler echocardiography, the BP profile of all subjects was evaluated by 24-h ambulatory BP monitoring. All subjects from the NT group presented normal monitored levels of BP. In contrast, 19 subjects from the original BH group presented normal monitored BP levels and 17 presented elevated monitored BP levels. In the NT group all Doppler echocardiographic indexes were normal. All subjects from the original BH group presented normal left ventricular mass and geometrical pattern. However, in the subjects with elevated monitored BP levels, fractional shortening was greater, isovolumetric relaxation time longer, and early to late flow velocity ratio was reduced in relation to subjects from the original BH group with normal monitored BP levels (P<0.05. These subjects also presented an exaggerated BP response during the cold pressor test. These results support the notion of an integrated pattern of cardiac and vascular adaptation during the development of hypertension.

  2. Nursing diagnosis Noncompliance to treatment in men with hypertension

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    Talliton Uchôa de Araújo

    2016-01-01

    Full Text Available Objective : to identify the frequency of occurrence of nursing diagnosis Noncompliance of treatment in men with high blood pressure, its defining characteristics, and related factors. Methods : a Cross-sectional study involving 44 men with hypertension by applying a validated instrument for identification of nursing diagnosis. Results : the diagnosis frequency of occurrence was 56.8%, the most present defining characteristics were the inadequate management of nonpharmacological treatment (p=0.000 and adherence failure of indicative behavior (p=0.000. The most common related factors were deficient knowledge for the monitor of the non- drug treatment regimen (p=0.000 and insufficient teaching ability of health staff (p=0.002. Conclusion : it was found a high frequency of diagnosis in men and the data point to the need for training of health professionals for the development of skills in promoting adherence of men to the treatment of hypertension.

  3. Hypertension and color blindness in young men.

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    Morton, W E

    1975-05-01

    Medical data from Selective Service registrants born from 1939 to 1941 were studied in Oregon and Colorado. Among 29,119 registrants with medical information (41.3% of all registrants), 1,073 (3.6%) had definite hypertension, and 1,226 (4.2%) had some type of color blindness. In both states, there was a highly significant association between the prevalence of hypertension and the prevalence of color blindness. Thus, definite hypertension was present in 6.0% of color clind individuals but in only 3.6% of those with unimparied color vision, while color blindness occurred in 6.8% with definite hypertension, in 5.8% with borderline hypertension, and in only 4.0% with normal blood pressure. The data did not differentiate among types of color blindness, and the reason for the association is not yet evident.

  4. Erectile dysfunction among hypertensive men in a rapidly developing country

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    Abdulbari Bener

    2007-01-01

    Full Text Available Background: Previous studies have supported the association between hypertension and erectile dysfunction (ED. In addition, a significant correlation between hypertension in men and ED has been well established. Objectives: The aim of this study was to investigate the prevalence of ED, its severity and other sexual function domains in hypertensive patients in Qatar. Design and Setting: Cross-sectional study conducted between January and December 2006 at the Hamad General Hospital. Subjects: Qatari and nonQatari nationals 25 to 75 years of age were approached to participate in this study, 642 (75.5% gave their consent. Materials and Methods: Qatari and nonQatari men aged 25 to 75 years who gave consent were interviewed face-to-face. Sexual function was evaluated with the International index of erectile function. Results: A total of 642 (75.5% men responded, mean age of subjects was 57.1 ± 11.9 years. The prevalence of ED in hypertensive patients was 58.3%. 21.2% of hypertensive men reported severe ED, 20.7% moderate ED and 16.4% mild ED. The comorbidities and risk factors were significantly more prominent in ED patients than in those with normal ED for hypercholesterolemia ( P =0.009, diabetes ( P =0.022 for hypertriglyceridemia ( P =0.033 and myocardial ischemia ( P =0.042. Conclusions: Our results have shown a greater prevalence of ED in the hypertensive men in the population of Qatar. The presence of another risk factor in addition to elevated blood pressure can increase the likelihood of ED.

  5. Soccer improves fitness and attenuates cardiovascular risk factors in hypertensive men

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    Krustrup, Peter; Randers, Morten Bredsgaard; Andersen, Lars Juel

    2013-01-01

    INTRODUCTION: The present study investigated the fitness and health effects of medium-term soccer training for untrained hypertensive middle-aged men. METHODS: Thirty-three untrained males (31-54 y) with mild-to-moderate hypertension were randomised 2:1 to a soccer training group (STG, two 1-h se......, average heart rate was 155±2 bpm or 85±2% HRmax. In STG, systolic and diastolic blood pressures decreased (P...

  6. Nursing diagnosis on the Noncompliance to treatment in men with hypertension

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    Talliton Uchôa de Araújo

    2016-06-01

    Full Text Available Objective: to identify the frequency of occurrence of nursing diagnosis on the Noncompliance of treatment in men with high blood pressure, its defining characteristics, and related factors. Methods: a Cross-sectional study involving 44 men with hypertension by applying a validated instrument for identification of nursing diagnosis. Results: the diagnosis frequency of occurrence was 56.8%, the most present defining characteristics were the inadequate management of nonpharmacological treatment (p=0.000 and adherence failure of indicative behavior (p=0.000. The most common related factors were deficient knowledge for the monitor of the non-drug treatment regimen (p=0.000 and insufficient teaching ability of health staff (p=0.002. Conclusion: it was found a high frequency of diagnosis in men and the data point to the need for training of health professionals for the development of skills in promoting adherence of men to the treatment of hypertension.

  7. Football as a treatment for hypertension in untrained 30-55-year-old men: a prospective randomized study

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    Andersen, L J; Randers, M B; Westh, K;

    2010-01-01

    The present study investigated whether football has favorable effects in the treatment of mild-to-moderate arterial hypertension in untrained middle-aged men. Twenty-five untrained males aged 31-54 year with mild-to-moderate hypertension were randomized to a football training group (FTG, two 1-h...... to the treatment of mild-to-moderate arterial hypertension in untrained middle-aged men....... sessions per week) and a control group receiving physician-guided traditional recommendations on cardiovascular risk factor modification (doctoral advice group, DAG). After 3 months, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were lowered (P

  8. Muscular strength and incident hypertension in normotensive and prehypertensive men.

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    Maslow, Andréa L; Sui, Xuemei; Colabianchi, Natalie; Hussey, Jim; Blair, Steven N

    2010-02-01

    The protective effects of cardiorespiratory fitness (CRF) on hypertension (HTN) are well known; however, the association between muscular strength and incidence of HTN has yet to be examined. This study evaluated the strength-HTN association with and without accounting for CRF. Participants were 4147 men (age = 20-82 yr) in the Aerobics Center Longitudinal Study for whom an age-specific composite muscular strength score was computed from measures of a one-repetition maximal leg and a one-repetition maximal bench press. CRF was quantified by maximal treadmill exercise test time in minutes. Cox proportional hazards regression analysis was used to estimate hazard ratios (HR) and 95% confidence intervals of incident HTN events according to exposure categories. During a mean follow-up of 19 yr, there were 503 incident HTN cases. Multivariable-adjusted (excluding CRF) HR of HTN in normotensive men comparing middle- and high-strength thirds to the lowest third were not significant at 1.17 and 0.84, respectively. Multivariable-adjusted (excluding CRF) HR of HTN in baseline prehypertensive men comparing middle- and high-strength thirds to the lowest third were significant at 0.73 and 0.72 (P = 0.01 each), respectively. The association between muscular strength and incidence of HTN in baseline prehypertensive men was no longer significant after control for CRF (P = 0.26). The study indicated that middle and high levels of muscular strength were associated with a reduced risk of HTN in prehypertensive men only. However, this relationship was no longer significant after controlling for CRF.

  9. Gastric adenocarcinoma inducing portal hypertension: A rare presentation

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    Pradipta Ghosh; Katsumi Miyai; Mario Chojkier

    2007-01-01

    Advanced gastric cancer usually presents with symptoms due to direct extension into adjacent viscera, distant metastases from lymphatic or hematogenic dissemination and peritoneal seeding. However, portal hypertension as a presentation of metastatic gastric cancer is rare and usually seen in association with other malignancies, e.g. hepatocellular and pancreatic carcinoma. We report a case of signet ring adenocarcinoma of the stomach that presented with esophageal and duodenal varices and bleeding due to portal hypertensive gastropathy. Pagetoid spread of cancer cells likely caused early metastasis and the unusual presentation. We also discussed the pathophysiology of development of portal hypertension in association with malignancies.

  10. Management of a child with pulmonary arterial hypertension presenting with systemic hypertension.

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    Flores, Saul; Daily, Joshua; Pratap, Jayant Nick; Cash, Michelle C; Hirsch, Russel

    2016-02-01

    We describe the course and management of a 12-year-old girl with severe pulmonary arterial hypertension who initially presented with severe systemic hypertension. Successful therapy included pulmonary vasodilators and an atrial septostomy, while ensuring adequate maintenance of her systemic vascular resistance to maintain cardiac output. Clear understanding of the physiology and judicious medical management in patients with severe pulmonary arterial hypertension using extreme compensatory mechanisms is vitally important.

  11. Metaboreflex activation delays heart rate recovery after aerobic exercise in never-treated hypertensive men.

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    Peçanha, Tiago; de Brito, Leandro Campos; Fecchio, Rafael Yokoyama; de Sousa, Patricia Nascimento; da Silva Junior, Natan Daniel; de Abreu, Andrea Pio; da Silva, Giovanio Vieira; Mion-Junior, Décio; Forjaz, Cláudia Lúcia de Moraes

    2016-11-01

    Recent evidence indicates that metaboreflex regulates heart rate recovery after exercise (HRR). An increased metaboreflex activity during the post-exercise period might help to explain the reduced HRR observed in hypertensive subjects. Using lower limb circulatory occlusion, the present study showed that metaboreflex activation during the post-exercise period delayed HRR in never-treated hypertensive men compared to normotensives. These findings may be relevant for understanding the physiological mechanisms associated with autonomic dysfunction in hypertensive men. Muscle metaboreflex influences heart rate (HR) regulation after aerobic exercise. Therefore, increased metaboreflex sensitivity may help to explain the delayed HR recovery (HRR) reported in hypertension. The present study assessed and compared the effect of metaboreflex activation after exercise on HRR, cardiac baroreflex sensitivity (cBRS) and heart rate variability (HRV) in normotensive (NT) and hypertensive (HT) men. Twenty-three never-treated HT and 25 NT men randomly underwent two-cycle ergometer exercise sessions (30 min, 70% V̇O2 peak ) followed by 5 min of inactive recovery performed with (occlusion) or without (control) leg circulatory occlusion (bilateral thigh cuffs inflated to a suprasystolic pressure). HRR was assessed via HR reduction after 30, 60 and 300 s of recovery (HRR30s, HRR60s and HRR300s), as well as by the analysis of short- and long-term time constants of HRR. cBRS was assessed by sequence technique and HRV by the root mean square residual and the root mean square of successive differences between adjacent RR intervals on subsequent 30 s segments. Data were analysed using two- and three-way ANOVA. HRR60s and cBRS were significant and similarly reduced in both groups in the occlusion compared to the control session (combined values: 20 ± 10 vs. 26 ± 9 beats min(-1) and 2.1 ± 1.2 vs. 3.2 ± 2.4 ms mmHg(-1) , respectively, P < 0.05). HRR300s and HRV were also

  12. Effects of Music on Cardiovascular Responses in Men with Essential Hypertension Compared with Healthy Men Based on Introversion and Extraversion

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    Hossein Namdar

    2014-10-01

    Full Text Available Introduction: The present research investigated the effects of two different types of music on cardiovascular responses in essential hypertensive men in comparison with healthy men based on introversion and extraversion. Methods: One hundred and thirteen hypertensive men referred to Madani Heart Hospital in Tabriz completed the NEO-FFI Questionnaire and after obtaining acceptable scores were classified in four groups: introvert patients, extravert patients, introvert healthy subjects, and extravert healthy subjects (each group with 25 samples with age range 31-50. Baseline blood pressure and heart rate of each subject was recorded without any stimulus. Then subjects were exposed to slow-beat music and blood pressure and heart rate were recorded. After15 minute break, and a little cognitive task for distraction, subjects were exposed to fast-beat music and blood pressure and heart rate were recorded again. Results: Multivariate analysis of covariance (MANCOVA test showed that extravert patient subjects obtained greater reduction in systolic blood pressure and heart rate after presenting slow-beat music compared with introvert patients (P= 0.035, and P= 0.033 respectively. And extravert healthy subjects obtained greater reduction in heart rate after presenting slow-beat music compared with introvert healthy subjects (P= 0.036. However, there are no significant differences between introvert and extravert groups in systolic and diastolic blood pressure and heart rate after presenting fast-beat music. Conclusion: Based on our results, introvert subjects experience negative emotions more than extravert subjects and negative emotions cause less change in blood pressure in these subjects compared with extravert subjects.

  13. Markers of oxidative stress in obese men with and without hypertension

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    Cejvanovic, Vanja; Asferg, Camilla; Kjær, Laura Kofoed

    2016-01-01

    with or without hypertension compared to lean controls. METHODS: A total of 63 obese hypertensive men (obeseHT), 40 obese normotensive men (obeseNT) and 27 lean normotensive men (leanNT) were included in the study. Body mass index (BMI) was between 20.0 and 24.9 kg/m(2) in leanNT participants and ≥30 kg/m(2......) in obese participants. Hypertension was defined as a mean 24-hour systolic ambulatory blood pressure (AMBP) ≥ 130 mmHg or a mean 24-hour diastolic AMBP ≥80 mmHg and normotension as mean 24-hour AMBP ...). CONCLUSION: The measurement of urinary excretion of 8-oxoGuo suggests that obesity in men, but not hypertension, is associated with increased oxidative damage to RNA....

  14. A UNIQUE CASE OF PHEOCHROMOCYTOMA PRESENTING WITH HYPERTENSIVE RETINOPATHY

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    Maji.S, Saha. ML, Kanwar KS, Das S, Bhagat P, Bhar P

    2015-04-01

    Full Text Available ABSTRACT Pheochromocytoma is an extremely uncommon tumor of childhood and there are several features that distinguish its presentation between adults and children. The incidence of pheochromocytoma in childhood is 10% of the adult incidence, occurring in approximately 1 in 500,000 children compared with 1 in 50,000 adults. Around 10% of childhood tumors are familial which is 4times the frequency in adults. Whereas only 7% of pheochromocytomas are bilateral in adults, the reported incidence of the same in children range from 24 % to as high as &70%.These tumors are known for their great diversity in clinical presentation. Greater than 50% of children present with headaches, fever, palpitation, thirst, polyuria, sweating, nausea and weight loss. However the commonest mode of presentation is sustained hypertension. Pheochromocytoma accounts for 0.5% of children with hypertension and must be considered once other causes have been eliminated. We here in report a unique case of a 13 year old girl who initially presented with bilateral hypertensive retinopathy and later found to have a pheochromocytoma on subsequent workup. Hypertensive retinopathy secondary to pheochromocytoma is itself a rare entity whose exact incidence in children is still unknown. This case highlights the importance of routine history, physical examination and measurement of bp. Prompt surgery can reverse the effect of hypertension and lead to good outcome as was evident in our case.

  15. Sexual dysfunction among Ghanaian men presenting with various medical conditions

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    Quaye Lawrence

    2010-10-01

    Full Text Available Abstract Background Several medical conditions can affect and disrupt human sexuality. The alteration of sexuality in these medical conditions often hinder effective communication and empathy between the patients and their sexual partners because of cultural attitudes, social norms and negative feelings such as anxiety and guilt. Validated and standardized sexual inventories might therefore help resolve this problem. The objective of this cross-sectional study was to obtain data on the prevalence of male sexual dysfunction (SD among Ghanaians with various medical conditions residing in Kumasi. Methods The Golombok Rust Inventory of Sexual Satisfaction (GRISS was administered to 150 Ghanaian men with various medical conditions between 19 and 66 years old (mean ± standard deviation: 40.01 ± 12.32 years domiciled in the Kumasi metropolis. Results Out of the total 150 questionnaires administered, 105 (70.0% men returned the questionnaires. Questionnaires from 3 men were incomplete, leaving 102 complete and evaluable questionnaires, indicating a 68.0% response rate. Of the remaining 102 men, 88.2% were married, 70.6% had attained higher education, 88.2% were non-smokers. Whereas 54.9% were engaged in exercise, 61.8% indulged in alcoholic beverages. The prevalence of the various medical conditions include: diabetes (18%, hypertension (24.5%, migraine (11.8%, ulcer (7.8%, surgery (6.9%, STD (3.9 and others (26.5%. The prevalence of SD among the respondents in the study was 59.8%. The highest prevalence of SD was seen among ulcer patients (100%, followed by patients who have undergone surgery (75%, diabetes (70%, hypertension (50%, STD (50% and the lowest was seen among migraine patients (41.7%. Conclusions SD rate is high among Ghanaian men with medical conditions (about 60% and vary according to the condition and age.

  16. Tropical pulmonary eosinophilia presenting as severe pulmonary arterial hypertension

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    Shikha Jindal

    2013-01-01

    Full Text Available Tropical pulmonary eosinophilia (TPE is an easily diagnosed and treatable disease. Patients with TPE usually present with respiratory symptoms that include paroxysmal cough, breathlessness, wheeze and chest pain, often misdiagnosed as bronchial asthma. This case highlights one of the unusual presentations of TPE and discusses the association between TPE and pulmonary hypertension.

  17. Clinical characterization of pediatric pulmonary hypertension : complex presentation and diagnosis

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    van Loon, Rosa Laura E.; Roofthooft, Marcus T. R.; van Osch-Gevers, Magdalena; Delhaas, Tammo; Strengers, Jan; Blom, Nico A.; Backx, Ad; Berger, Rolf M. F.

    OBJECTIVES: To describe the clinical presentation of pediatric pulmonary arterial hypertension (PAH) and the intricacies of how to classify pediatric PAH according to the Venice classification. STUDY DESIGN: Children (n = 63) seen at a national referral center for pediatric PAH underwent a

  18. Diabetes and hypertension in urban bhutanese men and women

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    Bhakta Raj Giri

    2013-01-01

    Full Text Available Background: Bhutan is a mountainous country with 31% urban population. There is no information on prevalence of diabetes and hypertension in Bhutan yet. This was the first study of its kind conducted in the capital city. Objective: To determine prevalence of diabetes, impaired fasting glucose (IFG, impaired glucose tolerance (IGT and hypertension in urban Bhutanese population aged 25 to 74 years. Materials and Methods: Stratified two-stage sampling was adopted to include 2474 respondents (Males: 1132, Females: 1342 equally distributed among different age and sex groups. A questionnaire containing demographic, educational and social details and history of diabetes and hypertension was administered on the sampled population the previous evening and blood pressure measured the next morning in nearby camp where fasting blood samples were collected and an oral glucose tolerance test done. Results: Age and sex standardized prevalence of diabetes, IGT and IFG were 8.2.0, 21.6 and 4%, respectively. Only 66.5% of the population had normal blood sugar. Prevalence of diabetes and IGT increased progressively with increasing age. Prevalence of hypertension was 26% (Males: 28.3%, Females: 23.2%. It was observed that 54.1% of diabetes population had hypertension. Conclusion: The study shows that not only is prevalence of diabetes and hypertension high in the urban Bhutanese but also there is a high diagnosis and treatment gap in these disorders.

  19. ANTIOXIDANT STATUS, OXIDATIVE STRESS AND LIPID PROF ILE IN ESSENTIAL HYPERTENSIVE MEN

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    Shantha Kumari

    2013-04-01

    Full Text Available ABSTRACT: Hypertension is a major health burden and coexists o f with imbalance in antioxidants and lipid profile. This study is done to evaluate the total antioxidant status and oxidative stress like Malondialdehyde (MDA, catala se, superoxide dismutase (SOD, uric acid and correlate with lipid profile among hypertensive m en. Significant increase in MDA, uric acid and dyslipidemia was found among hypertensive men. Al so total antioxidant status and other antioxidants like SOD, catalase was found to be dec reased in hypertensive men. Hence it is concluded that lipid peroxidation occur in hypertensi on which leads to endothelial dysfunction, renal blood flow alteration and tissue damage. As a result of which dyslipidemia, hyperuricemia and decrease in anti oxidants are seen. Hence decre ase in antioxidants is a useful marker for antioxidant therapy to prevent organ damage among hype rtensive.

  20. Correlates of Hypertension Among Adult Men and Women in Kosovo

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    Hashani, V.; Roshi, E.; Burazeri, G.

    2014-01-01

    AIM: We aimed to assess the independent socioeconomic, behavioral and psychosocial correlates of hypertension among the adult population of Kosovo. METHODS: This was a cross-sectional study carried out in Pristina in 2012-2013 which included a large representative sample of 1793 consecutive primary

  1. Swyer-James-Macleod Syndrome Presenting with Pulmonary Hypertension

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    Sh Hajsadeghi

    2010-09-01

    Full Text Available Swyer–James–MacLeod Syndrome is a rare condition as a result of childhood pulmonary infection, especially bronchiolitis obliterans or viral bronchiolitis/pneumonia. It appears as increased radiolucency on chest Xray, in the absence of obstructing lesions and can be confused for other thoracic disease processes such as a large pulmonary emboli or congenital bronchial and/or pulmonary vasculature malformations. We introduce a 46-year-old male patient presented with symptoms and signs of pulmonary hypertension which was initially misdiagnosed as chronic pulmonary emboli. This case highlights the possibility of pulmonary hypertension to be one of the cardinal manifestations of this syndrome, and outlines the significance of application of computedtomography in confirming the diagnosis of SJMS and in eliminating other diseases.

  2. A rare presentation of clinically intractable hypertension: Pancreatic paraganglioma

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    Chao-Ming Tseng

    2016-09-01

    Full Text Available Paraganglioma is a rare extra-adrenal pheochromocytoma which originates from chromaffin cells within the ganglia of the sympathetic trunk and of the celiac, renal, suprarenal, and hypogastric plexuses. Pancreatic paragangliomas are rarer still. And even then, paragangliomas are mostly reported to be nonfunctional. We report a case of a 64-year-old woman with underlying disease of hypertension who presented with biliary colic. Contrast-enhanced computer tomography showed an enhancing mass in the uncinate process of the pancreas. Pylorus-sparing Whipple procedure was performed for complete tumor excision. Hypertensive crisis developed after Whipple, which improved after continuous intravenous nicardipine infusion. Pathology revealed a paraganglioma. A 24-h catecholamine urine test showed increased norepinephrine and vanillylmandelic acid level. Functional paraganglioma was diagnosed.

  3. Elemental mercury poisoning presenting as hypertension in a young child.

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    Brannan, Elizabeth H; Su, Sharon; Alverson, Brian K

    2012-08-01

    Mercury intoxication is an uncommon cause of hypertension in children and can mimic several other diseases, such as pheochromocytoma and vasculitis. Mercury intoxication can present as a diagnostic challenge because levels of catecholamines may be elevated, suggesting that the etiology is a catecholamine-secreting tumor. Once acrodynia is identified as a primary symptom, a 24-hour urine mercury level can confirm the diagnosis. Inclusion of mercury intoxication in the differential diagnosis early on can help avoid unnecessary and invasive diagnostic tests and therapeutic interventions. We discuss a case of mercury intoxication in a 3-year-old girl presenting with hypertension and acrodynia, without a known history of exposure. Chelation therapy successfully treated our patient's mercury intoxication. However, it was also necessary to concurrently treat her hypertension and the pain associated with her acrodynia. Because there were no known risk factors for mercury poisoning in this case, and because ritual use of mercury is common in much of the United States, we recommend high clinical suspicion and subsequent testing in all cases of acrodynia.

  4. Obese Hypertensive Men Have Plasma Concentrations of C-Reactive Protein Similar to That of Obese Normotensive Men

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    Asferg, Camilla L; Andersen, Ulrik B; Linneberg, Allan

    2014-01-01

    plasma CRP concentrations are also closely associated with obesity. It is uncertain whether CRP is directly involved in the pathogenesis of hypertension or is only a marker of other pathogenic processes closely related to obesity. METHODS: We studied 103 obese men (body mass index (BMI) ≥ 30.0 kg/m(2......BACKGROUND: Low-grade chronic inflammation is a characteristic feature of obesity, the most important lifestyle risk factor for hypertension. Elevated plasma concentrations of the inflammatory biomarker C-reactive protein (CRP) are associated with an increased risk of hypertension, but elevated...... participants were medication-free. We measured plasma CRP concentrations with a high-sensitivity assay and determined body composition by dual energy x-ray absorptiometry scanning. RESULTS: There were no differences in anthropometric measures (BMI, waist circumference, or total fat mass percentage) between OHT...

  5. Substance use disorders in men presenting to a psychosexual clinic.

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    Rajkumar, Ravi Philip

    2014-01-01

    Introduction. Substance use disorders (SUDs) are commonly associated with a variety of psychiatric disorders. Community-based studies have found a significant association between SUDs and sexual dysfunction in men, with a possible causal relation in the case of nicotine. Methods. The case records of 105 men presenting to a clinic for patients with psychosexual disorders were reviewed. Men with and without comorbid SUDs were compared in terms of demographic, clinical, and familial variables. Results. 25 of the 105 men (23.8%) had a lifetime diagnosis of SUD, and 19 (18.1%) had a current SUD. The commonest substances involved were nicotine (n = 21, 20%) and alcohol (n = 9, 9.5%). Men with comorbid SUDs were more likely to report a family history of substance dependence, particularly alcoholism. Single men with SUDs were more likely to have a comorbid mood disorder. Conclusion. SUDs, particularly nicotine and alcohol use disorders, are common comorbidities in patients with psychosexual disorders. Identifying and treating these disorders in this population are important aspects of management.

  6. Dopamine-secreting adrenal ganglioneuroma presenting with paroxysmal hypertension attacks.

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    Erem, Cihangir; Kocak, Mustafa; Cinel, Akif; Erso, Halil O; Reis, Abdulkadir

    2008-01-01

    Adrenal ganglioneuromas are rare tumors originating from the neural crest tissue of the sympathetic nervous system. The clinical presentation for most patients is asymptomatic, and most of these tumors are hormone silent. We report a case of dopamine-secreting adrenal ganglioneuroma associated with paroxysmal hypertensive attacks in an adult patient. A 46-year-old woman was admitted to our hospital with a 2-month history of right flank pain, and a 2-year history of paroxysmal hypertensive attacks associated with headaches, palpitations, nervousness, and sweating. Abdominal CT and MRI revealed a solid round tumor approximately 4 cm in diameter on the upper pole of the right kidney. Urinary levels of dopamine and homovanillic acid were slightly elevated, although urinary levels of metanephrine and normetanephrine were suppressed. The urinary levels of epinephrine, norepinephrine, and vanillylmandelic acid were within normal limits. Right adrenalectomy was performed for treatment purposes. Histological diagnosis of the tumor was a ganglioneuroma originating from the adrenal medulla. In conclusion, this is a case of dopamine-secreting adrenal ganglioneuroma associated with paroxysmal hypertensive attacks in an adult patient.

  7. Correlates of hypertension among adult men and women in kosovo.

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    Hashani, Valdet; Roshi, Enver; Burazeri, Genc

    2014-06-01

    We aimed to assess the independent socioeconomic, behavioral and psychosocial correlates of hypertension among the adult population of Kosovo. This was a cross-sectional study carried out in Pristina in 2012-2013 which included a large representative sample of 1793 consecutive primary health care users aged ≥35 years (mean age: 51.2±6.7 years; 52.5% women; overall response: 95%). Systolic and diastolic blood pressure was measured, whereas demographic and socioeconomic characteristics (age, sex, marital status, place of residence, education, employment status and income), lifestyle factors (smoking, alcohol intake, physical exercise and dietary fat intake) and psychosocial factors (hostility and reaction to transition) were assessed through a structured questionnaire. Multivariable-adjusted binary logistic regression was used to assess the independent "predictors" of hypertension. Upon simultaneous adjustment in a backward stepwise elimination procedure for all socioeconomic characteristics, lifestyle factors and psychosocial factors, significant positive correlates of hypertension were older age (OR=1.03, 95%CI=1.01-1.05), male gender (OR=1.41, 95%CI=1.19-1.58), a lower educational attainment (OR=1.36, 95%CI=1.08-1.67), smoking (OR=1.53, 95%CI=1.28-2.16), physical inactivity (OR=1.98, 95%CI=1.46-2.74) and hostility (OR=1.42, 95%CI=1.17-2.08). Findings from this study conducted in transitional Kosovo are generally in line with previous reports from the Western Balkan countries and beyond. Decision-makers and policymakers should be aware of the rising trend and socioeconomic, behavioral and psychosocial determinants of hypertension in post-war Kosovo.

  8. Intrathecal fentanyl abolishes the exaggerated blood pressure response to cycling in hypertensive men

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    Barbosa, Thales C; Vianna, Lauro C; Fernandes, Igor A;

    2016-01-01

    of fentanyl, a μ-opioid receptor agonist, aiming to attenuate the central projection of opioid-sensitive group III and IV muscle afferent nerves. The cardiovascular response to exercise of these subjects was compared with that of six normotensive men. During cycling, the hypertensive group demonstrated...

  9. Association of resistin with impaired membrane fluidity of red blood cells in hypertensive and normotensive men: an electron paramagnetic resonance study.

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    Tsuda, Kazushi

    2016-10-01

    Abnormalities in physical properties of the cell membranes may strongly be linked to hypertension. Recent evidence indicates that resistin may actively participate in the pathophysiology of insulin resistance, diabetes mellitus, hypertension and other circulatory disorders. The present study was undertaken to investigate the possible relationships among plasma resistin, oxidative stress and membrane fluidity (a reciprocal value of membrane microviscosity) in hypertension. We measured the membrane fluidity of red blood cells (RBCs) in hypertensive and normotensive men using an electron paramagnetic resonance (EPR) and spin-labeling method. The order parameter (S) for the spin-label agents (5-nitroxide stearate) in EPR spectra of red blood cell (RBC) membranes was significantly higher in hypertensive men than in normotensive men, indicating that membrane fluidity was decreased in hypertension. Plasma resistin levels were correlated with systolic blood pressure and 8-iso-prostaglandin F2α levels (an index of oxidative stress). Furthermore, the order parameter (S) of RBCs significantly correlated with plasma resistin and plasma 8-isoPG F2α, suggesting that reduced membrane fluidity of RBCs might be associated with hyperresistinemia and increased oxidative stress. Multivariate regression analysis showed that, after adjustment for confounding factors, plasma resistin might be an independent determinant of membrane fluidity of RBCs. The EPR study suggests that resistin might have a close correlation with impaired rheologic behavior of RBCs and microcirculatory dysfunction in hypertension, at least in part, via an oxidative stress-dependent mechanism.

  10. Muscle Attenuation Is Associated With Newly Developed Hypertension in Men of African Ancestry.

    Science.gov (United States)

    Zhao, Qian; Zmuda, Joseph M; Kuipers, Allison L; Bunker, Clareann H; Patrick, Alan L; Youk, Ada O; Miljkovic, Iva

    2017-05-01

    Increased ectopic adipose tissue infiltration in skeletal muscle is associated with insulin resistance and diabetes mellitus. We evaluated whether change in skeletal muscle adiposity predicts subsequent development of hypertension in men of African ancestry, a population sample understudied in previous studies. In the Tobago Health Study, a prospective longitudinal study among men of African ancestry (age range 40-91 years), calf intermuscular adipose tissue, and skeletal muscle attenuation were measured with computed tomography. Hypertension was defined as a systolic blood pressure ≥140 mm Hg, or a diastolic blood pressure ≥90 mm Hg, or receiving antihypertensive medications. Logistic regression was performed with adjustment for age, insulin resistance, baseline and 6-year change in body mass index, baseline and 6-year change in waist circumference, and other potential confounding factors. Among 746 normotensive men at baseline, 321 (43%) developed hypertension during the mean 6.2 years of follow-up. Decreased skeletal muscle attenuation was associated with newly developed hypertension after adjustment for baseline and 6-year change of body mass index (odds ratio [95% confidence interval] per SD, 1.3 [1.0-1.6]) or baseline and 6-year change of waist circumference (odds ratio [95% confidence interval] per SD, 1.3 [1.0-1.6]). No association was observed between increased intermuscular adipose tissue and hypertension. Our novel findings show that decreased muscle attenuation is associated with newly developed hypertension among men of African ancestry, independent of general and central adiposity and insulin resistance. Further studies are needed to adjust for inflammation, visceral and other ectopic adipose tissue depots, and to confirm our findings in other population samples. © 2017 American Heart Association, Inc.

  11. Rumpel-Leede phenomenon presenting as a hypertensive urgency.

    Science.gov (United States)

    Varela, Daniel; Tran, Dat; Ngamdu, Kyari Sumayin; Trullender, Brett; Mukherjee, Debabrata; Abbas, Aamer

    2016-04-01

    Rumpel-Leede (R-L) phenomenon is the rare event in which the small dermal capillaries of an extremity rupture in response to application of a compressive device to that extremity, such as when inflating a cuff during noninvasive blood pressure monitoring or when applying a tourniquet to draw blood. This capillary rupture results in formation of a petechial rash distal to the compressive device. R-L phenomenon is believed to occur most often in patients with underlying vascular disease, such as diabetes mellitus or thrombocytopenia. R-L phenomenon is most often benign, though it may rarely be associated with pain and discomfort. There is no treatment for this condition apart from treatment of the underlying vascular disease or thrombocytopenia. We report a 57-year-old woman who presented with hypertensive urgency and experienced R-L phenomenon during blood pressure cuff inflation.

  12. Alcohol intake and triglycerides/high-density lipoprotein cholesterol ratio in men with hypertension.

    Science.gov (United States)

    Wakabayashi, Ichiro

    2013-07-01

    The triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) ratio has been proposed to be a good predictor of cardiovascular disease. The relationship between alcohol consumption and TG/HDL-C ratio in patients with hypertension is unknown. Subjects were normotensive and hypertensive men aged 35-60 years who were divided by daily ethanol intake into non-, light (<22g/day), heavy (≥22 but <44g/day), and very heavy (≥44g/day) drinkers. The TG/HDL-C ratio was significantly higher in the hypertensive group than in the normotensive group. Both in the normotensive and hypertensive groups, TG/HDL-C ratio was significantly lower in light, heavy, and very heavy drinkers than in nondrinkers and was lowest in light drinkers. In the hypertensive group, odds ratios (ORs) for high TG/HDL-C ratio (≥3.75) in light, heavy, and very heavy drinkers vs. nondrinkers were significantly lower (P < 0.01) than a reference level of 1.00 (light drinkers: OR = 0.49, 95% confidence interval (CI) = 0.40-0.59; heavy drinkers: OR = 0.59, 95% CI = 0.52-0.67; very heavy drinkers: OR = 0.70, 95% CI = 0.61-0.80) and were significantly lower than the corresponding ORs in the normotensive group. The ORs for hypertension in subjects with vs. subjects without high TG/HDL-C ratio were significantly higher than the reference level in all the alcohol groups and were significantly lower in light, heavy, and very heavy drinkers than in nondrinkers. The results suggest that there is an inverted J-shaped relationship between alcohol and TG/HDL-C ratio in individuals with hypertension and that alcohol weakens the positive association between TG/HDL-C ratio and hypertension.

  13. Similar Adiponectin Levels in Obese Normotensive and Obese Hypertensive Men and No Vasorelaxant Effect of Adiponectin on Human Arteries

    DEFF Research Database (Denmark)

    Dreier, Rasmus; Asferg, Camilla; Berg, Jais O;

    2016-01-01

    Obesity is a strong risk factor for hypertension, but the mechanism linking obesity to hypertension is not fully elucidated. In obesity, circulating concentrations of adiponectin are decreased and hypoadiponectinaemia has in some but not all studies been associated with increased risk....... In conclusion, obese hypertensive men have similar serum concentrations of adiponectin as obese normotensive men. In combination with the in vitro data, these findings question a pathogenic role of adiponectin in human hypertension....... of hypertension. Due to this inconsistency, we decided to study adiponectin from two aspects in a cross-sectional in vivo study and in an experimental in vitro study. In the cross-sectional study, 103 men with body mass index (BMI) ≥ 30.0 kg/m(2) were studied; 63 had 24-hr ambulatory blood pressure (ABP) ≥ 130...

  14. Hypertension in Kuwait: The Past, Present and Future

    Directory of Open Access Journals (Sweden)

    El-Reshaid Kamel

    1999-01-01

    Full Text Available Kuwait is a small country located on the northeastern part of the Arabian Peninsula. The most recent data on hypertension show: (a a prevalence rate of 26.3%, (b awareness of the disorder in only 23% of affected persons, (c mild to moderate hypertension in 86% of subjects, (d increased proportion of hypertensive patients at older age, (e high prevalence in diabetics at age > 35 years and (f high association with obesity. Most patients still use beta-blockers with a recent surge in calcium channel-blockers (except for immediate-release nifedipine and angiotensin converting enzyme inhibitors. Hypertension was responsible for 935 hospital admissions in 1997. Its related co-morbid conditions such as ischemic heart disease, cerebrovascular accidents, congestive heart failure and chronic renal failure were responsible for 4111, 791, 690 and 978, hospital admissions, respectively, during the same year. Hypertension is the fourth common cause of end-stage renal disease. The most disturbing observation is the lack of disease awareness and the persistently high mortality rate of the disease and its co-morbid conditions. Efforts should be directed towards increase of awareness of this important risk factor for cardiovascular disease.

  15. Mercury exposure and risk of hypertension in US men and women in 2 prospective cohorts

    DEFF Research Database (Denmark)

    Mozaffarian, Dariush; Shi, Peilin; Morris, J Steven

    2012-01-01

    toenail mercury, a valid biomarker of long-term methylmercury exposure, among 6045 US men and women free of hypertension at baseline. Geometric mean toenail mercury concentrations were 0.08 μg/g in the lowest quintile and 0.74 μg/g in the highest quintile, the latter corresponding with exposures ≈2.0-fold...... higher than the US Environmental Protection Agency reference dose. Participants were followed prospectively (mean±SD follow-up, 14.9±7.9 years) for a new self-report of physician-diagnosed hypertension (3540 cases), shown to be >95% sensitive and specific for diagnosing hypertension in these cohorts.......82 (0.62-1.08) in men, and 0.94 (0.84-1.06) in both cohorts combined. Findings were similar when more extreme categories of mercury were compared (across deciles, with geometric mean levels in highest decile ≈2.9-fold higher than the reference dose) and in analyses stratified by fish or omega-3...

  16. [State of microcirculation and cellular hemostasis in men with borderline arterial hypertension during thermoneutral "dry" water immersion].

    Science.gov (United States)

    Kirichenko, L L; Smirnov, V V; Evdokimova, A G

    1985-01-01

    Platelet hemostasis, microcirculation, blood viscosity and lipid metabolism were examined in 18 men with borderline hypertension and 8 healthy men before, during and after 7-day immersion. The exposure to thermoneutral dry water immersion produced hypercoagulopathic changes of platelet hemostasis in the healthy and hypertensive subjects. Platelet hemostasis returned to the pretest level in the healthy subjects 2 days and in the hypertensive subjects only 5 days after exposure. Prior to immersion the hypertensive subjects showed signs of capillarotrophic insufficiency which increased after exposure. On immersion day 3 the hypertensive subjects exhibited a higher blood viscosity and a larger content of total lipids and free fatty acids. All the parameters returned to normal 2 days after immersion.

  17. Relation of C-reactive protein, fibrinogen, and cardiorespiratory fitness to risk of systemic hypertension in men.

    Science.gov (United States)

    Jae, Sae Young; Kurl, Sudhir; Laukkanen, Jari A; Lee, Chong-Do; Choi, Yoon-Ho; Fernhall, Bo; Franklin, Barry A

    2015-06-15

    We investigated the relation between inflammation and incident hypertension, independent of obesity, and tested the associations of cardiorespiratory fitness (fitness) and indexes of inflammation for the development of hypertension in 2,475 normotensive men. Inflammatory markers were C-reactive protein (CRP) and fibrinogen. Fitness was directly measured by peak oxygen uptake during sign/symptom-limited treadmill exercise testing to volitional fatigue; 266 men (10.7%) developed hypertension during an average of 4 years follow-up. After adjusting for potential confounding variables, the relative risk (RR) and 95% confidence interval (CI) for incident hypertension in those in the upper tertile versus lower tertile were 1.55 (95% CI 1.15 to 2.09) for CRP and 1.51 (95% CI 1.10 to 2.06) for fibrinogen. Although the association between fibrinogen and incident hypertension persisted after adjusting for body mass index (p = 0.049), the relation between CRP and incident hypertension was no longer statistically significant (p = 0.08). Fit men had a 27% decreased (RR 0.73, 95% CI 0.56 to 0.94) risk of incident hypertension compared with unfit men in a multivariable adjusted model. In the joint analysis, unfit men with upper CRP had 1.81 times (95% CI 1.21 to 2.70) and unfit men with upper fibrinogen had 2.03 times (95% CI 1.33 to 3.12) greater risks of incident hypertension compared with fit men with low CRP and fibrinogen, respectively. However, these risks did not significantly increase in fit men with upper CRP (RR 1.12, 95% CI 0.76 to 1.63) and fibrinogen (RR 1.26, 95% CI 0.86 to 1.85) groups. In conclusion, these results suggest that heightened levels of fibrinogen, but not CRP, are associated with incident hypertension, independent of body weight, and that high fitness attenuates the risk of incident hypertension across upper levels of inflammatory markers in men.

  18. Fatal hypertensive crisis as presentation of mitochondrial complex I deficiency.

    NARCIS (Netherlands)

    Lohmeier, K.; Distelmaier, F.; Heuvel, L.P.W.J. van den; Rodenburg, R.J.T.; Smeitink, J.A.M.; Mayatepek, E.; Hoehn, T.

    2007-01-01

    Complex I deficiency is a frequent defect of the mitochondrial electron transport chain. We report on a 3-year-old boy, who rapidly deteriorated after sudden flushing and collapse. This fatal and unusual case was characterized by widely uncontrollable arterial hypertension. It might indicate that hy

  19. First-attack pediatric hypertensive crisis presenting to the pediatric emergency department

    Directory of Open Access Journals (Sweden)

    Yang Wen-Chieh

    2012-12-01

    Full Text Available Background Hypertensive crisis in children is a relatively rare condition presenting with elevated blood pressure (BP and related symptoms, and it is potentially life-threatening. The aim of this study was to survey children with first attacks of hypertensive crisis arriving at the emergency department (ED, and to determine the related parameters that predicted the severity of hypertensive crisis in children by age group. Methods This was a retrospective study conducted from 2000 to 2007 in pediatric patients aged 18 years and younger with a diagnosis of hypertensive crisis at the ED. All patients were divided into four age groups (infants, preschool age, elementary school age, and adolescents, and two severity groups (hypertensive urgency and hypertensive emergency. BP levels, etiology, severity, and clinical manifestations were analyzed by age group and compared between the hypertensive emergency and hypertensive urgency groups. Results The mean systolic/diastolic BP in the hypertensive crisis patients was 161/102 mmHg. The major causes of hypertensive crisis were essential hypertension, renal disorders and endocrine/metabolic disorders. Half of all patients had a single underlying cause, and 8 had a combination of underlying causes. Headache was the most common symptom (54.5%, followed by dizziness (45.5%, nausea/vomiting (36.4% and chest pain (29.1%. A family history of hypertension was a significant predictive factor for the older patients with hypertensive crisis. Clinical manifestations and severity showed a positive correlation with age. In contrast to diastolic BP, systolic BP showed a significant trend in the older children. Conclusions Primary clinicians should pay attention to the pediatric patients who present with elevated blood pressure and related clinical hypertensive symptoms, especially headache, nausea/vomiting, and altered consciousness which may indicate that appropriate and immediate antihypertensive medications are

  20. Hypertension

    Science.gov (United States)

    ... Hypertension Triglycerides Featured Resource Find an Endocrinologist Search Hypertension March 2010 Download PDFs English Espanol Editors Robert ... Additional Resources MedlinePlus (NIH) Mayo Clinic What is hypertension? Hypertension, or chronic (long-term) high blood pressure, ...

  1. Takayasu's arteritis and primary antiphospholipid syndrome presenting as hypertensive urgency.

    Science.gov (United States)

    Yang, Andrew; Nayeemuddin, Mohammed; Prasad, Bhanu

    2016-01-18

    A 33-year-old Caucasian man was admitted to the hospital with chest pain and hypertensive urgency. Physical examination revealed widespread arterial bruits and marked difference in blood pressure between the upper limbs. Vascular imaging showed widespread narrowing in multiple vascular territories. He met the established American College of Rheumatology criteria for Takayasu's arteritis. His resistant hypertension was considered to be a consequence of bilateral renal artery stenosis and he subsequently underwent sequential stenting of his renal arteries leading to improvement in blood pressure and reduction in the number of antihypertensive medications. Subsequent imaging revealed progression of aortic thrombus in the setting of an elevated erythrocyte sedimentation rate, and persistently elevated antiphospholipid antibodies fulfilling diagnostic criteria for primary antiphospholipid syndrome, requiring initiation of immunosuppression and anticoagulation.

  2. Q192R Paraoxonase (PON)1 Polymorphism, Insulin Sensitivity, and Endothelial Function in Essential Hypertensive Men

    Science.gov (United States)

    Dell’Omo, Giulia; Penno, Giuseppe; Pucci, Laura; Lucchesi, Daniela; Prato, Stefano Del; Pedrinelli, Roberto

    2014-01-01

    AIMS Essential hypertension is characterized by increased reactive oxygen species (ROS) generation harmful for insulin sensitivity and nitric oxide (NO)-mediated vasomotor function, a noxious effect that paraoxonase (PON)1, an antioxidant circulating high-density lipoprotein (HDL)-bound esterase, may counteract. The PON1 gene contains several polymorphisms including a glutamine (Q) to arginine (R) transition at position 192 encoding circulating allozymes with higher antioxidant activity that might influence both parameters. METHODS Q192R was determined by polymerase chain reaction in 72 never-treated, glucose-tolerant, uncomplicated essential hypertensive men. Insulin sensitivity was assessed by homeostasis model assessment (HOMA) and endothelial function by forearm vasodilation (strain-gage venous plethysmography) to intra-arterial acetylcholine (ACH) with sodium nitroprusside (NIP) as a NO-independent control. Additional evaluation variables included 24-hour blood pressure (BP), lipids, BMI, smoking status, and metabolic syndrome (MetS) by Adult Treatment Panel (ATP)-III criteria. R192 was considered as the rare allele, and its associations analyzed by dominant models (Q/Q vs. Q/R + R/R). RESULTS Genotype frequencies were consistent with the Hardy–Weinberg equilibrium. HOMA was lower and insulin resistance (the upper fourth of HOMA values distribution) less prevalent in Q/R + R/R carriers in whom ACH-mediated vasodilatation was greater and endothelial dysfunction (the bottom fourth of ACHAUC values distribution) less frequent than in Q/Q homozygotes. Q192R polymorphism and MetS were unrelated parameters despite their common association with insulin resistance. 24-hour BP, BMI, lipids, and smoking habits were homogeneously distributed across genotypes. CONCLUSIONS Q192R polymorphism associates differentially with insulin sensitivity and endothelial function in essential hypertensive men. PMID:25089090

  3. Postprandial lipemia in men with metabolic syndrome, hypertensives and healthy subjects

    Directory of Open Access Journals (Sweden)

    Iraklianou Stella A

    2005-09-01

    Full Text Available Abstract Background The metabolic syndrome (MetS, as well as postprandial hypertriglyceridemia, is associated with coronary heart disease. This study aimed to evaluate the postprandial lipemia after oral fat tolerance test (OFTT in subjects with MetS and compare them to hypertensive (HTN and healthy subjects. Results OFTT was given to 33 men with MetS (defined by the Adult Treatment Panel III, 17 HTN and 14 healthy men. The MetS group was further divided according to fasting triglycerides (TG into TG ≥ 150 [MetS+TG, (n = 22] or The postprandial response was significantly higher in MetS compared to HTN and healthy men [AUC (SD in mg/dl/h; 2534 ± 1016 vs. 1620 ± 494 and 1019 ± 280, respectively, p ≤ 0.001]. The TG levels were increased significantly in MetS+TG compared to MetS-TG subjects at 4 (p = 0.022, 6 (p Conclusion Fasting TG concentration is the main determinant of postprandial lipemia. However, an exaggeration of TG postprandialy was found in normotriglyceridemic MetS and HTN compared to healthy subjects. This suggests that intervention to lower fasting TG levels should be recommended in MetS subjects.

  4. Hyponatremic hypertensive syndrome (HHS in an 18-month old-child presenting as malignant hypertension: a case report

    Directory of Open Access Journals (Sweden)

    Theodorou Andreas

    2004-04-01

    Full Text Available Abstract Background The combination of hyponatremia and renovascular hypertension is called hyponatremic hypertensive syndrome (HHS. Malignant hypertension as a presentation has been reported in adults with HHS but is rare in children. Case presentation An eighteen month-old male presented with drowsiness, sudden onset status epilepticus and blood pressure of 210/160. The electrolytes on admission revealed sodium of 120 mEq/L and potassium of 2.1 mEq/L. The peripheral renin activity (PRA was 172 ng/ml/min (normal 3–11 ng/ml/min and serum aldosterone level was 91 ng/dl (normal 4 to 16 ng/dl. Patient underwent angioplasty with no success, followed by surgical correction. Two years since the diagnosis, the blood pressure is controlled with labetolol and amlodipine (at less than sixth of the pre-operative dosages. The PRA is 2.4 ng/ml/min and aldosterone 15.5 ng/dl. The child not only had three renal arteries on left but all of them were stenosed which to best of our knowledge has not been described. Conclusion As uncommon as HHS with malignant hypertension may be in adults it is under-reported in children and purpose of the case report is to raise its awareness.

  5. Structural and functional cardiac adaptations to 6 months of football training in untrained hypertensive men

    DEFF Research Database (Denmark)

    Andersen, L. J.; Randers, M. B.; Hansen, P. R.

    2014-01-01

    We investigated the effects of 3 and 6 months of regular football training on cardiac structure and function in hypertensive men. Thirty-one untrained males with mild-to-moderate hypertension were randomized 2:1 to a football training group (n = 20) and a control group receiving traditional...... recommendations on healthy lifestyle (n = 11). Cardiac measures were evaluated by echocardiography. The football group exhibited significant (P function after just 3 months: Left ventricular (LV) end-diastolic volume increased from 104 ± 25 to 117 ± 29 mL. LV diastolic...... function improved measured as E/A ratio (1.15 ± 0.32 to 1.54 ± 0.38), early diastolic velocity, E' (11.0 ± 2.5 to 11.9 ± 2.6 cm/s), and isovolumetric relaxation time (74 ± 13 to 62 ± 13 ms). LV systolic function improved measured as longitudinal displacement (10.7 ± 2.1 to 12.1 ± 2.3 mm). Right ventricular...

  6. Cardiac arrhythmias in recently diagnosed hypertensive patients at first presentation: an electrocardiographic-based study.

    Science.gov (United States)

    Ejim, E C; Ike, S O; Anisiuba, B C; Essien, I O; Onwubere, B J; Ikeh, V O

    2012-01-01

    Various forms of cardiac arrhythmias have been documented in hypertensive subjects, and hypertension is an important risk factor for the development of atrial and ventricular arrhythmias and sudden death. Electrocardiography at rest easily documents significant arrhythmias in patients, and this study was carried out to determine the types and frequency of arrhythmias in hypertensive subjects at first presentation in the Hypertension Clinics of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. The study was hospitalbased and retrospective in nature. The resting 12lead ECG reports of 346 consecutive hypertensive subjects seen at the Hypertension clinics of the UNTH Enugu over a 14 month period were retrieved from the case files and studied. Other information obtained from the case files included the age and gender of the subjects. The mean age of the subjects was 57.3 years. Ninety-five of the subjects had arrhythmias representing 27% of the study population, out of which fifty-five were males (57.9%) and forty were females (42.1%). However 26.9% of all the male subjects had arrhythmias while 28.2% of all the females had arrhythmias. Multiple ventricular ectopics, sinus tachycardia, sinus bradycardia and atrial fibrillation were the most prevalent arrhythmias. This study showed that a significant proportion of hypertensive subjects present initially with significant rhythm disturbances.

  7. Gliomatosis cerebri presenting as idiopathic intracranial hypertension in a child.

    Science.gov (United States)

    Zunz, Eran; Ben Sira, Liat; Constantini, Shlomi; Fattal-Valevski, Aviva; Yalon, Michal; Roth, Jonathan; Cagnano, Emanuela; Kesler, Anat

    2011-12-01

    We present a rare case of a diffuse anaplastic astrocytoma (gliomatosis configuration) in a child, which was misdiagnosed as pseudotumor cerebri following initially normal CT of the brain and elevated opening pressure on lumbar puncture with normal cerebrospinal composition.

  8. Prognostic value of QTc interval dispersion changes during exercise testing in hypertensive men

    Directory of Open Access Journals (Sweden)

    Đorđević Dragan

    2008-01-01

    Full Text Available INTRODUCTION The prognostic significance of QTc dispersion changes during exercise testing (ET in patients with left ventricular hypertrophy is not clear. OBJECTIVE The aim was to study the dynamics of QTc interval dispersion (QTcd in patients (pts with left ventricular hypertrophy (LVH during the exercise testing and its prognostic significance. METHOD In the study we included 55 men (aged 53 years with hypertensive left ventricular hypertrophy and a negative ET (LVH group, 20 men (aged 58 years with a positive ET and 20 healthy men (aged 55 years. There was no statistically significant difference in the left ventricular mass index (LVMI between LVH group and ILVH group (160.9±14.9 g/m2 and 152.8±22.7 g/m2. The first ECG was done before the ET and the second one was done during the first minute of recovery, with calculation of QTc dispersion. The patients were followed during five years for new cardiovascular events. RESULTS During the ET, the QTcd significantly increased in LVH group (56.8±18.0 - 76.7±22.6 ms; p<0.001. A statistically significant correlation was found between the amount of ST segment depression at the end of ET and QTc dispersion at the beginning and at the end of ET (r=0.673 and r=0.698; p<0.01. The QTc dispersion was increased in 35 (63.6% patients and decreased in 20 (36.4% patients during the ET. Three patients (5.4% in the first group had adverse cardiovascular events during the five-year follow-up. A multiple stepwise regression model was formed by including age, LVMI, QTc interval, QTc dispersion and change of QTc dispersion during the ET. There was no prognostic significance of QTc interval and QTc dispersion during five-year follow-up in regard to adverse cardiovascular events, but prognostic value was found for LVMI (coefficient β=0.480; p<0.001. CONCLUSION The increase of QTc interval dispersion is common in men with positive ET for myocardial ischemia and there is a correlation between QTc dispersion and

  9. Addison's disease presenting with idiopathic intracranial hypertension in 24-year-old woman: a case report

    Directory of Open Access Journals (Sweden)

    Moore Peter

    2010-02-01

    Full Text Available Abstract Introduction Idiopathic intracranial hypertension can rarely be associated with an underlying endocrine disorder such as Cushing's syndrome, hyperthyroidism, or with administration of thyroxine or growth hormone. Though cases of idiopathic intracranial hypertension associated with Addison's disease in children have been reported, there is only one documented case report of this association in adults. We describe a case of an acute adrenal insufficiency precipitated by idiopathic intracranial hypertension in a Caucasian female. Case presentation A 24-year-old Caucasian woman was acutely unwell with a background of several months of generalised fatigue and intermittent headaches. She had unremarkable neurological and systemic examination with a normal computerised tomography and magnetic resonance imaging of the brain. Normal cerebrospinal fluid but increased opening pressure at lumbar puncture suggested intracranial hypertension. A flat short synacthen test and raised level of adrenocorticotrophic hormone were consistent with primary adrenal failure. Conclusion Addison's disease can remain unrecognised until precipitated by acute stress. This case suggests that idiopathic intracranial hypertension can rarely be associated with Addison's disease and present as an acute illness. Idiopathic intracranial hypertension is possibly related to an increase in the levels of arginine vasopressin peptide in serum and cerebrospinal fluid secondary to a glucocorticoid deficient state.

  10. The effect of resistance exercise on fitness, blood pressure, and blood lipid of hypertensive middle-aged men

    Science.gov (United States)

    Shim, Kyu-Sik; Kim, Jong-Won

    2017-01-01

    The purpose of this study is to investigate the effect of resistance exercise on fitness, blood pressure, and blood lipid of hypertensive middle-aged men. To achieve the goal of the study, a total of 23 subjects were selected. Among them, 14 subjects who exercised regularly were selected as the exercise group, while the remaining 9 subjects were selected as the control group. In terms of data processing, the IBM SPSS Statistics ver. 21.0 software was used to calculate the mean and standard deviation. Regarding the verification of difference on the change of means between the groups, analysis of covariance was used for statistical process. As a result, significant differences were found in cardiovascular endurance, muscle endurance, flexibility, and triglyceride. These results indicate that the resistance exercise only had slight effect on hypertensive middle-aged men.

  11. Similar Adiponectin Levels in Obese Normotensive and Obese Hypertensive Men and No Vasorelaxant Effect of Adiponectin on Human Arteries

    DEFF Research Database (Denmark)

    Dreier, Rasmus; Asferg, Camilla; Berg, Jais O

    2016-01-01

    Obesity is a strong risk factor for hypertension, but the mechanism linking obesity to hypertension is not fully elucidated. In obesity, circulating concentrations of adiponectin are decreased and hypoadiponectinaemia has in some but not all studies been associated with increased risk of hyperten......Obesity is a strong risk factor for hypertension, but the mechanism linking obesity to hypertension is not fully elucidated. In obesity, circulating concentrations of adiponectin are decreased and hypoadiponectinaemia has in some but not all studies been associated with increased risk...... of hypertension. Due to this inconsistency, we decided to study adiponectin from two aspects in a cross-sectional in vivo study and in an experimental in vitro study. In the cross-sectional study, 103 men with body mass index (BMI) ≥ 30.0 kg/m(2) were studied; 63 had 24-hr ambulatory blood pressure (ABP) ≥ 130....../80 mmHg (ObeseHT) and 40 had 24-hr ABP adiponectin and body composition using dual-energy X-ray absorptiometry scanning were determined. In vitro...

  12. Multi-drug-resistant hypertension caused by severe aortic coarctation presenting in late adulthood.

    Science.gov (United States)

    Meller, Stephanie M; Fahey, John T; Setaro, John F; Forrest, John K

    2015-04-01

    Aortic coarctation, a congenital narrowing in the region of the ligamentum arteriosium, is a rare etiology for multi-drug-resistant hypertension in adulthood; however, advances in stenting modalities may offer long-term improvements in morbidity and possibly even cure. We report on a female patient in her late 50s presenting with refractory hypertension and severely elevated renin levels, ultimately diagnosed with aortic coarctation and treated with percutaneous stent implantation, which resulted in successful blood pressure control with verapamil monotherapy. This case highlights the efficacy of endovascular stent implantation for the treatment of coarctation and the need for clinicians to consider this disease entity in the differential diagnosis of refractory hypertension even in late adulthood.

  13. Portal hypertensive gastropathy: A systematic review of the pathophysiology, clinical presentation, natural history and therapy.

    Science.gov (United States)

    Gjeorgjievski, Mihajlo; Cappell, Mitchell S

    2016-02-08

    To describe the pathophysiology, clinical presentation, natural history, and therapy of portal hypertensive gastropathy (PHG) based on a systematic literature review. Computerized search of the literature was performed via PubMed using the following medical subject headings or keywords: "portal" and "gastropathy"; or "portal" and "hypertensive"; or "congestive" and "gastropathy"; or "congestive" and "gastroenteropathy". The following criteria were applied for study inclusion: Publication in peer-reviewed journals, and publication since 1980. Articles were independently evaluated by each author and selected for inclusion by consensus after discussion based on the following criteria: Well-designed, prospective trials; recent studies; large study populations; and study emphasis on PHG. PHG is diagnosed by characteristic endoscopic findings of small polygonal areas of variable erythema surrounded by a pale, reticular border in a mosaic pattern in the gastric fundus/body in a patient with cirrhotic or non-cirrhotic portal hypertension. Histologic findings include capillary and venule dilatation, congestion, and tortuosity, without vascular fibrin thrombi or inflammatory cells in gastric submucosa. PHG is differentiated from gastric antral vascular ectasia by a different endoscopic appearance. The etiology of PHG is inadequately understood. Portal hypertension is necessary but insufficient to develop PHG because many patients have portal hypertension without PHG. PHG increases in frequency with more severe portal hypertension, advanced liver disease, longer liver disease duration, presence of esophageal varices, and endoscopic variceal obliteration. PHG pathogenesis is related to a hyperdynamic circulation, induced by portal hypertension, characterized by increased intrahepatic resistance to flow, increased splanchnic flow, increased total gastric flow, and most likely decreased gastric mucosal flow. Gastric mucosa in PHG shows increased susceptibility to gastrotoxic

  14. PORTAL-HYPERTENSION AS PRESENTING FEATURE OF A MYELOPROLIFERATIVE DISORDER - DIAGNOSIS AND THERAPEUTIC DILEMMAS

    NARCIS (Netherlands)

    MULLER, EW; DEWOLF, JTM; HAAGSMA, EB

    1993-01-01

    In some patients presenting with complications of portal hypertension, thrombosis of hepatic or portal veins is identified as the cause. Hepatic or portal vein thrombosis may be secondary to recognized etiologies like infection or malignancy. When no etiology for the thrombosis is found, it is

  15. PORTAL-HYPERTENSION AS PRESENTING FEATURE OF A MYELOPROLIFERATIVE DISORDER - DIAGNOSIS AND THERAPEUTIC DILEMMAS

    NARCIS (Netherlands)

    MULLER, EW; DEWOLF, JTM; HAAGSMA, EB

    1993-01-01

    In some patients presenting with complications of portal hypertension, thrombosis of hepatic or portal veins is identified as the cause. Hepatic or portal vein thrombosis may be secondary to recognized etiologies like infection or malignancy. When no etiology for the thrombosis is found, it is likel

  16. EFFICACY AND SAFETY OF BISOPROLOL IN YOUNG MEN WITH ARTERIAL HYPERTENSION AND OBESITY

    Directory of Open Access Journals (Sweden)

    A. G. Avtandilov

    2011-01-01

    Full Text Available Aim. To evaluate effect of bisoprolol on circadian blood pressure (BP profile, autonomic cardiovascular regulation, lipid and carbohydrate metabolism in young patients with arterial hypertension (HT and obesity. Materials and methods. 36 men aged 18 to 35 years with HT 1-2 degrees, obesity 1-2 degrees and signs of sympathetic over activity were examined. In addition to standard clinical examination assessment of heart rate variability (HRV during orthostatic test with spectral analysis, ambulatory BP monitoring, evaluation of lipid profile, oral glucose tolerance test, determination of immunoreactive insulin, insulin resistance index and functional activity of beta-cells were performed. Anthropometric measurements included body mass index and waist circumference. Bisoprolol in the initial dose of 5 mg QD orally for 12 weeks was assigned to all patients. After 12 weeks of bisoprolol treatment repeated examination was performed. Results. Significant changes in HRV after 12 weeks of treatment with bisoprolol was found. Parasympathetic influence of autonomic nervous system increased during orthostatic test. Contribution of the slow and very slow waves, which reflect sympathetic and neurohumoral activity , reduced. Total spectral power was significantly increased. Initial tachycardia reduced. Target BP values were achieved after 12 weeks of treatment with bisoprolol 5 mg QD. Increase in a number of dippers and decrease in a number of nondippers in terms of both systolic and diastolic BP was observed. Heart rate and HRV was significantly decreased. No adverse events in terms of lipid or carbohydrate metabolism were found during treatment with bisoprolol. Conclusion. Bisoprolol 12 week treatment resulted in sympathetic activity decrease and parasympathetic activity increase, achievement of BP target levels, improvement of BP circadian profile. Bisoprolol therapy in dose of 5 mg/day demonstrated metabolic neutrality in patients with risk factors of

  17. [Hypertension].

    Science.gov (United States)

    Ohishi, Mitsuru

    2014-04-01

    Hypertension is well known to one of the risk factors to reduce cognitive function, however, it is still unclear whether anti-hypertensive therapy is effective to prevent development of dementia or Alzheimer's disease. Epidemiological studies suggested antihypertensive therapy from the middle-age could reduce risk of dementia. The meta-analysis including HYVET also suggested blood pressure lowering from the elderly might be also effective to prevent development of dementia. The network meta-analysis and the cohort study using mega-data bank suggested ARB might be effective to prevent development of dementia or Alzheimer's disease compared to administration with other anti-hypertensive drugs. Although the further major clinical investigation is required, anti-hypertensive treatment might be useful to manage hypertensive patients with dementia.

  18. Syphilis presenting as inflammatory tumors of the liver in HIV-positive homosexual men.

    Science.gov (United States)

    Hagen, Catherine E; Kamionek, Michal; McKinsey, David S; Misdraji, Joseph

    2014-12-01

    Syphilis, a sexually transmitted infection caused by the spirochete Treponema pallidum, has seen a resurgence since 2001, particularly in men who have sex with men. Syphilis can affect the liver during the secondary stage as syphilitic hepatitis and during the tertiary stage as gummas. We describe 3 cases of syphilis in human immunodeficiency virus-positive homosexual men that presented as hepatic mass lesions clinically suspected of being malignant tumors. Histologically, 2 of the 3 cases showed a plump spindle cell proliferation, mixed inflammatory infiltrate with numerous neutrophils, and abscesses, whereas the third case showed granulomas and pericholangitis/cholangitis. Immunohistochemical staining for T. pallidum showed innumerable organisms in 2 of the cases. Pathologists must be aware of the possibility of syphilis causing hepatic inflammatory masses in human immunodeficiency virus-positive men who have sex with men in order to avoid misdiagnosis or delayed treatment.

  19. Portal hypertensive gastropathy: A systematic review of the pathophysiology, clinical presentation, natural history and therapy

    Science.gov (United States)

    Gjeorgjievski, Mihajlo; Cappell, Mitchell S

    2016-01-01

    AIM: To describe the pathophysiology, clinical presentation, natural history, and therapy of portal hypertensive gastropathy (PHG) based on a systematic literature review. METHODS: Computerized search of the literature was performed via PubMed using the following medical subject headings or keywords: “portal” and “gastropathy”; or “portal” and “hypertensive”; or “congestive” and “gastropathy”; or “congestive” and “gastroenteropathy”. The following criteria were applied for study inclusion: Publication in peer-reviewed journals, and publication since 1980. Articles were independently evaluated by each author and selected for inclusion by consensus after discussion based on the following criteria: Well-designed, prospective trials; recent studies; large study populations; and study emphasis on PHG. RESULTS: PHG is diagnosed by characteristic endoscopic findings of small polygonal areas of variable erythema surrounded by a pale, reticular border in a mosaic pattern in the gastric fundus/body in a patient with cirrhotic or non-cirrhotic portal hypertension. Histologic findings include capillary and venule dilatation, congestion, and tortuosity, without vascular fibrin thrombi or inflammatory cells in gastric submucosa. PHG is differentiated from gastric antral vascular ectasia by a different endoscopic appearance. The etiology of PHG is inadequately understood. Portal hypertension is necessary but insufficient to develop PHG because many patients have portal hypertension without PHG. PHG increases in frequency with more severe portal hypertension, advanced liver disease, longer liver disease duration, presence of esophageal varices, and endoscopic variceal obliteration. PHG pathogenesis is related to a hyperdynamic circulation, induced by portal hypertension, characterized by increased intrahepatic resistance to flow, increased splanchnic flow, increased total gastric flow, and most likely decreased gastric mucosal flow. Gastric mucosa

  20. Hypertension

    OpenAIRE

    2012-01-01

    Hypertension is responsible for roughly one-in-six adult deaths annually in the United States and is associated with five of the top nine causes of death. 1 Ten trillion dollars is the estimated annual cost worldwide of the direct and indirect effects of hypertension. 2,3 In the U.S. alone, costs estimated at almost $74 billion in 2009 placed a huge economic burden on the health care system. 4 The prevalence of hypertension increases with advancing age to the point where more than half of peo...

  1. Alcohol consumption and risk for coronary heart disease among men with hypertension

    NARCIS (Netherlands)

    Beulens, J.W.J.; Rimm, E.B.; Ascherio, A.; Spiegelman, D.; Hendriks, H.F.J.; Mukamal, K.J.

    2007-01-01

    Background: Heavy alcohol consumption increases risk for hypertension, which is in itself a strong risk factor for cardiovascular disease (CVD). However, data on the association between alcohol consumption and CVD among individuals with hypertension are scarce. Objective: To assess whether alcohol

  2. Relative Atrial Natriuretic Peptide Deficiency and Inadequate Renin and Angiotensin II Suppression in Obese Hypertensive Men

    DEFF Research Database (Denmark)

    Asferg, Camilla L; Nielsen, Søren J; Andersen, Ulrik B

    2013-01-01

    Obesity is a strong risk factor for hypertension, but the mechanisms by which obesity leads to hypertension are incompletely understood. On this background, we assessed dietary sodium intake, serum levels of natriuretic peptides (NPs), and the activity of the renin-angiotensin system in 63 obese...

  3. Hypertension

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — These datasets provide de-identified insurance data for hypertension hyperlipidemia. The data is provided by three managed care organizations in Allegheny County...

  4. Occupational noise exposure and incident hypertension in men: a prospective cohort study.

    Science.gov (United States)

    Chang, Ta-Yuan; Hwang, Bing-Fang; Liu, Chiu-Shong; Chen, Ren-Yin; Wang, Ven-Shing; Bao, Bo-Ying; Lai, Jim-Shoung

    2013-04-15

    The associations between occupational noise exposure and hypertension remain controversial because of the differences in study designs, exposure assessments, and confounding controls. This prospective study investigated the relationship between noise exposure and the 10-year risk of hypertension. A cohort of 578 male workers in Taiwan was followed from 1998 to 2008. All subjects were divided into high-, intermediate-, and low-exposure groups on the basis of noise exposure assessment. Cox regression models were used to estimate the relative risks of hypertension after adjustment for potential confounders. During the 7,805 person-years of follow-up, 141 hypertension cases were identified. Significant increases of 3.2 (95% confidence interval (CI): 0.2, 6.2) mm Hg in systolic blood pressure and 2.5 (95% CI: 0.1, 4.8) mm Hg in diastolic blood pressure between the baseline and follow-up measurements were observed in the high-exposure group. Participants exposed to ≥85 A-weighted decibels (dBA) had a 1.93-fold (95% CI: 1.15, 3.22) risk of hypertension compared with those exposed to risk of hypertension and the stratum of noise exposure. Prolonged exposure to noise levels ≥85 dBA may increase males' systolic and diastolic blood pressure levels. This association may translate into a higher incidence of hypertension.

  5. RENAL HEMODYNAMICS AND GLOMERULAR FILTRATION RATE IN MEN AND WOMEN WITH ARTERIAL HYPERTENSION AT THE AGE OF 40-60 YEARS

    Directory of Open Access Journals (Sweden)

    I. G. Fomina

    2015-12-01

    Full Text Available Aim. To study parameters of a renal hemodynamic and the general glomerular filtration rate (GGFR and their correlations with cardiovascular risk factors (RF in patient with arterial hypertension (AH.Material and methods. 102 patients with AH (35 men and 67 women of 40-60 y.o. were involved in the study. 20 persons (10 men and 10 women with normal blood pressure (BP were included in control group. Dynamic renal angioscintigraphy was used for an estimation of a renal hemodynamic and GGFR.Results. Hypertensive women had lower renal blood flow and GGFR than these in men (p<0,000. Renal hemodynamics and GGFR in men and women did not differ in control group. Positive correlation  r=0,61; p<0,05 between GGFR and a tobacco smoking was found in hypertensive men as well as negative correlation (r=-0,41; p<0,005 between GGFR and body mass index (BMI in women.Conclusion. Renal blood flow and GGFR are lower in hypertensive women than these in men. Positive correlation between GGFR and tobacco smoking and negative correlation between GGFR and BMI were found in men and women respectively.

  6. Implicit racial bias as a moderator of the association between racial discrimination and hypertension: a study of Midlife African American men.

    Science.gov (United States)

    Chae, David H; Nuru-Jeter, Amani M; Adler, Nancy E

    2012-01-01

    Empirical findings on racial discrimination and hypertension risk have been inconsistent. Some studies have found no association between self-reported experiences of discrimination and cardiovascular health outcomes, whereas others have found moderated or curvilinear relationships. The current cross-sectional study examined whether the association between racial discrimination and hypertension is moderated by implicit racial bias among African American midlife men. This study examined the data on 91 African American men between 30 and 50 years of age. Primary variables were self-reported experiences of racial discrimination and unconscious racial bias as measured by the Black-White Implicit Association Test. Modified Poisson regression models were specified, examining hypertension, defined as a mean resting systolic level of at least 140 mm Hg or diastolic level of at least 90 mm Hg, or self-reported history of cardiovascular medication use with a physician diagnosis of hypertension. No main effects for discrimination or implicit racial bias were found, but the interaction of the two variables was significantly related to hypertension (χ(2)(1) = 4.89, p discrimination were associated with a higher probability of hypertension, whereas among those with an implicit problack bias, it was associated with lower risk. The combination of experiencing racial discrimination and holding an antiblack bias may have particularly detrimental consequences on hypertension among African American midlife men, whereas holding an implicit problack bias may buffer the effects of racial discrimination. Efforts to address both internalized racial bias and racial discrimination may lower cardiovascular risk in this population.

  7. Prevalence of Peyronie's Disease-Like Symptoms in Men Presenting With Dupuytren Contractures.

    Science.gov (United States)

    Shindel, Alan W; Sweet, Genevieve; Thieu, William; Durbin-Johnson, Blythe; Rothschild, Jennifer; Szabo, Robert

    2017-09-01

    Peyronie's disease (PD) and Dupuytren contractures (DC) are often comorbid and are believed to have a similar underlying pathophysiologic mechanism. To investigate the prevalence of PD-like symptoms (PDLS) in men with DC. From October 2013 to December 2016, men who were seen and evaluated for DC were offered the opportunity to participate in an anonymous survey. The survey assessed several basic demographic and sexual health factors and included items from the International Index of Erectile Function and the Erection Hardness Scale. Men who reported PDLS were asked a series of questions derived from the Peyronie's Disease Questionnaire and for their opinions on theoretical treatment modalities for sexual problems and penile deformity. Prevalence of PDLS in men with DC. One hundred forty men with DC were invited to participate; 85 surveys were returned (response rate = 61%). Twenty-two respondents (26%, 95% confidence interval = 17-35) reported PDLS. Approximately one fourth of all respondents had an Erection Hardness Scale score lower than 3. The most common specific PDLS concerns were penile curvature (91%), length loss (55%), narrowing (36%), and hinging (32%). In men with PDLS, 73% felt at least a little bothered by the symptoms when attempting sexual activity and 40% reported having sex less frequently because of the symptoms. Just 27% of men with PDLS had ever used a treatment for a sexual concern. In terms of treatments for penile deformities, 64% of men with PDLS expressed an interest in treatment administered in the form of an in-office procedure; 41% were potentially amenable to a surgical procedure. The prevalence of PDLS in men with DC is similar to the prevalence of DC in men diagnosed with PD. A substantial number of these men have distress and would consider standard-of-care treatments for PD. Shindel AW, Sweet G, Thieu W, et al. Prevalence of Peyronie's Disease-Like Symptoms in Men Presenting With Dupuytren Contractures. Sex Med 2017;5:e135-e141

  8. Effects of Docosahexaenoic Acid Supplementation on Blood Pressure, Heart Rate, and Serum Lipids in Scottish Men with Hypertension and Hypercholesterolemia

    Directory of Open Access Journals (Sweden)

    Miki Sagara

    2011-01-01

    Full Text Available To investigate the effects of daily supplementation with docosahexaenoic acid (DHA on coronary heart disease risks in 38 middle-aged men with hypertension and/or hypercholesterolemia in Scotland, a five-week double-blind placebo-controlled dietary supplementation with either 2 g of DHA or active placebo (1 g of olive oil was conducted. Percent composition of DHA in plasma phospholipids increased significantly in DHA group. Systolic and diastolic blood pressure and heart rate decreased significantly in DHA group, but not in placebo group. High-density lipoprotein cholesterol (HDL-C increased significantly, and total cholesterol (TC/HDL-C and non-HDL-C/HDL-C ratios decreased significantly in both groups. There was no change in TC and non-HDL-C. We conclude that 2 g/day of DHA supplementation reduced coronary heart disease risk factor level improving blood pressure, heart rate, and lipid profiles in hypertensive, hypercholesterolemic Scottish men who do not eat fish on a regular basis.

  9. Hypertension and obesity and the risk of kidney cancer in 2 large cohorts of US men and women.

    Science.gov (United States)

    Sanfilippo, Kristen M; McTigue, Kathleen M; Fidler, Christian J; Neaton, James D; Chang, Yuefang; Fried, Linda F; Liu, Simin; Kuller, Lewis H

    2014-05-01

    Kidney cancer incidence is increasing globally. Reasons for this rise are unclear but could relate to obesity and hypertension. We analyzed longitudinal relationships between hypertension and obesity and kidney cancer incidence in 156 774 participants of the Women's Health Initiative clinical trials and observational studies over 10.8 years. In addition, we examined the effect of blood pressure (BP) on kidney cancer deaths for over 25 years among the 353 340 men screened for the Multiple Risk Factor Intervention Trial (MRFIT). In the Women's Health Initiative, systolic BP (SBP) was categorized in 6 groups from 160 mm Hg, and body mass index was categorized using standard criteria. In age-adjusted analyses, kidney cancer risk increased across SBP categories (P value for trend fashion with increasing SBP (hazard ratio, 1.87 for SBP>160 versus <120 mm Hg; 95% confidence interval, 1.38-2.53). Risk was increased among cigarette smokers. Further research is needed to determine the pathophysiologic basis of relationships between both higher BP and the risk of kidney cancer, and whether specific drug therapies for hypertension can reduce kidney cancer risk.

  10. Hypertension

    OpenAIRE

    2016-01-01

    Defining hypertension in pregnancy is challenging because blood pressure levels in pregnancy are dynamic, having a circadian rhythm and also changing with advancing gestational age. The accepted definition is a sustained systolic (sBP) of ≥140 mmHg or a sustained diastolic blood pressure (dBP) ≥90 mmHg, by office (or in-hospital) measurement. Measurement of blood pressure in pregnancy should follow standardised methods, as outside pregnancy. Blood pressure measurement may occur in three types...

  11. Hypertension and vascular dynamics in men and women with metabolic syndrome.

    Science.gov (United States)

    Safar, Michel E; Balkau, Beverley; Lange, Céline; Protogerou, Athanase D; Czernichow, Sébastien; Blacher, Jacques; Levy, Bernard I; Smulyan, Harold

    2013-01-08

    Metabolic syndrome (MetS), an important component of insulin resistance and cardiovascular (CV) risk, is defined by 3 or more of the following characteristics: abdominal obesity, hyperglycemia, hypertension, hypertriglyceridemia, and hypo-high-density lipoprotein cholesterolemia. Based on the previously published age- and sex-mediated DESIR (Data from an Epidemiological Study on the Insulin Resistance Syndrome) cohort and parallel central hemodynamic measurements, our goal was to evaluate the effects of MetS on brachial central pulse pressure (PP), PP amplification, aortic stiffness, and wave reflections. These data were then compared with those of patients with essential hypertension but without MetS for the same mean arterial pressure. Increased aortic stiffness, a major mechanical factor predicting CV risk, has been well identified as playing a role in MetS. Its age progression is proportional to the number of risk factors involved in MetS and is responsible for increased systolic blood pressure and decreased diastolic blood pressure with increasing age, the principal hallmarks of hypertension in the elderly. Beyond brachial pressure measurements, central hemodynamic parameters involve increased aortic stiffness, reduced wave reflections, and increased PP amplification, a parameter commonly associated with increased heart rate. With the exception of arterial stiffness, all these findings are opposite in direction to those observed in essential hypertension, in which MetS is absent. A divergent behavior of wave reflections and PP amplification, but not of arterial stiffness, is observed when hypertension is studied alone or when compared with MetS for the same mean arterial pressure. This pulsatile hemodynamic abnormality contributes independently to increase age- and sex-mediated CV risk, justifying new research regarding Framingham scores and drug treatment.

  12. Endovascular stenting of the transverse sinus in a patient presenting with benign intracranial hypertension.

    Science.gov (United States)

    Ogungbo, B; Roy, D; Gholkar, A; Mendelow, A D

    2003-12-01

    The authors present a 37-year-old lady with symptoms and signs suggestive of benign intracranial hypertension (BIH). Routine CT and MRI scans were normal. Further investigations were performed with magnetic resonance venography (MRV) and cerebral venography. These revealed obstruction of the right transverse sinus with high pressure (40 mmHg) proximal to the obstruction and low pressure (15 mmHg) distally. She was treated by transvenous stent deployment with resolution of her symptoms and the bilateral papilloedema. Evaluation of the cerebral venous system with MRV and or with formal cerebral venography should be included in routine investigations of patients with suspected BIH.

  13. Malignant hypertensive retinopathy as a presenting sign of an occult dead fetus

    Directory of Open Access Journals (Sweden)

    Araújo J

    2015-06-01

    Full Text Available Joana Araújo,1 João Tavares-Ferreira,1 Susana Penas,1,2 Luís Figueira,1,3 Flávio Prézia Paiva,1 Fernando Falcão-Reis1,2 1Ophthalmology Department, São João Hospital, 2Department of Sense Organs, 3Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal Abstract: We report one case of malignant hypertensive retinopathy as a presenting sign of fetal death in utero. Ophthalmic examination (including intravenous fluorescein angiography and optical coherence tomography and obstetric and systemic evaluation were performed, providing a multidisciplinary approach. A 33-year-old overweight woman (body mass index 47 kg/m2 with no systemic or ocular known disease was admitted to our emergency department with a one-week history of bilateral vision loss and no systemic complaints. On examination, best corrected visual acuity was 1/10 in the right eye and 1/10 in the left eye. Anterior segment examination of both eyes was unremarkable. Ophthalmoscopic fundus findings included bilateral optic disc edema, diffuse cotton wool spots, intraretinal exudates, retinal hemorrhages, and multiple serous retinal detachments involving both maculae. Physical examination revealed a blood pressure of 220/ 110 mmHg. Further systemic workup revealed a previously unknown 35-week pregnancy with a dead fetus. An emergency cesarean section was performed. Pre-eclampsia is a life-threatening disorder for both mother and fetus. This case highlights the need to rule out pre-eclampsia in all women of childbearing age presenting with ocular signs of malignant hypertension, even without external signs of pregnancy. Keywords: hypertensive retinopathy, pre-eclampsia, vision loss  

  14. The curious case of a cardiac tamponade in the hypertensive patient presenting as abdominal fullness.

    Science.gov (United States)

    Li, William; Subedi, Rogin; Madhira, Bhaskara

    2017-01-19

    Cardiac tamponade is a medical emergency consisting of an accumulation of fluid in the pericardial space which is rapidly progressing and fatal. Because cardiac tamponade is ultimately a clinical diagnosis, mindful consideration for atypical presentations is essential for the reduction of mortality in the acute setting. Our patient was a 77year-old female admitted after presenting with general malaise, weakness, somnolence, altered mental status and urinary incontinence found to have CML (chronic myeloid leukemia) on confirmatory bone marrow biopsy after suspicions arose from a leukocytosis of 34,000 cells per mcL with 85% neutrophils and elevated blasts (8%). Initial vital signs revealed mild tachycardia, mild tachypnea and blood pressure elevated to 162/84mm Hg along with a temperature of 38.7°C and oxygen saturation of 96% on 2l by nasal cannula. She received the standard of care for a community acquired pneumonia and was started on treatment with decitabine as further work-up was unremarkable. An abdominal CT performed for abdominal fullness later displayed a large pericardial effusion. Repeat echocardiography exhibited right atrial diastolic collapse, inferior vena cava dilatation (IVC) without inspiratory collapse >50% and the large pericardial effusion consistent with tamponade. The blood pressure remained hypertensive until she suddenly went into cardiac arrest after being intubated for a pericardial window and expired. Our case highlights the need to keep cardiac tamponade as a differential in the hypertensive individual with abdominal complaints as atypical presentations can obscure diagnosis, delay treatment and increase mortality.

  15. Atypical presentation of cystic fibrosis: Obese adolescent with hypertension and pseudo-Bartter’s syndrome

    Directory of Open Access Journals (Sweden)

    Sovtić Aleksandar

    2012-01-01

    Full Text Available Introduction. Infants with cystic fibrosis may fail to thrive despite recommended caloric intake because of electrolyte disurbances caused by salt depletion resulting in hypochloremic metabolic alkalosis or pseudo-Bartter's syndrome. In most patients reported symptoms began in infancy, but it may be an initial presentation of disease in a previously healthy adolescent. Case report. A 15-year-old boy was admitted for evaluation of recurrent episodes of malaise associated with dehydration and acute renal insufficiency. Laboratory analysis showed hypochloremic metabolic alkalosis with hyponatremia and hypokalemia. On admission the boy was obese, with body weight of 95.5 kg (> P97, height 174 cm (> P75, and body mass index of 31.2 kg/m2 (> P95. Physical examination was inconclusive. Blood pressure holter monitoring proved significant systolic hypertension. Routine urinalysis, protein and electrolyte levels in urine were normal. Plasma renin and aldosteron were normal. Sweat chloride concentration was 63 mmol/L. Genetic testing confirmed the diagnosis of cystic fibrosis. Conclusion. To our knowledge, this is the first reported case of atypical presentation of cystic fibrosis in an adolescent presented with pseudo-Bartter's syndrome and signs of obesity and hypertension. We suggest that every patient with hypochloremic metabolic alkalosis should be evaluated for cystic fibrosis.

  16. Intimate Partner Violence Among Men Presenting to a University Emergency Department

    Directory of Open Access Journals (Sweden)

    Johnson, Cherlin

    2004-01-01

    Full Text Available Objective: We sought to investigate the one-year point prevalence for male intimate partner violence (IPV in men presenting to a university emergency department, to identify types of violence, to examine differences in male IPV rates based on patient demographics, and to identify any differences in prevalence based on types of partnership. Methods: This survey study was conducted from September 2001 until January 2002 at a tertiary, academic, Level I Trauma Center with an emergency department (ED that has 40,000 visits per year. The anonymous written survey consisted of 16 questions previously validated in the Colorado Partner Violence Study, Index of Spouse Abuse and the Conflict Tactics Scale. This survey was administered to all consenting adult men who presented to the ED. Odds ratios (OR with 95% CI were calculated when appropriate and a p-value of 0.05 was set for significance. Results: The oneyear point prevalence rate of male IPV was 24% in our study population (82/346. Among the men who experienced some form of abuse specified as either physical, emotional, or sexual, the prevalence was calculated to be 15.6% (54/346, 13.6% (47/346, and 2.6% (9/346, respectively. Education, income, age, and race did not demonstrate an association for any one variable to be associated with intimate partner abuse (p>0.05 with the exception of increased risk of IPV among unemployed men in the relationship (p<0.04, OR 0.592. IPV towards men was found to affect both heterosexual as well as homosexual relationships. Overall, 2% (8/346 of the men surveyed had received medical treatment as a result of IPV by their intimate partner within the past year. Three percent (11/344 of those men reporting abuse were abusers themselves. Conclusion: The point prevalence of IPV among our study population was 24%. In our study of 346 men, male IPV crossed all socioeconomic boundaries, racial differences, and educational levels regardless of the sex of the partner.

  17. Taurine and magnesium supplementation enhances the function of endothelial progenitor cells through antioxidation in healthy men and spontaneously hypertensive rats.

    Science.gov (United States)

    Katakawa, Mayumi; Fukuda, Noboru; Tsunemi, Akiko; Mori, Mari; Maruyama, Takashi; Matsumoto, Taro; Abe, Masanori; Yamori, Yukio

    2016-12-01

    Endothelial damage is repaired by endothelial progenitor cells (EPCs), which are pivotal in preventing cardiovascular diseases and prolonging lifespan. The WHO Cardiovascular Diseases and Alimentary Comparison Study demonstrated that dietary taurine and magnesium (Mg) intake suppresses cardiovascular diseases. We herein evaluate the effects of taurine and Mg supplementation on EPC function and oxidative stress in healthy men and spontaneously hypertensive rats (SHRs). Healthy men received taurine (3 g per day) or Mg (340 mg per day) for 2 weeks. SHRs and Wistar-Kyoto (WKY) rats were housed with high-salt drinking water (1% NaCl). The SHRs received 3% taurine solution and/or a high-Mg (600 mg per 100 g) diet for 4 weeks. Their peripheral blood mononuclear cells were separated to quantify EPC colony formation. Oxidative stress markers in their peripheral blood were evaluated using a free radical analytical system and a thiobarbituric acid reactive substance (TBARS) assay. Taurine and Mg supplementation significantly increased EPC colony numbers and significantly decreased free radical levels and TBARS scores in healthy men. Taurine and Mg supplementation significantly increased EPC colony numbers and significantly decreased TBARS scores and free radical levels in SHRs. Nicotinamide adenine dinucleotide phosphate oxidase component mRNA expression was significantly higher in the renal cortex of salt-loaded SHRs than in WKY rats, in which it was suppressed by taurine and Mg supplementation. Taurine and Mg supplementation increased EPC colony formation in healthy men and improved impaired EPC function in SHRs through antioxidation, indicating that the dietary intake of taurine and Mg may prolong lifespan by preventing the progression of cardiovascular diseases.

  18. Sexual Preferences and Presentation on Geosocial Networking Apps by Indian Men Who Have Sex With Men in Maharashtra

    Science.gov (United States)

    Patankar, Pallav; Ekstrand, Maria L

    2016-01-01

    Background The affordability of smartphones and improved mobile networks globally has increased the popularity of geosocial networking (GSN) apps (eg, Grindr, Scruff, Planetromeo) as a method for men who have sex with men (MSM) to seek causal sex partners and engage with the queer community. As mobile penetration continues to grow in India, it is important to understand how self-presentation on GSN app is relevant because it offers insight into a population that has not been largely studied. There is very little information about how Indian MSM discuss their sexual preferences and condom preferences and disclose their human immunodeficiency virus (HIV) status with potential sex partners on Web-based platforms. Objective The objective of this study was to describe how self-presentation by Indian MSM on GSN apps contributes to sexual preferences, HIV or sexually transmitted infection (STI) disclosure, and if the presentation differs due to proximity to the Greater Mumbai or Thane region. Methods Between September 2013 and May 2014, participants were recruited through banner advertisements on gay websites, social media advertisements and posts, and distribution of print materials at outreach events hosted by lesbian, gay, bisexual, transgender (LGBT) and HIV service organizations in Maharashtra, India. Eligible participants self-identified as being MSM or hijra (transgender) women, living in Maharashtra, aged above 18 years, having regular Internet access, and having at least one male sex partner in the previous 90 days. Results Indian MSM living inside and outside the Greater Mumbai or Thane region reported an average of 6.7 (SD 11.8) male sex partners in the last 3 months; on average HIV status of the sex partners was disclosed to 2.9 (SD 8.9). The most commonly used websites and GSN apps by MSM living inside Greater Mumbai or Thane region were Planetromeo, Grindr, and Gaydar. Results demonstrated that MSM used smartphones to access GSN apps and stated a preference

  19. Effects of a 12-week intervention period with football and running for habitually active men with mild hypertension

    DEFF Research Database (Denmark)

    Knoepfli-Lenzin, C.; Sennhauser, C.; Toigo, M.

    2010-01-01

    /L) but was not altered in R and C. We conclude that football training, consisting of high-intensity intermittent exercise, results in positive effects on blood pressure, body composition, stroke volume and supine heart rate variability, and elicits at least the same cardiovascular health benefits as continuous running......) and total fat mass (-2.0 +/- 1.5 vs -1.6 +/- 1.5 kg) and in increasing supine heart rate variability, whereas no changes were detected for C. Maximal stroke volume improved in F (+13.1%) as well as in R (+10.1%) compared with C (-4.9%). Total cholesterol decreased in F (5.8 +/- 1.2 to 5.5 +/- 0.9 mmol...... exercise in habitually active men with mild hypertension....

  20. Correlation between Systemic Arterial Hypertension and Bone Morphogenetic Protein-2 in Central Obese Non-Diabetic Men with Evidence of Coronary Artery Calcification

    Directory of Open Access Journals (Sweden)

    Antonia Anna Lukito

    2011-12-01

    Full Text Available BACKGROUND: Previous studies have confirmed separately the relationship between obesity, insulin-resistance, hypertension and bone morphogenetic protein-2 (BMP-2 with coronary artery calcification, a parameter of subclinical atherosclerosis. It was also reported that BMPs may function as proinflammatory, prohypertensive and proatherogenic mediators. The study aimed to assess the correlation between systemic hypertension and BMP-2 plasma concentration in central-obese non-diabetic men with evidence of coronary artery calcification. METHODS: This was a cross sectional study on 60 central-obese non-diabetic men, of an average age of 55.2 years, with evidence of coronary calcification, who came for health check-up and met the inclusion criteria consecutively as defined by waist circumference >90 cm and fasting blood glucose <126 mg/dL. Coronary calcification was defined by coronary artery calcium (CAC score ≥10 Agatson-unit Dual Source 64 slice CT scan. RESULTS: There is positive correlation between hypertension and BMP-2 in central-obese non-diabetic men with evidence of coronary artery calcification. BMP-2 plasma concentration was higher in the hypertensive subjects. The correlation was stronger in younger (<55 years old subjects and subjects with insulin-resitance. KEYWORDS: hypertension, BMP-2, coronary calcification, central obesity, age, insulin resistance.

  1. Portal hypertensive gastropathy: A systematic review of thepathophysiology, clinical presentation, natural history andtherapy

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    AIM To describe the pathophysiology, clinical presentation,natural history, and therapy of portal hypertensivegastropathy (PHG) based on a systematic literaturereview.METHODS: Computerized search of the literature wasperformed via PubMed using the following medicalsubject headings or keywords: "portal" and "gastropathy";or "portal" and "hypertensive"; or "congestive"and "gastropathy"; or "congestive" and "gastroenteropathy".The following criteria were applied for studyinclusion: Publication in peer-reviewed journals, andpublication since 1980. Articles were independentlyevaluated by each author and selected for inclusionby consensus after discussion based on the followingcriteria: Well-designed, prospective trials; recent studies;large study populations; and study emphasis on PHG.RESULTS: PHG is diagnosed by characteristic endoscopicfindings of small polygonal areas of variableerythema surrounded by a pale, reticular border in amosaic pattern in the gastric fundus/body in a patientwith cirrhotic or non-cirrhotic portal hypertension. Histologicfindings include capillary and venule dilatation,congestion, and tortuosity, without vascular fibrinthrombi or inflammatory cells in gastric submucosa.PHG is differentiated from gastric antral vascular ectasiaby a different endoscopic appearance. The etiology ofPHG is inadequately understood. Portal hypertensionis necessary but insufficient to develop PHG becausemany patients have portal hypertension without PHG.PHG increases in frequency with more severe portalhypertension, advanced liver disease, longer liver diseaseduration, presence of esophageal varices, and endoscopicvariceal obliteration. PHG pathogenesis is related to ahyperdynamic circulation, induced by portal hypertension,characterized by increased intrahepatic resistance toflow, increased splanchnic flow, increased total gastricflow, and most likely decreased gastric mucosal flow.Gastric mucosa in PHG shows increased

  2. Newly diagnosed hyperthyroidism in the 25th gestational week of pregnancy presenting with systolic arterial hypertension only.

    Science.gov (United States)

    Zaveljcina, Janez; Legan, Mateja; Gaberšček, Simona

    2016-05-01

    We present a case of a 30-year-old woman diagnosed with arterial hypertension in the 25th week of pregnancy. Our search for secondary causes of arterial hypertension revealed hyperthyroid Hashimoto's thyroiditis (HT), which was treated with propilthiouracil. Three weeks after delivery, she was normotensive without medication. In the next four months, she developed hypothyroidism and treatment with L-thyroxine was started. In conclusion, in the second half of pregnancy, a hyperthyroid HT can occur - in spite of the well-known amelioration of autoimmune thyroid disorders in that period, and can be the only cause of arterial hypertension.

  3. THE CLINICAL PRESENTATION OF AUTOIMMUNE THYROID DISEASE IN MEN IS ASSOCIATED WITH IL12B GENOTYPE

    DEFF Research Database (Denmark)

    Walsh, John P; Berry, Jemma; Liu, Shu;

    2011-01-01

    hypothesized that IL12B genotype may influence the clinical presentation of autoimmune thyroid disease. Objective.  We tested for differences in IL12B genotype between Graves' disease and Hashimoto's disease. Patients.  We studied a discovery cohort of 203 Australian women and 37 men with autoimmune thyroid......' disease (P=0.005) and Hashimoto's disease (P=0.029). Conclusion.  In men with autoimmune thyroid disease, a common variant located upstream of the IL12B coding region may influence whether patients present with Graves' disease or Hashimoto's disease.......Background.  Common variants in the interleukin 12B (IL12B) gene are associated with predominantly inflammatory (Th1) or antibody-mediated (Th2) immune responses. Since Hashimoto's disease and Graves' disease are thought to arise from mainly Th1 and Th2 immune responses respectively, we...

  4. Secondary Pulmonary Hypertension and Right-Sided Heart Failure at Presentation in Grave’s Disease

    Directory of Open Access Journals (Sweden)

    Swapnil Panjabrao Ganeshpure

    2012-01-01

    Full Text Available A young female presented with evidence of right-sided heart failure and was subsequently found to have significant pulmonary artery hypertension (PAH. Because of her normal left ventricular function and pulmonary capillary wedge pressure, the most probable site of etiology seemed to be the pulmonary vasculature. All the common possible secondary causes of PAH were ruled out, but during the investigations, she was found to have elevated thyroid function tests compatible with the diagnosis of Grave’s disease. The treatment of Grave’s disease, initially by medications and subsequently by radioiodine therapy, was associated with a significant reduction in the pulmonary artery systolic pressure. The purpose of this case report is to highlight one of the unusual and underdiagnosed presentations of Grave’s disease.

  5. Self-Presentation, Desired Partner Characteristics, and Sexual Behavior Preferences in Online Personal Advertisements of Men Seeking Non-Gay-Identified Men.

    Science.gov (United States)

    Downing, Martin J; Schrimshaw, Eric W

    2014-03-14

    Despite attention to the sexual behaviors of non-gay-identified (NGI) men who have same-sex encounters, virtually no research has focused on issues of partner desirability and selection. Limited evidence suggests that a subgroup of men who have sex with men (MSM) advertise online for sexual encounters with NGI men. Exchange theory provided a framework to investigate this seeking of NGI men, based on the content of Internet personal advertisements for same-sex encounters. Researchers analyzed 282 ads posted to an online bulletin board. Ads by men who explicitly desired encounters with NGI men were compared with those by men who did not indicate this preference in potential partners. Multivariate analyses revealed that NGI-seeking men had significantly increased odds of identifying as discreet (Adjusted odds ratio [AOR] = 2.82), seeking a discreet encounter (AOR = 4.68), seeking a masculine partner (AOR = 2.18), being willing to host (AOR = 2.77), as well as seeking oral-receptive sex (AOR = 2.69), unprotected oral sex (AOR = 6.76), and anal-receptive sex (AOR = 2.18). Further, NGI-seeking ads were more likely to not mention condom use or safer sex practices (AOR = 4.13) and were less likely to indicate a desire for oral-insertive sex (AOR = 0.34) and rimming (AOR = 0.21). Findings suggest that some men may deliberately present themselves in ways that they perceive as being attractive to NGI men, and have research implications for NGI MSM, their partners, and the risk outcomes of these online ads.

  6. Previously clinically “silent” adrenal phaeochromocytoma presenting as hypovolemic shock with paradoxical hypertension

    Directory of Open Access Journals (Sweden)

    Ali AA

    2007-01-01

    Full Text Available CASE PRESENTATIONA 58-year-old male patient presented to the Emergency Department with a 6-8 hour history of left upper quadrant pain associated with general malaise, dizziness, nausea and vomiting. There were no other gastrointestinal or genitourinary symptoms; in particular the patient denied any evidence of gastrointestinal bleeding. He had a past medical history of hypertension, which was being treated with lisinopril. On examination, the patient appeared unwell. He was fully alert but anxious with a Glasgow Coma Score (GCS of 15. He was tachypnoeic (respiratory rate 25/min with normal oxygen saturations (98%, FiO2 0.21 and temperature (36°C. He was sweaty with a tachycardia (heart rate 140 bpm and prolonged capillary refill time (>5 seconds. The patient was also very hypertensive (BP 220/120 mmHg, but the rest of the cardiovascular and respiratory examination was normal. Abdominal examination demonstrated tenderness with guarding over the left upper quadrant and normal bowel sounds. There were no palpable masses. Blood tests showed a leucocytosis (27.54 x 106 with a neutrophilia (24.97 x 106, normal haemoglobin (14.9g/dL and platelet count (445,000/L. The urea and creatinine were raised (9.6mmol/L and 160mmol/L respectively. He also had an elevated alkaline phosphatase (249mmol/L, alanine aspartase (41nmol/L and C-reactive protein (9nmol/L. He was also hyperglycaemic (random glucose 12.6mmol/L. A chest radiograph showed an elevated left hemi-diaphragm. A computed tomography (CT scan of the abdomen revealed a left peri-renal collection consistent with a haematoma and left adrenal mass measuring 12cm in diameter (see Figure 1. Also of note was a large left pleural effusion and moderate right pleural effusion.

  7. Effects of low-intensity exercise conditioning on blood pressure, heart rate, and autonomic modulation of heart rate in men and women with hypertension.

    Science.gov (United States)

    Hua, Lien P T; Brown, C Ann; Hains, Sylvia J M; Godwin, Marshall; Parlow, Joel L

    2009-10-01

    Untreated hypertension increases cardiovascular risk 2-fold to 3-fold, leading to serious cardiovascular problems that include left ventricular hypertrophy, stroke, ischemic heart disease, myocardial infarction, vascular disease, renal disease, and death. Exercise conditioning is recommended as one of the initial treatments for hypertension. The purpose of this pretest-posttest study was to quantify the effects of a 12-week home-based low-intensity exercise conditioning (walking) program in hypertensive men and women on systolic and diastolic blood pressure, heart rate, and autonomic modulation of heart rate. A total of 20 mildly hypertensive men and women who were assigned to a structured exercise (walking) program were compared with a control group of 20 nonexercising mildly hypertensive participants. Electrocardiographic heart rate and R-R interval data and beat-by-beat arterial blood pressure data were collected continuously for 10 min with participants in the supine and standing postures and during low-intensity steady-state exercise. The results show that systolic and diastolic blood pressure and R-R interval decreased and spontaneous baroreflex sensitivity increased in the exercise group. The decline in blood pressure was significant statistically and clinically. The increase in spontaneous baroreflex sensitivity indicates that the ability of the cardiovascular system to respond rapidly to changing stimuli improved after the 12-week walking protocol. The low-intensity exercise conditioning program achieved a training effect in this population.

  8. Differences in clinical presentation of ankylosing spondylitis in men and women

    Directory of Open Access Journals (Sweden)

    Hossain Soleymani Salehabadi

    2016-10-01

    Full Text Available Background: Ankylosing spondylitis (AS is an inflammatory disease that mainly affects axial skeleton of the body and ankylosing spondylitis ligaments around the spine at the junction of the spine are inflamed, because the disease is progressive and can lead to significantly cause of disability and the studies could provide a mechanism for the early detection of the disease or help determine when to start treatment, the difference in clinical presentations of AS in men and women is indicative of potential effect of gender on severity of the disease. This study was conducted with the aim to investigate the effect of gender on severity of AS. Methods: In a cross-sectional study, one hundred and fifteen patients with ankylosing spondylitis who referred to Yazd Rheumatology Clinic between 2001 and 2013 were evaluated. Sampling was performed using non-random convenient method. The most important variables studied included demographic data, clinical presentation, radiographic stage of sacroiliac involvement, and laboratory data extracted from patients’ files and recorded in questionnaires. Results: Both groups according to age at diagnosis, presence of enteritis, peripheral joint involvement and laboratory data such as C-reactive protein (CRP, erythrocyte sedimentation rate (ESR and hemoglobin were matched. Inflammatory neck pain was more prevalent in men than in women (77.2% against 51.8%; P< 0.05. Sacroiliac radiographic study revealed stage 1 involvement in 11.3% of men and 37% of women (P= 0.009, and stage 4 in 27.2% of men and 3.7% of women (P< 0.001, with a significant difference. Conclusion: According to the results of the study, the time between age of onset and age at diagnosis, inflammatory pain in the neck and advanced stage in men than in women was higher. Although these findings suggest that gender may have an impact on the pattern and severity of AS but the time delay in diagnosis as a disease affecting the intensity and pattern should

  9. Time of day affects heart rate recovery and variability after maximal exercise in pre-hypertensive men.

    Science.gov (United States)

    Brito, Leandro; Peçanha, Tiago; Tinucci, Taís; Silva-Junior, Natan; Costa, Luiz; Forjaz, Claudia

    2015-01-01

    Heart rate (HR) recovery (HRR) and variability (HRV) after exercise are non-invasive tools used to assess cardiac autonomic regulation and cardiovascular prognosis. Autonomic recovery is slower after evening than morning exercise in healthy individuals, but this influence is unknown in subjects with autonomic dysfunction, although it may affect prognostic evaluation. This study compared post-exercise HRR and HRV after maximal morning and evening exercise in pre-hypertensive men. Ten volunteers randomly underwent two maximal exercise tests conducted in the morning (8-10 a.m.) and evening (6-8 p.m.). HRR60s (HR reduction at 60 s of recovery - prognostic index), T30 (short-term time-constant of HRR - parasympathetic reactivation marker), rMSSD30s (square root of the mean of the sum of the squares of differences between adjacent R-R intervals on subsequent 30 s segments - parasympathetic reactivation marker), and HRRτ (time constant of the first order exponential fitting of HRR - marker of sympathetic withdraw and parasympathetic reactivation) were measured. Paired t-test and two-way ANOVA were used. HRR60s and HRRτ were similar after exercise in the morning and evening (27 ± 7 vs. 29 ± 7 bpm, p = 0.111, and 79 ± 14 vs. 96 ± 29 s, p = 0.119, respectively). T30 was significantly greater after evening exercise (405 ± 215 vs. 295 ± 119 s, p = 0.002) and rMSSD30s was lower in the evening (main factor session, p = 0.009). In conclusion, in pre-hypertensive men, the prognostic index of HRR, HRR60s, is not affected by the time of day when exercise is conducted. However, post-exercise parasympathetic reactivation, evaluated by T30 and rMSSD30s, is blunted after evening exercise.

  10. Seasonal variation and atypical presentation of idiopathic intracranial hypertension in pre-pubertal children.

    NARCIS (Netherlands)

    Distelmaier, F.; Tibussek, D.; Schneider, D.T.; Mayatepek, E.

    2007-01-01

    Idiopathic intracranial hypertension is an enigmatic disorder of elevated cerebrospinal fluid pressure. In adulthood, patients are typically obese women of childbearing age; however, in young children the clinical picture is strikingly different, indicating age-related differences in the aetiology

  11. Are doctors assessing patients with hypertension appropriately at their initial presentation?

    Science.gov (United States)

    Wong, Siew Lee Stalia; Lee, Ping Yein; Ng, Chirk Jenn; Hanafi, Nik Sherina; Chia, Yook Chin; Lai, Pauline Siew Mei; Liew, Su May; Khoo, Ee Ming

    2015-01-01

    INTRODUCTION The aim of this study was to determine the extent to which primary care doctors assessed patients newly diagnosed with hypertension for the risk factors of cardiovascular disease (CVD) during the patients’ first clinic visit for hypertension. The study also aimed to examine the trend of assessment for CVD risk factors over a 15-year period. METHODS This retrospective study was conducted between January and May 2012. Data was extracted from the paper-based medical records of patients with hypertension using a 1:4 systematic random sampling method. Data collected included CVD risk factors and a history of target organ damage (TOD), which were identified during the patient’s first visit to the primary care doctor for hypertension, as well as the results of the physical examinations and investigations performed during the same visit. RESULTS A total of 1,060 medical records were reviewed. We found that assessment of CVD risk factors during the first clinic visit for hypertension was poor (5.4%–40.8%). Assessments for a history of TOD were found in only 5.8%–11.8% of the records, and documented physical examinations and investigations for the assessment of TOD and secondary hypertension ranged from 0.1%–63.3%. Over time, there was a decreasing trend in the percentage of documented physical examinations performed, but an increasing trend in the percentage of investigations ordered. CONCLUSION There was poor assessment of the patients’ CVD risk factors, secondary causes of hypertension and TOD at their first clinic visit for hypertension. The trends observed in the assessment suggest an over-reliance on investigations over clinical examinations. PMID:26451055

  12. Posterior Reversible Encephelopathy Syndrome Presenting as Quadriparesis in Pregnancy Induced Hypertension

    Science.gov (United States)

    Pranita; Kumar, Ajit; Shahi, Seema

    2015-01-01

    Pregnancy Induced Hypertension (PIH) is a condition characterised by raised blood pressure in pregnancy. It affects approximately one out of every 14 pregnant women. Although PIH more commonly occurs during first pregnancy, it can also occur in subsequent pregnancies. It can present with variable complications related to vasospasm. But focal neurologic deficits are extremely rare in patients with PIH. We report a case of quadriparesis due to posterior reversible encephalopathy syndrome (PRES). A 36 year old full term pregnant female was admitted for emergency lower segment caesarean section (LSCS) as a result of uncontrolled PIH with early clinical signs of left ventricular failure. She was recovering well from pulmonary oedema after being provided with mechanical ventilation. However on 4th day she developed sudden onset quadriparesis without any alteration in sensorium, bladder & bowel disturbance or any sensory deficit. Diffusion weighted neuroimaging (DWI) was carried out which revealed finding suggestive of PRES. The patient was treated with antihypertensive which followed improvement in neurological deficit. Although rare, PRES should be considered as a potential cause of acute onset focal neurological deficit in pregnant females with PIH. With this case report we have tried to create awareness and vigilance about rare but potentially serious yet salvageable condition like PRES. PMID:26023585

  13. Seasonal variation and atypical presentation of idiopathic intracranial hypertension in pre-pubertal children.

    NARCIS (Netherlands)

    Distelmaier, F.; Tibussek, D.; Schneider, D.T.; Mayatepek, E.

    2007-01-01

    Idiopathic intracranial hypertension is an enigmatic disorder of elevated cerebrospinal fluid pressure. In adulthood, patients are typically obese women of childbearing age; however, in young children the clinical picture is strikingly different, indicating age-related differences in the aetiology o

  14. Reproduction in men with Klinefelter syndrome: the past, the present, and the future.

    Science.gov (United States)

    Paduch, Darius A; Bolyakov, Alexander; Cohen, Paula; Travis, Alexander

    2009-03-01

    Klinefelter syndrome (KS) is the most common chromosomal aberration in men. There are approximately 250,000 men with KS in the United States, and the prevalence of KS in male reproductive practices is 3 to 4%; however, most men are never diagnosed. KS has an effect on normal development, growth, social interactions, bone structure, and sexual and reproductive function, thus a multidisciplinary approach to men with KS is important in providing state of the art care to children and men with KS. Over the last 10 years, with advancements in artificial reproductive techniques and the successful delivery of healthy children from men with KS, the involvement of reproductive endocrinologists and urologists in the care of patients with KS is becoming commonplace. The new areas of intense research investigate optimal methods of hormonal manipulations, preservation of fertility in adolescents, and development of universal early screening programs for KS. This review provides the latest update in our understanding of the pathophysiology, natural history, and evolving paradigms of therapy in adolescents and men with KS.

  15. Surgical therapy for portal hypertension in patients with cirrhosis in China: present situation and prospects

    Institute of Scientific and Technical Information of China (English)

    ZHOU Guang-wen; LI Hong-wei

    2009-01-01

    @@ Surgical therapy for portal hypertension (PHT) in patients with cirrhosis has long been controversial,and various operative approaches have been used to prevent or manage such lethal complications as gastroesophageal variceal hemorrhage. However, over a century various portazygos devascularization and shunt approaches have been developed or modified, but the therapeutic effects have not been satisfactory till 1963 when Starzl did the first liver transplantation in the world, which provides a new hope to the surgical treatment of PHT.

  16. The association between serum ferritin level, microalbuminuria and non-alcoholic fatty liver disease in non-diabetic, non-hypertensive men.

    Science.gov (United States)

    Kim, Byung Jin; Kim, Bum Soo; Kang, Jin Ho

    2014-01-01

    Iron-mediated cell injury may cause glomerular endothelial dysfunction, which precedes microalbumuria. However, there have been no reports on the relationship between serum ferritin level and microalbuminuria. The aim of this study is to assess the relationship between serum ferritin level and microalbuminuria in apparently healthy men and to evaluate how non-alcoholic fatty liver disease (NAFLD) affects this association. Microalbuminuria and serum ferritin level were measured, and hepatic ultrasound was performed in a sample of 2489 non-diabetic, non-hypertensive men. The patients were classified into two groups according to urinary albumin-creatinine ratio (UACR) in morning urine specimens: normoalbuminuria (serum ferritin than the normoalbuminuric group (255.4 pmol/L versus 207.5 pmol/L, pserum ferritin level was independently associated with microalbuminuria irrespective of multiple covariates (OR [95% CI] 1.746 [1.221-2.497]). Subgroup analyses according to NAFLD revealed that the NAFLD group had higher serum ferritin level and a higher prevalence of microalbuminuria compared with the non-NAFLD group (233.8 pmol/L versus 194.3 pmol/L, pserum ferritin level and microalbuminuria in both the non-NAFLD and the NAFLD group. Our results indicate that serum ferritin level is associated with microalbuminuria in non-hypertensive, non-diabetic men, irrespective of NAFLD.

  17. Use of diagnostic coronary angiography in women and men presenting with acute myocardial infarction

    DEFF Research Database (Denmark)

    Bjerking, Louise Hougesen; Hansen, Kim Wadt; Madsen, Mette

    2016-01-01

    .4 %). Type 2 myocardial infarction was noted in 11 patients (women versus men; 14.5 % vs. 3.8 %, p = 0.06) and identified as a potential confounder of the sex-DCA relationship. Receipt of DCA was predicted by traditional risk factors for ischaemic heart disease (family history of cardiovascular disease...

  18. Differences in presentation of symptoms between women and men with intermittent claudication

    Directory of Open Access Journals (Sweden)

    Nilsson Bo

    2011-06-01

    Full Text Available Abstract Background More women than men have PAD with exception for the stage intermittent claudication (IC. The purpose of this study was to evaluate differences in disease characteristics between men and women when using current diagnostic criteria for making the diagnosis IC, defined as ABI Study Design Cohort study Methods 5040 elderly (median age 71 subjects participated in a point-prevalence study 2004. They had their ABI measured and filled out questionnaires covering medical history, current medication, PAD symptoms and walking ability. The prevalence of IC was 6.5% for women and 7.2% for men (P = 0.09. A subset of subjects with IC (N = 56 was followed up four years later with the same procedures. They also performed additional tests aiming to determine all factors influencing walking ability. Results Men with IC had more concomitant cardiovascular disease and a more profound smoking history than women. Women, on the other hand, reported a lower walking speed (P Conclusion Sex differences in the description of IC symptoms may influence diagnosis even if objective features of PAD are similar. This may influence accuracy of prevalence estimates and selection to treatment.

  19. Trichomonas vaginalis infection: How significant is it in men presenting with recurrent or persistent symptoms of urethritis?

    Science.gov (United States)

    Ng, Andrea; Ross, Jonathan D C

    2016-01-01

    Persistent or recurrent non-gonococcal urethritis has been reported to affect up to 10-20% of men attending sexual health clinics. An audit was undertaken to review the management of persistent or recurrent non-gonococcal urethritis in men presenting at Whittall Street Clinic, Birmingham, UK. Detection of Trichomonas vaginalis infection was with the newly-introduced nucleic acid amplification test. A total of 43 (8%) of 533 men treated for urethritis re-attended within three months with persistent or recurrent symptoms. Chlamydia trachomatis infection was identified in 13/40 (33%), T. vaginalis in 1/27 (4%) and Mycoplasma genitalium in 6/12 (50%). These findings suggest that the prevalence of T. vaginalis infection remains low in our clinic population and may not contribute significantly to persistent or recurrent non-gonococcal urethritis.

  20. [The influence of intravenous ozone therapy on the electrophysiological properties of myocardium during combined treatment of the patients presenting with arterial hypertension].

    Science.gov (United States)

    Gimaev, R Kh; Drapova, D P; Skvortsov, D Iu; Olezov, N V

    2013-01-01

    The present investigation included 65 patients (36 men and 29 women of the mean age of 51.3 +/- 6.7 years) presenting with grade I-II arterial hypertension (AH) and undergoing intravenous ozone therapy in combination with the intake of antihypertensive preparations. ECG studies showed that a course of ozone therapy decreases the degree of in homogeneity of intra-myocardial electrophysiological processes in the patients with AH as apparent from reduced dispersion of P-wave and corrected QT-interval. Analysis of the results of high-resolution ECG revealed a significant decrease in the frequency of ventricular late potentials from 29.2% (19 patients) to 13.8% (9 patients) (chi2=4.5; p=0.03) whereas the decrease in the frequency of atrial late potentials was insignificant, from 40% (26 patients) to 29.2% (19 patients) (chi2=1.67; p=0.19). The results of spectral-temporal mapping indicate that a course of ozone therapy resulted in a significant decrease of the total number of local peaks in the QRS complex and the number of peaks with low-amplitude and high-frequency characteristics.

  1. Men Presenting With Sexual Thoughts of Children or Coercion: Flights of Fancy or Plans for Crime?

    Science.gov (United States)

    Turner-Moore, Tamara; Waterman, Mitch

    2017-01-01

    There is limited evaluation of clinical and theoretical claims that sexual thoughts of children and coercing others facilitate sexual offending. The nature of these thoughts (what they contain) also is unknown. To examine the relation between child or coercive sexual thoughts and sexual offending and to determine the nature of these thoughts and any differences among sexual offending (SO), non-sexual offending (NSO), and non-offending (NO) men. In a cross-sectional computerized survey, anonymous qualitative and quantitative self-reported sexual thought and experience data were collected from 279 adult volunteers composing equal numbers of SO, NSO, and NO men recruited from a medium-security UK prison and a community sample of 6,081 men. Computerized Interview for Sexual Thoughts and Computerized Inventory of Sexual Experiences. Three analytical approaches found child sexual thoughts were related to sexual offending; sexual thoughts with coercive themes were not. Latent class analyses identified three types of child sexual thought (primarily differentiated by interpersonal context: the reporting of own emotions, emotions of others, or both) and four types of sexual thoughts of coercing others (chiefly discriminated by the other person's response: no emotional states reported, consent, non-consent, or mixed). Type of child sexual thought and participant group were not significantly related. Type of coercive sexual thought and group were marginally related; the consensual type was more common for the NO group and the non-consensual type was more common for the SO group than expected statistically. Child sexual thoughts are a risk factor for sexual offending and should be assessed by clinicians. In general, sexual thoughts with coercive themes are not a risk factor, although thought type could be important (ie, thoughts in which the other person expresses an enduring lack of consent). Exploring the dynamic risk factors associated with each type of child and coercive

  2. Elderly men with moderate and intense training lifestyle present sustained higher antibody responses to influenza vaccine.

    Science.gov (United States)

    de Araújo, Adriana Ladeira; Silva, Léia Cristina Rodrigues; Fernandes, Juliana Ruiz; Matias, Manuella de Sousa Toledo; Boas, Lucy Santos; Machado, Clarisse Martins; Garcez-Leme, Luiz Eugênio; Benard, Gil

    2015-12-01

    We aimed to verify whether different levels of training performed regularly and voluntarily for many years could have an impact on one of the main issues of immunosenescence: the poor response to vaccines. We recruited 61 healthy elderly men (65-85 years old), 23 with a moderate training (MT) lifestyle (for 17.0 ± 3.2 years), 22 with an intense training (IT) lifestyle (for 25.9 ± 3.4 years), and 16 without a training lifestyle (NT). Fitness was evaluated through the IPAQ and VO2max consumption. The participants were evaluated regarding cognitive aspects, nutritional status, depression, and quality of life. Antibody titers were determined by hemagglutination inhibition assay prior to influenza vaccination and at 6 weeks and 6 months post-vaccination. Strains used were B, H3N2, and H1N1. Our groups were matched for most characteristics, except for those directly influenced by their lifestyles, such as BMI, VO2max, and MET. In general, MT and IT elderly men showed significantly higher antibody titers to the three vaccine strains post-vaccination than NT elderly men. There were also higher titers against B and H1N1 strains in the trained groups before vaccination. Additionally, there were higher proportions of seroprotected (titers ≥1:40) individuals in the pooled trained groups both at 6 weeks (B and H3N2, p < 0.05) and 6 months (H1N1, p < 0.05; B, p = 0.07). There were no significant differences between the MT and IT groups. Either a moderate or an intense training is associated with stronger and longstanding antibody responses to the influenza vaccine, resulting in higher percentages of seroprotected individuals.

  3. [Obesity and hypertension].

    Science.gov (United States)

    Simonyi, Gábor; Kollár, Réka

    2013-11-01

    The frequency of hypertension and obesity is gradually growing in Hungary. At present 68.5% of men and 78% of women are obese. Hypertension and obesity are the most important risk factors of morbidity and mortality from cardiovascular disease. The relationship between increased sympathetic activity and hypertension is well known. Waist circumference and body fat mass correlate significantly with sympathetic activity, in which hyperlipidemia plays also a role. The increased activity of renin-angiotensin-aldosterone system via its vascular and renal effects also contributes to an increase of blood pressure. Increased sympathetic activity with decreasing vagal tone accompanying the imbalance of the autonomous nervous system is independent and significant risk factor of cardiovascular events including sudden cardiac death.

  4. Men are from Mars, women are from Venus? Examining gender differences in self-presentation on social networking sites.

    Science.gov (United States)

    Haferkamp, Nina; Eimler, Sabrina C; Papadakis, Anna-Margarita; Kruck, Jana Vanessa

    2012-02-01

    Psychological research on gender differences in self-presentation has already revealed that women place higher priority on creating a positive self-presentation, while men are less concerned about the image they present in face-to-face (ftf) communication. Nowadays, with the extensive use of new media, self-presentation is no longer so closely tied to ftf situations, but can also take place in the online world. Specifically, social networking sites (SNS), such as Facebook or MySpace, offer various features such as profile pictures, groups, and virtual bulletin boards with which users can create elaborated online representations of themselves. What remains open is whether this virtual self-presentation on SNS is subject to gender differences. Based on studies emphasizing gender-related differences in Internet communication and behavior in general, it can be assumed that men and women have different motives regarding their SNS usage as well. A multimethodological study, combining results of an online survey and a content analysis of 106 user profiles, assessed users' diverse motives for participating in SNS in general, and their use of specific profile elements or self-presentation in particular. In this sample of StudiVZ users, women tend to be more likely to use SNS for comparing themselves with others and for searching for information. Men, on the other hand, are more likely to look at other people's profiles to find friends. Moreover, women tend to use group names for their self-presentation and prefer adding portrait photos to their profiles, while men choose full-body shots.

  5. Hypertension in postmenopausal women.

    Science.gov (United States)

    Lima, Roberta; Wofford, Marion; Reckelhoff, Jane F

    2012-06-01

    Blood pressure is typically lower in premenopausal women than in men. However, after menopause, the prevalence of hypertension in women is higher than it is in men. Hypertension is a major risk factor for cardiovascular disease in women and men, but cardiovascular disease is the leading cause of death in women. Furthermore, there is evidence that blood pressure may not be as well-controlled in women as in men, despite the fact that most women adhere better to their therapeutic regimens and medications than do men, and have their blood pressures measured more frequently than do men. This review describes possible mechanisms by which blood pressure may be increased in postmenopausal women.

  6. VACTERL (vertebral anomalies, anal atresia or imperforate anus, cardiac anomalies, tracheoesophageal fistula, renal and limb defect spectrum presenting with portal hypertension: a case report

    Directory of Open Access Journals (Sweden)

    Losa Ignatius

    2010-05-01

    Full Text Available Abstract Introduction We report for the first time a unique case of VACTERL (vertebral anomalies, anal atresia or imperforate anus, cardiac anomalies, tracheoesophageal fistula, renal and limb defect spectrum associated with portal hypertension. The occurrence of both VACTERL spectrum and extrahepatic portal hypertension in a patient has not been reported in the literature. We examined whether or not there was any association between extrahepatic portal hypertension and VACTERL spectrum. Case Presentation A two-and-half-year-old Caucasian girl with VACTERL spectrum presented with hematemesis and abdominal distension. She had caput medusae, ascites, splenomegaly, gastric and esophageal varices. Her liver function tests were within normal limits. Magnetic resonance imaging of the liver with contrast showed a thready portal vein with collateral vessels involving both right and left portal veins without intrahepatic duct dilation. Conclusion A thready portal vein, with features of extrahepatic portal hypertension, is a rare non- VACTERL-type defect in patients with VACTERL spectrum. Understandably, clinicians should give low priority to looking for portal hypertension in VACTERL spectrum patients presenting with gastrointestinal bleeding. However before routinely looking for a thready portal vein and/or extrahepatic portal hypertension in asymptomatic VACTERL spectrum patients, we need further evidence to support this rare association.

  7. Factors associated with presenting >12 hours after symptom onset of acute myocardial infarction among Veteran men

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    McDermott Kelly

    2012-09-01

    Full Text Available Abstract Background Approximately 2/3 of Veterans admitting to Veterans Health Administration (VHA facilities present >12 hours after symptom onset of acute myocardial infarction (AMI (“late presenters”. Veterans admitted to VHA facilities with AMI may delay hospital presentation for different reasons compared to their general population counter parts. Despite the large descriptive literature on factors associated with delayed presentation in the general population, the literature describing these factors among the Veteran AMI population is limited. The purpose of this analysis is to identify predictors of late presentation in the Veteran population presenting with AMI to VHA facilities. Identifying predictors will help inform and target interventions for Veterans at a high risk of late presentation. Methods In our cross-sectional study, we analyzed a cohort of 335 male Veterans from nine VHA facilities with physician diagnosed AMI between April 2005 and December 2006. We compared demographics, presentation characteristics, medical history, perceptions of health, and access to health care between early and late presenting Veterans. We used standard descriptive statistics for bivariate comparisons and multivariate logistic regression to identify independent predictors of late presentation. Results Our cohort was an average of 64 ± 10 years old and was 88% white. Sixty-eight percent of our cohort were late presenters. Bivariate comparisons found that fewer late presenters had attended at least some college or vocational school (late 53% vs. early 66%, p = 0.02. Multivariate analysis showed that presentation with ST-elevation myocardial infarction (STEMI was associated with early presentation (OR = 0.4 95%CI [0.2, 0.9] and ≥2 angina episodes in the prior 24 hours (versus 0-1 episode was associated with late presentation (OR = 7.5 95%CI [3.6,15.6]. Conclusions A significant majority of Veterans presenting to VHA

  8. Metabolic syndrome in white European men presenting for primary couple's infertility: investigation of the clinical and reproductive burden.

    Science.gov (United States)

    Ventimiglia, E; Capogrosso, P; Colicchia, M; Boeri, L; Serino, A; Castagna, G; Clementi, M C; La Croce, G; Regina, C; Bianchi, M; Mirone, V; Damiano, R; Montorsi, F; Salonia, A

    2016-09-01

    Despite complex interactions between obesity, dyslipidemia, hyperinsulinaemia, and the reproductive axis, the impact of metabolic syndrome on human male reproductive function has not been analysed comprehensively. Complete demographic, clinical, and laboratory data from 1337 consecutive primary infertile men were analysed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (categorised 0 vs. 1 vs. 2 or higher). NCEP-ATPIII criteria were used to define metabolic syndrome. Semen analysis values were assessed based on the 2010 World Health Organisation (WHO) reference criteria. Descriptive statistics and logistic regression models tested the association between semen parameters and clinical characteristics and metabolic syndrome. Metabolic syndrome was found in 128 (9.6%) of 1337 men. Patients with metabolic syndrome were older (p metabolic syndrome. Metabolic syndrome patients had lower levels of total testosterone (p metabolic syndrome. Conversely, the two groups did not differ significantly in further hormonal levels, semen parameters, and rate of either obstructive or non-obstructive azoospermia. At multivariate logistic regression analysis, testicular volume (OR: 0.90; p = 0.002) achieved independent predictor status for WHO pathological semen concentration; conversely, age, Charlson Comorbidity Index scores, metabolic syndrome, and inhibin B values did not. No parameters predicted normal sperm morphology and total progressive motility. Metabolic syndrome accounts for roughly 9% of men presenting for primary couple's infertility. Although metabolic syndrome patients have a lower general male health status, semen analysis values seem independent of the presence of metabolic syndrome.

  9. A rare presentation of multiple endocrine neoplasia (MEN type 2A syndrome

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    Elroy Patrick Weledji

    2016-02-01

    Full Text Available Peptic ulcer disease may be a manifestation of symptomatic primary hyperparathyroidism. A case of an intractable complicated peptic ulcer disease secondary to hypercalcaemia from multiple endocrine neoplasia type 2A is presented. Hypercalcaemia should always be excluded as a cause of recurrent, or complicated peptic ulcer disease.

  10. A rare presentation of patent ductus arteriosus in an adult patient with normal pulmonary hypertension and limb edema

    Science.gov (United States)

    Pishgoo, Bahram; Saburi, Amin; Khosravi, Arezoo

    2014-01-01

    BACKGROUND Patent ductus arteriosus (PDA) at childhood is one of the five major and frequent congenital abnormalities, but it can be rarely seen in adults. Pulmonary hypertension (PHTN) and other presentations such as heart failure and edema are the identified complications of longstanding PDA, but adult case with no permanent heart symptoms and PHTN was rare. We reported a rare case of with an obvious PDA and normal pulmonary pressure. CASE REPORT A 61-year-old woman presented with dyspnea (New York Heart Association class 2), chest pain, and lower limb edema. Echocardiogram showed; normal left ventricular chamber size and function, normal size of both atria. Furthermore, an obvious PDA (diameter = 6-7 mm) connecting the aortic arch to the pulmonary artery was reported in echocardiography. No lung congestion and evidence for PHTN was reported by computed tomographic angiography [Pulmonary capillary wedge pressure (PCWP) = 30 mmHg]. The patient was treated with antihypertensive drugs and after 1 and 3 months follow-up, edema and other symptoms were resolved. CONCLUSION Finally, we conclude that PDA in adulthood can present with nonspecific cardiovascular symptoms, and it seems that PHTN is not a fixed echocardiographic finding in these patients. PMID:25477985

  11. The efficacy and safety of udenafil [Zydena] for the treatment of erectile dysfunction in hypertensive men taking concomitant antihypertensive agents.

    Science.gov (United States)

    Paick, Jae-Seung; Kim, Sae Woong; Park, Yoon Kyu; Hyun, Jae Seog; Park, Nam Cheol; Lee, Sung Won; Park, Kwanjin; Moon, Ki Hak; Chung, Woo Sik

    2009-11-01

    Erectile dysfunction (ED) and hypertension are frequent comorbid conditions. The vasodilating properties of type 5 phosphodiesterase inhibitor (PDE5I) are the major concerns for the treatment of ED patients on antihypertensive medications. To evaluate the efficacy and safety of Udenafil [Zydena] (Dong-A, Seoul, Korea), a newly developed PDE5I, for the treatment of ED patients on antihypertensive medication. It was a multicentered, randomized, double-blind, placebo-controlled, fix-dosed clinical trial among 165 ED patients receiving antihypertensive medications. The subjects treated with placebo, 100 mg or 200 mg of Udenafil for 12 weeks were asked to complete the Sexual Encounter Profile (SEP) diary, the International Index of Erectile Function (IIEF), and the Global Assessment Question (GAQ) during the study period. Primary parameter: the change from baseline for IIEF erectile function domain (EFD) score; Secondary parameters: the IIEF Question 3 and 4, SEP Question 2 and 3, the rate of achieving normal erectile function (EFD > or = 26) and the response to GAQ. Compared to placebo, patients receiving both doses of Udenafil showed significantly improved the IIEF-EFD score. The least squares means for the change from baseline in IIEF-EFD scores were 8.4 and 9.8 for 100 mg and 200 mg Udenafil groups, respectively; those values were significantly higher than that of placebo (2.4, P treatment-emergent adverse events, which were transient and mild-to-moderate in nature. No parameters of efficacy and safety were affected among the subsets stratified according to either the number of antihypertensive medication received or the previous experience of PDE5Is treatment. Udenafil significantly improved erectile function among ED patients with hypertensive symptom treated with concomitant antihypertensive medication. The treatment did not increase the frequency or severity of adverse events.

  12. Hospital admissions for hypertensive crisis in the emergency departments: a large multicenter Italian study.

    Science.gov (United States)

    Pinna, Giuliano; Pascale, Claudio; Fornengo, Paolo; Arras, Sebastiana; Piras, Carmela; Panzarasa, Pietro; Carmosino, Gianpaolo; Franza, Orietta; Semeraro, Vincenzo; Lenti, Salvatore; Pietrelli, Susanna; Panzone, Sergio; Bracco, Christian; Fiorini, Roberto; Rastelli, Giovanni; Bergandi, Daniela; Zampaglione, Bruno; Musso, Roberto; Marengo, Claudio; Santoro, Giancarlo; Zamboni, Sergio; Traversa, Barbara; Barattini, Maddalena; Bruno, Graziella

    2014-01-01

    Epidemiological data on the impact of hypertensive crises (emergencies and urgencies) on referral to the Emergency Departments (EDs) are lacking, in spite of the evidence that they may be life-threatening conditions. We performed a multicenter study to identify all patients aged 18 years and over who were admitted to 10 Italian EDs during 2009 for hypertensive crises (systolic blood pressure ≥220 mmHg and/or diastolic blood pressure ≥120 mmHg). We classified patients as affected by either hypertensive emergencies or hypertensive urgencies depending on the presence or the absence of progressive target organ damage, respectively. Logistic regression analysis was then performed to assess variables independently associated with hypertensive emergencies with respect to hypertensive urgencies. Of 333,407 patients admitted to the EDs over the one-year period, 1,546 had hypertensive crises (4.6/1,000, 95% CI 4.4-4.9), and 23% of them had unknown hypertension. Hypertensive emergencies (n = 391, 25.3% of hypertensive crises) were acute pulmonary edema (30.9%), stroke (22.0%,), myocardial infarction (17.9%), acute aortic dissection (7.9%), acute renal failure (5.9%) and hypertensive encephalopathy (4.9%). Men had higher frequency than women of unknown hypertension (27.9% vs 18.5%, phypertensive patients, a larger proportion of men than women reported not taking anti-hypertensive drug (12.6% among men and 9.4% among women (phypertensive emergencies than urgencies (OR = 1.34, 95% CI 1.06-1.70), independently of presenting symptoms, creatinine, smoking habit and known hypertension. This study shows that hypertensive crises involved almost 5 out of 1,000 patients-year admitted to EDs. Sex differences in frequencies of unknown hypertension, compliance to treatment and risk of hypertensive emergencies might have implications for public health programs.

  13. [Prevalence of hypertension in the population of the right-bank Warsaw districts based on research from the Pol-Monica study].

    Science.gov (United States)

    Wagrowska, H; Rywik, S

    In 1984 a group of 1309 men and 1337 women aged 35-64 years were studied in the population of Warsaw. The standardized mean systolic blood pressure was 143.4 mm Hg in men and 144.0 mm Hg in women (p less than 0.05), the mean values for the diastolic pressure were 89.7 mm Hg in men and 85.8 mm Hg in women (p less than 0.05). The standardized per cent values of borderline hypertension were 23.4% for men and 21.9% for women (p less than 0.05), according to WHO criteria the prevalence of hypertension was 35.8% in men and 28.0% in women (p less than 0.05). Only 55% of hypertensive men and 73% of hypertensive women knew that they had had hypertension, and 42% of male patients and 64% of female patients had had any treatment for hypertension. In the present study a correlation was demonstrated between hypertension and socioeconomic class (significantly higher blood pressure was found in people at lower educational level), besides that higher pressure was noted in married men and in women working artisans in relation to hose doing clerical work. The proportion of hypertensive subjects increased with increasing cholesterol level and with increasing overweight. A negative correlation was showed between hypertension and cigarette smoking. Ischaemic heart disease was significantly more frequent in hypertensive subjects as in normotensive ones.

  14. Treating Hypertension in Pregnancy.

    Science.gov (United States)

    Schlembach, Dietmar; Homuth, Volker; Dechend, Ralf

    2015-08-01

    Hypertension is present in about 10 % of all pregnancies. The frequency of chronic hypertension and that of gestational hypertension is increasing. The management of pregnant women with hypertension remains a significant, but controversial, public health problem. Although treatment of hypertension in pregnancy has shown to reduce maternal target organ damage, considerable debate remains concerning treatment. We review current evidence regarding treatment goals, the ideal treatment starting time, and which drugs are available for the treatment of hypertension in pregnancy.

  15. Gemcitabine-induced hemolytic uremic syndrome mimicking scleroderma renal crisis presenting with Raynaud's phenomenon, positive antinuclear antibodies and hypertensive emergency.

    Science.gov (United States)

    Yamada, Yuichiro; Suzuki, Keisuke; Nobata, Hironobu; Kawai, Hirohisa; Wakamatsu, Ryo; Miura, Naoto; Banno, Shogo; Imai, Hirokazu

    2014-01-01

    A 58-year-old woman who received gemcitabine for advanced gallbladder cancer developed an impaired renal function, thrombocytopenia, Raynaud's phenomenon, digital ischemic changes, a high antinuclear antibody titer and hypertensive emergency that mimicked a scleroderma renal crisis. A kidney biopsy specimen demonstrated onion-skin lesions in the arterioles and small arteries along with ischemic changes in the glomeruli, compatible with a diagnosis of hypertensive emergency (malignant hypertension). The intravenous administration of a calcium channel blocker, the oral administration of an angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker and the transfusion of fresh frozen plasma were effective for treating the thrombocytopenia and progressive kidney dysfunction. Gemcitabine induces hemolytic uremic syndrome with accelerated hypertension and Raynaud's phenomenon, mimicking scleroderma renal crisis.

  16. Presenting the female condom to men: a dyadic analysis of effect of the woman's approach.

    Science.gov (United States)

    Penman-Aguilar, Ana; Hall, Jeffrey; Artz, Lynn; Crawford, Myra A; Peacock, Nadine; van Olphen, Juliana; Parker, Lutissa; Macaluso, Maurizio

    2002-01-01

    Although male partner resistance to female condom use has been reported, little is understood about circumstances under which partners will agree to female condom use. This study documents the experiences of couples who have worked together to achieve female condom use. As part of a prospective female condom efficacy study, female participants (age 18-34) received a behavioral intervention and an assortment of take-home items. Selected women and their partners were recruited for a qualitative interview focusing on their experience with the female condom. Interviews were transcribed, double-coded, and verified using a standard retrieval coding system. Twenty-six pairs of linked interviews were analyzed dyadically: 9 couples who used the female condom "consistently," 12 "experimenters," and 5 "non-users." Women who successfully promoted the female condom to their partners used multiple presentation strategies. Initial male partner reaction did not predict continued use beyond the first trial. In conclusion, employment of multiple strategies facilitates successful introduction of the female condom into a sexual partnership.

  17. Pregnancy-Associated Heart Failure: A Comparison of Clinical Presentation and Outcome between Hypertensive Heart Failure of Pregnancy and Idiopathic Peripartum Cardiomyopathy.

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    Ntobeko B A Ntusi

    Full Text Available There is controversy regarding the inclusion of patients with hypertension among cases of peripartum cardiomyopathy (PPCM, as the practice has contributed significantly to the discrepancy in reported characteristics of PPCM. We sought to determine whether hypertensive heart failure of pregnancy (HHFP (i.e., peripartum cardiac failure associated with any form of hypertension and PPCM have similar or different clinical features and outcome.We compared the time of onset of symptoms, clinical profile (including electrocardiographic [ECG] and echocardiographic features and outcome of patients with HHFP (n = 53; age 29.6 ± 6.6 years and PPCM (n = 30; age 31.5 ± 7.5 years. The onset of symptoms was postpartum in all PPCM patients, whereas it was antepartum in 85% of HHFP cases (p<0.001. PPCM was more significantly associated with the following features than HHFP (p<0.05: twin pregnancy, smoking, cardiomegaly with lower left ventricular ejection fraction on echocardiography, and longer QRS duration, QRS abnormalities, left atrial hypertrophy, left bundle branch block, T wave inversion and atrial fibrillation on ECG. By contrast, HHFP patients were significantly more likely (p<0.05 to have a family history of hypertension, hypertension and pre-eclampsia in a previous pregnancy, tachycardia at presentation on ECG, and left ventricular hypertrophy on echocardiography. Chronic heart failure, intra-cardiac thrombus and pulmonary hypertension were found significantly more commonly in PPCM than in HHFP (p<0.05. There were 5 deaths in the PPCM group compared to none among HHFP cases (p = 0.005 during follow-up.There are significant differences in the time of onset of heart failure, clinical, ECG and echocardiographic features, and outcome of HHFP compared to PPCM, indicating that the presence of hypertension in pregnancy-associated heart failure may not fit the case definition of idiopathic PPCM.

  18. Associations between psychological distress and the most concerning present personal problems among working-age men in Japan.

    Science.gov (United States)

    Wada, Koji; Eguchi, Hisashi; Yoneoka, Daisuke; Okahisa, Jun; Smith, Derek R

    2015-03-31

    Personal problems are known to influence mental health among workers. The current study investigated the most concerning present personal problems which have the greatest impact on psychological distress among working-age Japanese men, rather than issues relating to work tasks or duties. We obtained data from the 2010 Comprehensive Survey of Living Conditions conducted by the Ministry of Health, Labour and Welfare. The original survey interviewed 289,363 households in 5,150 randomly selected municipalities of Japan, from which 228,664 households agreed to participate. We analyzed the data pertaining to men who were 20 to 59 years of age and the head of a family. The questionnaire included occupation, employment status, the most concerning present personal problems, and a measure of psychological distress (the Kessler 6 scale). Multiple logistic regression analysis was conducted to delineate the association between present personal problems and psychological distress. A total of 76,950 males were included in the analysis, 27.7% of whom reported some type of psychological distress. Statistical analysis revealed that psychological distress was associated with bullying and harassment (Odds Ratio (OR): 2.05, 95% Confidence Interval (95% CI): 1.50-2.56), divorce (OR: 1.90, 95% CI: 1.53-2.26), concerns about one's purpose in life (OR: 1.73, 95% CI: 1.59-1.88), personal relationships with family members (OR: 1.49, 95% CI: 1.37-1.60), personal relationships with others (OR: 1.38, 95% CI: 1.29-1.48), own diseases (OR: 1.24, 95% CI: 1.15-1.33), and financial difficulties (OR: 1.16, 95% CI: 1.12-1.20); when compared with problems related to work tasks or duties. Several personal factors appear to have a greater impact on the mental health of Japanese men of working age, when compared to the influence of work tasks or duties. Asking workers directly about the problems that most concern them in life might help better identify those in need psychological support

  19. Ocular Hypertension

    Science.gov (United States)

    ... Español Eye Health / Eye Health A-Z Ocular Hypertension Sections What Is Ocular Hypertension? Ocular Hypertension Causes ... Hypertension Diagnosis Ocular Hypertension Treatment What Is Ocular Hypertension? Written By: Kierstan Boyd Reviewed By: J Kevin ...

  20. Present Situation and Development of the Special Department Management of Hypertension%高血压专科管理的现状和发展

    Institute of Scientific and Technical Information of China (English)

    徐新娟

    2011-01-01

    Hypertension is a common and frequently-occurring disease in global and our country at present. hs incidence is higher,the course is longer, and the burden is heavier. These features make it become one of the chronic disease of focal management in intemational field and our country. For controUing hypertension much better, building new effective hypertension management pattern has already become the main problem that the national experts concern. This article summarizes global methods and experience of special management of hypertension. It comments current major models and features of the special department management of hypertension in our country with its development situation, and it provides advice for special department management of hypertension%高血压病是全球及我国目前的常见病和多发病,其发病率高、病程长、疾病负担重的特点,使它成为国际及我国重点管理的慢性疾病之一.为了更好地控制高血压,建立新的有效的高血压管理模式已成为各国专家关注的主要问题.现综述了全球范围内主要高血压专病专科管理的方法和经验,结合我国高血压专科管理发展的状况,评述了目前我国高血压专科管理的主要模式及其特点,强调了高血压专病、专科规范化管理的特点和优势,为高血压专科管理提供建议.

  1. Hypertensive Crisis in A Young Woman: A Rare Presentation of an Uncommon Disease (Poster), New Nerve racking Neurologic Symptoms (Podium)

    Science.gov (United States)

    2017-04-26

    lesions or bleeding. CT evaluation of chest and abdomen demonstrated c ircumferential th ickening of the abdomina l aorta I at the level of the renal...Takayasu arteritis is a large vessel vascu li tis primary affecting young adult fema les involving the ao11ic arch and upper extremities. Hypertension, fat

  2. Trends in Pulmonary Hypertension Mortality and Morbidity

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    Alem Mehari

    2014-01-01

    Full Text Available Context. Few reports have been published regarding surveillance data for pulmonary hypertension, a debilitating and often fatal condition. Aims. We report trends in pulmonary hypertension. Settings and Design. United States of America; vital statistics, hospital data. Methods and Material. We used mortality data from the National Vital Statistics System (NVSS for 1999–2008 and hospital discharge data from the National Hospital Discharge Survey (NHDS for 1999–2009. Statistical Analysis Used. We present age-standardized rates. Results. Since 1999, the numbers of deaths and hospitalizations as well as death rates and hospitalization rates for pulmonary hypertension have increased. In 1999 death rates were higher for men than for women; however, by 2002, no differences by gender remained because of the increasing death rates among women and the declining death rates among men; after 2003 death rates for women were higher than for men. Death rates throughout the reporting period 1999–2008 were higher for blacks than for whites. Hospitalization rates in women were 1.3–1.6 times higher than in men. Conclusions. Pulmonary hypertension mortality and hospitalization numbers and rates increased from 1999 to 2008.

  3. Gender differences in hypertension and hypertension awareness among young adults.

    Science.gov (United States)

    Everett, Bethany; Zajacova, Anna

    2015-01-01

    Previous research has shown that men have higher levels of hypertension and lower levels of hypertension awareness than women, but it remains unclear if these differences emerge among young adults. Using the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study examines gender differences in hypertension and hypertension awareness among U.S. young adults, with special focus on factors that may contribute to observed disparities (N = 14,497). Our results show that the gender disparities in hypertension status were already evident among men and women in their twenties: women were far less likely to be hypertensive compared to men (12% vs. 27%). The results also reveal very low levels of hypertension awareness among young women (32% of hypertensive women were aware of their status) and even lower levels among men (25%). Finally, this study identifies key factors that contribute to these observed gender disparities. In particular, health care use, while not related to the actual hypertension status, fully explains the gender differences in hypertension awareness. The findings thus suggest that regular medical visits are critical for improving hypertension awareness among young adults and reducing gender disparities in cardiovascular health.

  4. Pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Lauro Martins Júnior

    2014-12-01

    Full Text Available Pulmonary hypertension is a pathological condition associated with various diseases, which must be remembered by the physicians, since early diagnosis may anticipate and avoid dangerous complications and even death if appropriate measures were not taken. The relationship with chronic obstructive pulmonary disease (COPD, important pathological process that is in increasing prevalence in developing countries, and leading position as cause of death, emphasizes its importance. Here are presented the classifications, pathophysiology, and general rules of treatment of pulmonary hypertension.

  5. Sex differences in hypertension prevalence and control: Analysis of the 2010-2014 Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Choi, Hayon Michelle; Kim, Hyeon Chang; Kang, Dae Ryong

    2017-01-01

    Although not fully understood, sex may affect both the prevalence and control rate of hypertension. The present study was designed to investigate factors associated with hypertension prevalence and control among Korean adults. We analyzed 27,887 individuals (12,089 males and 15,798 females) aged 30 years or older who participated in the fifth (2010-2012) and sixth (2013-2014) Korea National Health and Nutrition Examination Survey. Multiple logistic regression models were applied to delineate factors associated with the prevalence and control of hypertension separately for men and women. Overall, the prevalence of hypertension was higher in men (34.6%) than in women (30.8%). However, after the age of 60 years, hypertension was more prevalent in females than in males. Regardless of sex, the older the participants were, the more likely they were to have hypertension. Factors positively associated with hypertension prevalence were old age, low education, and high BMI in women (pFactors decreasing hypertension control were white-collared women and young age, alcohol consumption in men. Sex differences in hypertension prevalence and control were discovered among Korean adults. After the age of 60, females were more likely to have hypertension and less likely to maintain hypertension control than males of the same age range. Accordingly, sex-specific approaches are recommended for effective blood pressure management.

  6. Hospital admissions for hypertensive crisis in the emergency departments: a large multicenter Italian study.

    Directory of Open Access Journals (Sweden)

    Giuliano Pinna

    Full Text Available Epidemiological data on the impact of hypertensive crises (emergencies and urgencies on referral to the Emergency Departments (EDs are lacking, in spite of the evidence that they may be life-threatening conditions. We performed a multicenter study to identify all patients aged 18 years and over who were admitted to 10 Italian EDs during 2009 for hypertensive crises (systolic blood pressure ≥220 mmHg and/or diastolic blood pressure ≥120 mmHg. We classified patients as affected by either hypertensive emergencies or hypertensive urgencies depending on the presence or the absence of progressive target organ damage, respectively. Logistic regression analysis was then performed to assess variables independently associated with hypertensive emergencies with respect to hypertensive urgencies. Of 333,407 patients admitted to the EDs over the one-year period, 1,546 had hypertensive crises (4.6/1,000, 95% CI 4.4-4.9, and 23% of them had unknown hypertension. Hypertensive emergencies (n = 391, 25.3% of hypertensive crises were acute pulmonary edema (30.9%, stroke (22.0%,, myocardial infarction (17.9%, acute aortic dissection (7.9%, acute renal failure (5.9% and hypertensive encephalopathy (4.9%. Men had higher frequency than women of unknown hypertension (27.9% vs 18.5%, p<0.001. Even among known hypertensive patients, a larger proportion of men than women reported not taking anti-hypertensive drug (12.6% among men and 9.4% among women (p<0.001. Compared to women of similar age, men had higher likelihood of having hypertensive emergencies than urgencies (OR = 1.34, 95% CI 1.06-1.70, independently of presenting symptoms, creatinine, smoking habit and known hypertension. This study shows that hypertensive crises involved almost 5 out of 1,000 patients-year admitted to EDs. Sex differences in frequencies of unknown hypertension, compliance to treatment and risk of hypertensive emergencies might have implications for public health programs.

  7. The malleability of gender stereotypes: influence of population size on perceptions of men and women in the past, present, and future.

    Science.gov (United States)

    Garcia-Retamero, Rocio; Müller, Stephanie M; López-Zafra, Esther

    2011-01-01

    Recent studies on the malleability of gender stereotypes show that they are flexible, dynamic structures that change with the passage of time. In a study, we examined perceptions about men and women of the past, present, and future in Spain and focused on the influence of an important demographic variable on these perceptions: the population size of people's location of residence. Results showed that people perceived an increase in similarity of men and women from the past to the present and from the present to the future. In less-populated locations, however, men and women were more gender stereotyped and, consequently, still perceived to be further from equality than those in more populated areas. We concluded that the study of dynamic gender stereotypes benefits from extensive research in populations that vary in their demographic characteristics and shows the importance of recent movements in rural areas supporting women's participation in the modernization process.

  8. Sex, the brain and hypertension: brain oestrogen receptors and high blood pressure risk factors.

    Science.gov (United States)

    Hay, Meredith

    2016-01-01

    Hypertension is a major contributor to worldwide morbidity and mortality rates related to cardiovascular disease. There are important sex differences in the onset and rate of hypertension in humans. Compared with age-matched men, premenopausal women are less likely to develop hypertension. However, after age 60, the incidence of hypertension increases in women and even surpasses that seen in older men. It is thought that changes in levels of circulating ovarian hormones as women age may be involved in the increase in hypertension in older women. One of the key mechanisms involved in the development of hypertension in both men and women is an increase in sympathetic nerve activity (SNA). Brain regions important for the regulation of SNA, such as the subfornical organ, the paraventricular nucleus and the rostral ventral lateral medulla, also express specific subtypes of oestrogen receptors. Each of these brain regions has also been implicated in mechanisms underlying risk factors for hypertension such as obesity, stress and inflammation. The present review brings together evidence that links actions of oestrogen at these receptors to modulate some of the common brain mechanisms involved in the ability of hypertensive risk factors to increase SNA and blood pressure. Understanding the mechanisms by which oestrogen acts at key sites in the brain for the regulation of SNA is important for the development of novel, sex-specific therapies for treating hypertension. © 2016 Authors; published by Portland Press Limited.

  9. Joint associations of physical activity and hypertension with the development of type 2 diabetes among urban men and women in Mainland China.

    Science.gov (United States)

    Xu, Fei; Ware, Robert S; Tse, Lap Ah; Wang, YouFa; Wang, ZhiYong; Hong, Xin; Chan, Emily Ying Yang; Dunstan, David W; Owen, Neville

    2014-01-01

    Physical activity (PA) and hypertension (HTN) are important influences on the development of type 2 diabetes (T2D). However, the joint impact of PA and HTN on T2D development is unknown. Two community-based prospective cohort studies, with the same protocols, instruments and questionnaires, were conducted among adults in urban areas of Nanjing, China, during 2004-2007 and 2007-2010. T2D was defined using World Health Organization criteria based on physicians' diagnosis and fasting blood glucose concentration. PA level (sufficient/insufficient) and blood pressure status (hypertensive/normotensive) were assessed at baseline and the third year of follow-up. We pooled and analyzed data from these two studies. Among 4550 participants aged 35 years or older, the three-year cumulative incidence of T2D was 5.1%. After adjusting for potential confounders, participants with sufficient PA were less likely to develop T2D than those with insufficient PA (OR = 0.43, 95%CI = 0.27, 0.68) and those who were normotensive were less likely to develop T2D than those who were hypertensive (OR = 0.39, 95%CI = 0.29, 0.51). Compared to participants with insufficient PA and who were hypertensive, those with sufficient PA and hypertension were at lower risk of developing T2D (OR = 0.36, 95%CI = 0.19, 0.69), as were those with insufficient PA who were normotensive (OR = 0.37, 95%CI = 0.28, 0.50) and those with sufficient PA who were normotensive (OR = 0.19, 95%CI = 0.10, 0.37). Insufficient PA was found to be associated with the development of T2D among adults with and without hypertension. These findings support a role for promoting higher physical activity levels to lower T2D risk in both hypertensive and non-hypertensive individuals.

  10. Hypertension and hypertensive encephalopathy.

    Science.gov (United States)

    Price, Raymond S; Kasner, Scott E

    2014-01-01

    The definition of hypertension has continuously evolved over the last 50 years. Hypertension is currently defined as a blood pressure greater than 140/90mmHg. One in every four people in the US has been diagnosed with hypertension. The prevalence of hypertension increases further with age, affecting 75% of people over the age of 70. Hypertension is by far the most common risk factor identified in stroke patients. Hypertension causes pathologic changes in the walls of small (diameter<300 microns) arteries and arterioles usually at short branches of major arteries, which may result in either ischemic stroke or intracerebral hemorrhage. Reduction of blood pressure with diuretics, β-blockers, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors have all been shown to markedly reduce the incidence of stroke. Hypertensive emergency is defined as a blood pressure greater than 180/120mmHg with end organ dysfunction, such as chest pain, shortness of breath, encephalopathy, or focal neurologic deficits. Hypertensive encephalopathy is believed to be caused by acute failure of cerebrovascular autoregulation. Hypertensive emergency is treated with intravenous antihypertensive agents to reduce blood pressure by 25% within the first hour. Selective inhibition of cerebrovascular blood vessel permeability for the treatment of hypertensive emergency is beginning early clinical trials. © 2014 Elsevier B.V. All rights reserved.

  11. Presentation

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    Paulo Henrique Freire Vieira

    2013-12-01

    Full Text Available This dossier focuses on one of the essential debate topics today about the territorial dimension of the new development strategies concerned with the worsening of the global socioecological crisis, that is: the challenges related to the activation and integration in networks of localized agri-food systems. For its composition, some contributions presented and debated during the VI International Conference on Localized Agri-food System - The LAFS facing the opportunities and challenges of the new global context have been gathered. The event took place in the city of Florianópolis, from May 21th to 25th of 2013. The event was promoted by the Federal University of Santa Catarina (UFSC and by the Center for the International Cooperation on Agricultural Research for Development (CIRAD. Besides UFSC and CIRAD, EPAGRI, State University of Santa Catarina (UDESC, as well as research institutes and universities from other states (UFMG, IEA/SP, UFS, UFRGS and Mexican and Argentinian partners from the RED SIAL Latino Americana also participated in the organization of lectures, discussion tables and workshops.

  12. Presentation

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    Eduardo Vicente

    2013-06-01

    Full Text Available In the present edition of Significação – Scientific Journal for Audiovisual Culture and in the others to follow something new is brought: the presence of thematic dossiers which are to be organized by invited scholars. The appointed subject for the very first one of them was Radio and the invited scholar, Eduardo Vicente, professor at the Graduate Course in Audiovisual and at the Postgraduate Program in Audiovisual Media and Processes of the School of Communication and Arts of the University of São Paulo (ECA-USP. Entitled Radio Beyond Borders the dossier gathers six articles and the intention of reuniting works on the perspectives of usage of such media as much as on the new possibilities of aesthetical experimenting being build up for it, especially considering the new digital technologies and technological convergences. It also intends to present works with original theoretical approach and original reflections able to reset the way we look at what is today already a centennial media. Having broadened the meaning of “beyond borders”, four foreign authors were invited to join the dossier. This is the first time they are being published in this country and so, in all cases, the articles where either written or translated into Portuguese.The dossier begins with “Radio is dead…Long live to the sound”, which is the transcription of a thought provoking lecture given by Armand Balsebre (Autonomous University of Barcelona – one of the most influential authors in the world on the Radio study field. It addresses the challenges such media is to face so that it can become “a new sound media, in the context of a new soundscape or sound-sphere, for the new listeners”. Andrew Dubber (Birmingham City University regarding the challenges posed by a Digital Era argues for a theoretical approach in radio studies which can consider a Media Ecology. The author understands the form and discourse of radio as a negotiation of affordances and

  13. Presentation

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    Helmut Renders

    2008-10-01

    Full Text Available We present to our esteemed readers the second edition of our journal for 2008. We have chosen the theme “The life and work of Prof. Dr. Jürgen Moltmann” as its special emphasis. It is our way to pay homage to J. Moltmann in the year the Universidade Metodista de São Paulo awards him an honorary Doctor Honoris Causa degree. Sincethe seventies, Moltmann and Latin America have been in dialog. In his emblematic work “A Theology of Liberation”, Gustavo Gutiérrez, the Catholic, discussed with Moltmann, the Reformed, the relationship between eschatology and history (GUTIÉRREZ, Gustavo.Teologia da Libertação. 5ª edição. Petrópolis, RJ: Vozes, 1985, p. 27, 137-139. A dialog held in the premises of IMS, which nowadays is called UMESP, has produced the little book “Passion for life” (MOLTMANN, Jürgen. Paixão pela vida. São Paulo, SP: ASTE - Associaçãode Seminários Teológicos Evangélicos, 1978.In the following years, the wide theological work of J. Moltmann went all the way from debates to congresses and has conquered the classrooms. Most probably, J. Moltmann is nowadays the most widely read European author in Brazilian theological seminaries. Thisrecognition can only be held in unison and the wide response to our request for articles confirms the huge repercussion that Moltmann’s work has been having up to today in Brazil. The ecumenical theologian J. Moltmann is ecumenically read. We believe that thisway we may be better equipped to answer to anyone who asks us for the reason there is hope in us. We have organized the articles on J. Moltmann’s theology according to the original publication date of the books dealt with in each essay. We also communicate that some articles which were originally requested for this edition of the journal will be published in the journal Estudos de Regilião in May 2009.As it is usual with the journal Caminhando, we have, besides this thematic emphasis, yet other contributions in the areas of

  14. Decreased levels of genuine large free hCG alpha in men presenting with abnormal semen analysis

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    Plas Eugen

    2011-08-01

    Full Text Available Abstract Background The pregnancy hormone human chorionic gonadotropin (hCG and its free subunits (hCG alpha, hCG beta are produced in the male reproductive tract and found in high concentrations in seminal fluid, in particular hCG alpha. This study aimed to elucidate changes in peptide hormone profiles in patients showing abnormal semen analyses and to determine the genuineness of the highly abundant hCG alpha. Methods Seminal plasma was obtained from 45 male patients undergoing semen analysis during infertility workups. Comprehensive peptide hormone profiles were established by a panel of immunofluorometric assays for hCG, hCG alpha, hCG beta and its metabolite hCG beta core fragment, placental lactogen, growth hormone and prolactin in seminal plasma of patients with abnormal semen analysis results (n = 29 versus normozoospermic men (n = 16. The molecular identity of large hyperglycosylated hCG alpha was analyzed by mass-spectrometry and selective deglycosylation. Results hCG alpha levels were found to be significantly lower in men with impaired semen quality (1346 +/- 191 vs. 2753 +/- 533 ng/ml, P = 0.022. Moreover, patients with reduced sperm count had reduced intact hCG levels compared with normozoospermic men (0.097 +/- 0.022 vs. 0.203 +/- 0.040 ng/ml, P = 0.028. Using mass-spectrometry, the biochemical identity of hCG alpha purified from seminal plasma was verified. Under non-reducing conditions in SDS-PAGE, hCG alpha isolated from seminal plasma migrated in a manner comparable with large free hCG alpha with an apparent molecular mass (Mr, app of 24 kDa, while hCG alpha dissociated from pregnancy-derived holo-hCG migrated at approximately 22 kDa. After deglycosylation with PNGase F under denaturing conditions, all hCG alpha variants showed an Mr, app of 15 kDa, indicating identical amino acid backbones. Conclusions The findings indicate a pathophysiological relevance of hCG, particularly its free alpha subunit, in spermatogenesis. The

  15. Presentation

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    Nicanor Lopes

    2010-11-01

    Full Text Available The Journal Caminhando debuts with a new editorial format: eachmagazine will have a Dossier.In 2010 Christianity celebrated the centenary of Edinburgh. TheWorld Missionary Conference in Edinburgh in 1910 is regarded by manyas missiological watershed in the missionary and ecumenical movement.So the Faculty of Theology of the Methodist Church (FATEO decidedto organize a Wesleyan Week discussing the issue of mission. For anevent of this magnitude FATEO invited the Rev. Dr. Wesley Ariarajah,Methodist pastor and teacher of Sri Lanka with extensive experience inpastoral ministry in local churches and professor of History of Religionsand the New Testament at the Theological College of Lanka, maintainedby the Protestant Churches in Sri Lanka. In 1981 he was invited to jointhe World Council of Churches, where he presided for over ten years theCouncil of Interreligious Dialogue. From 1992 he served as Deputy GeneralSecretary of the WCC.The following texts are not the speeches of the Rev. Dr. WesleyAriarajah, for they will be published separately. Nevertheless, the journaldialogs with the celebrations of the centenary of Edinburgh, parting formthe intriguing theme: "Mission in the 21st century in Brazil". After all, howis it that mission takes place among us in personal, church, and communityactivities?Within the Dossier, as common to the journal, the textos are organizedas follows: Bible, Theology / History and Pastoral Care. Other items thatdo not fit within the Dossier, but, do articulate mission, can be found inthe section Declarations and Documents and Book Reviews.The authors of the Dossier have important considerations in buildinga contemporary missiological concept considering Brazilian reality.Anderson de Oliveira, in the Bible-Section, presents a significantexegeses of Matthew 26.6-13. What does it mean when Jesus is quotedwith the words: "For the poor always ye have with you, but me ye havenot always." Is this declaration challenging the gospels

  16. Unusual presentation of multiple endocrine neoplasia type 1 in a young woman with a novel mutation of the MEN1 gene.

    Science.gov (United States)

    Balogh, Katalin; Patócs, Attila; Majnik, Judit; Varga, Fatima; Illyés, György; Hunyady, László; Rácz, Károly

    2004-01-01

    We report an unusual presentation of multiple endocrine neoplasia type 1 (MEN 1) in a young woman who was subsequently proven to have a novel mutation of the MEN1 gene. The young patient, aged 25 years, was investigated for abdominal discomfort and left upper abdominal pain. Her family history was unremarkable, except an unknown disorder of her father causing early death. Abdominal ultrasonography (USG) and computed tomography revealed a giant pancreatic tumor measuring 10 cm in diameter. The diagnosis of a clinically nonfunctioning pancreatic neuroendocrine tumor was established by clinical and other studies, including USG-guided aspiration biopsy and octreotide scintigraphy, and the patient underwent a distal pancreatectomy. Histology proved a well-differentiated multinodular neuroendocrine tumor of the pancreas. During surgery, a subcutaneous lipoma was also removed from the abdominal wall. Two years later, the patient developed primary hyperparathyroidism, and two enlarged parathyroid glands were surgically removed. Magnetic resonance imaging of the pituitary gland was normal. Screening for MEN1 gene mutation by temperature gradient gel electrophoresis revealed heterozygosities in exons 3, 8, and 9, while direct sequencing indicated a novel germline mutation (C354X) resulting in a stop codon in exon 8 and polymorphisms in exon 3 (R171Q) and exon 9 (D418D and L432L). Genetic screening revealed no mutation in living family members. Our unusual case suggests that a multinodular pancreatic neuroendocrine tumor in a young patient may justify screening for MEN 1 syndrome, even in the absence of other endocrinopathy or family history.

  17. 40. Hoarseness of voice as a primary presentation of pulmonary hypertension: A rare case of Ortner’s (cardio-vocal syndrome

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    K. Naeem

    2016-07-01

    Full Text Available Ortner’s (cardio-vocal syndrome is a rare disease entity that involves compression of the left recurrent laryngeal nerve due to enlargement of cardiovascular structures. The syndrome was first described by Norbert Ortner (an Austrian physician in 1897 and is usually reported to be associated with mitral stenosis. However, we report a rare case when a 20-year-old girl presented with hoarseness of voice and was found to have an enlarged main pulmonary trunk due to pulmonary hypertension that was compressing the left recurrent laryngeal nerve. The case highlights a rare presentation of a relatively common disease and stresses the importance of detailed cardiac workup in a patient with hoarseness of voice. We present the case and review the literature. A 20-year-old lady was referred from primary health center due to complaints of hoarseness of voice for the last four months. She reported only mild exertional palpitations and shortness of breath. She did not report any previous cardiac problem in childhood. Examination revealed a loud pulmonary component of 2nd heart sound, a pan-systolic murmur at the tricuspid area, and a palpable thrill. There was no evidence of right heart failure or any stigmata of connective tissue disease. Electrocardiography showed sinus rhythm with dominant R-wave in lead V1 indicating right ventricular hypertrophy. Laboratory tests did not reveal any abnormality. 2-D transthoracic echocardiograhy revealed normal left ventricle in size and function, right ventricular hypertrophy (6 mm thickness of free wall, mild to moderate tricuspid regurgitation, pulmonary hypertension (pulmonary pressure 60–65 mmHg and an enlarged main pulmonary trunk. Computed tomography (CT of the chest showed dilated main pulmonary trunk (max diameter 42 mm. An angiogram excluded pulmonary emboli. The patient was also seen by the Otolaryngology team in view of the main complaint of hoarseness of voice. Indirect laryngoscopy showed left vocal

  18. [Reflections on mentalization-based treatment and its adaptation for men presenting a narcissistic personality disorder and a not otherwise specified personality disorder].

    Science.gov (United States)

    Cherrier, Jean-François

    2013-01-01

    Narcissistic personality disorder (NPD) and not otherwise specified personality disorder (borderline and narcissistic) are major mental health problems for men. These pathologies predispose patients to significant relational difficulties which are characterised by intense reactions to perceived threats to the self-esteem and an impaired empathic ability. Understanding these disorders as affect dysregulation stimulated by shame, the author presents how patients in this context are prone to lose their capacity to mentalize. This article describes a specific individual and group mentalization-based treatment and its implementation for treating narcissistic men. Different reflections on the treatment, on empathy, as well as on the adaptation of this treatment for NPD patients are presented and illustrated with clinical vignettes.

  19. Marital Status, Hypertension, Coronary Heart Disease, Diabetes, and Death among African American Women and Men: Incidence and Prevalence in the Atherosclerosis Risk in Communities (ARIC) Study Participants

    Science.gov (United States)

    Schwandt, Hilary M.; Coresh, Josef; Hindin, Michelle J.

    2010-01-01

    Heart disease is the leading cause of death in the United States, and African Americans disproportionately experience more cardiovascular disease, including coronary heart disease (CHD), hypertension, and diabetes. The literature documents a complex relationship between marital status and health, which varies by gender. We prospectively examine…

  20. Marital Status, Hypertension, Coronary Heart Disease, Diabetes, and Death among African American Women and Men: Incidence and Prevalence in the Atherosclerosis Risk in Communities (ARIC) Study Participants

    Science.gov (United States)

    Schwandt, Hilary M.; Coresh, Josef; Hindin, Michelle J.

    2010-01-01

    Heart disease is the leading cause of death in the United States, and African Americans disproportionately experience more cardiovascular disease, including coronary heart disease (CHD), hypertension, and diabetes. The literature documents a complex relationship between marital status and health, which varies by gender. We prospectively examine…

  1. Complicações da hipertensão arterial em homens e mulheres atendidos em um ambulatório de referência Complications of hypertension in men and women seen in a referral outpatient care unit

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    Antonio Carlos Beisl Noblat

    2004-10-01

    association between sex and target-organ lesions in hypertension adjusted for race, age, and duration of the disease. RESULTS: The mean age of the patients was 48.4±13.8 years; 74.1% were women, and 84.9% were mulattos or blacks. Almost half of the men and more than 40% of the women had had at least 1 definite event involving a target-organ lesion. The incidence of renal failure was greater among men [adjusted OR (ORa = 2.73, P= 0.002]. In white patients, the incidence of stroke was significantly (P= 0.017 greater among men (4/33 than among women (0/56, and, in the age group > 49 years, the prevalence of left ventricular hypertrophy was significantly greater among men (ORa = 1.99, P= 0.024. CONCLUSION: The data obtained suggest a greater prevalence of renal failure in men than in women, of stroke in white men than in white women, and of left ventricular hypertrophy in men than in women aged 49 years and above.

  2. The spectrum of genital human papillomavirus infection among men attending a Swedish sexually-transmitted infections clinic: human papillomavirus typing and clinical presentation of histopathologically benign lesions.

    Science.gov (United States)

    Wikström, Arne; Vassilaki, Ismini; Hedblad, Mari-Anne; Syrjänen, Stina

    2013-03-27

    There have been a number of Swedish studies on human papillomavirus (HPV) typing in men, most of which have used less sensitive HPV-typing techniques. The present study included male patients with genital HPV-induced lesions planned for surgery. Samples were prepared for histopathology and PCR. HPV was detected in 233/253 (92%) and HPV 6 or 11 in 89% of the HPV-positive lesions. There were statistically significant differences regarding morphology (p=0.002), location (p=0.000001) and colour (p=0.005) of the lesions for low- vs. mixed or high-risk HPV types. For example, acuminate lesions were mostly found among men with low-risk HPV types, whereas macular lesions were over-represented among them with mixed or high-risk types. The HPV type distribution is similar to that in earlier studies, but we also found correlations with some clinical parameters.

  3. Accuracy of dual-source CT to identify significant coronary artery disease in patients with uncontrolled hypertension presenting with chest pain: comparison with coronary angiography.

    Science.gov (United States)

    Marwan, Mohamed; Pflederer, Tobias; Schepis, Tiziano; Seltmann, Martin; Klinghammer, Lutz; Muschiol, Gerd; Ropers, Dieter; Daniel, Werner G; Achenbach, Stephan

    2012-06-01

    It has been previously reported that the sensitivity and specificity of multislice CT for detecting significant CAD (coronary artery disease) is high. Chest pain is a common presentation in patients with uncontrolled hypertension. We investigated the sensitivity and specificity of dual-source CT to detect and rule out significant CAD in patients presenting with uncontrolled hypertension accompanied by chest pain. 260 consecutive patients presenting with acute chest pain in the context of stage 2 hypertension (systolic pressure ≥160 and/or diastolic pressure ≥100) were enrolled in the study. After admission, control of blood pressure and risk stratification, 82 patients were excluded due to renal insufficiency, prior coronary revascularisation or refused participation in the study. 90 further patients with low pre-test probability of CAD were also excluded. 88 remaining patients were subjected to CT coronary angiography using dual-source CT (Definition, Siemens Medical Solutions, Forchheim, Germany) within 24 h before invasive coronary angiography. A contrast-enhanced volume dataset was acquired (120 kV, 400 mAs/rot, collimation 2 × 64 × 0.6 mm, retrospective ECG gating). Data sets were evaluated concerning the presence or absence of significant coronary stenoses and validated against invasive coronary angiography. A significant stenosis was assumed if the diameter reduction was ≥50%. 88 patients (mean age 66 ± 11 years, mean heart rate 61 ± 9 bpm) were evaluated regarding the presence or absence of significant CAD (at least one stenosis ≥50% diameter reduction). Mean systolic blood pressure on presentation was 203 ± 20 mmHg and mean diastolic blood pressure was 103 ± 13 mmHg. On a per patient basis, the sensitivity and specificity for dual-source CT to detect significant CAD in vessels >1.5 mm diameter was 100% (36/36, 95% CI 90-100) and 90% (47/52, 95% CI 79-97), respectively with a negative predictive value (NPV) of 100% (47/47, 95% CI 92-100) and a

  4. Pulmonary veno-occlusive disease: a rare cause of pulmonary hypertension in systemic sclerosis. Case presentation and review of the literature .

    Science.gov (United States)

    Daraban, Ana Maria; Enache, Roxana; Predescu, L; Platon, P; Constantinescu, T; Mihai, Carina; Coman, I M; Ginghina, Carmen; Jurcuţ, Ruxandra

    2015-01-01

    Pulmonary veno-occlusive disease (PVOD) is a rare cause of pulmonary arterial hypertension (PAH). Because of the similar clinical picture of dyspnea on exertion and signs of right heart failure, PVOD is difficult to distinguish from idiopathic PAH. However, the distinction is mandatory because PVOD has a worse prognosis and, more importantly, the administration of PAH specific therapy (vasodilators) can precipitate severe acute pulmonary oedema. We present a challenging case of PAH in a patient with systemic sclerosis in whom a marked decrease in functional capacity after the initiation of bosentan therapy led to the diagnosis of PVOD. Management of PVOD patients is challenging and referral for lung transplantation should be done at the moment of diagnosis.

  5. Should weight loss and maintenance programmes be designed differently for men? A systematic review of long-term randomised controlled trials presenting data for men and women: The ROMEO project.

    Science.gov (United States)

    Robertson, Clare; Avenell, Alison; Boachie, Charles; Stewart, Fiona; Archibald, Daryll; Douglas, Flora; Hoddinott, Pat; van Teijlingen, Edwin; Boyers, Dwayne

    2016-01-01

    We systematically reviewed the randomised controlled trial (RCT) evidence for long-term (≥12 months) weight management interventions for obese men in contrast to women to help understand whether programmes should be designed differently for men. We searched 11 databases up to October 2014. Twenty-two RCTs reported data separately for men and women in weight loss or weight maintenance interventions. We found men were under-represented in RCTs of weight loss interventions open to both sexes. Men comprised 36% of participants (4771 from 13,305 participants). Despite this, men were 11% (95% CI 8-14%, pmeta-analysis of 13 trials showed no significant difference in weight loss between men and women, either for weight loss in kg (p=0.90) or percentage weight loss (p=0.78), although men tended to lose more weight with intensive low fat reducing diets, with or without meal replacements, and structured physical activity/exercise programmes than women. Orlistat was less beneficial for men for weight maintenance. Individual support and tailoring appeared more helpful for men than women. We found evidence that men and women respond differently to, and have different preferences for, varying types of weight management programme. We suggest that it is important to understand men's views on weight loss, as this is likely to also improve the uptake and effectiveness of programmes for men.

  6. Hypertension and its risk factors among postmenopausal women in Delhi

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    Nidhi Gupta

    2014-12-01

    Full Text Available Background: Hypertension is the commonest cardiovascular disorder, posing a major public health challenge to population in epidemiological transition. The prevalence of hypertension increases with age and is more common in men as compared to women. But women loose this advantage after menopause due to estrogen deficiency. Objectives: 1. To assess the prevalence of hypertension and risk factors for hypertension among postmenopausal women in an urban community in Delhi. 2. To study association of risk factors with hypertension. Methodology: A community based cross-sectional study was conducted at Palam, an urbanized village in Delhi. A total 416 postmenopausal women were interviewed, examined and investigated. Results: Majority (78% of postmenopausal women were in the age group of 45-65 years. More than three fourth 342 (82.4% of women belonged to lower middle and upper lower socio-economic status. The prevalence of hypertension in these women was 39.6%, another one third (37% were pre-hypertensive. All women had one or more than one risk factor for hypertension. The most common risk factors were high salt intake (82.7%, low vegetable and fruit intake (64.2%, stress (53.2% and truncal obesity (36.1%. Risk factors like diabetes, obesity, smoking and physical inactivity were significantly more common in hypertensive as compared to non-hypertensive. Conclusion: Burden of hypertension among postmenopausal women in the present study was found to be high. Interventions integrating promotive, preventive and curative care for postmenopausal women should be provided to them.

  7. Association between cigarette smoking and hypertension in men: a dose response relationship analysis%男性吸烟与高血压病的剂量-反应关系

    Institute of Scientific and Technical Information of China (English)

    胡文斌; 张婷; 史建国; 秦威; 仝岚; 沈月平

    2014-01-01

    Objective To estimate the dose response relationship between cigarette smoking and hypertension in men based on restricted cubic spline method.Methods Under the proportion to the population size,38 520 subjects were randomly selected from May to August 2012 with cluster sampling method in urban and rural areas of Kunshan,China.Each participant received face-to-face interview with the standardized questionnaire,and physical examination.Restricted cubic spline was employed to estimate the dose response relation of cigarette smoking on the risk of hypertension.Results The overall prevalence of cigarette smoking was 22.6% (8 691/38 520),prevalence of cigarette smoking in men was 46.1% (8 499/18 454).Multiple logistic regression analysis showed that current smoking (OR =1.16,95% CI:1.05-1.28) and previous cigarette smoking (OR =1.32,95% CI:1.07-1.63) were associated with hypertension after adjusted confounding factors (age,sex,body mass index,education,family income per month,urban or rural areas,physical activity and physical exercise) in men.After further adjusting drinking status,only previous cigarette smoking was associated with hypertension (OR =1.28,95 % CI:1.04-1.58).The restricted cubic spline model indicated a linear dose-response relation between hypertension and cigarette smoking per day in men (non-linearity test P =0.604 1).However,a non-linear dose response relation was found between duration of smoking (non-linearity test P < 0.000 1),smoking index (non-linearity test P =0.009 9) and hypertension.Conclusion Long-term and heavy cigarette smoking is associated with hypertension in men.%目的 采用限制性立方样条模型,探讨男性吸烟与高血压病的剂量-反应关系.方法 采用与人口规模成比例的整群抽样方法,于2012年5至8月对江苏省昆山市18岁以上38 520名户籍居民进行问卷调查和体格测量.采用logistic回归模型和限制性立方样条模型,分析男性吸烟数量、年限及吸烟指

  8. Valproate Induced Hypertensive Urgency

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    Mauran Sivananthan

    2016-01-01

    Full Text Available Valproate is a medication used in the treatment of seizures, bipolar disorder, migraines, and behavioral problems. Here we present a case of an 8-year-old boy who presented with hypertensive urgency after initiation of valproate. Primary treatment of his hypertension was ineffective. Blood pressure stabilization was achieved following discontinuation of valproate. Clinicians should be aware of the risk of developing hypertensive urgency with administration of valproate.

  9. Hypertensive crisis in a patient with thyroid cancer.

    Science.gov (United States)

    Asha, H S; Seshadri, M S; Rajaratnam, Simon

    2012-01-01

    Phaeochromocytomas may be discovered incidentally when patients present with hypertensive crisis during general anaesthesia. A 49-year-old man underwent thyroidectomy 25 years ago and was diagnosed to have spindle cell carcinoma of the thyroid. He presented with recent onset of hoarseness of voice and was found to have a vocal cord nodule. He developed a hypertensive crisis during surgery. He was subsequently evaluated and found to have bilateral phaeochromocytoma. Further evaluation revealed a RET proto-oncogene mutation at codon 634 consistent with multiple endocrine neoplasia (MEN)-2A.

  10. Portal hypertension and an atypical reactive arthritis like presentation in a patient infected with hepatitis C virus genotype 3

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    Moushumi Lodh

    2014-01-01

    Full Text Available Background: Reactive arthritis (ReA is defined as a peripheral arthritis lasting longer than 1 month, associated with urethritis, cervicitis, or diarrhea. The reported annual incidence of ReA is approximately 30-40 cases per 100,000 adults, occurring commonly in the age group of 16 and 35 years. It is known to be associated with gastrointestinal infections with Shigella, Salmonella, and Campylobacter species and other microorganisms, as well as with genitourinary infections (especially with Chlamydia trachomatis. Case Report: This article reports the case of a 53-year-old, post-right total hip replacement, Indian man, with ReA, who presented with fever, respiratory distress, and abdominal discomfort. He complained of itching, tingling sensation, pain on urination, and retention of urine. He had right hip joint pain for 3 weeks, inability to move right leg since 10 days, and melena since 1 week. Laboratory tests revealed anemia, high liver and kidney function tests, elevated erythrocyte sedimentation rate, C reactive protein, procalcitonin and occult blood in stool. He tested positive for hepatitis C virus genotype 3. Gastroduodenoscopy revealed multiple apthoid ulcers at D2 and large gastric varix. Ultrasonography of whole abdomen revealed cholelithiasis and splenomegaly. Skin lesions and arthritis led to the diagnosis of associated ReA. The patient was managed conservatively and discharged in a stable condition. Conclusions: Our case is unlike classical ReA because the patient is older, HLA B27 negative, and without florid urethritis. Admitted for fever and lower urinary tract symptoms, along with respiratory distress, the primary objective of the emergency doctors was to prevent the patient from progressing to organ failure. The diagnosis of underlying atypical/incomplete ReA could easily have been missed without adequate awareness, dermatological consultation, and a skin biopsy.

  11. Liquorice: a root cause of secondary hypertension

    Science.gov (United States)

    Ross, Calum N.

    2017-01-01

    We describe a patient presenting with hypertension and hypokalaemia who was ultimately diagnosed with liquorice- induced pseudohyperaldosteronism. This rare cause of secondary hypertension illustrates the importance of a methodical approach to the assessment of hypertension. PMID:28210494

  12. Hypertension And Poor Semen Quality: A New Compelling ...

    African Journals Online (AJOL)

    Treatment of hypertension is usually individualized for optimal results. ... favourable effects on the side not necessarily related to blood pressure lowering effect. ... as preferred first line drugs in hypertension for men with poor quality semen.

  13. Comparison of outcomes and presentation in men-versus-women with bicuspid aortic valves undergoing aortic valve replacement.

    Science.gov (United States)

    Andrei, Adin-Cristian; Yadlapati, Ajay; Malaisrie, S Chris; Puthumana, Jyothy J; Li, Zhi; Rigolin, Vera H; Mendelson, Marla; Clennon, Colleen; Kruse, Jane; Fedak, Paul W M; Thomas, James D; Higgins, Jennifer A; Rinewalt, Daniel; Bonow, Robert O; McCarthy, Patrick M

    2015-07-15

    Gender disparities in short- and long-term outcomes have been documented in cardiac and valvular heart surgery. However, there is a paucity of data regarding these differences in the bicuspid aortic valve (BAV) population. The aim of this study was to examine gender-specific differences in short- and long-term outcomes after surgical aortic valve (AV) replacement in patients with BAV. A retrospective analysis was performed in 628 consecutive patients with BAV who underwent AV surgery from April 2004 to December 2013. To reduce bias when comparing outcomes by gender, propensity score matching obtained on the basis of potential confounders was used. Women with BAV who underwent AV surgery presented with more advanced age (mean 60.7 ± 13.8 vs 56.3 ± 13.6 years, p <0.001) and less aortic regurgitation (29% vs 44%, p <0.001) and had a higher risk for in-hospital mortality (mean Ambler score 3.4 ± 4.4 vs 2.5 ± 4.0, p = 0.015). After propensity score matching, women received more blood products postoperatively (48% vs 34%, p = 0.028) and had more prolonged postoperative lengths of stay (median 5 days [interquartile range 5 to 7] vs 5 days [interquartile range 4 to 6], p = 0.027). Operative, discharge, and 30-day mortality and overall survival were not significantly different. In conclusion, women with BAV who underwent AV surgery were older, presented with less aortic regurgitation, and had increased co-morbidities, lending higher operative risk. Although women received more blood products and had significantly longer lengths of stay, short- and long-term outcomes were similar.

  14. Blood pressure change and risk of hypertension associated with parental hypertension: the Johns Hopkins Precursors Study.

    Science.gov (United States)

    Wang, Nae-Yuh; Young, J Hunter; Meoni, Lucy A; Ford, Daniel E; Erlinger, Thomas P; Klag, Michael J

    2008-03-24

    Parental hypertension is used to classify hypertension risk in young adults, but the long-term association of parental hypertension with blood pressure (BP) change and risk of hypertension over the adult life span has not been well studied. We examined the association of parental hypertension with BP change and hypertension risk from young adulthood through the ninth decade of life in a longitudinal cohort of 1160 male former medical students with 54 years of follow-up. In mixed-effects models using 29 867 BP measurements, mean systolic and diastolic BP readings were significantly higher at baseline among participants with parental hypertension. The rate of annual increase was slightly higher for systolic (0.03 mm Hg, P= .04), but not diastolic, BP in those with parental hypertension. After adjustment for baseline systolic and diastolic BP and time-dependent covariates--body mass index, alcohol consumption, coffee drinking, physical activity, and cigarette smoking--the hazard ratio (95% confidence interval [CI]) of hypertension development was 1.5 (1.2-2.0) for men with maternal hypertension only, 1.8 (1.4-2.4) for men with paternal hypertension only, and 2.4 (1.8-3.2) for men with hypertension in both parents compared with men whose parents never developed hypertension. Early-onset (at age hypertension in both parents imparted a 6.2-fold higher adjusted risk (95% CI, 3.6-10.7) for the development of hypertension throughout adult life and a 20.0-fold higher adjusted risk (95% CI, 8.4-47.9) at the age of 35 years. Hypertension in both mothers and fathers has a strong independent association with elevated BP levels and incident hypertension over the course of adult life.

  15. Very Early Presentation of Extrahepatic Portal Vein Obstruction Causing Portal Hypertension in an Infant: Uncertainties in the Management and Therapeutic Limitations

    OpenAIRE

    Parisá Khodayar-Pardo; Andrés Peña Aldea; Ana Ramírez González; Adela Meseguer Carrascosa; Cristina Calabuig Bayo

    2016-01-01

    Extrahepatic portal vein obstruction, although rare in children, is a significant cause of portal hypertension (PHT) leading to life-threatening gastrointestinal bleeding in the pediatric age group. PHT may also lead to other complications such as hyperesplenism, cholangyopathy, ascites, and even hepatopulmonary syndrome and portopulmonary hypertension that may require organ transplantation. Herein we report the case of an asymptomatic 11-month-old infant wherein a hepatomegaly and cavernous ...

  16. Hypertension in young adults.

    Science.gov (United States)

    De Venecia, Toni; Lu, Marvin; Figueredo, Vincent M

    2016-01-01

    Hypertension remains a major societal problem affecting 76 million, or approximately one third, of US adults. While more prevalent in the older population, an increasing incidence in the younger population, including athletes, is being observed. Active individuals, like the young and athletes, are viewed as free of diseases such as hypertension. However, the increased prevalence of traditional risk factors in the young, including obesity, diabetes mellitus, and renal disease, increase the risk of developing hypertension in younger adults. Psychosocial factors may also be contributing factors to the increasing incidence of hypertension in the younger population. Increased left ventricular wall thickness and mass are increasingly found in young adults on routine echocardiograms and predict future cardiovascular events. This increasing incidence of hypertension in the young calls for early surveillance and prompt treatment to prevent future cardiac events. In this review we present the current epidemiological data, potential mechanisms, clinical implications, and treatment of hypertension in young patients and athletes.

  17. Perfil de crise hipertensiva: prevalência e apresentação clínica Hypertensive crisis profile: prevalence and clinical presentation

    Directory of Open Access Journals (Sweden)

    José Fernando Vilela Martin

    2004-08-01

    Full Text Available OBJETIVO: Avaliar a prevalência, o quadro clínico e as lesões orgânicas envolvidas em uma crise hipertensiva. MÉTODO: Estudo retrospectivo de análise de prontuários médicos de pacientes com elevação dos níveis de pressão arterial diastólica > 120 mmHg e sintomáticos, atendidos em setor de emergência de hospital universitário durante 12 meses. Urgência foi caracterizada como elevação sintomática da pressão arterial sem evidências de lesão em órgão-alvo e, emergência hipertensiva, como elevação sintomática da pressão arterial com evidências de lesão aguda ou em evolução de órgão-alvo. RESULTADOS: Incluídos 452 pacientes com crise hipertensiva, representando 0,5% de todas as emergências clínico-cirúrgicas, sendo 273 (60,4% de urgência e 179 (39,6% de emergência hipertensiva. Não conheciam ser hipertensos 18%. Tabagismo e diabetes foram fatores de risco associados ao desenvolvimento de crise hipertensiva em 1/4 e 1/5 dos pacientes, respectivamente. Pacientes com emergência apresentaram maior idade (59,6 ± 14,8 vs 49,9 ± 18,6 anos, p OBJECTIVE: To assess the prevalence of hypertensive crisis, related clinical findings, and the organic lesions involved. METHOD: This retrospective study comprised the analysis of the medical records of symptomatic patients with an elevation in diastolic blood pressure levels > 120 mmHg, who sought the emergency unit of a university-affiliated hospital over 12 months. Hypertensive urgency was characterized as the symptomatic elevation of blood pressure levels with no evidence of target-organ lesions, and hypertensive emergency was characterized as the symptomatic elevation of blood pressure levels with evidence of acute or ongoing target-organ lesion. RESULTS: This study comprised 452 patients with hypertensive crisis, accounting for 0.5% of all clinicosurgical emergencies, of which, 273 (60.4% were hypertensive urgencies and 179 (39.6% were hypertensive emergencies. Eighteen

  18. [Hypertension in women].

    Science.gov (United States)

    Tagle, Rodrigo; Tagle V, Rodrigo; Acevedo, Mónica; Valdés, Gloria

    2013-02-01

    The present review examines the types of hypertension that women may suffer throughout life, their physiopathological characteristics and management. In early life, the currently used low-dose oral contraceptives seldom cause hypertension. Pregnancy provokes preeclampsia, its main medical complication, secondary to inadequate transformation of the spiral arteries and the subsequent multisystem endothelial damage caused by deportation of placental factors and microparticles. Hypertension in preeclampsia is an epiphenomenon which needs to be controlled at levels that reduce maternal risk without impairing placental perfusion. The hemodynamic changes of pregnancy may unmask a hypertensive phenotype, may exacerbate a chronic hypertension, or may complicate hypertension secondary to lupus, renovascular lesions, and pheochromocytoma. On the other hand a primary aldosteronism may benefit from the effect of progesterone and present as a postpartum hypertension. A hypertensive pregnancy, especially preeclampsia, represents a risk for cardiac, vascular and renal disease in later life. Menopause may mimic a pheochromocytoma, and is associated to endothelial dysfunction and salt-sensitivity. Among women, non-pharmacological treatment should be forcefully advocated, except for sodium restriction during pregnancy. The blockade of the renin-angiotensin system should be avoided in women at risk of pregnancy; betablockers could be used with precautions during pregnancy; diuretics, ACE inhibitors and angiotensin receptor antagonists should not be used during breast feeding. Collateral effects of antihypertensives, such as hyponatremia, cough and edema are more common in women. Thus, hypertension in women should be managed according to the different life stages.

  19. Present situation of community-based hypertension management in our country%我国高血压病的社区管理现状

    Institute of Scientific and Technical Information of China (English)

    刘静

    2012-01-01

    高血压病是目前我国社区卫生服务重点管理的慢性疾病.社区管理被证明是有效控制高血压的最重要的途径.本文综述我国高血压病的流行状况、特点和危险因素,阐明高血压病社区管理的重要性与必要性;重点总结目前我国高血压病社区管理的主要方法.高血压病社区综合防治主要有三种管理模式,即协议管理、自我管理和家庭管理.高血压病的防治从现代预防医学的角度看就是三级预防,在社区管理中健康教育意义更突出.以社区全科医学团队合作开展的高血压规范化管理已显成效,是高血压社区管理的主要发展方向.本文也指出了我国高血压社区管理存在的问题与改进办法.%Hypertension is a common and frequently-occurring disease in our country and even in the world. It is a focus of the management of chronic diseases in China's community health service station, and community-based management of hypertension has been proven to be the most important and effective way. This paper reviews the prevalence, characteristics and risk factors of the hypertension, points out the importance and necessity of community-based management of hypertension, and sums up main methods of the community-based management of hypertension in our country. In hypertension community comprehensive prevention and control, there are three management modes: contractual management, self-management and household management. From the point of view of modem preventive medicine, the prevention and control of hypertension is the three-grade prevention. In the community management of hypertension, health education has more significance than other methods. Standardized management of hypertension carried out by general medical team has already produced results and is the main direction of community management of hypertension. Also, this paper points out the problems existing in the community management of hypertension and puts

  20. The Value of 18F-FDG PET/CT in Diagnostic Procedure of Intravascular Large B-Cell Lymphoma Presenting Fever of Unknown Origin and Pulmonary Hypertension as an Initial Manifestation.

    Science.gov (United States)

    Wu, Fengyu; Wang, Zhenguang; Xing, Xiaoming; Yu, Mingming; Shi, Bin

    2016-06-01

    A 57-year-old man presented with fever of unknown origin and pulmonary hypertension. An F-FDG PET/CT scan was performed to evaluate the source of fever, which showed diffuse, homogeneously increased FDG uptake in both lungs, which prompted the transbronchial lung biopsy. The pathological examination from biopsy specimen demonstrated intravascular large B-cell lymphoma.

  1. Sex differences in primary hypertension

    Science.gov (United States)

    2012-01-01

    Men have higher blood pressure than women through much of life regardless of race and ethnicity. This is a robust and highly conserved sex difference that it is also observed across species including dogs, rats, mice and chickens and it is found in induced, genetic and transgenic animal models of hypertension. Not only do the differences between the ovarian and testicular hormonal milieu contribute to this sexual dimorphism in blood pressure, the sex chromosomes also play a role in and of themselves. This review primarily focuses on epidemiological studies of blood pressure in men and women and experimental models of hypertension in both sexes. Gaps in current knowledge regarding what underlie male-female differences in blood pressure control are discussed. Elucidating the mechanisms underlying sex differences in hypertension may lead to the development of anti-hypertensives tailored to one's sex and ultimately to improved therapeutic strategies for treating this disease and preventing its devastating consequences. PMID:22417477

  2. PREVALENCE, CLINICAL PRESENTATION, DIAGNOSIS AND TREATMENT OF ACUTE PULMONARY OEDEMA IN SEVERE PREGNANCY-INDUCED HYPERTENSION AND ECLAMPSIA CASES IN TRIBAL POPULATION OF SOUTH RAJASTHAN

    Directory of Open Access Journals (Sweden)

    (Brig. Pradeep Kuma

    2016-05-01

    Full Text Available BACKGROUND Pulmonary oedema in severe pregnancy-induced hypertension is a life threatening complication with high maternal mortality, particularly in tribal population of South Rajasthan. METHODS Thirteen cases which occurred in the duration of two and half years were analysed through medical records and findings were recorded. RESULTS Maximum cases 10(76.92% were in less than 20 years of age. 12 (92.30% cases were nulliparous. Out of 13 cases of PIH, pulmonary oedema developed in 5 (38.46% cases of eclampsia and 8 (61.54% cases of severe pregnancy-induced hypertension. 10 (76.92%cases were 28 to 30 weeks of gestation and 3 (23.08% were 31 to 34 weeks of gestation. 8 (61.54% cases were severely anaemic. 12 (92.30% were unbooked cases. CONCLUSION Regular antenatal checkups, early diagnosis, prompt treatment of hypertension and pulmonary oedema and termination of pregnancy is required to prevent maternal death.

  3. [Clinico-statistical analysis of arterial hypertension complicated with hypertensive crisis in Moscow in 2005-2009].

    Science.gov (United States)

    Gaponova, N I; Plavunov, N F; Tereshchenko, S N; Baratashvili, V L; Abdurakhmanov, V R; Komissarenko, I A; Filippov, D V; Podkopaev, D V

    2011-01-01

    Clinicostatistical analysis of arterial hypertension complicated with hypertensive crisis using data of Moscow A.S.Puchkov Station of Urgent and Emergent Medical Aid revealed 14% rise in number of hypertensive crises during the period from 2005 to 2009. Number of hypertensive crises increased among persons of young age (18-35 years). Frequency of cerebrovascular complications of hypertensive crises was age dependent with maximal values among men aged 36-74 years and women older than 75 years.

  4. Hypertensive Crisis

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Hypertensive Crisis: When You Should Call 9-1-1 for ... 18,2017 Know the two types of HBP crisis to watch for A hypertensive ( high blood pressure ) ...

  5. Portal Hypertension

    Science.gov (United States)

    ... Obesity to Liver Cancer Additional Content Medical News Portal Hypertension By Steven K. Herrine, MD, Thomas Jefferson ... Liver Hepatic Encephalopathy Jaundice in Adults Liver Failure Portal Hypertension (See also Overview of Liver Disease .) Portal ...

  6. Tom Pickering as a clinical scientist: masked hypertension.

    Science.gov (United States)

    Eguchi, Kazuo

    2010-04-01

    Masked hypertension has been 'unmasked' by the use of the out-of-office measurement of blood pressure, as home BP monitoring or ambulatory blood pressure monitoring has become available. The term masked hypertension could be used more widely than the original version of masked hypertension; morning hypertension, stress-induced hypertension, and nocturnal hypertension are all classified as subtypes of masked hypertension. Masked hypertension can also be seen in patients with diabetes, that could change clinical practice in diabetes. Masked hypertension is associated with cardiovascular events, but most of the outcome studies are on antihypertensive medications. Therefore, masked hypertension includes insufficient treatment of hypertension. In Dr Pickering's latest review of masked hypertension, prehypertension or high normal blood pressure was stressed as an associating factor with masked hypertension. The biggest theme in the field of hypertension is how we can detect masked hypertension. I present two interesting cases of possible masked hypertension in this commentary.

  7. METOPROLOL VERSUS THIAZIDE DIURETICS IN HYPERTENSION - MORBIDITY RESULTS FROM THE MAPHY STUDY

    NARCIS (Netherlands)

    WIKSTRAND, J; WARNOLD, [No Value; TUOMILEHTO, J; OLSSON, G; BARBER, HJ; ELIASSON, K; ELMFELDT, D; JASTRUP, B; KARATZAS, NB; LEER, J; MARCHETTA, F; RAGNARSSON, J; ROBITAILLE, NM; VALKOVA, L; WESSELING, H; BERGLUND, G

    1991-01-01

    The present study in hypertensive men (40-64 years old) with untreated diastolic blood pressure above 100 mm Hg was aimed at investigating whether metoprolol (n = 1,609) given as initial treatment would lower the risk for coronary events (sudden death and myocardial infarction) more effectively than

  8. [Cardiovascular complications of hypertensive crisis].

    Science.gov (United States)

    Rosas-Peralta, Martín; Borrayo-Sánchez, Gabriela; Madrid-Miller, Alejandra; Ramírez-Arias, Erick; Pérez-Rodríguez, Gilberto

    2016-01-01

    It is inexorable that a proportion of patients with systemic arterial hypertension will develop a hypertensive crisis at some point in their lives. The hypertensive crises can be divided in hypertensive patients with emergency or hypertensive emergency, according to the presence or absence of acute end-organ damage. In this review, we discuss the cardiovascular hypertensive emergencies, including acute coronary syndrome, congestive heart failure, aortic dissection and sympathomimetic hypertensive crises (those caused by cocaine use included). Each is presented in a unique way, although some patients with hypertensive emergency report non-specific symptoms. Treatment includes multiple medications for quick and effective action with security to reduce blood pressure, protect the function of organs remaining, relieve symptoms, minimize the risk of complications and improve patient outcomes.

  9. Men's Educational Group Appointments in Rural Nicaragua.

    Science.gov (United States)

    Campbell, Bruce B; Gonzalez, Hugo; Campbell, McKenzie; Campbell, Kent

    2017-03-01

    Men's preventive health and wellness is largely neglected in rural Nicaragua, where a machismo culture prevents men from seeking health care. To address this issue, a men's educational group appointment model was initiated at a rural health post to increase awareness about hypertension, and to train community health leaders to measure blood pressure. Men's hypertension workshops were conducted with patient knowledge pretesting, didactic teaching, and posttesting. Pretesting and posttesting performances were recorded, blood pressures were screened, and community leaders were trained to perform sphygmomanometry. An increase in hypertension-related knowledge was observed after every workshop and community health leaders demonstrated proficiency in sphygmomanometry. In addition, several at-risk patients were identified and follow-up care arranged. Men's educational group appointments, shown to be effective in the United States in increasing patient knowledge and satisfaction, appear to function similarly in a resource-constrained environment and may be an effective mechanism for reaching underserved men in Nicaragua.

  10. Socio-Economic Differences in the Association between Self-Reported and Clinically Present Diabetes and Hypertension: Secondary Analysis of a Population-Based Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Gerald Tompkins

    Full Text Available Diabetes and hypertension are key risk factors for coronary heart disease. Prevalence of both conditions is socio-economically patterned. Awareness of presence of the conditions may influence risk behaviour and use of preventative services. Our aim was to examine whether there were socio-economic differences in awareness of hypertension and diabetes in a UK population.Data from the Scottish Health Survey was used to compare self-reported awareness of hypertension and diabetes amongst those found on examination to have these conditions, by socioeconomic position (SEP (measured by occupation, education and income. Odds ratios of self-reported awareness against presence, and the sensitivity, specificity and predictive value of self-reporting as a measure of the presence of the condition, were calculated.Presence and self-reported awareness of both conditions increased as SEP decreased, on most measures. There was only one significant difference in awareness by SEP once other factors had been taken into account. Sensitivity showed that those in the most disadvantaged groups were most likely to self-report awareness of their hypertension, and specificity showed that those in the least disadvantaged groups were most likely to self-report awareness of its absence. There were few differences of note for diabetes.We found no consistent pattern in the associations between SEP and the presence and self-reported awareness of hypertension and diabetes amongst those with these conditions. Without evidence of differences, it is important that universal approaches continue to be applied to the identification and management of those at risk of these and other conditions that underpin cardiovascular disease.

  11. Detection of testicular cancer in men presenting with infertility Detecção de câncer de testículo em homens com infertilidade

    Directory of Open Access Journals (Sweden)

    Fabio Firmbach Pasqualotto

    2003-01-01

    Full Text Available PURPOSE: Infertility is one of the less common presenting features associated with testicular tumors. We evaluated the histologic and biochemical findings, and pregnancy outcome in patients presenting with infertility who were found to have testicular tumors. METHODS: Seven patients with infertility were found to have testicular cancer over a 15-year period. All patients had a testicular ultrasound evaluation. The indications for the ultrasound were testicular pain in 2 patients, suspicious palpable mass in 4, and to rule out the presence of germ cell neoplasia in a patient with carcinoma in situ detected on a previous biopsy. Physical exam, histological findings, hormonal levels, tumor markers, and pregnancy outcome results were recorded from the patients medical charts. RESULTS: Two men had elevated serum follicle stimulant hormone and luteinizing hormone levels, 1 of them had an abnormally low serum testosterone level. Tumor markers were normal in all patients. In 4 patients the tumor was on the right side and in 3 on the left. The histological diagnoses were seminoma (n = 5, Leydig cell tumor (n = 1, and carcinoma in situ (n = 1. Of the 7 patients, 5 underwent adjuvant radiation therapy. Two patients had sperm cryopreserved. Follow up on fertility status was available in 6 cases. One patient has established a pregnancy and 5 did not achieve a pregnancy after treatment for their cancer. CONCLUSIONS: Most of the men who have testicular cancer and male infertility have a seminona. Therefore, men who present with infertility should be thoroughly investigated to rule out such serious, concomitant diseases along with their infertility.PROPÓSITO: Infertilidade é um dos padrões incomuns associados com tumores de testículo. Nós avaliamos os achados histológicos, bioquímicos, e gravidez em pacientes com infertilidade nos quais foram detectados tumores de testículo. MÉTODOS: Sete pacientes com infertilidade nos quais câncer de testículo foi

  12. Hypertension in the Elderly

    Directory of Open Access Journals (Sweden)

    Blas Gil-Extremera

    2012-01-01

    Full Text Available Background. The incidence of hypertension in the Western countries is continuously increasing in the elderly population and remains the leading cause of cardiovascular and morbidity. Methods. we analysed some significant clinical trials in order to present the relevant findings on those hypertensive population. Results. Several studies (SYST-EUR, HYVET, CONVINCE, VALUE, etc. have demonstrated the benefits of treatment (nitrendipine, hydrochrotiazyde, perindopril, indapamide, verapamil, or valsartan in aged hypertensive patients not only concerning blood pressure values but also the other important risk factors. Conclusion. Hypertension is the most prevalent cardiovascular disorder in the Western countries, and the relevance of receiving pharmacological treatment of hypertension in aged patients is crucial; in addition, the results suggest that combination therapy—nitrendipine plus enalapril—could have more benefits than those observed with the use of nitrendipine alone.

  13. Metabolic Syndrome, Androgens, and Hypertension

    OpenAIRE

    Moulana, Mohadetheh; Lima, Roberta; Reckelhoff, Jane F.

    2011-01-01

    Obesity is one of the constellation of factors that make up the definition of the metabolic syndrome. Metabolic syndrome is also associated with insulin resistance, dyslipidemia, hypertriglyceridemia, and type 2 diabetes mellitus. The presence of obesity and metabolic syndrome in men and women is also associated with increased risk of cardiovascular disease and hypertension. In men, obesity and metabolic syndrome are associated with reductions in testosterone levels. In women, obesity and met...

  14. Trend, projection, and appropriate body mass index cut-off point for diabetes and hypertension in Bangladesh.

    Science.gov (United States)

    Rahman, Md Mizanur; Akter, Shamima; Jung, Jenny; Rahman, Md Shafiur; Sultana, Papia

    2017-04-01

    Rapid increasing of high body mass index (BMI) is a global health concern. Population with high BMI predicts an increased risk of diabetes and hypertension. The objective of the present study is to estimate the trend and prediction of diabetes and hypertension in Bangladesh, to examine the association of BMI with risk of diabetes and hypertension, and to ascertain an appropriate BMI cut-off point for screening diabetes. We searched PubMed from inception to August 2016 and identified studies reporting diabetes and hypertension prevalence in Bangladesh. Bangladesh Demographic and Health Survey 2011 data was also included in this study. Bayesian model was used to estimate trend and projection in diabetes and hypertension prevalence by sex and residence. Receiver operating characteristic curves was used to determine the optimal BMI cut-off point for screening diabetes. Of 535 articles reviewed, 35 studies reported prevalence of diabetes and hypertension. Prevalence of diabetes (95% credible interval) increased between 1992 and 2015 from 3.2% (2.2-4.3) to 12.1% (9.1-15.4) in men, and from 2.5% (1.8-3.5) to 13.4% (9.7-17.6) in women. Diabetes prevalence in 2030 is expected to reach 23.6% (13.6-36.3) for men and 33.5% (19.9-50.9) for women. Hypertension prevalence increased between 1992 and 2015 from 11.0% (8.6-13.7) to 20.4% (18.4-22.4%) in 2015 in men, and from 14.0% (10.3-19.0) to 21.3% (19.0-23.6) in women. Annual average rate of change for diabetes prevalence was higher among women and in rural areas, while for hypertension prevalence it was higher in men and urban areas. Adults with BMI of 22.5kg/m(2) or above had a higher risk of diabetes and hypertension in this study. The optimal BMI cut-off point for screening diabetes was 23kg/m(2) for overall population, 22kg/m(2) for men, and 23kg/m(2) for women. Diabetes is more prevalent among women and rural population groups, while hypertension is more prevalent among men and urban population groups in Bangladesh. A BMI

  15. Evaluation of hypertension in children.

    Science.gov (United States)

    Kapur, Gaurav; Baracco, Rossana

    2013-10-01

    Hypertension is an important public health problem, and increasingly children are being diagnosed with primary hypertension. As the list of secondary causes of hypertension is extensive, pediatric practitioners increasingly need to decide on investigations needed for evaluating children presenting with high blood pressure. The differentiation between primary and secondary hypertension is paramount to understanding this important health issue, since many forms of secondary hypertension require specific treatment. The review evaluates the current available guidelines and practice patterns for evaluating children with elevated blood pressure. The review also aims to provide a framework for cost-effective evaluation strategies for children with elevated blood pressure based on current recommendations and evidence.

  16. Men's Health

    Science.gov (United States)

    ... men need to pay more attention to their health. Compared to women, men are more likely to ... regular checkups and medical care There are also health conditions that only affect men, such as prostate ...

  17. Dietary patterns and their association with hypertension among Pakistani urban adults.

    Science.gov (United States)

    Safdar, Nilofer F; Bertone-Johnson, Elizabeth R; Cordeiro, Lorraine; Jafar, Tazeen H; Cohen, Nancy L

    2015-01-01

    Hypertension is one of the most common chronic diseases affecting more than 25% of adults worldwide. In Pakistan, 33% of the adult population suffers from hypertension. Numerous epidemiological studies have demonstrated the critical role of dietary patterns in the causation, prevention and management of hypertension. There's a dearth of evidence from South Asia in this regard. The present study aimed to identify the association between dietary patterns and hypertension among 4304 low income urban adults who participated in the Control of Blood Pressure and Risk Attenuation (COBRA) study in Karachi, Pakistan. Dietary information was collected by a 33- item food frequency questionnaire and 3 unique dietary patterns namely; fat and sweet, fruit and vegetable, and seafood and yogurt patterns were derived using principal component factor analyses. We used univariate and multivariable logistic regression to examine the association between dietary patterns and hypertension. Men were more likely to have hypertension, while increase in age, and body mass index were also associated with hypertension (phypertension, whereas no significant associations were seen for other two dietary patterns. These findings suggest that certain dietary patterns may be associated with hypertension among Pakistani low income urban adults.

  18. Trends and determinant factors in hypertension control in a population study with 25 years of follow-up

    DEFF Research Database (Denmark)

    Andersen, Ulla O; Jensen, Gorm B

    2010-01-01

    as compared with younger hypertensive patients. Obesity was associated with a high threshold SBP. The fourth factor was diagnosis. Patients with myocardial infarction were better treated in last surveys than patients from other diagnosis groups. Treated DBP was stable. CONCLUSION: Hypertension treatment...... efficacy is improving but still far from acceptable. The evaluation of determinant factors identified four areas that need special attention: men, elderly and obese hypertensive patients. The fourth factor is diagnosis. The results may indicate a beneficial effect of systematic control of hypertensive......OBJECTIVE: The present study focused on trend in hypertension control and on determinant factors that may influence efficacy in antihypertensive therapy. Two measures of treatment efficacy were used: population blood pressure and the relative frequency of effectively treated patients (blood...

  19. Hypertension in pregnancy.

    Science.gov (United States)

    Solomon, Caren G; Seely, Ellen W

    2011-12-01

    Hypertension is a common complication of pregnancy. Preeclampsia, in particular, is associated with substantial risk to both the mother and the fetus. Several risk factors have been recognized to predict risk for preeclampsia. However, at present no biomarkers have sufficient discriminatory ability to be useful in clinical practice, and no effective preventive strategies have yet been identified. Commonly used medications for the treatment of hypertension in pregnancy include methyldopa and labetalol. Blood pressure thresholds for initiating antihypertensive therapy are higher than outside of pregnancy. Women with prior preeclampsia are at increased risk of hypertension, cardiovascular disease, and renal disease.

  20. Prevalence of hypertension in indigenous inhabitants of traditional communities from the north of Mexico.

    Science.gov (United States)

    Guerrero-Romero, F; Rodríguez-Morán, M; Sandoval-Herrrera, F; Alvarado-Ruiz, R

    2000-09-01

    The purpose of this study was to estimate the prevalence and risk factors of hypertension in adults indigenous to their traditional communities from the north of Mexico. The study was based on a cross- sectional survey of inhabitants from Mexicaneros, Huicholes and Tepehuanos communities, which have not been influenced by a western lifestyle. A home interview and clinical examination that included blood pressure and anthropometric measurements of 217 men and 598 non-pregnant women aged between 35 to 64 years was carried out. Eligible indigenous subjects must have had no migratory history to partially or totally urbanised areas. Target population represented approximately 100% of the indigenous people who have spent all their life time in the community of birthplace. Age and body mass index average was 48.9+/-12.9 years and 25.6+/-5.1 kg/m2. Hypertension was identified in 56 individuals, 45 women and 11 men (prevalence 6.87%, 95% confidence interval (CI) 5.1-8.6). Forty-one percent of the hypertensive subjects were aware of being hypertensive. Hypertensive subjects had a higher intake of saturated fats than non-hypertensives. Salt consumption was lower than 6 g per day in subjects with and without hypertension. High intake of saturated fats (odds ratio 6.4, 95% CI 2.1-12.3; Phypertension. This study presents, for the first time, data concerning hypertension in adults who are indigenous to and living in traditional communities from Mexico. Prevalence of hypertension was lower than in the partly urbanised rural communities with a westernised lifestyle and the urban areas of Mexico.

  1. Hypertension: physiology and pathophysiology.

    Science.gov (United States)

    Hall, John E; Granger, Joey P; do Carmo, Jussara M; da Silva, Alexandre A; Dubinion, John; George, Eric; Hamza, Shereen; Speed, Joshua; Hall, Michael E

    2012-10-01

    Despite major advances in understanding the pathophysiology of hypertension and availability of effective and safe antihypertensive drugs, suboptimal blood pressure (BP) control is still the most important risk factor for cardiovascular mortality and is globally responsible for more than 7 million deaths annually. Short-term and long-term BP regulation involve the integrated actions of multiple cardiovascular, renal, neural, endocrine, and local tissue control systems. Clinical and experimental observations strongly support a central role for the kidneys in the long-term regulation of BP, and abnormal renal-pressure natriuresis is present in all forms of chronic hypertension. Impaired renal-pressure natriuresis and chronic hypertension can be caused by intrarenal or extrarenal factors that reduce glomerular filtration rate or increase renal tubular reabsorption of salt and water; these factors include excessive activation of the renin-angiotensin-aldosterone and sympathetic nervous systems, increased formation of reactive oxygen species, endothelin, and inflammatory cytokines, or decreased synthesis of nitric oxide and various natriuretic factors. In human primary (essential) hypertension, the precise causes of impaired renal function are not completely understood, although excessive weight gain and dietary factors appear to play a major role since hypertension is rare in nonobese hunter-gathers living in nonindustrialized societies. Recent advances in genetics offer opportunities to discover gene-environment interactions that may also contribute to hypertension, although success thus far has been limited mainly to identification of rare monogenic forms of hypertension. © 2012 American Physiological Society

  2. Association between fried food consumption and hypertension in Korean adults.

    Science.gov (United States)

    Kang, Yunjin; Kim, Jihye

    2016-01-14

    The present study explored the relationships between fried food consumption and metabolic risk factors and hypertension in Korean adults. The study was based on the fifth Korean National Health and Nutrition Examination Survey between 2010 and 2011. A total of 9221 Korean adults aged ≥19 years were studied. Fried food consumption was assessed using a validated FFQ. Metabolic risk factors such as waist circumference, fasting plasma glucose (FPG), TAG, HDL-cholesterol and systolic and diastolic blood pressure (SBP and DBP) were measured. Hypertension was defined as SBP≥140 mmHg, DBP≥90 mmHg or current use of antihypertensive medication. Adjusted OR for elevated blood pressure significantly increased in men (OR 1·62; 95% CI 1·11, 2·37; P(trend)=0·0447) and women (OR 2·20; 95% CI 1·21, 4·00; P(trend)=0·0403) with a greater than twice a week consumption of fried food compared with those who rarely consumed fried food. However, fried food consumption was not associated with other metabolic risk factors (abdominal obesity, high FPG, hypertriacylglycerolaemia, low HDL-cholesterol and the metabolic syndrome). The adjusted OR for hypertension increased by 2·4-fold in women (OR 2·37; 95% CI 1·19, 4·72; P(trend)=0·0272) with a greater than twice a week fried food consumption compared with those who rarely consumed it. No significant association was found between fried food consumption and hypertension in men. This study suggests that frequent fried food consumption is associated with hypertension in Korean women. Further studies are needed to investigate the effect of different types of fried foods on hypertension.

  3. Midterm results of diagnostic treatment and repair strategy in older patients presenting with nonrestrictive ventricular septal defect and severe pulmonary artery hypertension

    Institute of Scientific and Technical Information of China (English)

    Liu Aijun; Li Zhiqiang; Li Xiaofeng; Fan Xiangming; Su Junwu; Zhang Jing; He Yan

    2014-01-01

    Background Congenital heart disease with severe pulmonary arterial hypertension (SPAH),previously thought to have irreversible pulmonary vascular disease (PVD),has been recently successfully corrected using diagnostic treatment and repair strategy by our surgery team.This study aimed to evaluate the midterm results of a selected cohort of older patients with nonrestrictive ventricular septal defect (VSD) and SPAH using diagnostic treatment and repair strategy.Methods The records of 56 patients older than six years with nonrestrictive VSD and SPAH undergoing diagnostic treatment and repair strategy from 2006 to 2012 were retrospectively reviewed.All patients received advanced pulmonary arterial hypertension (PAH) therapy and radical repairs were performed when transcutaneous oxygen saturation (SPO2) increased up to 93%.Results There were no operative deaths.SPO2 and baseline six-minute walk test (SMWT) distance of all selected patients increased significantly and mean pulmonary artery pressure (MPAP) regressed significantly after diagnostic treatment and at late follow-up (P <0.01).The incidence of late postoperative PAH was seen in six (10.7%) patients and by Logistic regression analysis,early postoperative PAH was an independent risk factor related to late postoperative PAH.Conclusions Diagnostic treatment and repair strategy was effective and safe for treatment of nonrestrictive VSD and SPAH and the midterm results were excellent.Diagnostic treatment strategy was effective in assessing the reversibility of SPAH in older patients associated with nonrestrictive VSD and the PVD in these selective patients is generally reversible.

  4. Very Early Presentation of Extrahepatic Portal Vein Obstruction Causing Portal Hypertension in an Infant: Uncertainties in the Management and Therapeutic Limitations.

    Science.gov (United States)

    Khodayar-Pardo, Parisá; Peña Aldea, Andrés; Ramírez González, Ana; Meseguer Carrascosa, Adela; Calabuig Bayo, Cristina

    2016-01-01

    Extrahepatic portal vein obstruction, although rare in children, is a significant cause of portal hypertension (PHT) leading to life-threatening gastrointestinal bleeding in the pediatric age group. PHT may also lead to other complications such as hyperesplenism, cholangyopathy, ascites, and even hepatopulmonary syndrome and portopulmonary hypertension that may require organ transplantation. Herein we report the case of an asymptomatic 11-month-old infant wherein a hepatomegaly and cavernous transformation of the portal vein was detected by liver ultrasound. Neither signs of thrombosis in arteriovenous system, nor affectation of biliary tract were identified in the magnetic resonance imaging study. A significant enlargement of the caudate lobe of the liver was reported. No risk factors were detected. The differential diagnosis performed was extensive. Inherited thrombophilia and storage disorders were especially considered. Liver biopsy was normal. Upper gastrointestinal esophagogastroduodenoscopy detected two small varicose cords on the distal third of the esophagus. Finding a cavernous transformation of the portal vein with evidence of collateral circulation in such an early age is a challenging condition for professionals, since PHT may lead to severe complications during childhood and can compromise growth and development. Evidence-based guidelines for the management of PHT in adults have been published. However, follow-up and treatment of pediatric patients have not yet been standardized. Moreover, management of PHT in infants faces particular difficulties such as technical restrictions that could hinder their treatment.

  5. Very Early Presentation of Extrahepatic Portal Vein Obstruction Causing Portal Hypertension in an Infant: Uncertainties in the Management and Therapeutic Limitations

    Directory of Open Access Journals (Sweden)

    Parisá Khodayar-Pardo

    2016-07-01

    Full Text Available Extrahepatic portal vein obstruction, although rare in children, is a significant cause of portal hypertension (PHT leading to life-threatening gastrointestinal bleeding in the pediatric age group. PHT may also lead to other complications such as hyperesplenism, cholangyopathy, ascites, and even hepatopulmonary syndrome and portopulmonary hypertension that may require organ transplantation. Herein we report the case of an asymptomatic 11-month-old infant wherein a hepatomegaly and cavernous transformation of the portal vein was detected by liver ultrasound. Neither signs of thrombosis in arteriovenous system, nor affectation of biliary tract were identified in the magnetic resonance imaging study. A significant enlargement of the caudate lobe of the liver was reported. No risk factors were detected. The differential diagnosis performed was extensive. Inherited thrombophilia and storage disorders were especially considered. Liver biopsy was normal. Upper gastrointestinal esophagogastroduodenoscopy detected two small varicose cords on the distal third of the esophagus. Finding a cavernous transformation of the portal vein with evidence of collateral circulation in such an early age is a challenging condition for professionals, since PHT may lead to severe complications during childhood and can compromise growth and development. Evidence-based guidelines for the management of PHT in adults have been published. However, follow-up and treatment of pediatric patients have not yet been standardized. Moreover, management of PHT in infants faces particular difficulties such as technical restrictions that could hinder their treatment.

  6. Very Early Presentation of Extrahepatic Portal Vein Obstruction Causing Portal Hypertension in an Infant: Uncertainties in the Management and Therapeutic Limitations

    Science.gov (United States)

    Khodayar-Pardo, Parisá; Peña Aldea, Andrés; Ramírez González, Ana; Meseguer Carrascosa, Adela; Calabuig Bayo, Cristina

    2016-01-01

    Extrahepatic portal vein obstruction, although rare in children, is a significant cause of portal hypertension (PHT) leading to life-threatening gastrointestinal bleeding in the pediatric age group. PHT may also lead to other complications such as hyperesplenism, cholangyopathy, ascites, and even hepatopulmonary syndrome and portopulmonary hypertension that may require organ transplantation. Herein we report the case of an asymptomatic 11-month-old infant wherein a hepatomegaly and cavernous transformation of the portal vein was detected by liver ultrasound. Neither signs of thrombosis in arteriovenous system, nor affectation of biliary tract were identified in the magnetic resonance imaging study. A significant enlargement of the caudate lobe of the liver was reported. No risk factors were detected. The differential diagnosis performed was extensive. Inherited thrombophilia and storage disorders were especially considered. Liver biopsy was normal. Upper gastrointestinal esophagogastroduodenoscopy detected two small varicose cords on the distal third of the esophagus. Finding a cavernous transformation of the portal vein with evidence of collateral circulation in such an early age is a challenging condition for professionals, since PHT may lead to severe complications during childhood and can compromise growth and development. Evidence-based guidelines for the management of PHT in adults have been published. However, follow-up and treatment of pediatric patients have not yet been standardized. Moreover, management of PHT in infants faces particular difficulties such as technical restrictions that could hinder their treatment. PMID:27504083

  7. Classification-based data mining for identification of risk patterns associated with hypertension in Middle Eastern population: A 12-year longitudinal study.

    Science.gov (United States)

    Ramezankhani, Azra; Kabir, Ali; Pournik, Omid; Azizi, Fereidoun; Hadaegh, Farzad

    2016-08-01

    Hypertension is a critical public health concern worldwide. Identification of risk factors using traditional multivariable models has been a field of active research. The present study was undertaken to identify risk patterns associated with hypertension incidence using data mining methods in a cohort of Iranian adult population.Data on 6205 participants (44% men) age > 20 years, free from hypertension at baseline with no history of cardiovascular disease, were used to develop a series of prediction models by 3 types of decision tree (DT) algorithms. The performances of all classifiers were evaluated on the testing data set.The Quick Unbiased Efficient Statistical Tree algorithm among men and women and Classification and Regression Tree among the total population had the best performance. The C-statistic and sensitivity for the prediction models were (0.70 and 71%) in men, (0.79 and 71%) in women, and (0.78 and 72%) in total population, respectively. In DT models, systolic blood pressure (SBP), diastolic blood pressure, age, and waist circumference significantly contributed to the risk of incident hypertension in both genders and total population, wrist circumference and 2-h postchallenge plasma glucose among women and fasting plasma glucose among men. In men, the highest hypertension risk was seen in those with SBP > 115 mm Hg and age > 30 years. In women those with SBP > 114 mm Hg and age > 33 years had the highest risk for hypertension. For the total population, higher risk was observed in those with SBP > 114 mm Hg and age > 38 years.Our study emphasizes the utility of DTs for prediction of hypertension and exploring interaction between predictors. DT models used the easily available variables to identify homogeneous subgroups with different risk pattern for the hypertension.

  8. PRESENTED AT TRIANGLE CONSORTIUM FOR REPRODUCTIVE BIOLOGY MEETING IN CHAPEL HILL, NC ON 2/11/2006: SPERM COUNT DISTRIBUTIONS IN FERTILE MEN

    Science.gov (United States)

    Sperm concentration and count are often used as indicators of environmental impacts on male reproductive health. Existing clinical databases may be biased towards sub-fertile men with low sperm counts and less is known about expected sperm count distributions in cohorts of ferti...

  9. Prevalence and correlates of left atrial enlargement in essential hypertension: role of ventricular geometry and the metabolic syndrome: the Evaluation of Target Organ Damage in Hypertension study.

    Science.gov (United States)

    Cuspidi, Cesare; Meani, Stefano; Fusi, Veronica; Valerio, Cristiana; Catini, Eleonora; Sala, Carla; Sampieri, Lorena; Magrini, Fabio; Zanchetti, Alberto

    2005-04-01

    The cardiac effects of hypertension include a variety of structural changes such as increases in left ventricular mass (LVM) and left atrium (LA) size. Although data on hypertension-induced left ventricular changes are extensive, relatively little information is available on LA size from large-scale studies. We sought to assess the prevalence of LA enlargement in a large selected hypertensive population and to determine the relations of LA size to several biologic variables including left ventricular hypertrophy (LVH) and metabolic disturbances. A total of 2500 untreated and treated uncomplicated essential hypertensives consecutively attending, for the first time, our hospital out-patient hypertension clinic and included in the Evaluation of Target Organ Damage in Hypertension, an observational ongoing registry of hypertension-related target organ damage (TOD), were considered for this analysis. All patients underwent extensive clinical, laboratory and ultrasonographic investigations searching for cardiac (and extracardiac) TOD. The LA was considered enlarged when its anteroposterior diameter exceeded 3.7 cm in women and 4.1 cm in men. LVH was defined according to two different criteria: >/= 125 g/m in men and >/= 110 g/m in women; or >/= 51 g/m in men and >/=47 g/m in women. Enlarged LA diameter was present in 24.5% of women and in 21.5% of men. Compared with 1925 patients with normal LA size, the 575 patients with enlarged LA were older, more frequently overweight, had higher systolic blood pressure and included a greater proportion of subjects under antihypertensive treatment, with diabetes and metabolic syndrome. Both LA size and prevalence of LA enlargement differed significantly in relation to left ventricular geometry and LVM, being greater in patients with concentric or eccentric LVH than in those with left ventricular concentric remodeling or normal geometry. The prevalence of LA enlargement was similar in patients with concentric and eccentric LVH

  10. Effects of parental hypertension on longitudinal trends in blood pressure and plasma metabolic profile: mixed-effects model analysis.

    Science.gov (United States)

    Mitsumata, Kaneto; Saitoh, Shigeyuki; Ohnishi, Hirofumi; Akasaka, Hiroshi; Miura, Tetsuji

    2012-11-01

    The mechanism underlying the association of parental hypertension with cardiovascular events in offspring remains unclear. In this study, the effects of parental hypertension on longitudinal trends of blood pressure and metabolic parameters were examined by mixed-effects model analysis. From 1977 to 2006, 5198 subjects participated in the Tanno-Sobetsu Study, and we selected 2607 subjects (1095 men and 1512 women) for whom data on parental history of hypertension were available. In both men and women with and without parental hypertension, systolic blood pressure and fasting blood glucose levels consistently increased from the third to eighth decades of life, whereas diastolic blood pressure and serum triglyceride levels followed biphasic (inverted U shape) time courses during that period. However, the relationships between the parameters and age were significantly shifted upward (by ≈5.3 mm Hg in systolic blood pressure, 2.8 mm Hg in diastolic blood pressure, 0.30 mmol/L in blood glucose, and 0.09 mmol/L in triglyceride) in the group with parental hypertension compared with those in the group without parental hypertension. Both paternal and maternal histories of hypertension were determinants of systolic blood pressure and diastolic blood pressure, and there was no significant interaction between the sides of parental history. There were no significant effects of parental hypertension on age-dependent or body mass index-dependent changes in serum low-density lipoprotein cholesterol or high-density lipoprotein cholesterol level. The present results indicate that parental hypertension has an age-independent impact on elevation of blood pressure, plasma glucose, and triglyceride levels, which may underlie the reported increase in cardiovascular events by family history of hypertension.

  11. TRAJECTORIES OF DEPRESSIVE EPISODES AND HYPERTENSION OVER 24 YEARS: THE WHITEHALL II PROSPECTIVE COHORT STUDY

    Science.gov (United States)

    Nabi, Hermann; Chastang, Jean-François; Lefèvre, Thomas; Dugravot, Aline; Melchior, Maria; Marmot, Michael G.; Shipley, Martin J.; Kivimäki, Mika; Singh-Manoux, Archana

    2011-01-01

    Prospective data on depressive symptoms and blood pressure (BP) are scarce, and the impact of age on this association is poorly understood. The present study examines longitudinal trajectories of depressive episodes and the probability of hypertension associated with these trajectories over time. Participants were 6,889 men and 3,413 women London based civil servants, aged 35–55 years at baseline, followed for 24 years between 1985 and 2009. Depressive episode (defined as scoring 4 or more on the General Health Questionnaire-Depression subscale or using prescribed antidepressant medication) and hypertension (systolic/diastolic blood pressure ≥ 140/90 mm Hg or use of antihypertensive medication) were assessed concurrently at five medical examinations. In the fully adjusted longitudinal logistic regression analyses based on Generalized-Estimating-Equations using age as the time scale, participants in the “increasing depression” group had a 24% (p<0.05) lower risk of hypertension at ages 35–39, compared to those in the “low/transient depression” group. However, there was a faster age-related increase in hypertension in the “increasing depression” group, corresponding to a 7% (p<0.01) greater increase in the odds of hypertension for every each five-year increase in age. A higher risk of hypertension in the first group of participants was not evident before age 55. A similar pattern of association was observed in men and women although it was stronger in men. This study suggests that the risk of hypertension increases with repeated experience of depressive episodes over time and becomes evident in later adulthood. PMID:21339474

  12. Self-reported knowledge and awareness about blood pressure and hypertension: a cross-sectional study of a random sample of men and women aged 60–74 years

    Directory of Open Access Journals (Sweden)

    Qvist I

    2014-02-01

    Full Text Available Ina Qvist,1 Marie D Thomsen,2 Jes S Lindholt,2,3 Hans Ibsen,4 Jeroen ML Hendriks,5 Lars Frost1 1Department of Medicine, Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark; 2Department of Vascular Surgery, Viborg Regional Hospital and Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark; 3Centre of Individualized Medicine in Arterial Diseases, Department of Cardiothoracic and Vascular Department T, Odense University Hospital, Odense, Denmark; 4Department of Medicine, Holbæk Hospital, Holbæk, Denmark; 5Department of Cardiology, Maastricht University Medical Centre, Maastricht, the Netherlands Background: In general, it is assumed that patient education, by increasing knowledge, may change behavior and lifestyle and promote health. In this context, it is a surprise that knowledge and awareness about blood pressure and hypertension among elderly people is poor. We hypothesized that knowledge about blood pressure and hypertension would be better among individuals with self-reported hypertension compared with subjects without self-reported hypertension. Methods: We mailed a questionnaire to a random sample of 1,000 subjects living in the municipality of Silkeborg, Denmark. The study sample was drawn from the Central Person Registry. Results: The response rate was 72%. Of these, 43% of responders had self-reported hypertension. The people with self-reported hypertension were older, less educated, had higher self-reported blood cholesterol levels, had higher body weight, and more often had a family history of hypertension. More than 80% reported that overweight and obesity increases blood pressure. More than 60% reported that untreated hypertension may cause heart disease or stroke. More than half of the responders did not know their blood pressure, and only 21% knew that hypertension can occur without symptoms. Knowledge about hypertension was

  13. Serum specific vasopressin-degrading activity is related to blood total cholesterol levels in men but not in women.

    Science.gov (United States)

    Ramírez-Expósito, María Jesús; Arrazola, Marcelina; Carrera-González, María Pilar; Arias de Saavedra, José Manuel; Sánchez-Agesta, Rafael; Mayas, María Dolores; Martínez-Martos, José Manuel

    2012-07-01

    The role of vasopressin (AVP) in the pathophysiology of cardiovascular disease is controversial, but this peptide hormone is elevated in heart failure and some forms of hypertension. Also, AVP has vasoconstrictor, mitogenic, hyperplasic and renal fluid retaining properties which, by analogy with angiotensin II, may have deleterious effects when present in chronic excess. Furthermore, cholesterol blood levels are also associated with hypertension, although the underlying mechanism is not known. Here we analyze the relationship between blood total cholesterol levels and serum vasopressin- degrading cystyl-aminopeptidase activity (AVP-DA) in healthy humans, and the differences between men and women. Linear correlation coefficients were calculated to test relationships between AVP-DA and blood total cholesterol levels. Sex differences were observed for AVP-DA, being this activity higher in men than in women. According to the linear model of the regression analysis, AVP-DA showed a significant negative correlation with blood total cholesterol levels in men, whereas no correlation was observed in women. Several studies in humans demonstrate the existence of greater plasma AVP concentrations in normal men compared to normal women, which could explain the gender-differences observed in the present work in relation with AVP-DA. However, AVP-DA is related to blood cholesterol levels only in men, although in our hands, women showed higher blood cholesterol levels than men. This could indicate that the risk of high cholesterol-related hypertension is more probable in men than in women. Although AVP-DA misregulation could be involved in the pathogenesis of hypertension, its relation with cholesterol levels appears only in men, but not in women.

  14. [Scientific statement] Report of the Salt Reduction Committee of the Japanese Society of Hypertension(2) Goal and strategies of dietary salt reduction in the management of hypertension.

    Science.gov (United States)

    Miura, Katsuyuki; Ando, Katsuyuki; Tsuchihashi, Takuya; Yoshita, Katsushi; Watanabe, Yoshihiko; Kawarazaki, Hiroo; Matsuura, Hideo; Kusaka, Miho; Kai, Hisashi; Kawamura, Minoru; Kawano, Yuhei

    2013-12-01

    In this section of the Report of the Salt Reduction Committee of the Japanese Society of Hypertension, the target level of dietary salt reduction and its scientific evidence, present status of salt consumption in Japan, salt-reducing measures/guidance methods in individuals and population strategies to reduce salt intake are introduced. In the Dietary Reference Intake for the general population in Japan (2010 version), the target levels of salt restriction in men and women were established as less than 9.0 per day and 7.5 g per day, respectively. The Japanese Society of Hypertension Guidelines for the Management of Hypertension 2009 recommended the target level of dietary salt restriction in patients with hypertension as less than 6 g per day. However, the National Health and Nutrition Survey of Japan in 2010 reported that the mean salt intake in adults was 10.6 g per day (men: 11.4 g per day and women: 9.8 g per day). To effectively decrease salt intake in Japan, it is necessary to reduce the consumption of high-salt foods (especially traditional foods) and replace high-salt seasonings (soy sauce and so on) with low-salt alternatives. Health-care professionals must effectively perform salt-reduction guidance for hypertensive patients in hospitals/administrative organizations. To promote population strategies for salt reduction in the whole society of Japan, social strategies, such as administrative policies, companies' cooperation and educational staff's cooperation, are necessary.

  15. The Relationships between Metabolic Disorders (Hypertension, Dyslipidemia, and Impaired Glucose Tolerance and Computed Tomography-Based Indices of Hepatic Steatosis or Visceral Fat Accumulation in Middle-Aged Japanese Men.

    Directory of Open Access Journals (Sweden)

    Kazutoshi Fujibayashi

    Full Text Available Most studies on the relationships between metabolic disorders (hypertension, dyslipidemia, and impaired glucose tolerance and hepatic steatosis (HS or visceral fat accumulation (VFA have been cross-sectional, and thus, these relationships remain unclear. We conducted a retrospective cohort study to clarify the relationships between components of metabolic disorders and HS/VFA.The participants were 615 middle-aged men who were free from serious liver disorders, diabetes, and HS/VFA and underwent multiple general health check-ups at our institution between 2009 and 2013. The data from the initial and final check-ups were used. HS and VFA were assessed by computed tomography. HS was defined as a liver to spleen attenuation ratio of ≤1.0. VFA was defined as a visceral fat cross-sectional area of ≥100 cm2 at the level of the navel. Metabolic disorders were defined using Japan's metabolic syndrome diagnostic criteria. The participants were divided into four groups based on the presence (+ or absence (- of HS/VFA. The onset rates of each metabolic disorder were compared among the four groups.Among the participants, 521, 55, 24, and 15 were classified as HS(-/VFA(-, HS(-/VFA(+, HS(+/VFA(-, and HS(+/VFA(+, respectively, at the end of the study. Impaired glucose tolerance was more common among the participants that exhibited HS or VFA (p = 0.05. On the other hand, dyslipidemia was more common among the participants that displayed VFA (p = 0.01.It is likely that VFA is associated with impaired glucose tolerance and dyslipidemia, while HS might be associated with impaired glucose tolerance. Unfortunately, our study failed to detect associations between HS/VFA and metabolic disorders due to the low number of subjects that exhibited fat accumulation. Although our observational study had major limitations, we consider that it obtained some interesting results. HS and VFA might affect different metabolic disorders. Further large-scale longitudinal studies

  16. Hypertension screening

    Science.gov (United States)

    Foulke, J. M.

    1975-01-01

    An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.

  17. Hypertension screening

    Science.gov (United States)

    Foulke, J. M.

    1975-01-01

    An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.

  18. Endokrin hypertension

    DEFF Research Database (Denmark)

    Poulsen, Per Løgstrup; Ibsen, Hans

    2009-01-01

    Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma-aldosterone-to-renin ......Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma...

  19. Pulmonary hypertension

    OpenAIRE

    2016-01-01

    In 2015, more than 800 papers were published in the field of pulmonary hypertension. A Clinical Year in Review article cannot possibly incorporate all this work and needs to be selective. The recently published European guidelines for the diagnosis and treatment of pulmonary hypertension contain an inclusive summary of all published clinical studies conducted until very recently. Here, we provide an overview of papers published after the finalisation of the guideline. In addition, we summaris...

  20. Aircraft noise and incidence of hypertension--gender specific effects.

    Science.gov (United States)

    Eriksson, Charlotta; Bluhm, Gösta; Hilding, Agneta; Ostenson, Claes-Göran; Pershagen, Göran

    2010-11-01

    Recent studies show associations between aircraft noise and cardiovascular outcomes such as hypertension. However, these studies were mostly cross-sectional and there are uncertainties regarding potential gender differences as well as sensitive subgroups. In this study, we investigated the cumulative incidence of hypertension in relation to aircraft noise exposure among Swedish men and women living in Stockholm County. A total of 4721 subjects, aged 35-56 at baseline, were followed for 8-10 years. The population was selected according to family history of diabetes, which was present for half of the subjects. The exposure assessment was performed by geographical information systems and based on residential history during the period of follow-up. Blood pressure was measured at baseline and at the end of follow-up. Additional information regarding diagnosis and treatment of hypertension as well as various lifestyle factors was provided by questionnaires. In the overall population, no increased risk for hypertension was found among subjects exposed to aircraft noise ≥ 50 dB(A) L(den); relative risk (RR) 1.02 (95% CI 0.90-1.15). When restricting the cohort to those not using tobacco at the blood pressure measurements, a significant risk increase per 5 dB(A) of aircraft noise exposure was found in men; RR 1.21 (1.05-1.39), but not in women; RR 0.97 (0.83-1.13). In both sexes combined, an increased risk of hypertension related to aircraft noise exposure was indicated primarily among those reporting annoyance to aircraft noise; RR 1.42 (1.11-1.82). No consistent effect modification was detected for any of the cardiovascular risk factors under investigation although a family history of diabetes appeared to modify the risk in women. In conclusion, the results suggest an increased risk of hypertension following long-term aircraft noise exposure in men, and that subjects annoyed by aircraft noise may be particularly sensitive to noise related hypertension. Copyright © 2010

  1. Does aircraft noise exposure increase the risk of hypertension in the population living near airports in France?

    Science.gov (United States)

    Evrard, Anne-Sophie; Lefèvre, Marie; Champelovier, Patricia; Lambert, Jacques; Laumon, Bernard

    2017-02-01

    The largest study until now around 6 major European airports, the HYENA (HYpertension and Exposure to Noise near Airports) study, reported an excess risk of hypertension related to long-term aircraft noise exposure. The DEBATS (Discussion on the health effects of aircraft noise) study investigated the relationship between this exposure and the risk of hypertension in men and in women near French airports. Blood pressure of 1244 participants older than 18 years of age was measured. Information about health, socioeconomic and lifestyle factors was collected by means of a face-to-face questionnaire performed at home by an interviewer. Aircraft noise exposure was assessed for each participant's home address using noise maps. They were calculated with the Integrated Noise Model with a 1 dB(A)-resolution. The major potential confounders being risk factors for hypertension were included in the logistic regression models: age, occupational activity, body mass index, physical activity and alcohol consumption. After adjustment for the main potential confounders, an exposure-response relationship was evidenced between the risk of hypertension and aircraft noise exposure at night for men only. A 10-dB(A) increase in Lnight was associated with an OR of 1.34 (95% CI 1.00 to 1.97). These findings contribute to the overall evidence suggesting that aircraft noise exposure at night-time may increase the risk of hypertension in men. Hypertension is a well-known and established risk factor for cardiovascular disease. The association reported in the present study between aircraft noise and hypertension implies that aircraft noise might be a risk factor also for cardiovascular disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  2. Portopulmonary hypertension: from diagnosis to treatment.

    Science.gov (United States)

    Giusca, Sorin; Jinga, Mariana; Jurcut, Ciprian; Jurcut, Ruxandra; Serban, Marinela; Ginghina, Carmen

    2011-10-01

    Portopulmonary hypertension is a form of pulmonary arterial hypertension that has gained interest in recent years with the development of liver transplantation techniques and new pulmonary vasodilator therapies. Portopulmonary hypertension is defined as pulmonary artery hypertension associated with portal hypertension with or without advanced hepatic disease. Echocardiography plays a major role in screening for portopulmonary hypertension but right heart catheterization remains the gold standard for diagnosis. The treatment of patients with portopulmonary hypertension consists of general measures that apply to all patients that carry the diagnosis of pulmonary hypertension and specific vasodilator therapies. These new therapies showed encouraging results in patients who would otherwise have a contraindication for liver transplantation. The review presents a summary of the current knowledge on the epidemiology, diagnosis, treatment and prognosis of patients with portopulmonary hypertension.

  3. Psoriasis and increased prevalence of hypertension and diabetes mellitus

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    Maryam Ghiasi

    2011-01-01

    Full Text Available Background: Psoriasis is an autoimmune skin disease and associated with other diseases such as cardiovascular, hypertension, and diabetes mellitus. Aim: Our aim was to explore the prevalence of diabetes mellitus and hypertension in psoriatic patients. Materials and Methods: Between April 2008 and May 2010, a total of 304 psoriatic and 300 nonpsoriatic patients were enrolled in this cross sectional study. Data were obtained on age, sex, weight, heights, etc; documented medical history of diabetes mellitus and hypertension; family history of diabetes mellitus and hypertension in first relatives, history of smoking. Results: There was no significant difference in age and gender distribution between two groups. There was also no difference in body mass index between two groups. Within psoriatic group, 79.3% of patients present with plaque type of the disease and 20.7% present with other types. The results showed that within psoriatic patients, the prevalence of diabetes in women is significantly higher than in men (OR=1.93, CI95%: 1.1-3.6, P=0.004 but this difference is not present in nonpsoriatic patients. The results also showed that the prevalence of diabetes in psoriatic patients is significantly higher than nonpsoriatic patients (OR=1.76, CI95%: 1.11-2.8, P=0.015. The data showed that psoriatic patients were more likely to develop hypertension compared with nonpsoriatic patients (OR=2.2, CI95%: 1.2-4.6, P=0.003. According to results, although smoking rate within psoriatic patients is higher than the other group but the difference was not significant. Conclusion: Psoriatic patients have an increased risk of developing metabolic syndrome and hypertension in comparison to nonpsoriatic patients.

  4. Cutting balloon angioplasty for in-stent restenosis of the aortic coarctation in a young boy presenting with systemic hypertension of the upper extremities.

    Science.gov (United States)

    Lee, Meng-Luen

    2013-12-01

    An 8.25-year-old boy was incidentally found to have systemic hypertension of the upper extremities. Blood pressures of the upper extremities were 142-150/86-98 mmHg, and those of the lower extremities 110-116/60-66 mmHg. Doppler echocardiography showed in-stent restenosis of the aortic coarctation. Traditional high-pressure balloon angioplasty failed to dilate this inveterate in-stent restenosis. Instead, a cutting balloon angioplasty was performed. The lumen was dilated from 4.80 mm to 7.89 mm. The pressure gradient dropped from 32 mmHg to 9 mmHg. Blood pressures of the upper extremities were 112-116/76-78 mmHg, and those of the lower extremities 100-104/70-72 mmHg. This paper highlights that a cutting balloon angioplasty can serve as a juste milieu to relieve in-stent restenosis of the aortic coarctation when traditional high-pressure balloon angioplasty is debatable.

  5. A comparison of the predictive power of anthropometric indices for hypertension and hypotension risk.

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    Bum Ju Lee

    Full Text Available BACKGROUND AND AIMS: It is commonly accepted that body fat distribution is associated with hypertension, but the strongest anthropometric indicator of the risk of hypertension is still controversial. Furthermore, no studies on the association of hypotension with anthropometric indices have been reported. The objectives of the present study were to determine the best predictors of hypertension and hypotension among various anthropometric indices and to assess the use of combined indices as a method of improving the predictive power in adult Korean women and men. METHODS: For 12789 subjects 21-85 years of age, we assessed 41 anthropometric indices using statistical analyses and data mining techniques to determine their ability to discriminate between hypertension and normotension as well as between hypotension and normotension. We evaluated the predictive power of combined indices using two machine learning algorithms and two variable subset selection techniques. RESULTS: The best indicator for predicting hypertension was rib circumference in both women (p = <0.0001; OR = 1.813; AUC = 0.669 and men (p = <0.0001; OR = 1.601; AUC = 0.627; for hypotension, the strongest predictor was chest circumference in women (p = <0.0001; OR = 0.541; AUC = 0.657 and neck circumference in men (p = <0.0001; OR = 0.522; AUC = 0.672. In experiments using combined indices, the areas under the receiver operating characteristic curves (AUC for the prediction of hypertension risk in women and men were 0.721 and 0.652, respectively, according to the logistic regression with wrapper-based variable selection; for hypotension, the corresponding values were 0.675 in women and 0.737 in men, according to the naïve Bayes with wrapper-based variable selection. CONCLUSIONS: The best indicators of the risk of hypertension and the risk of hypotension may differ. The use of combined indices seems to slightly improve the predictive

  6. Dutch guideline for the management of hypertensive crisis -- 2010 revision.

    Science.gov (United States)

    van den Born, B J H; Beutler, J J; Gaillard, C A J M; de Gooijer, A; van den Meiracker, A H; Kroon, A A

    2011-05-01

    Hypertensive crises are divided into hypertensive urgencies and emergencies. Together they form a heterogeneous group of acute hypertensive disorders depending on the presence or type of target organs involved. Despite better treatment options for hypertension, hypertensive crisis and its associated complications remain relatively common. In the Netherlands the number of patients starting renal replacement therapy because of 'malignant hypertension' has increased in the past two decades. In 2003, the first Dutch guideline on hypertensive crisis was released to allow a standardised evidence-based approach for patients presenting with a hypertensive crisis. In this paper we give an overview of the current management of hypertensive crisis and discuss several important changes incorporated in the 2010 revision. These changes include a modification in terminology replacing 'malignant hypertension' with 'hypertensive crisis with retinopathy and reclassification of hypertensive crisis with retinopathy under hypertensive emergencies instead of urgencies. With regard to the treatment of hypertensive emergencies, nicardipine instead of nitroprusside or labetalol is favoured for the management of perioperative hypertension, whereas labetalol has become the drug of choice for the treatment of hypertension associated with pre-eclampsia. For the treatment of hypertensive urgencies, oral administration of nifedipine retard instead of captopril is recommended as first-line therapy. In addition, a section on the management of hypertensive emergencies according to the type of target organ involved has been added. Efforts to increase the awareness and treatment of hypertension in the population at large may lower the incidence of hypertensive crisis and its complications.

  7. Perioperative hypertension

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    G. Pinna

    2013-05-01

    Full Text Available BACKGROUND Perioperative hypertension is a situation whose management is suggested by the clinical judgement much more than clinical evidences. JNC 7 guidelines give a classification of blood pressure (BP, without any mention specifically dedicated to patients undergoing surgery. The ACC/AHA guidelines recommend deferring surgery if diastolic BP is above 110 mmHg and systolic BP is above 180 mmHg. AIM OF THE STUDY In this review we considered pathogenetic, clinical and therapeutic factors related to perioperative management of hypertensive patients. DISCUSSION In actual trend of the preoperative evaluation, alone hypertension is considered as a minor risk factor. BP values ≤ 180/110 mmHg do not influence the outcomes in patients who underwent noncardiac surgery. Therefore, in these conditions it’s not necessary to delay surgery. Hypertensive picks are possible during the operation, mostly because of the intubation, but, much more dangerous, falls of pressure are possible. The intraoperative arterial pressure should be maintained within 20% of the best estimated preoperative arterial pressure, especially in patients with markedly elevated preoperative pressures. After surgery the arterial BP can increase for stress factors, pain, hypoxia and hypercapnia, hypothermia and infusional liquids overload. For all these reasons a careful monitoring is mandatory. Anti-hypertensive medication should be continued during the postoperative period in patients with known and treated hypertension, as unplanned withdrawal of treatment can result in rebounded hypertension. The decision to give anti-hypertensive drugs must be made for each patient, taking into account their normal BP and their postoperative BP. With regard to the optimal treatment of the patient with poorly or uncontrolled hypertension in the perioperative evaluation, recent guidelines suggest that the best treatment may consider cardioselective β-blockers therapy, but also clonidin by

  8. Hypertensive Encephalopathy

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    Mostafa SHARIFIAN

    2012-09-01

    Full Text Available How to cite this article: Sharifian M. Hypertensive Encephalopathy. Iran J Child Neurol 2012; 6(3:1-7.Hypertension is called the silent killer and vital organs such as the brain, eyes,kidneys and the heart are the targets. Seizure, central nervous system (CNShemorrhage, and cerebrovascular accident (CVA, blindness and heart attacksare the end points.The prevalence of hypertension in children is much less than adults, but evidencereveals that the source of hypertension in adulthood goes back to childhood. In70-80% of cases hypertension is due to renal diseases. In children, hypertensiveencephalopathy (HE may be the first manifestation of renal diseases. Seizure isone of the most common manifestations of HE.In this article, definitions, etiology, pathophysiology and finally the acute andchronic managements of HE will be discussed.ReferencesSawicka K, Szczyrek M, Jastrzębska I, Prasal M, ZwolakA, Jadwiga D. Hypertension – The silent killer. J Pre-Clin Clin Res 2011;5(2:43-6.Croix B, Feig DI. Childhood hypertension is not a silent disease. Pediatr Nephrol 2006 Apr;21(4:527-32.Wong TY, Mitchell P. Hypertensive retinopathy. N Engl J Med 2004 Nov;351(22:2310-7.Krzesinski JM, Cohen EP.Hypertension and the kidney.Acta Clin Belg 2007 Jan-Feb;62(1:5-14.Report of the Second Task Force on Blood Pressure Control in Children – 1987. Task Force on Blood Pressure Control in Children. National Heart, Lung, and Blood Institute, Bethesda, Maryland. Pediatrics 1987Jan;79(1:1-25.Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Pediatrics 1996 Oct;98(4 Pt1:649-58.Ataei N, Aghamohammadi A, Yousefi E, Hosseini M, Nourijelyani K, Tayebi M, et al. Blood pressure nomograms for school children in Iran. Pediatr Nephrol 2004 Feb;19

  9. Masked Hypertension in Diabetes Mellitus

    Science.gov (United States)

    Franklin, Stanley S.; Thijs, Lutgarde; Li, Yan; Hansen, Tine W.; Boggia, José; Liu, Yanping; Asayama, Kei; Björklund-Bodegård, Kristina; Ohkubo, Takayoshi; Jeppesen, Jørgen; Torp-Pedersen, Christian; Dolan, Eamon; Kuznetsova, Tatiana; Stolarz-Skrzypek, Katarzyna; Tikhonoff, Valérie; Malyutina, Sofia; Casiglia, Edoardo; Nikitin, Yuri; Lind, Lars; Sandoya, Edgardo; Kawecka-Jaszcz, Kalina; Filipovský, Jan; Imai, Yutaka; Wang, Jiguang; Ibsen, Hans; O’Brien, Eoin; Staessen, Jan A.

    2013-01-01

    Although distinguishing features of masked hypertension in diabetics are well known, the significance of antihypertensive treatment on clinical practice decisions has not been fully explored. We analyzed 9691 subjects from the population-based 11-country International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcomes. Prevalence of masked hypertension in untreated normotensive participants was higher (Phypertensives tended to be higher than in normotensives (hazard rate [HR], 1.96; 95% confidence interval [CI], 0.97–3.97; P=0.059), similar to untreated stage 1 hypertensives (HR, 1.07; CI, 0.58–1.98; P=0.82), but less than stage 2 hypertensives (HR, 0.53; CI, 0.29–0.99; P=0.048). In contrast, cardiovascular risk was not significantly different in antihypertensive-treated diabetic-masked hypertensives, as compared with the normotensive comparator group (HR, 1.13; CI, 0.54–2.35; P=0.75), stage 1 hypertensives (HR, 0.91; CI, 0.49–1.69; P=0.76), and stage 2 hypertensives (HR, 0.65; CI, 0.35–1.20; P=0.17). In the untreated diabetic-masked hypertensive population, mean conventional systolic/diastolic blood pressure was 129.2±8.0/76.0±7.3 mm Hg, and mean daytime systolic/diastolic blood pressure 141.5±9.1/83.7±6.5 mm Hg. In conclusion, masked hypertension occurred in 29% of untreated diabetics, had comparable cardiovascular risk as stage 1 hypertension, and would require considerable reduction in conventional blood pressure to reach daytime ambulatory treatment goal. Importantly, many hypertensive diabetics when receiving antihypertensive therapy can present with normalized conventional and elevated ambulatory blood pressure that mimics masked hypertension. PMID:23478096

  10. Types of Pulmonary Hypertension

    Science.gov (United States)

    ... from the NHLBI on Twitter. Types of Pulmonary Hypertension The World Health Organization divides pulmonary hypertension (PH) ... are called pulmonary hypertension.) Group 1 Pulmonary Arterial Hypertension Group 1 PAH includes: PAH that has no ...

  11. Comportamiento de las crisis hipertensivas en un centro médico de diagnóstico integral Behavior of the hypertensive crisis present in patients from an integral diagnosis medical center

    Directory of Open Access Journals (Sweden)

    Vladimir Curbelo Serrano

    2009-09-01

    Full Text Available Se realizó un estudio descriptivo y retrospectivo, con el objetivo de describir el comportamiento de las crisis hipertensivas en el Cuerpo de Guardia del Centro Médico de Diagnóstico Integral "Carvajal", del municipio del mismo nombre, en el estado de Trujillo, Venezuela, en el período de enero a junio de 2007. Se trabajó con un universo de 104 pacientes diagnosticados con crisis hipertensivas que acudieron al cuerpo de guardia en el período mencionado. Para la recogida de los datos se utilizaron las hojas de cargo y las microhistorias. Se emplearon frecuencias absolutas y relativas (porcentaje para resumir la información, y tablas para su presentación. Se obtuvo un predominio del sexo masculino, el grupo de edades de 50-59 años y una mayor frecuencia de las urgencias hipertensivas. Los accidentes vasculares encefálicos y el síndrome coronario agudo, así como la hipertrofia del ventrículo izquierdo y la elevación del segmento ST dentro de las alteraciones electrocardiográficas, fueron las de mayor significación.A descriptive and retrospective study was carried out to describe the behavior of hypertensive crises in Emergency Room of "Carvajal" Integral Diagnosis Medical Center from this municipality in Trujillo state, Venezuela from January to June, 2007. Universe included 104 patients diagnosed with hypertensive crises seen in emergency room during above period. For data collection charge records and micro-medical records were used as well as absolute end relative frequencies (percentage to summarize the information and tables for its presentation. There was a male predominance, 50-59 years age group, and a great frequency of hypertensive urgencies. Encephalic vascular accidents (strokes and the acute coronary syndrome, as well as left ventricle atrophy and rise of ST-segment within the electrocardiographic alterations, were the more significant.

  12. Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies

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    Patel NH

    2012-11-01

    Full Text Available Nirali H Patel,1 Sarah K Romero,2 David C Kaelber31Division of Emergency Medicine, Akron Children's Hospital, Akron, OH, USA; 2Division of Emergency Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH, USA; 3Departments of Information Services, Internal Medicine, Pediatrics, and Epidemiology and Biostatistics, The Center for Clinical Informatics Research and Education, The MetroHealth System and School of Medicine, Case Western Reserve University, Cleveland OH, USAAbstract: Hypertension (HTN in the pediatric population is estimated to have a world-wide prevalence of 2%-5%. As with adults, pediatric patients with HTN can present with hypertensive crises include hypertensive urgency and hypertensive emergencies. However, pediatric blood pressure problems have a greater chance of being from secondary causes of HTN, as opposed to primary HTN, than in adults. Thorough evaluation of a child with a hypertensive emergency includes accurate blood pressure readings, complete and focused symptom history, and appropriate past medical, surgical, and family history. Physical exam should include height, weight, four-limb blood pressures, a general overall examination and especially detailed cardiovascular and neurological examinations, including fundoscopic examination. Initial work-up should typically include electrocardiography, chest X-ray, serum chemistries, complete blood count, and urinalysis. Initial management of hypertensive emergencies generally includes the use of intravenous or oral antihypertensive medications, as well as appropriate, typically outpatient, follow-up. Emergency department goals for hypertensive crises are to (1 safely lower blood pressure, and (2 treat/minimize acute end organ damage, while (3 identifying underlying etiology. Intravenous antihypertensive medications are the treatment modality of choice for hypertensive emergencies with the goal of reducing systolic blood pressure by 25% of the original value over an 8

  13. Usefulness of speckle tracking echocardiography in hypertensive crisis and the effect of medical treatment.

    Science.gov (United States)

    Alam, Mahboob; Zhang, Lily; Stampehl, Mark; Lakkis, Nasser; Dokainish, Hisham

    2013-07-15

    The acute impact of hypertensive crisis, and changes after treatment, on left ventricular (LV) systolic and diastolic function using comprehensive echocardiography, including speckle tracking, has not been well characterized. Thirty consecutive patients admitted to the hospital from the emergency room with hypertensive crisis underwent Doppler echocardiography at baseline and after blood pressure optimization. The mean age of the patients was 54 ± 13 years, with 19 men (63%). The most common presenting symptoms included dyspnea (70%), chest pain (43%), and altered mental status (13%). Mean systolic and diastolic blood pressures at presentation were 198 ± 12 and 122 ± 12 mm Hg, decreasing to 143 ± 15 and 77 ± 12 mm Hg (p hypertensive crisis and significantly improved after medical treatment. LV diastolic function, assessed using conventional and speckle-tracking parameters, was also depressed and significantly improved after treatment.

  14. Correlations of urinary cadmium with hypertension and diabetes in persons living in cadmium-contaminated villages in northwestern Thailand: A population study

    Energy Technology Data Exchange (ETDEWEB)

    Swaddiwudhipong, Witaya, E-mail: swaddi@hotmail.com [Department of Community and Social Medicine, Mae Sot General Hospital, Tak 63110 (Thailand); Mahasakpan, Pranee [Department of Community and Social Medicine, Mae Sot General Hospital, Tak 63110 (Thailand); Limpatanachote, Pisit; Krintratun, Somyot [Department of Internal Medicine, Mae Sot General Hospital, Tak (Thailand)

    2010-08-15

    Risk for hypertension and diabetes has not been conclusively found to be a result of cadmium exposure. A population-based study was conducted in 2009 to examine the correlations of urinary cadmium, a good biomarker of long-term cadmium exposure, with hypertension and diabetes in persons aged 35 years and older who lived in the 12 cadmium-contaminated rural villages in northwestern Thailand. A total of 5273 persons were interviewed and screened for urinary cadmium, hypertension, and diabetes. The geometric mean level of urinary cadmium for women (2.4{+-}2.3 {mu}g/g creatinine) was significantly greater than that for men (2.0{+-}2.2 {mu}g/g creatinine). Hypertension was presented in 29.8% of the study population and diabetes was detected in 6.6%. The prevalence of hypertension significantly increased from 25.0% among persons in the lowest tertile of urinary cadmium to 35.0% in the highest tertile. In women, the rate of hypertension significantly increased with increasing urinary cadmium levels in both ever and never smokers, after adjusting for age, alcohol consumption, body mass index, and diabetes. In men, such association was less significantly found in never smokers. The study revealed no significant association between urinary cadmium and diabetes in either gender. Our study supports the hypothesis that environmental exposure to cadmium may increase the risk of hypertension. Risk for diabetes in relation to cadmium exposure remains uncertain in this exposed population.

  15. The clinical value of ankle brachial index in the evaluation of peripheral artery disease in patients of aged men with hypertension%踝肱指数评价老年男性高血压患者下肢动脉病变的临床意义

    Institute of Scientific and Technical Information of China (English)

    李燕; 丁一妹; 朱平; 李小鹰

    2011-01-01

    Objective To evaluate the prevalence of peripheral arterial disease (PAD) in patients of aged men with hypertension by measuring the ankle-brachial index (ABI).Methods A total of 264 patients of aged men with hypertension were recruited in the study.The patients were divided into PAD group (ABI < 0.9) and non PAD group (ABI ≥0.9) Age, height, weight, body mass index, blood pressure concomitant diseases and smoking status were recorded.Results The incidence of ABI < 0.9 in the total subjects was 33.3%.The incidences of CHD, hyperlipidemia, diabetes, tobacco use in PAD group were significantly higher than those in non PAD group.Conclusions PAD is highly prevalent among the patients of aged men with hypertension and more popular in the patients with other risk factors added.It was related the age, CHD, diabetes and tobacco use to patients of aged men with hypertension.Detection of ABI could early make the diagnosis of PAD to the patients of aged men with hypertension.%目的 通过测量踝肱指数(ABI)评价老年男性高血压患者下肢外周动脉病(PAD)的患病情况,并对发生高血压和PAD的共同危险因素进行评价.方法 选取我院老年男性高血压患者264例,按ABI<0.9者入选PAD组(88例),ABI≥0.9者为非PAD组(176例).比较两组患者年龄、身高、体质量、血压、ABI、BMI、共患病情况及是否吸烟等指标.结果 264例患者中ABI异常88例,检出率为33.3%.PAD组的冠心病、高脂血症、糖尿病、吸烟的检出率分别为77.27%、35.22%、51.13%、65.90%,高于非PAD组的62.50%、21.59%、33.52%和19.88%,P值分别为0.018,0.025,0.007,0.000.通过PAD患病率危险因素Logistic回归分析,年龄、冠心病、高脂血症、糖尿病、吸烟为独立危险因素(P<0.05或P<0.01).结论 老年男性高血压患者有较高的PAD发生率,其合并有冠心病、高脂血症、糖尿病、吸烟的检出率远高于非PAD高血压患者.ABI可用于早期诊断其下肢血管病变.

  16. Hypertensive Disorders of Pregnancy.

    Science.gov (United States)

    Leeman, Lawrence; Dresang, Lee T; Fontaine, Patricia

    2016-01-15

    Elevated blood pressure in pregnancy may represent chronic hypertension (occurring before 20 weeks' gestation or persisting longer than 12 weeks after delivery), gestational hypertension (occurring after 20 weeks' gestation), preeclampsia, or preeclampsia superimposed on chronic hypertension. Preeclampsia is defined as hypertension and either proteinuria or thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema, or cerebral or visual symptoms. Proteinuria is not essential for the diagnosis and does not correlate with outcomes. Severe features of preeclampsia include a systolic blood pressure of at least 160 mm Hg or a diastolic blood pressure of at least 110 mm Hg, platelet count less than 100 × 103 per µL, liver transaminase levels two times the upper limit of normal, a doubling of the serum creatinine level or level greater than 1.1 mg per dL, severe persistent right upper-quadrant pain, pulmonary edema, or new-onset cerebral or visual disturbances. Preeclampsia without severe features can be managed with twice-weekly blood pressure monitoring, antenatal testing for fetal well-being and disease progression, and delivery by 37 weeks' gestation. Preeclampsia with any severe feature requires immediate stabilization and inpatient treatment with magnesium sulfate, antihypertensive drugs, corticosteroids for fetal lung maturity if less than 34 weeks' gestation, and delivery plans. Preeclampsia can worsen or initially present after delivery. Women with hypertensive disorders should be monitored as inpatients or closely at home for 72 hours postpartum.

  17. Hypertension in postmenopausal women: pathophysiology and treatment.

    Science.gov (United States)

    Leuzzi, Chiara; Modena, Maria Grazia

    2011-03-01

    Hypertension is the most common chronic disease in industrialized countries and represents the most common major cardiovascular risk factor after the fifth decade of life in both men and women. The prevalence of hypertension is lower in premenopausal women than men, whereas in postmenopausal women it is higher than in men. Mechanisms responsible for the increase in blood pressure are complex and multifactorial, including loss of estrogen, oxidative stress, endothelial dysfunction, modification in renin-angiotensin system spillover and sympathetic activation. In addition, postmenopausal hypertension can be considered an isolated disease, more typical of elderly women, or part of the metabolic syndrome, which is indeed more common in early postmenopausal women. In particular, metabolic syndrome may be considered a potentially unfavourable prognostic factor in hypertensive postmenopausal women, because it seems to worsen the severity of hypertension and reduce the capacity to respond to specific treatments. This article summarizes the different causes of postmenopausal hypertension and the specific treatment recommended by guidelines for this condition.

  18. Endocrine causes of secondary hypertension.

    Science.gov (United States)

    Sica, Domenic A

    2008-07-01

    Secondary hypertension is common in clinical practice if a broad definition is applied. Various patterns of hypertension exist in the patient with an endocrine source of their disease, including new-onset hypertension in a previously normotensive individual, a loss of blood pressure control in a patient with previously well-controlled blood pressure, and/or labile blood pressure in the setting of either of these 2 patterns. A thorough history and physical exam, which can rule out concomitant medications, alcohol intake, and over-the-counter medication use, is an important prerequisite to the workup for endocrine causes of hypertension. Endocrine forms of secondary hypertension, such as pheochromocytoma and Cushing's disease, are extremely uncommon. Conversely, primary aldosteronism now occurs with sufficient frequency so as to be considered "top of the list" for secondary endocrine causes in otherwise difficult-to-treat or resistant hypertension. Primary aldosteronism can be insidious in its presentation since a supposed hallmark finding, hypokalemia, may be variable in its presentation. It is important to identify secondary causes of hypertension that are endocrine in nature because surgical intervention may result in correction or substantial improvement of the hypertension.

  19. Screening for renovascular hypertension.

    Science.gov (United States)

    Dunnick, N R; Sfakianakis, G N

    1991-05-01

    The most common curable cause of high blood pressure is renovascular hypertension. Although hypertension is common in the United States, only a minority, approximately 1%, of patients have a renovascular cause. Using clinical criteria, a subgroup of these patients can be selected in which the prevalence of renovascular hypertension will be approximately 15%. In these selected patients, it is appropriate to proceed to a radiographic screening modality to look for a significant renal artery stenosis. The choice of modality should reflect the strengths and expertise of each specific institution. Hypertensive urography is no longer recommended for screening. Excellent results have been reported with intravenous DSRA in institutions where a strong interest in this procedure exists. Furthermore, intravenous DSRA is easily coupled with the collection of renal vein samples for renin assay. Intravenous DSRA, however, has not maintained widespread use. Although the radionuclide renogram is no longer adequate as a radiographic screening tool, stimulation with an ACE inhibitor, such as captopril or enalaprilat, may produce excellent results. In many institutions, this is the most appropriate examination. Furthermore, it is relatively noninvasive. Merely detecting a significant renal artery stenosis does not, however, mean the patient has renovascular hypertension. Both hypertension and a renal artery stenosis may be present and not be causally related. Because renovascular hypertension is, at least initially, renin mediated, the demonstration of increased renin production by the ipsilateral kidney should confirm renovascular hypertension. Prospective application of these results to patients undergoing revascularization techniques, however, has been disappointing. This may be related to problems in patient preparation, sample collection, renin assay, or even the physiology of chronic hypertension, which is incompletely renin mediated. Thus, offering revascularization only to

  20. Endokrin hypertension

    DEFF Research Database (Denmark)

    Poulsen, Per Løgstrup; Ibsen, Hans

    2009-01-01

    Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma-aldosterone-to-renin ...

  1. Study of urban community survey in India: growing trend of high prevalence of hypertension in a developing country

    Directory of Open Access Journals (Sweden)

    2005-04-01

    Full Text Available The prevalence pattern of hypertension in developing countries is different from that in the developed countries. In India, a very large, populous and typical developing country, community surveys have documented that between three and six decades, prevalence of hypertension has increased by about 30 times among urban dwellers and by about 10 times among the rural inhabitants. Various factors might have contributed to this rising trend and among others, consequences of urbanization such as change in life style pattern, diet and stress, increased population and shrinking employment have been implicated. In this paper, we study the prevalence of hypertension in an urban community of India using the JNC VII criteria, with the aim of identifying the risk factors and suggesting intervention strategies. A total of 1609 respondents out of 1662 individuals participated in our cross-sectional survey of validated and structured questionnaire followed by blood pressure measurement. Results showed pre-hypertensive levels of blood pressures among 35.8% of the participants in systolic group (120-139mm of Hg and 47.7% in diastolic group (80-89 mm of Hg. Systolic hypertension (140 mm of Hg was present in 40.9% and diastolic hypertension (90 mm of Hg in 29.3% of the participants. Age and sex-specific prevalence of hypertension showed progressive rise of systolic and diastolic hypertension in women when compared to men. Men showed progressive rise in systolic hypertension beyond fifth decade of life. Bivariate analysis showed significant relationship of hypertension with age, sedentary occupation, body mass index (BMI, diet, ischemic heart disease, and smoking. Multivariate analysis revealed age and BMI as risk factors, and non-vegetarian diet as protective factor with respect to hypertension. Prevalence of prehypertensives was high among younger subjects - particularly students and laborers who need special attention. Role of non-vegetarian diet as a protective

  2. Hypertension and hypertensive heart disease in African women.

    Science.gov (United States)

    Sliwa, Karen; Ojji, Dike; Bachelier, Katrin; Böhm, Michael; Damasceno, Albertino; Stewart, Simon

    2014-07-01

    Hypertension and hypertensive heart disease is one of the main contributors to a growing burden of non-communicable forms of cardiovascular disease around the globe. The recently published global burden of disease series showed a 33 % increase of hypertensive disorders in pregnancy in the past two decades with long-term consequences. Africans, particularly younger African women, appear to be bearing the brunt of this increasing public health problem. Hypertensive heart disease is particularly problematic in pregnancy and is an important contributor to maternal case-fatality. European physicians increasingly need to attend to patients from African decent and need to know about unique aspects of disease presentation and pharmacological as well as non-pharmacological care. Reductions in salt consumption, as well as timely detection and treatment of hypertension and hypertensive heart disease remain a priority for effective primary and secondary prevention of CVD (particularly stroke and CHF) in African women. This article reviews the pattern, potential causes and consequences and treatment of hypertension and hypertensive heart disease in African women, identifying the key challenges for effective primary and secondary prevention in this regard.

  3. Hypertensive crisis-induced electrocardiographic changes: a case series

    Directory of Open Access Journals (Sweden)

    Farha Khalid Abou

    2009-08-01

    Full Text Available Abstract Introduction Myocardial injury is one of the most notorious complications of a hypertensive crisis. Key electrocardiograph signs used to detect cardiac injury such as ST segment changes and cardiac arrhythmias usually indicate acute ongoing end-organ damage. Lack of early signs to predict end-organ damage might lead to a delay in the initiation of therapy and selection of the incorrect therapeutic strategy. Case presentation We describe five cases of tall, hyper acute symmetrical T-waves alone or accompanied by other electrocardiograph abnormalities in five healthy participants: three women aged 52, 60 and 62-years and two men aged 49 and 66-years, during a tyramine-monoamine oxidase-inhibitor interaction, phase I clinical trial. T-wave changes appeared early during the course of the hypertensive crisis and were attributed to subendocardial ischemia. The changes were transient and reverted to baseline in parallel with a fall in blood pressure. Conclusion Recognition of tall symmetrical T-waves in early phases of hypertensive crisis heralds commencement of myocardial damage. This calls for prompt medical intervention to avoid an impending irreversible myocardial injury. It is our belief that these findings will add new insight into the management of hypertensive crisis and will open avenues of further investigation.

  4. Determinants and treatment of hypertension in South Africans: The ...

    African Journals Online (AJOL)

    In the first national Demographic and Health Survey, 12 952 randomly selected ... overweight and obese people, excess alcohol use, and a family history of ... Poorer, younger men without health insurance had the worst level of hypertension

  5. Misdiagnosis Analysis of a Case with Motor Neuron Disease Whose Main Presentation Is Pulmonary Hypertension%以肺动脉高压为表现的运动神经元疾病的误诊

    Institute of Scientific and Technical Information of China (English)

    秦茵茵; 钟南山

    2011-01-01

    目的 加强对以肺动脉高压为主要表现的运动神经元疾病的认识,提高诊断率.方法 回顾分析1例以肺动脉高压为主要表现的运动神经元疾病患者的临床资料,结合相关文献,详细分析该病的临床特点、早期征象和误诊原因.结果 运动神经元疾病起病隐匿,进展缓慢,在出现呼吸系统症状前已有较长时间的肌肉萎缩和肌乏力等症状,查体有明显肌肉萎缩等特点.详细询问病史、系统的体格检查和简便呼吸肌检查,既可降低误诊率,又可避免进行一些既昂贵且创伤性大的检查.结论 临床上对以肺动脉高压为主要表现的运动神经元疾病认识不足,极易延误诊断,应予重视.%Objective To summarize the clinical features of motor neuron disease (MND) with main presentation of pulmonary hypertension,so as to improve the diagnosis. Methods A patient with MND whose main presentation was pulmonary hypertension was analyzed retrospectively. Meanwhile related literatures were reviewed. Clinical data including symptoms, early signs, misdiagnosis causes, and necessary functional examination of respiratory muscle were collected. Results The symptoms of MND was slow-onset and insidious with gradual progression over time. History inquiring found that the symptoms of muscle wasting and physical debilitation emerged long time before the respiratory symptoms. Physical examination also revealed obvious sign of muscle atrophy. Conclusions MND with main presentation of pulmonary hypertension has been recognized insufficiently and often misdiagnosed as other pulmonary diseases. Detailed history taking, systematic physical examination,and convenient functional examination of respiratory muscle,can not only reduce misdiagnosis, but also avoid some expensive and traumatic process.

  6. Renal hemodynamics in hypertensive renal allograft recipients: effects of calcium antagonists and ACE inhibitors.

    Science.gov (United States)

    Grekas, D; Dioudis, C; Kalevrosoglou, I; Alivanis, P; Derveniotis, V; Tourkantonis, A

    1996-06-01

    Hypertension present in more than 50% of successfully renal transplanted patients and its prevalence has slightly increased since the introduction of cyclosporine A. Twenty patients, 9 women and 11 men aged from 30 to 58 years, with stable cadaveric renal allograft function and moderate to severe hypertension, were included in the study. Renal artery graft stenosis causing hypertension were excluded. All patients were given triple drug immunosuppressive treatment with methylprednisolone, azathioprine and cyclosporine A (CsA) and their hypertension was treated with a nifedipine dose of 20 mg twice daily. To evaluate the effect of ACE inhibitors on renal hemodynamics and hypertension, a 4 mg/daily dose of perindopril was added to the above regimen for two months. Effective renal plasma flow (ERPF) decreased from 208 +/- 54 to 168 +/- 61 ml/min and renal vascular resistance (RVR) increased from 75 +/- 12 to 88 +/- 17 mm Hg/ml/min (P nifedipine. It is suggested that the combination of both antihypertensive agents was more effective than monotherapy with nifedipine in controlling blood pressure, but less favorable on the renal hemodynamic response in hypertensive renal transplant patients who were maintained on CsA.

  7. Hypertension in Renal Allograft Recipients

    Directory of Open Access Journals (Sweden)

    Waiser Johannes

    1999-01-01

    Full Text Available Hypertension is a frequent complication after renal transplantation. It contributes to the considerable cardiovascular morbidity and mortality in renal allograft recipients. Additionally, it has a major impact on long-term allograft survival. The pathogenesis of post transplant hypertension is multifactorial. Besides common risk factors, renal allograft recipients accumulate specific risk factors related to the original renal disease, renal transplantation per se and the immunosuppressive regimen. Chronic allograft dysfunction is the main cause of post transplant hypertension. The introduction of calcineurin inhibitors, such as cyclosporine, has increased the prevalence of hypertension. At present, the growing manual of diagnostic and therapeutic tools enables us to adapt better antihypertensive therapy. Tight monitoring, individualization of the immunosuppressive protocol, inclusion of non-pharmacological measures and aggressive antihypertensive treatment should help to minimize the negative implications of post transplant hypertension. Probably, this goal can only be reached by "normalization" of systolic and diastolic blood pressure to below 135/85 mmHg.

  8. A clinical classification of hypertension

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Hypertension is a common cardiovascular problem worldwide. As with any other disease it is important to assess the severity of the disease. However the present classification of hypertension by the Joint National Committee in its seventh report (JNC 7) with numerical values staging the severity of hypertension is theoretically correct but difficult to apply in practice (Table 1).1 Admittedly this is a step in the right direction with lesser number of stages compared to the sixth report.2 The World Health Organization- International Society of Hypertension (WHO-ISH)-1999 3 and the European Society of Hypertension - European Society of Cardiology (ESH-ESC)4 guidelines follow similar numerical classifications (Table 2). All these papers are referred to as 'guidelines' in this article.

  9. RESISTANT HYPERTENSION IN A PATIENT WITH METABOLIC SYNDROME

    OpenAIRE

    O. M. Drapkina; J. S. Sibgatullina

    2016-01-01

    Clinical case of resistant hypertension in a patient with metabolic syndrome is presented. Features of hypertension in metabolic syndrome and features of metabolic syndrome in women of pre- and postmenopausal age are also considered. Understanding the features of metabolic syndrome in women, as well as features of hypertension and metabolic syndrome will improve the results of treatment in patients with resistant hypertension.

  10. Prevalence of renal artery stenosis in subjects with moderate hypertension. A population-based study

    DEFF Research Database (Denmark)

    Andersen, Ulrik B; Borglykke, Anders; Jørgensen, Torben

    2011-01-01

    to balloon angioplasty. Two patients had reduced size and function of the affected kidney. Among the non-invasively treated patients, one showed stenosis progression at the 2-year follow-up examination. Conclusion. In subjects aged 50-66 years with hypertension grade II-III, RAS is rare among men......Abstract Aim. To examine the prevalence of significant renal artery stenosis (RAS) in subjects with moderate to severe hypertension. Materials and methods. Subjects aged 50-66 years with blood pressure >160/100 mmHg or receiving antihypertensive treatment were selected from the population study......, but not among women. These women may suffer from fibromuscular dysplasia. They are at risk of losing kidney function and developing severe hypertension, but they would not have been considered for screening according to present criteria....

  11. PGC-1alpha Gly482Ser polymorphism associates with hypertension among Danish whites

    DEFF Research Database (Denmark)

    Andersen, Gitte; Wegner, Lise; Jensen, Dorit Packert

    2005-01-01

    . The common Gly482Ser polymorphism of PGC-1alpha has previously shown association with arterial hypertension among Austrian men. Thus, we aimed at investigating this relationship in the Danish white population. The Gly482Ser polymorphism was genotyped in a total of 2562 Danish white subjects using polymerase...... chain reaction (PCR)-restriction fragment length polymorphism (RFLP) and a GenoView locked nucleic acid assay (LNA), and the relationships of this variant with blood pressure levels and arterial hypertension were analyzed. Furthermore, we performed a combined analysis of the data from the present study...... in combination with previously published results. The Ser/Ser genotype was significantly associated with a reduced risk of hypertension and with lower systolic, diastolic, and mean arterial blood pressure levels, predominantly among women. Finally, in a combined analysis using data obtained in both sexes...

  12. Hypertension Subtypes among Hypertensive Patients in Ibadan

    Directory of Open Access Journals (Sweden)

    Abiodun M. Adeoye

    2014-01-01

    Full Text Available Background. Certain hypertension subtypes have been shown to increase the risk for cardiovascular morbidity and mortality and may be related to specific underlying genetic determinants. Inappropriate characterization of subtypes of hypertension makes efforts at elucidating the genetic contributions to the etiology of hypertension largely vapid. We report the hypertension subtypes among patients with hypertension from South-Western Nigeria. Methods. A total of 1858 subjects comprising 76% female, hypertensive, aged 18 and above were recruited into the study from two centers in Ibadan, Nigeria. Hypertension was identified using JNCVII definition and was further grouped into four subtypes: controlled hypertension (CH, isolated systolic hypertension (ISH, isolated diastolic hypertension (IDH, and systolic-diastolic hypertension (SDH. Results. Systolic-diastolic hypertension was the most prevalent. Whereas SDH (77.6% versus 73.5% and IDH (4.9% versus 4.7% were more prevalent among females, ISH (10.1% versus 6.2% was higher among males (P=0.048. Female subjects were more obese (P<0.0001 and SDH was prevalent among the obese group. Conclusion. Gender and obesity significantly influenced the distribution of the hypertension subtypes. Characterization of hypertension by subtypes in genetic association studies could lead to identification of previously unknown genetic variants involved in the etiology of hypertension. Large-scale studies among various ethnic groups may be needed to confirm these observations.

  13. Evaluation of the Medical Care of Patients with Hypertension in an Emergency Department and in Ambulatory Hypertension Unit

    Directory of Open Access Journals (Sweden)

    Fernando Nobre

    2002-02-01

    Full Text Available OBJECTIVE: To evaluate the characteristics of the patients receiving medical care in the Ambulatory of Hypertension of the Emergency Department, Division of Cardiology, and in the Emergency Unit of the Clinical Hospital of the Ribeirão Preto Medical School. METHODS: Using a protocol, we compared the care of the same hypertensive patients in on different occasions in the 2 different places. The characteristics of 62 patients, 29 men with a mean age of 57 years, were analyzed between January 1996 and December 1997. RESULTS: The care of these patients resulted in different medical treatment regardless of their clinical features and blood pressure levels. Thus, in the Emergency Unit, 97% presented with symptoms, and 64.5% received medication to rapidly reduce blood pressure. In 50% of the cases, nifedipine SL was the elected medication. Patients who applied to the Ambulatory of Hypertension presenting with similar features, or, in some cases, presenting with similar clinically higher levels of blood pressure, were not prescribed medication for a rapid reduction of blood pressure at any of the appointments. CONCLUSION: The therapeutic approach to patients with high blood pressure levels, symptomatic or asymptomatic, was dependent on the place of treatment. In the Emergency Unit, the conduct was, in the majority of cases, to decrease blood pressure immediately, whereas in the Ambulatory of Hypertension, the same levels of blood pressure, in the same individuals, resulted in therapeutic adjustment with nonpharmacological management. These results show the need to reconsider the concept of hypertensive crises and their therapeutical implications.

  14. Hypertension Briefing

    OpenAIRE

    2012-01-01

    Blood pressure is the force exerted on artery walls as the heart pumps blood through the body. Hypertension, or high blood pressure, occurs when blood pressure is constantly higher than the pressure needed to carry blood through the body. The Chronic Conditions Hub is a website that brings together information on chronic health conditions. It allows you to easily access, manage and share relevant information resources. The Chronic Conditions Hub includes the Institute of Public Health in Irel...

  15. Resistant hypertension.

    Science.gov (United States)

    Armario, P; Oliveras, A; de la Sierra, A

    2013-11-01

    A 53 year old woman with hypercholesterolemia treated with statins, with no history of cardiovascular disease, was referred to the Hypertension and Vascular Risk Unit for management of hypertension resistant to 4 antihypertensive agents at full doses. The patient had obesity, with a body mass index of 36.3kg/m(2) and office blood pressure 162/102mm Hg. Physical examination showed no data of interest. glucose 120mg/dl, glycated Hb: 6.4%, albuminuria 68mg/g, kidney function and study of the renin angiotensin system and other biochemical parameters were normal. Echocardiography: left ventricular mass, 131g/m(2) (normal, <110g/m(2)). True resistant hypertension was confirmed by ambulatory monitoring of blood pressure during 24h (153/89mm Hg). Spironolactone treatment (25mg/day) was added and was well tolerated, with no change in renal function and kaliemia within normal (4.1mmol/l) following the treatment. After 8 weeks, blood pressure was well controlled: office blood pressure 132/86mm Hg and 24h-ambulatory blood pressure: 128/79mm Hg. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  16. Graves’ disease presenting as bi - ventricular heart failure with severe pulmonary hypertension and pre-eclampsia in pregnancy – a case report and review of the literature

    OpenAIRE

    Sabah, Khandker Mohammad Nurus; Chowdhury, Abdul Wadud; Islam, Mohammad shahidul; Cader, Fathima Aaysha; Kawser, Shamima; Hosen, Md Imam; Saleh, Mohammed Abaye Deen; Alam, Md Shariful; Chowdhury, Mohammad Monjurul Kader; Tabassum, Humayara

    2014-01-01

    Background Graves’ disease, a well-known cause of hyperthyroidism, is an autoimmune disease with multi-system involvement. More prevalent among young women, it appears as an uncommon cardiovascular complication during pregnancy, posing a diagnostic challenge, largely owing to difficulty in detecting the complication, as a result of a low index of suspicion of Graves’ disease presenting during pregnancy. Globally, cardiovascular disease is an important factor for pregnancy-related morbidity an...

  17. Metabolic syndrome, androgens, and hypertension.

    Science.gov (United States)

    Moulana, Mohadetheh; Lima, Roberta; Reckelhoff, Jane F

    2011-04-01

    Obesity is one of the constellation of factors that make up the definition of the metabolic syndrome. Metabolic syndrome is also associated with insulin resistance, dyslipidemia, hypertriglyceridemia, and type 2 diabetes mellitus. The presence of obesity and metabolic syndrome in men and women is also associated with increased risk of cardiovascular disease and hypertension. In men, obesity and metabolic syndrome are associated with reductions in testosterone levels. In women, obesity and metabolic syndrome are associated with increases in androgen levels. In men, reductions in androgen levels are associated with inflammation, and androgen supplements reduce inflammation. In women, increases in androgens are associated with increases in inflammatory cytokines, and reducing androgens reduces inflammation. This review discusses the possibility that the effects of androgens on metabolic syndrome and its sequelae may differ between males and females.

  18. Men, food, and prostate cancer: gender influences on men's diets.

    Science.gov (United States)

    Mróz, Lawrence W; Chapman, Gwen E; Oliffe, John L; Bottorff, Joan L

    2011-03-01

    Although healthy eating might enhance long-term survival, few men with prostate cancer make diet changes to advance their well-being. Men's typically poor diets and uninterest in self-health may impede nutrition interventions and diet change. Food choice behavior is complex involving many determinants, including gender, which can shape men's health practices, diets, and prostate cancer experiences. Developing men-centered prostate cancer nutrition interventions to engage men (and where appropriate their partners) in promoting healthy diets can afford health benefits. This article presents an overview and synthesis of current knowledge about men's food practices and provides an analysis of diet and diet change behaviors for men with prostate cancer. Masculinity and gender relations theory are discussed in the context of men's food practices, and suggestions for future applications to nutrition and prostate cancer research and diet interventions are made.

  19. HYPERTENSION IN PSYCHIATRIC PATIENTS

    OpenAIRE

    Chaturvedi, Santosh K.; Michael, Albert

    1986-01-01

    SUMMARY Known cases of hypertension and those fulfilling WHO criteria for diagnosis of hypertension were identified in psychiatric patients and compared with non - hypertensive psychiatric patients. Hypertension was detected in 141 (9.98%) cases, and was significantly more associated with elder age, married status, urban background and neurotic illness. The implications are in early detection and effective management of hypertension in psychiatric patients.

  20. Hypertension hos gravide

    DEFF Research Database (Denmark)

    Mathiesen, Elisabeth R; Johansen, Marianne; Kamper, Anne Lise;

    2009-01-01

    There are four major hypertensive disorders in pregnancy: chronic hypertension, gestational hypertension, preeclampsia and chronic hypertension with superimposed preeclampsia. The indications and efficacy of antihypertensive treatment of the different hypertensive disorders are assessed. Advantages...... and disadvantages of different classes of antihypertensive drugs during pregnancy and lactation are described....

  1. [Hypertension during pregnancy

    DEFF Research Database (Denmark)

    Mathiesen, E.R.; Johansen, M.; Kamper, A.L.;

    2009-01-01

    There are four major hypertensive disorders in pregnancy: chronic hypertension, gestational hypertension, preeclampsia and chronic hypertension with superimposed preeclampsia. The indications and efficacy of antihypertensive treatment of the different hypertensive disorders are assessed. Advantages...... and disadvantages of different classes of antihypertensive drugs during pregnancy and lactation are described Udgivelsesdato: 2009/6/15...

  2. Awareness, Treatment and Control of Pre-hypertension and Hypertension among Adults in Iran.

    Science.gov (United States)

    Esteghamati, Alireza; Etemad, Koorosh; Koohpayehzadeh, Jalil; Abbasi, Mehrshad; Meysamie, Alipasha; Khajeh, Elias; Asgari, Fereshteh; Noshad, Sina; Rafei, Ali; Mousavizadeh, Mostafa; Neishaboury, Mohamad Reza; Afarideh, Mohsen; Nakhjavani, Manouchehr

    2016-07-01

    Hypertension is a major risk factor for non-communicable diseases. Yet, Nation-wide prevalence and trend reports in developing countries are sparsely available. Data from three cycles of Survey of Risk Factors of Non-communicable Diseases (SuRFNCD) 2005 - 2011 were aggregated. In 2011, 8218 adults aged 25 - 70 years were enrolled. For trend analysis 68850, 4184, and 7416 adults aged 25 - 64 years were included from 2005, 2007, and 2011 surveys, respectively. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg, diastolic blood pressure (DBP) ≥ 90 mmHg, or receiving anti-hypertensive medication. Pre-hypertension was defined as SBP between 120 - 139 or DBP between 80 - 89 mmHg. The status of awareness, non-pharmacologic treatment (management), pharmacologic treatment, and control (SBP hypertensive individuals were also determined. 25.6% (95%CI: 23.5 - 27.5) of the adults aged 25 - 70 years had hypertension and 39.8% (95%CI: 37.8 - 41.9) had pre-hypertension. The prevalence of hypertension was greater among older adults (P adults with hypertension (25.7% to 24.1%) and pre-hypertension (45.5% to 40.4%) significantly decreased. In 2011, rates for awareness, management, treatment, and control among hypertensives were 43.2% (95%CI: 40.0 - 46.4), 40.3% (95%CI: 37.0 - 43.6), 34.8% (95%CI: 31.5 - 38.2), and 38.6% (95%CI: 33.1 - 44.2), respectively. Over time, status of awareness, management, treatment and control was significantly improved and was more salient among men (P hypertension and pre-hypertension is gradually declining. Despite improvements in awareness, management, treatment and control, these decline rates are still low and initiative strategies need to be implemented to further improve the current status.

  3. Mad Men

    DEFF Research Database (Denmark)

    Bjerre, Thomas Ærvold

    2015-01-01

    Artiklen omhandler den amerikanske tv-serie Mad Men. Fokus er på hvordan Koreakrigens indflydelse på ændrede manderoller har haft betydning for hovedpersonen Don Drapers performative maskulinitet.......Artiklen omhandler den amerikanske tv-serie Mad Men. Fokus er på hvordan Koreakrigens indflydelse på ændrede manderoller har haft betydning for hovedpersonen Don Drapers performative maskulinitet....

  4. Hypertensive Crisis: A Review of Pathophysiology and Treatment.

    Science.gov (United States)

    Taylor, Deborah A

    2015-12-01

    Hypertensive crisis presents as hypertensive urgency or hypertensive emergency, the differences being the presence or absence of target organ damage (TOD) and the type of treatment the patient will receive. Patients with hypertensive urgency do not express TOD, which is seen only in hypertensive emergencies and can involve the heart, kidneys, or brain. Recognition of hypertensive crisis at initial assessment is crucial. An important first step is to obtain a full medical and medication history to be used as a guide for treatment. Proper and effective treatment of hypertensive urgency or emergency involves appropriate use of specific agents based on knowledge of any comorbid disease state.

  5. Recent Trends of Epidemic Hypertension in Guangdong Province

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Hypertension survey was carried out in Guangdong Province in 1991, according to a national sampling survey program. 42 899 urban and rural men and women aged ≥ 15 were involved in the survey. The results revealed that the standardized prevalence rate of hypertension was 8.99% (definite 4. 24%, borderline 4.75% ) . It was higher in men than in women, in urban than in rural samples.Compared with the survey in 1979, the prevalence rate increased by 90% and the curve of aged- prevalence rates shifted leftward. This article also discuss the possible factors that lead to the increase of hypertension.

  6. Pulmonary Arterial Hypertension

    Science.gov (United States)

    Pulmonary Arterial Hypertension What Is Pulmonary Hypertension? To understand pulmonary hypertension (PH) it helps to understand how blood ows throughout your body. While the heart is one organ, it ...

  7. Hypertensive Disorders of Pregnancy

    OpenAIRE

    Mammaro, Alessia; Carrara, Sabina; Cavaliere, Alessandro; Ermito, Santina; Dinatale, Angela; Pappalardo, Elisa Maria; Militello, Mariapia; Pedata, Rosa

    2009-01-01

    Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories, as recommended by the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy: 1) chronic hypertension, 2) preeclampsia-eclampsia, 3) preeclampsia superimposed on chronic hypertension, and 4) gestational hypertension (transient hypertension of pregnancy or chronic hyper...

  8. WNK kinases and essential hypertension.

    Science.gov (United States)

    Huang, Chou-Long; Kuo, Elizabeth; Toto, Robert D

    2008-03-01

    The present review summarizes recent literature and discusses the potential roles of WNKs in the pathogenesis of essential hypertension. WNKs (with-no-lysine [K]) are a recently discovered family of serine-threonine protein kinases with unusual protein kinase domains. The role of WNK kinases in the control of blood pressure was first revealed by the findings that mutations of two members, WNK1 and WNK4, cause Gordon's syndrome. Laboratory studies have revealed that WNK kinases play important roles in the regulation of sodium and potassium transport. Animal models have been created to unravel the pathophysiology of sodium transport disorders caused by mutations of the WNK4 gene. Potassium deficiency causes sodium retention and increases hypertension prevalence. The expression of WNK1 is upregulated by potassium deficiency, raising the possibility that WNK1 may contribute to salt-sensitive essential hypertension associated with potassium deficiency. Associations of polymorphisms of WNK genes with essential hypertension in the general population have been reported. Mutations of WNK1 and WNK4 cause hypertension at least partly by increasing renal sodium retention. The role of WNK kinases in salt-sensitive hypertension within general hypertension is suggested, but future work is required to firmly establish the connection.

  9. Pathophysiology of salt sensitivity hypertension.

    Science.gov (United States)

    Ando, Katsuyuki; Fujita, Toshiro

    2012-06-01

    Dietary salt intake is the most important factor contributing to hypertension, but the salt susceptibility of blood pressure (BP) is different in individual subjects. Although the pathogenesis of salt-sensitive hypertension is heterogeneous, it is mainly attributable to an impaired renal capacity to excrete sodium (Na(+) ). We recently identified two novel mechanisms that impair renal Na(+) -excreting function and result in an increase in BP. First, mineralocorticoid receptor (MR) activation in the kidney, which facilitates distal Na(+) reabsorption through epithelial Na(+) channel activation, causes salt-sensitive hypertension. This mechanism exists not only in models of high-aldosterone hypertension as seen in conditions of obesity or metabolic syndrome, but also in normal- or low-aldosterone type of salt-sensitive hypertension. In the latter, Rac1 activation by salt excess causes MR stimulation. Second, renospecific sympathoactivation may cause an increase in BP under conditions of salt excess. Renal beta2 adrenoceptor stimulation in the kidney leads to decreased transcription of the gene encoding WNK4, a negative regulator of Na(+) reabsorption through Na(+) -Cl (-) cotransporter in the distal convoluted tubules, resulting in salt-dependent hypertension. Abnormalities identified in these two pathways of Na(+) reabsorption in the distal nephron may present therapeutic targets for the treatment of salt-sensitive hypertension.

  10. Paradoxical hypertension with cardiac tamponade.

    Science.gov (United States)

    Argulian, Edgar; Herzog, Eyal; Halpern, Dan G; Messerli, Franz H

    2012-10-01

    Subacute (medical) tamponade develops over a period of days or even weeks. Previous studies have shown that subacute tamponade is uncommonly associated with hypotension. On the contrary, many of those patients are indeed hypertensive at initial presentation. We sought to determine the prevalence and predictors of hypertensive cardiac tamponade and hemodynamic response to pericardial effusion drainage. We conducted a retrospective study of patients who underwent pericardial effusion drainage for subacute pericardial tamponade. Diagnosis of pericardial tamponade was established by the treating physician based on clinical data and supportive echocardiographic findings. Patients were defined as hypertensive if initial systolic blood pressure (BP) was ≥140 mm Hg. Thirty patients with subacute tamponade who underwent pericardial effusion drainage were included in the analysis. Eight patients (27%) were hypertensive with a mean systolic BP of 167 compared to 116 mm Hg in 22 nonhypertensive patients. Hypertensive patients with tamponade were more likely to have advanced renal disease (63% vs 14%, p tamponade after pericardial effusion drainage. Those results are consistent with previous studies with an estimated prevalence of hypertensive tamponade from 27% to 43%. In conclusion, a hypertensive response was observed in approximately 1/3 of patients with subacute pericardial tamponade. Relief of cardiac tamponade commonly resulted in a decrease in BP.

  11. [Effect of smoking on blood viscosity and arterial rigidity in normal and hypertensive subjects].

    Science.gov (United States)

    Levenson, J; Simon, A C; Cambien, F; Beretti, C

    1987-06-01

    The purpose of the study was to assess whether cigarettes smoking could induce blood hyperviscosity and arterial rigidity in 30 normotensive and 70 hypertensive men aged from 24 to 65 years. Of those, 20 normotensive and 20 hypertensive were cigarettes smokers, while the remaining subjects were non smokers. Age and weight were similar in the 4 groups of subjects. A couette viscometer with coaxial cylinders allowed the measurements of blood viscosity over a wide range of shear rates (0.033 to 241 sec-1) mimicking the flow condition of the circulation, and two strain gauge transducers permitted the measurements of the brachial to radial pulse wave velocity as an index of arterial wall distensibility. In normotensive subjects cigarettes smoking increased pulse wave velocity from 7.1 + 1 to 9.2 + 0.6 m/sec. (P less than 0.05) as well as blood viscosity, which increased both at higher shear rates (+10% from 52 to 241 sec-1, P less than 0.05) and lower shear rates (+20% from 11.2 to 0.2 sec-1, P less than 0.02). In hypertensives, cigarettes smoking increased pulse wave velocity (9.8 + 0.3 to 11.3 + 0.4; P less than 0.05) and blood viscosity (4% at higher shear rate P less than 0.05 and 10% at lower shear rates P less than 0.02). Although hypertensive patients had increased pulse wave velocity and blood viscosity compared to normotensive controls, these variables were not significantly different when hypertensive non smokers were compared to normotensive. The present study demonstrated that cigarettes smoking produced in normotensive and hypertensive men significant rheological disturbances of flow and wall arteries.2

  12. [FEATURES OF ARTERIAL HYPERTENSION IN THE WORKING POPULATION].

    Science.gov (United States)

    Mershenova, G; Kossybayeva, M; Chancharov, B; Mirzayeva, B; Amangeldiyeva, K

    2017-01-01

    Purpose of the research was to study clinical features of arterial hypertension in the working population in Karaganda. The number of participants (500 patients): base group (250 patients) and control group (250 patients). The criteria for inclusion (age and gender characteristics, diseases/conditions and etc): age from 18 to 63 years; presence of arterial hypertension 1, 2 and 3 grades; possibility to measure the arterial pressure in dynamic; patients, who agreed to participate in the research work (the existence of informed consent). The criteria for an exception: children under 18 years, pregnant, the patient's refusal to participate in the research work. Methods of research - retrospective analysis of patients card in base and control groups at the working population of the city of Karaganda; physical examinations (anthropometrical indicators) in base and control groups. The processing and analysis of materials was conducted by using the average values and their standard errors. Significance of differences of independent sets of were estimated with parametric and nonparametric methods. In the study group compared with control were more common all the risk factors of hypertension, especially hypercholesterolemia and dyslipidemia in half of the cases in patients with arterial hypertension working age. We believe that the main factors of risk in arterial hypertension are hypercholesterolemia and dyslipidemia with combination in other factors, affecting mainly on the course and outcome of hypertension. Degrees of hypertension was dependent from age of patients and duration of illness, there was a trend more pronounced degree of hypertension in men than in women. In men with slavic nationality was more pronounced hypertension 1,2 and 3 degree, while in Kazakh nationality men often was observed hypertension 1, 2 degree. The degree of hypertension in the study group depending on the mental and physical labor did not observed. Hypertension 2-3 degrees was observed at

  13. How Is Pulmonary Hypertension Treated?

    Science.gov (United States)

    ... from the NHLBI on Twitter. How Is Pulmonary Hypertension Treated? Pulmonary hypertension (PH) has no cure. However, ... Types of Pulmonary Hypertension." ) Group 1 Pulmonary Arterial Hypertension Group 1 pulmonary arterial hypertension (PAH) includes PH ...

  14. Apparent and true resistant hypertension: definition, prevalence and outcomes

    Science.gov (United States)

    Judd, E; Calhoun, DA

    2014-01-01

    Resistant hypertension, defined as blood pressure (BP) remaining above goal despite the use of ≥3 antihypertensive medications at maximally tolerated doses (one ideally being a diuretic) or BP that requires ≥4 agents to achieve control, has received more attention with increased efforts to improve BP control rates and the emergence of device-based therapies for hypertension. This classically defined resistant group consists of patients with true resistant hypertension, controlled resistant hypertension and pseudo-resistant hypertension. In studies where pseudo-resistant hypertension cannot be excluded (for example, 24-h ambulatory BP not obtained), the term apparent resistant hypertension has been used to identify ‘apparent’ lack of control on ≥3 medications. Large, well-designed studies have recently reported the prevalence of resistant hypertension. Pooling prevalence data from these studies and others within North America and Europe with a combined sample size of >600 000 hypertensive participants, the prevalence of resistant hypertension is 14.8% of treated hypertensive patients and 12.5% of all hypertensives. However, the prevalence of true resistant hypertension, defined as uncontrolled both by office and 24-h ambulatory BP monitoring with confirmed medication adherence, may be more meaningful in terms of identifying risk and estimating benefit from newer therapies like renal denervation. Rates of cardiovascular events and mortality follow mean 24-h ambulatory BPs in patients with resistant hypertension, and true resistant hypertension represents the highest risk. The prevalence of true resistant hypertension has not been directly measured in large trials; however, combined data from smaller studies suggest that true resistant hypertension is present in half of the patients with resistant hypertension who are uncontrolled in the office. Our pooled analysis shows prevalence rates of 10.1% and 7.9% for uncontrolled resistant hypertension among

  15. 不同证型老年男性高血压病患者性激素相关调控因素的比较研究%Comparative Study on Sex Hormones Related Regulating Factors of Elder Men with Hypertension of Different Syndromes

    Institute of Scientific and Technical Information of China (English)

    郭伟星; 于杰; 张磊; 戴霞; 涂晓龙

    2012-01-01

    Objective: This paper studies the relationship between sex hormones related regulating factors and elderly male with hypertension of kidney deficiency syndrome and liver fire upflaming syndrome,so as to provide basis for sludy on pathophysiologi-cal changes of kidney deficiency syndrome of hypertension and liver fire upflaming syndrome of hypertension. Methods: According to hypertension diagnosis and classification standard fTCM differentiation standard chose elder male with hypertension of kidney deficiency syndrome(30 cases) and liver fire upflaming( 30 cases)and healthy elderly men(30 cases). The Elisa method was used to detect IL -2,Leptin,TNF -α,GnRH and DHEA -S levels. Riesulls: Abnormal changes of sex hormones related regulating factors levels of elderly male patients with hypertension of kidney deficiency syndrome had relevant with kidney deficiency. That indicated abnormal changes of IL - 2,Leptin and GnRH and DHEA - S levels may be one of the mechanism of kidney deficiency syndrome of hypertension in elder male patients.%目的:探讨男性老年人高血压病肾气亏虚证、肝火上炎证与性激素相关调控因素的关联性,从而为研究老年人高血压病肾气亏虚证、肝火上炎证证候表现的病理生理基础提供依据.方法:根据高血压诊断与分级标准、中医辨证标准选择了男性高血压病肾气亏虚证、肝火上炎证患者各30例和健康老年男性30例,采用酶联免疫吸附法检测白介素-2(IL-2)、瘦素(Leptin)、肿瘤坏死因子(TNF-α)、促性腺激素释放激素(GnRH)和硫酸脱氢表雄酮(DHEA-S)的水平.结果:男性老年人高血压肾气亏虚证患者的性激素相关调控因素水平的异常变化与男性老年人高血压病肾气亏虚证的发病有关,预示血清白介素-2、瘦素、促性腺激素释放激素和硫酸脱氢表雄酮水平的异常变化可能是男性老年人高血压病肾气亏虚证形成的病理基础之一.

  16. Hypertension and Obesity in Dakar, Senegal

    Science.gov (United States)

    Macia, Enguerran; Gueye, Lamine; Duboz, Priscilla

    2016-01-01

    Background Cardiovascular disease is a major public health problem in many sub-Saharan African countries, but data on the main cardiovascular risk factors–hypertension and obesity–are almost nonexistent in Senegal. The aims of this study were therefore (i) to report the prevalence, awareness, treatment and control of hypertension among adults in Dakar, (ii) to assess the prevalence of general and central obesity, and (iii) to analyze the association between hypertension and general and central obesity. Methods A cross-sectional survey was carried out in 2015 on a representative sample of 1000 dwellers of the Senegalese capital aged 20–90. Results The overall prevalence of hypertension was 24.7%. Among hypertensive respondents, 28.4% were aware of their condition; 16.0% were on antihypertensive medication; 4.9% had controlled blood pressure. The frequency of doctor visits was a significant predictor of awareness (OR = 2.16; p<0.05) and treatment (OR = 2.57; p<0.05) of hypertension. The prevalence of underweight, overweight and general obesity were 12.6%, 19.2% and 9.7% respectively. The prevalence of central obesity was 26% by WC and 39.8% by WHtR. General obesity and central obesity by WHtR significantly predicted HTN among men and women, but not central obesity by WC. Conclusions This study has demonstrated a high prevalence of hypertension in Dakar and a high prevalence of obesity among women–particularly among older women. The awareness, treatment, and effective control of hypertension are unacceptably low. The blood pressure of women with general obesity, and men with central obesity, in the community should be monitored regularly to limit the burden of cardiovascular disease in Senegal. PMID:27622534

  17. HIV risk behavior among men who have sex with men

    Directory of Open Access Journals (Sweden)

    Vijay Silan

    2013-01-01

    Full Text Available Background: Sentinel surveillance reported high human immunodeficiency virus positivity rates among men who have sex with men. The current study has described the high-risk behavior and self-reported sexually transmitted infection(s among self-identified men who have sex with men. Aims: The present study was to find out the extent of high-risk behavior and prevalence of self-reported sexually transmitted diseases among self-identified men who have sex with men, registered with selected nongovernmental organizations in Delhi. Materials and Methods: A facility-based cross-sectional study was done among 250 men who have sex with men during March 2009 to February 2010, through consecutive sampling strategy. Results: Majority (80% were anal-receptive, received money for sex (61% and were involved in all types of sexual intercourse with men (oral-86%, manual-97%, and anal-94%. Consistent condom use with male partner was low (46%, most common reason (52% for not using condom was, that either the condoms were not available or the partner objected. Self-reported sexually transmitted infection(s was 41% in the past 12 months. Conclusions: This study underscores the increased vulnerability of men who have sex with men of Delhi and need for sustained interventions.

  18. Portal hypertensive colopathy is associated with portal hypertension severity in cirrhotic patients

    Institute of Scientific and Technical Information of China (English)

    Antonio Diaz-Sanchez; Oscar Nu(n)ez-Martinez; Cecilia Gonzalez-Asanza; Ana Matilla; Beatriz Merino; Diego Rincon; Inmaculada Beceiro; Maria Vega Catalina; Magdalena Salcedo; Rafael Ba(n)ares; Gerardo Clemente

    2009-01-01

    AIM: To assess the prevalence of portal hypertension (PH) related colorectal lesions in liver transplant candidates, and to evaluate its association with the severity of PH.METHODS: Between October 2004 and December 2005, colonoscopy was performed in 92 cirrhotic liver transplant candidates. We described the lesions resulting from colorectal PH and their association with the grade of PH in 77 patients who underwent measurement of hepatic venous pressure gradient (HVPG). RESULTS: Mean age was 55 years and 80.7% of patients were men. The main etiology of cirrhosis was alcoholism (45.5%). Portal hypertensive colopathy (PHC) was found in 23.9%, colonic varices in 7.6% and polyps in 38% of patients (adenomatous type 65.2%). One asymptomatic patient had a well-differentiated adenocarcinoma. The manifestations of colorectal PH were not associated with the etiology of liver disease or with the Child-Pugh grade. Ninety percent of patients with colopathy presented with gastroesophageal varices (GEV), and 27.5% of patients with GEV presented with colopathy ( P = 0.12). A relationship between higher values of HVPG and presence of colopathy was observed (19.9 ± 6.2 mmHg vs 16.8 ± 5.4 mmHg, P = 0.045), but not with the grade of colopathy ( P = 0.13). Preneoplastic polyps and neoplasm ( P = 0.02) and spontaneous bacterial peritonitis ( P = 0.006) were more prevalent in patients with colopathy. We did not observe any association between previous β-blocker therapy and the presence of colorectal portal hypertensive vasculopathy. CONCLUSION: PHC is common in cirrhotic liver transplant candidates and is associated with higher portal pressure.

  19. Understanding and living with glaucoma and non-communicable diseases like hypertension and diabetes in the Jhaukhel-Duwakot Health Demographic Surveillance Site: a qualitative study from Nepal

    Directory of Open Access Journals (Sweden)

    Suraj Shakya-Vaidya

    2014-10-01

    Full Text Available Background: Primary open-angle glaucoma (POAG is one of the most common causes of irreversible blindness. A possible association between POAG and non-communicable diseases such as hypertension and diabetes suggests that the incidence of POAG may increase. People with POAG in Nepal usually present late to hospital and have poor knowledge of glaucoma. Objectives: Anticipating a knowledge gap regarding these diseases, this study aimed to explore the knowledge of POAG, hypertension, and diabetes in the community and barriers to health care. Design: We conducted this qualitative study in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS, a peri-urban community near Kathmandu, a capital city of Nepal. To study how disease influences knowledge, we conducted focus group discussions separately for men and women with and without pre-existing POAG, hypertension, and diabetes. Data were analyzed using the framework analysis approach. Results: Although people suffering from POAG, hypertension, and/or diabetes exhibited adequate knowledge of hypertension and diabetes, they lacked in-depth knowledge of POAG. People believed mostly in internal health locus of control. Perception of disease consequences and impact of disease on daily life was influenced by pre-existing POAG, hypertension, and/or diabetes but only in men. Gender disparity was observed regarding health literacy, health perception, and health barriers, which put women in a more difficult situation to tackle their health. We also revealed a gap between knowledge, attitude, and practice of health among women and healthy men. Conclusion: Although people in JD-HDSS exhibited adequate knowledge regarding hypertension and diabetes, they lacked in-depth knowledge about POAG. This study demonstrated gender difference in health literacy and access to health care, making women more vulnerable towards disease. We also demonstrated a gap between knowledge, attitude, and practice of health

  20. Hypertensive Emergencies in Pregnancy.

    Science.gov (United States)

    Olson-Chen, Courtney; Seligman, Neil S

    2016-01-01

    The prevalence of hypertensive disorders in pregnancy is increasing. The etiology and pathophysiology of hypertensive disorders in pregnancy remain poorly understood. Hypertensive disorders are a major cause of maternal and perinatal morbidity and mortality. Treatment of hypertension decreases the incidence of severe hypertension, but it does not impact rates of preeclampsia or other pregnancy complications. Several antihypertensive medications are commonly used in pregnancy, although there is a lack of randomized controlled trials. Severe hypertension should be treated immediately to prevent maternal end-organ damage. Appropriate antepartum, intrapartum, and postpartum management is important in caring for patients with hypertensive disorders.

  1. Links between childhood and adult social circumstances and obesity and hypertension in the Mexican population.

    Science.gov (United States)

    Beltrán-Sánchez, Hiram; Crimmins, Eileen M; Teruel, Graciela M; Thomas, Duncan

    2011-10-01

    This study examines links between early life circumstances and adult socioeconomic status and obesity and hypertension in the adult Mexican population. We use data from the Mexican Family Life Survey (MxFLS) collected in 2002 for people aged 20 or older (N = 14,280). We found that men with low education and women with more education have significantly lower obesity. Women with higher education also have significantly less hypertension. Obesity triples the likelihood of hypertension among both men and women. Better childhood experiences are associated with less hypertension among women, but more hypertension among men in rural areas. Recent changes in income, nutrition, and infection in Mexico may be responsible for the observed high prevalence of overweight and obesity and the extremely high odds of hypertension among obese young adults.

  2. Seclusion, decision-making power, and gender disparities in adult health: Examining hypertension in India.

    Science.gov (United States)

    Stroope, Samuel

    2015-09-01

    Research on the social determinants of health in developing countries is increasingly focusing on the importance of gender. Cardiovascular conditions such as hypertension are a growing concern in developing countries, where they are now the leading cause of death. Researchers have documented differences in hypertension between men and women, but the importance of gendered practices in shaping these differences has been left unexamined. Using national data from the India Human Development Survey 2005 (N=101,593), this study assesses the moderating role of two salient and widespread gendered practices-women's seclusion and decision-making power-on hypertension disparities between women and men. Both seclusion and low decision-making power are associated with increased odds of hypertension for women, but in the case of seclusion reduced hypertension for men. Results also show the gender gap in hypertension is exacerbated with women's seclusion and low decision-making power. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Association of Serum Bisphenol A with Hypertension in Thai Population

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    Wichai Aekplakorn

    2015-01-01

    Full Text Available Objective. The present study aimed to examine the association between serum BPA and hypertension and evaluated whether it was influenced by estradiol level. Methods. A subsample of 2588 sera randomly selected from the Thai National Health Examination Survey IV, 2009, was measured for serum BPA and estradiol. Logistic regression was used to examine the association controlling for age, sex, diabetes, body mass index, and estradiol level. Results. Compared with the lowest quartile, the adjusted odds ratio (AOR of hypertension for the fourth quartile of serum BPA was 2.16 (95% CI 1.31, 3.56 in women and 1.44 (0.99, 2.09 in men. There was no interaction between serum BPA and estradiol level. For analysis using log(BPA as a continuous variable, the AOR per unit change in log(BPA was 1.09 (95% CI 1.02, 1.16. Among postmenopausal women, the AOR for the fourth quartile of BPA was 2.33 (95% CI 1.31, 4.15 and, for premenopausal women, it was 2.12 (95% CI 0.87, 5.19. Conclusion. Serum BPA was independently associated with hypertension in women and was not likely to be affected by estrogen; however, its mechanism related to blood pressure needs further investigation.

  4. Racial differences in hypertension: implications for high blood pressure management.

    Science.gov (United States)

    Lackland, Daniel T

    2014-08-01

    The racial disparity in hypertension and hypertension-related outcomes has been recognized for decades with African Americans with greater risks than Caucasians. Blood pressure levels have consistently been higher for African Americans with an earlier onset of hypertension. Although awareness and treatment levels of high blood pressure have been similar, racial differences in control rates are evident. The higher blood pressure levels for African Americans are associated with higher rates of stroke, end-stage renal disease and congestive heart failure. The reasons for the racial disparities in elevated blood pressure and hypertension-related outcomes risk remain unclear. However, the implications of the disparities of hypertension for prevention and clinical management are substantial, identifying African American men and women with excel hypertension risk and warranting interventions focused on these differences. In addition, focused research to identify the factors attributed to these disparities in risk burden is an essential need to address the evidence gaps.

  5. Men's Role and Men's Lives.

    Science.gov (United States)

    Harrison, James B.

    1978-01-01

    The growing literature on men is clearly a response to the cultural ferment generated by feminism. However, as in the discussion of women's lives since the first advent of feminism, centuries of assumptions do not give way readily to appropriate scientific skepticism. (Author/MC)

  6. 86Rubidium uptake in mononuclear leucocytes from young subjects at increased risk of developing essential hypertension

    DEFF Research Database (Denmark)

    Nielsen, J R; Johansen, Torben; Pedersen, K E

    1988-01-01

    This study was designed to assess any changes in mononuclear leucocytes from young men at increased risk of developing essential hypertension and to determine whether any changes found were associated with borderline hypertension and/or heredity. To this end we used mononuclear leucocytes...... as a cellular model for in vitro measurement of total 86rubidium uptake to give an index of sodium-potassium pump activity. Four groups of subjects were evaluated, 28 normotensive and 20 borderline hypertensive offspring of hypertensives, and 12 borderline hypertensives and 28 normotensives with normotensive...... parents. 86Rubidium uptake was significantly increased in the borderline hypertensive subjects, especially in the borderline hypertensive offspring of hypertensive patients. Our results indicate that the sodium-potassium pump is activated in mononuclear leucocytes from borderline hypertensives...

  7. The hidden epidemic of hypertension.

    Science.gov (United States)

    Grenfell, Robert; Lee, Rebecca; Stavreski, Bill; Page, Karen

    2014-04-01

    The majority of cardiovascular disease (CVD) is caused by risk factors that can be controlled, treated or modified. In terms of attributable deaths, the leading cardiovascular disease risk factor is hypertension. The Australian Health Survey results showed some startling figures-4.6 million adult Australians are hypertensive (>140/90 mmHg). Further, a fifth of the adult population experience hypertension, with more than two out of three not attaining blood pressure target levels. This is despite an estimated cost of $1 billion per annum spent on managing hypertension. It is now well recognised that the level of risk for coronary heart disease is linked to an individual's risk profile. Results indicate that many Australians have multiple risk factors, including hypertension. It could be considered that these numbers provide a proxy indicator of secondary prevention failure. Considerable attention needs to be given to the assessment of the combined risk of those with hypertension enabling effective management of identified, modifiable risk factors. We look forward to presenting the absolute risk profiles when the Australian Health Survey biometric results are released.

  8. TREATMENT OF HYPERTENSION IN PREGNANCY: GUIDELINES AND CLINICAL EXPERIENCE

    Directory of Open Access Journals (Sweden)

    O. V. Gaisenok

    2015-09-01

    Full Text Available Topical issues of the treatment of hypertension in pregnancy are presented. Examples from clinical practice are discussed as well as possible medical treatment of hypertension in pregnant women taking into account actual recommendations.

  9. TREATMENT OF HYPERTENSION IN PREGNANCY: GUIDELINES AND CLINICAL EXPERIENCE

    Directory of Open Access Journals (Sweden)

    O. V. Gaisenok

    2014-01-01

    Full Text Available Topical issues of the treatment of hypertension in pregnancy are presented. Examples from clinical practice are discussed as well as possible medical treatment of hypertension in pregnant women taking into account actual recommendations.

  10. TREATMENT OF HYPERTENSION IN PREGNANCY: GUIDELINES AND CLINICAL EXPERIENCE

    OpenAIRE

    O. V. Gaisenok; O. A. Zamyatina; N. Yu. Denisova; A. S. Leonov

    2015-01-01

    Topical issues of the treatment of hypertension in pregnancy are presented. Examples from clinical practice are discussed as well as possible medical treatment of hypertension in pregnant women taking into account actual recommendations.

  11. TREATMENT OF HYPERTENSION IN PREGNANCY: GUIDELINES AND CLINICAL EXPERIENCE

    OpenAIRE

    O. V. Gaisenok; O. A. Zamyatina; N. Yu. Denisova; A. S. Leonov

    2014-01-01

    Topical issues of the treatment of hypertension in pregnancy are presented. Examples from clinical practice are discussed as well as possible medical treatment of hypertension in pregnant women taking into account actual recommendations.

  12. Obesity and hypertension

    Science.gov (United States)

    Jiang, Shu-Zhong; Lu, Wen; Zong, Xue-Feng; Ruan, Hong-Yun; Liu, Yi

    2016-01-01

    The imbalance between energy intake and expenditure is the main cause of excessive overweight and obesity. Technically, obesity is defined as the abnormal accumulation of ≥20% of body fat, over the individual's ideal body weight. The latter constitutes the maximal healthful value for an individual that is calculated based chiefly on the height, age, build and degree of muscular development. However, obesity is diagnosed by measuring the weight in relation to the height of an individual, thereby determining or calculating the body mass index. The National Institutes of Health have defined 30 kg/m2 as the limit over which an individual is qualified as obese. Accordingly, the prevalence of obesity in on the increase in children and adults worldwide, despite World Health Organization warnings. The growth of obesity and the scale of associated health issues induce serious consequences for individuals and governmental health systems. Excessive overweight remains among the most neglected public health issues worldwide, while obesity is associated with increasing risks of disability, illness and death. Cardiovascular diseases, the leading cause of mortality worldwide, particularly hypertension and diabetes, are the main illnesses associated with obesity. Nevertheless, the mechanisms underlying obesity-associated hypertension or other associated metabolic diseases remains to be adequately investigated. In the present review, we addressed the association between obesity and cardiovascular disease, particularly the biological mechanisms linking obesity and hypertension. PMID:27703502

  13. Treatment Resistant Hypertension.

    Science.gov (United States)

    Egan, Brent M

    2015-11-05

    Treatment resistant hypertension (TRH) is defined by office blood pressure (BP) uncontrolled on ≥ 3 or controlled on ≥ 4 antihypertensive medications, preferably at optimal doses and including a diuretic. Apparent (a)TRH is used when optimal therapy, adherence, and measurement artifacts are unknown. Among treated hypertensives, ~30% of uncontrolled and 10% of controlled individuals have aTRH, with a higher prevalence in Blacks than other race-ethnicity groups. In ≥ 50% of aTRH patients, BP measurement artifacts ('office' TRH), suboptimal regimens, or suboptimal adherence are present, ie, pseudo-resistance. While patients with 'office' TRH have fewer cardiovascular events than those with 'true' TRH, no evidence confirms that patients with suboptimal regimens or adherence are spared. Averaging several office BPs obtained with an automated monitor can reduce 'office' TRH. Home or ambulatory BP monitoring can identify office resistance. Prescribing ≥ 3 different antihypertensive medication classes, eg, thiazide-type diuretic, renin-angiotensin blocker and calcium antagonist at ≥ 50% of maximum recommended doses reasonably defines optimal therapy. Intensifying diuretic therapy, eg, adding an aldosterone antagonist, is effective for many TRH patients who are volume expanded. Clinical information, hemodynamic and renin-guided therapeutics can inform other treatment options. Attention to adverse effects, medication costs, and pill burden can improve adherence and control. Patients with aTRH and suspected secondary hypertension should be evaluated. Interfering substances or medications should be discontinued. These approaches will identify or correct the problem in ~80% of aTRH patients. Referral to a hypertension specialist and newer therapeutic approaches are options for TRH patients who cannot take or do not respond to optimal therapy.

  14. Lp(a) in hypertensive patients.

    Science.gov (United States)

    Catalano, M; Perilli, E; Carzaniga, G; Colombo, F; Carotta, M; Andreoni, S

    1998-02-01

    Lipoprotein(a) (Lp(a)) is considered an important risk factor for coronary disease, cerebrovascular pathology and re-stenosis of coronary bypass. Few studies have been conducted on this lipoprotein in essential arterial hypertensive patients. The purpose of our study was to measure the serum concentrations of Lp(a) and the main parameters of the lipid profile in a group of essential hypertensive patients not receiving pharmacological treatment and with no clinical signs of associated pathologies or organ damage. A total of 123 Caucasian essential arterial hypertensive patients (47 men and 76 women) were studied and compared with 89 controls (36 men and 53 women) matched in terms of age, sex, body mass index (BMI) and smoking habits. It was found that the hypertensive patients had higher plasma concentrations of Lp(a), total cholesterol (TC), triglycerides (TG) and very low density lipoprotein (VLDL-C) than controls (P < 0.01), with no differences in the plasma concentrations of Lp(a) between the two sexes. Only 10 hypertension patients and seven controls had plasma concentrations of Lp(a) of over 30 mg/dl. Lp(a) does not correlate with the main parameters of the lipid profile. We can confirm that hypertension and dyslipidaemia, which are two of the main risk factors for vascular diseases on an atherosclerotic basis, are often associated. However, higher plasma concentrations of Lp(a), albeit within the normal range, could be an independent risk factor for atherosclerosis, and could contribute towards increasing the incidence of cardiovascular disease in people with essential arterial hypertension.

  15. Hypertension in Danish seafarers

    DEFF Research Database (Denmark)

    Tu, Mingshan; Jepsen, Jørgen Riis

    2016-01-01

    intake, and body mass index. Results: The overall prevalence of hypertension in the study population was 44.7% (95% CI 40.8–48.6). In a comparison sample of adult Danes, the crude rate of hypertension was 12.6%. In addition, 41.8% (95% CI 38.0–45.7) of seafarers were pre-hypertensive. Hypertension......Background: Due to the high prevalence of arterial hypertension and its role in the development of athe- rosclerosis, myocardial infarction and stroke, hypertension is a major public health challenge worldwide. There is limited knowledge of the prevalence of hypertension among seafarers who......, however, are known to have an excess morbidity and mortality from these disorders. This article addresses the prevalence of hypertension among Danish seafarers and discusses potential risk factors for hypertension in maritime settings. Materials and methods: A representative sample of 629 Danish seafarers...

  16. Experiences of patients with hypertension at primary health care in facilitating own lifestyle change of regular physical exercise

    Directory of Open Access Journals (Sweden)

    Nomasonto B.D. Magobe

    2017-02-01

    Full Text Available Background: Regular physical exercise is one of the lifestyle modification general measures to control the blood pressure (BP of patients with hypertension. Globally, hypertension is considered a non-communicable disease (NCD, as well as a chronic condition of lifestyle, that contributes to the mortality rate caused by complications of cardiovascular burden of diseases. In South Africa, NCDs account for nearly 40% of adult deaths, with a high prevalence among black people in urban areas such as Soweto.The first step in treating hypertension is lifestyle modification, referred to in this study as health-promoting lifestyle change measures. Despite the positive benefits of regular physical exercise in controlling hypertension, in 2014, only 10% of men and 18% of women with hypertension had their BP controlled to a level that would eliminate the risk of cardiovascular disease (CVD complications.Objectives: The aim of this article is to present the experiences of patients with hypertension regarding the facilitation of their own health-promoting lifestyle change measure of regular physical exercise.Method: A qualitative, exploratory, descriptive and contextual research design was used. The accessible population of patients with hypertension at three primary health care (PHC clinics in Soweto was targeted and purposefully sampled. Focus group and individual interviews were conducted to collect data till data saturation occurred. Tesch’s open-coding method of data analysis was used.Results and conclusions: Findings show that participants experienced poor self-care due to poor self-efficacy, demonstrated by not engaging in regular physical exercise, which in turn, resulted in uncontrolled BP and cardiovascular complications from hypertension. More should be done to educate, motivate and empower patients with the necessary knowledge, skills and the values in facilitating their own regular physical exercise in order to improve their own quality of

  17. Hypertension management: the primary care nursing role.

    Science.gov (United States)

    Khan, Ehsan Ullah

    2005-03-01

    Hypertension is a prevalent chronic illness that is implicated in many cardiovascular diseases. Practice nurses and the district nursing team have a major role to play in its management. In this article, current British Hypertension Society guidelines are presented and discussed with regards to their evidence base. Implications for nursing practice are highlighted.

  18. Serum lipids and apolipoproteins in patients with essential hypertension.

    Science.gov (United States)

    Catalano, M; Aronica, A; Carzaniga, G; Seregni, R; Libretti, A

    1991-03-01

    Fifty hypertensive untreated outpatients (34 women, 16 men), with stage I and II essential hypertension, were studied in comparison to 50 age- and sex-matched controls with similar life-styles. Total cholesterol triglycerides, LDL-cholesterol, VLDL-cholesterol, and HDL-cholesterol were measured by enzymatic methods, and apolipoproteins AI, AII, B, CII, CIII and E by RID. The results showed significant differences between hypertensives and controls respectively in triglycerides (135.2 +/- 73.9 versus 90.2 +/- 33.8, P less than 0.01) and VLDL cholesterol (26.7 +/- 14.8 versus 17.7 +/- 6.6, P less than 0.01) while no significant differences were observed in total, LDL and HDL cholesterol. Significant differences between the two groups were also observed in apolipoproteins, particularly in apo AI (130.0 +/- 28.2 versus 144.9 +/- 27.9, P less than 0.05), apo AII (32.9 +/- 10.2 versus 39.6 +/- 11.4, P less than 0.01), apo CII (4.0 +/- 2.6 versus 5.4 +/- 2.9, P less than 0.05) and apo E (5.0 +/- 1.8 versus 4.3 +/- 1.8, P less than 0.05), while no significant differences were observed in apo B and CIII values. The results suggest that in untreated hypertensive patients alterations in the apolipoproteins profile are present which, in part, may be responsible for the elevated incidence of cardiovascular disease, independently from the blood pressure values.

  19. An assessment of dietary intake and state of nutritional in hypertensive patients from rural and urban areas of Greater Poland.

    Science.gov (United States)

    Suliburska, Joanna; Bogdański, Paweł; Duda, Grażyna; Pupek-Musialik, Danuta; Piątek, Jacek; Żukiewicz-Sobczak, Wioletta

    2012-01-01

    The aim of this study was to determine the nutritional factors connected with the prevalence of hypertension in rural and urban areas of Greater Poland. The study consisted of 308 people aged 35-62, with essential hypertension but without any other coexisting disorders. The studied group consisted of 154 residents of Poznań (79 women and 75 men) and 152 inhabitants of rural areas in Greater Poland (78 women and 74 men). Participants were randomly assigned to the study. Nutritional state assessment was based on Body Mass Index (BMI) and body fat percentage. Dietary intake were assessed with a 24-hour nutritional survey from 3 consecutive days. Analysis of anthropometric examination results showed a large prevalence of obesity in the studied group. Moreover people living in rural areas had a significantly higher BMI and body fat percentage than those living in a city. It has been proved that the patients with hypertension consume food with an excess of fat and a shortage of fibre, antioxidant vitamins, potassium, calcium and magnesium. The total food rations of rural dwellers consisted of larger amounts of fat, cholesterol and vitamin A compared to those of city dwellers. Present studies have shown incorrect dietary intake among patients with hypertension, often related to the coexistence of overweight and obesity. Obtained results indicate significantly worse eating habits and state of nutrition among rural inhabitants.

  20. Renal dopamine receptors and hypertension.

    Science.gov (United States)

    Hussain, Tahir; Lokhandwala, Mustafa F

    2003-02-01

    Dopamine has been recognized as an important modulator of central as well as peripheral physiologic functions in both humans and animals. Dopamine receptors have been identified in a number of organs and tissues, which include several regions within the central nervous system, sympathetic ganglia and postganglionic nerve terminals, various vascular beds, the heart, the gastrointestinal tract, and the kidney. The peripheral dopamine receptors influence cardiovascular and renal function by decreasing afterload and vascular resistance and promoting sodium excretion. Within the kidney, dopamine receptors are present along the nephron, with highest density on proximal tubule epithelial cells. It has been reported that there is a defective dopamine receptor, especially D(1) receptor function, in the proximal tubule of various animal models of hypertension as well as in humans with essential hypertension. Recent reports have revealed the site of and the molecular mechanisms responsible for the defect in D(1) receptors in hypertension. Moreover, recent studies have also demonstrated that the disruption of various dopamine receptor subtypes and their function produces hypertension in rodents. In this review, we present evidence that dopamine and dopamine receptors play an important role in regulating renal sodium excretion and that defective renal dopamine production and/or dopamine receptor function may contribute to the development of various forms of hypertension.

  1. BURNOUT SYNDROME IN PATIENTS WITH WORKPLACE HYPERTENSION

    Directory of Open Access Journals (Sweden)

    Yu. P. Zinchenko

    2016-01-01

    Full Text Available Aim. To study the presence, severity and qualitative characteristics of «burnout syndrome» in patients with «workplace hypertension» (WPH, in comparison with patients with essential hypertension and healthy people.Material and methods. Untreated patients with hypertension stage II, degree 1-2 (n=170; age 32-52 years; mean age 46.7Ѓ}4.1 years were examined. Group 1 included 85 patients with WPH (mean age 44.7Ѓ}4.3 years and Group 2 included 85 patients without WPH (mean age 47.4Ѓ}4.5 years. The duration of hypertension on average was 7.2Ѓ}2.6 years and was comparable in both groups. The control group included 82 healthy subjects (mean age 44.9Ѓ}3.1 years. The Russian version of the Maslach Burnout Inventory (MBI was used to diagnose «burnout syndrome».Results. Signs of «burnout syndrome» were found in the hypertensive patients of both groups. The high and medium levels of the «burnout syndrome» severity according to all three analyzed factors (emotional exhaustion, dehumanization/depersonification, and personal achievements were found in 59% of WPH patients, in 36% of hypertensive patients without WPH, and in 9% of healthy individuals. Most of WPH patients had high emotional exhaustion compared with other groups (27.5Ѓ}3.67 points vs 24.6Ѓ}4.3 and 20.1Ѓ}5.7 points in group 2, and group of healthy, respectively; p<0.05. Hypertensive men rated themselves as less successful professionally in comparison with women. Hypertensive women were more prone to emotional exhaustion and dehumanization/depersonification in comparison with men. Conclusion. Signs of «burnout syndrome» were found significantly more often in hypertensive patients in both groups than in healthy people. Medium and high intensity of all forms of «burnout syndrome» occurred in patients with WPH in comparison with healthy people and hypertensive patients without WPH.

  2. Hypertension and ethnicity.

    Science.gov (United States)

    Bennett, Amanda; Parto, Parham; Krim, Selim R

    2016-07-01

    Despite its continued increase in prevalence in minorities, data regarding hypertension (HTN) control among such ethnic groups remains limited. This review highlights the most recent literature on the epidemiology, prevalence, and treatment strategies of HTN among four racial groups (non-Hispanic Whites (NHW), Blacks, Hispanics, and Asians). Overall awareness and treatment of HTN were found to be higher in blacks when compared with NHWs. Access to health insurance is associated with successful HTN control, particularly among the Hispanic populations. Recent data from SBP Intervention Trial suggests the blood pressure control and adherence rates in blacks were highest among men, with a higher number of comorbidities, and on diuretic therapy. Additionally, the initiation of thiazide-type diuretics and calcium channel blocker was superior to β-adrenergic blockers and angiotensin converting enzyme inhibitor/angiotensin receptor blockers in blood pressure lowering among blacks. However, no specific treatment recommendations exist for Hispanics or Asians. Finally, recent guidelines from the Joint National Commission recommend initial treatment with a thiazide-type diuretic regardless of race. Despite recent progress, racial disparities in awareness and treatment of HTN continue to exist. To reduce this important gap, future research should focus on epidemiologic, genetic, and sociologic factors as well as specific therapies to achieve maximum medical benefit in these subgroups.

  3. Pregnancy and pulmonary hypertension

    NARCIS (Netherlands)

    Pieper, Petronella G.; Lameijer, Heleen; Hoendermis, Elke S.

    Pulmonary hypertension during pregnancy is associated with considerable risks of maternal mortality and morbidity. Our systematic review of the literature on the use of targeted treatments for pulmonary arterial hypertension during pregnancy indicates a considerable decrease of mortality since a

  4. HIV and Pulmonary Hypertension

    Science.gov (United States)

    ... 03-13T18:29:11+00:00 PH and HIV Print PH and HIV Brochure (PDF) Order Copies ... to know about pulmonary hypertension in connection with HIV? Although pulmonary hypertension and HIV are two separate ...

  5. Hypertension (High Blood Pressure)

    Science.gov (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Hypertension (High Blood Pressure) KidsHealth > For Teens > Hypertension (High Blood Pressure) Print ... rest temperature diet emotions posture medicines Why Is High Blood Pressure Bad? High blood pressure means a person's heart ...

  6. Poor sleep quality and resistant hypertension.

    Science.gov (United States)

    Bruno, Rosa Maria; Palagini, Laura; Gemignani, Angelo; Virdis, Agostino; Di Giulio, Alessia; Ghiadoni, Lorenzo; Riemann, Dieter; Taddei, Stefano

    2013-11-01

    We aimed to determine the relationship between sleep quality and treatment-resistant hypertension (RH). In our cross-sectional cohort study, 270 consecutive essential hypertensive patients were recruited at the Outpatient Hypertension Unit, University of Pisa, Italy. The Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI-Y2) were administered to all subjects. RH was defined as office blood pressure (BP) >140/90 mmHg with three or more antihypertensive drugs or controlled BP with four or more drugs. Poor sleep quality was defined as PSQI >5, depressive symptoms as BDI >10, and trait anxiety as STAI-Y2 >40. Patients with other sleep disorders were excluded. Complete data were available for 222 patients (50.9% men; mean age, 56.6±12.5 y; RH, 14.9%). Poor sleep quality had a prevalence of 38.2% in the overall population. RH was associated with poor sleep quality, increased sleep latency and reduced sleep efficiency. No significant relationship was found between RH and short sleep duration or depressive symptoms and trait anxiety. Poor sleep quality was more prevalent in resistant vs nonresistant hypertensive women (70.6% vs 40.2%; P=.02) but not in resistant vs nonresistant men (43.8% vs 29.2%; P=.24). In women poor sleep quality was an independent predictor of RH, even after adjustment for cardiovascular and psychiatric comorbidities (odds ratio [OR], 5.3 [confidence interval {CI}, 1.1-27.6), explaining 4.7% of its variance. In men age, diabetes mellitus (DM), and obesity were the only variables associated with RH. Poor sleep quality is significantly associated with resistance to treatment in hypertensive women, independent of cardiovascular and psychiatric confounders. Copyright © 2013 Elsevier B.V. All rights reserved.

  7. Hypertension in pregnancy

    Directory of Open Access Journals (Sweden)

    Andrea Ungar

    2007-03-01

    Full Text Available Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories: chronic hypertension, pre-eclampsia/eclampsia, pre-eclampsia superimposed on chronic hypertension, and gestational hypertension. A relative paucity of investigative data, as well as the frequent difficulty in making an etiological diagnosis, may lead to problems in its management. This case report analyses current concepts regarding the hypertensive disorders of gestation, focusing on chronic hypertension. Chronic hypertension is defined as blood pressure exceeding 140/90 mmHg before pregnancy or before 20 weeks gestation. Hypertensive disorders in pregnancy may cause maternal and fetal morbidity and remain a leading source of maternal mortality. A prompt diagnosis is needed also because hypertension may be an indicator of pre-eclampsia, a condition which can evolve into serious complications. Maintaining blood pressure below 140/90 mmHg is recommended, although treatment should be determined on an individual basis. Many anti-hypertensive agents appear to be safe for use during pregnancy: methildopa has been the most studied of the anti-hypertensive drugs and has the best safety record. Labetalol, idralazine and nifedipine also have been found to be safe; ACE-inhibitors are absolutely contraindicated, because they are associated with intrauterine growth retardation.

  8. Hypertension in developing countries.

    Science.gov (United States)

    Tibazarwa, Kemi B; Damasceno, Albertino A

    2014-05-01

    The past 2 decades have seen a considerable global increase in cardiovascular disease, with hypertension remaining by far the most common. More than one-third of adults in Africa are hypertensive; as in the urban populations of most developing countries. Being a condition that occurs with relatively few symptoms, hypertension remains underdetected in many countries; especially in developing countries where routine screening at any point of health care is grossly underutilized. Because hypertension is directly related to cardiovascular disease, this has led to hypertension being the leading cause of adverse cardiovascular outcomes, as a result of patients living, often unknowingly, with uncontrolled hypertension for prolonged periods of time. In Africa, hypertension is the leading cause of heart failure; whereas at global levels, hypertension is responsible for more than half of deaths from stroke, just less than half of deaths from coronary artery disease, and for more than one-tenth of all global deaths. In this review, we discuss the escalating occurrence of hypertension in developing countries, before exploring the strengths and weaknesses of different measures to control hypertension, and the challenges of adopting these measures in developing countries. On a broad level, these include steps to curb the ripple effect of urbanization on the health and disease profile of developing societies, and suggestions to improve loopholes in various aspects of health care delivery that affect surveillance and management of hypertension. Furthermore, we consider how the industrial sectors' contributions toward the burden of hypertension can also be the source of the solution.

  9. Genetik og hypertension

    DEFF Research Database (Denmark)

    Ellervik, Christina; Tarnow, Lise; Pedersen, Erling Bjerregaard

    2009-01-01

    Monogenic forms of hypertension are very rare, but have a well-characterized heredity. Primary hypertension is very common with a complex and polygenic heredity. Primary hypertension arises due to an interaction between multiple genetic and environmental factors. Its heredity is unknown, although...

  10. Pulmonary Hypertension Association

    Science.gov (United States)

    ... at www.AHeartCures.org . Help Kickoff November’s Pulmonary Hypertension Awareness Month Want to help raise awareness for ... Heart2CurePH | Help promote Awareness Month Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Awareness Chronic thromboembolic pulmonary hypertension (CTEPH) is ...

  11. Reported fried food consumption and the incidence of hypertension in a Mediterranean cohort: the SUN (Seguimiento Universidad de Navarra) project.

    Science.gov (United States)

    Sayon-Orea, Carmen; Bes-Rastrollo, Maira; Gea, Alfredo; Zazpe, Itziar; Basterra-Gortari, Francisco J; Martinez-Gonzalez, Miguel A

    2014-09-28

    Reported associations between the consumption of fried foods and the incidence of obesity or weight gain make it likely that fried food consumption might also be associated with the development of hypertension. However, evidence from long-term prospective studies is scarce. Therefore, the aim of the present study was to longitudinally evaluate this association in a prospective cohort. The SUN (Seguimiento Universidad de Navarra) project is a Mediterranean cohort study of university graduates conducted in Spain, which started in December 1999 and is still ongoing. In the present study, we included 13,679 participants (5059 men and 8620 women), free of hypertension at baseline with a mean age of 36·5 (SD 10·8) years. Total fried food consumption was estimated at baseline. The outcome was the incidence of a medical diagnosis of self-reported hypertension during the follow-up period. To assess the association between the consumption of fried foods and the subsequent risk of developing incident hypertension during the follow-up period, Cox regression models were used. During a median follow-up period of 6·3 years, 1232 incident cases of hypertension were identified. After adjusting for potential confounders, the adjusted hazard ratios for developing hypertension were 1·18 (95% CI 1·03, 1·36) and 1·21 (95% CI 1·04, 1·41) for those consuming fried foods 2-4 and >4 times/week, respectively, compared with those consuming fried foods < 2 times/week (P for trend = 0·009). In conclusion, frequent consumption of fried foods at baseline was found to be associated with a higher risk of hypertension during the follow-up period in a Mediterranean cohort of university graduates.

  12. Incident Cardiovascular Risk Factors Among Men and Women Veterans After Return From Deployment.

    Science.gov (United States)

    Haskell, Sally G; Brandt, Cynthia; Burg, Matthew; Bastian, Lori; Driscoll, Mary; Goulet, Joseph; Mattocks, Kristin; Dziura, James

    2017-10-03

    Stressors associated with military service and reintegration may impact psychologic well-being and behaviors that result in increased incidence rates for cardiovascular (CV) risk factors. Using electronic health record data from the Veterans Health Administration we sought to measure the incidence of newly diagnosed CV risk factors and how these incident risks were moderated by race and mental health conditions. A cohort study including Veterans whose end of last deployment was between October 1, 2001 and July 31, 2014. A total of 267,305 Operations Iraqi Freedom, Enduring Freedom, and New Dawn Veterans were present. Incident risk factors (hypertension, obesity, dyslipidemia, diabetes, or coronary artery disease), identified through new International Classification of Diseases, 9th Revision, Clinical Modification diagnostic codes or measurement recordings at primary care visits. The rate of developing at least 1 risk factor or coronary artery disease was 240 and 151 per 1000 person-years in men and women, respectively. Except for obesity, women were significantly less likely to develop any other CV risk factor compared with men (Crude hazard ratios ranging from 0.44 to 0.82). The impact of sex on hypertension (Prisk factor (P=0.007) and obesity (Preturn from deployment, but less likely to develop any other risk . For black women, the protective effect of female sex on the combined event (any risk factor), and hypertension was lessened compared with white women. The increased risk of obesity for women was greater in black women, and those with depression.

  13. Occupational Disparities in the Association between Self-Reported Salt-Eating Habit and Hypertension in Older Adults in Xiamen, China

    Directory of Open Access Journals (Sweden)

    Manqiong Yuan

    2016-01-01

    Full Text Available Blood pressure responses to sodium intake are heterogeneous among populations. Few studies have assessed occupational disparities in the association between sodium intake and hypertension in older people. We used cross-sectional data from 14,292 participants aged 60 years or older in Xiamen, China, in 2013. Self-reported salt-eating habit was examined with three levels: low, medium, and high. The main lifetime occupation was classified into indoor laborer and outdoor laborer. Multivariable logistic regression was used to examine associations of hypertension with self-reported salt-eating habit, main lifetime occupation, and their interactions by adjusting for some covariates, with further stratification by sex. Overall, 13,738 participants had complete data, of whom 30.22% had hypertension. The prevalence of hypertension was 31.57%, 28.63%, and 31.97% in participants who reported to have low, medium, and high salt-eating habit, respectively. Outdoor laborers presented significantly lower prevalence of hypertension than indoor laborers (26.04% vs. 34.26%, p < 0.001. Indoor laborers with high salt-eating habit had the greatest odds of hypertension (OR = 1.32, 95% CI [1.09–1.59]. An increased trend of odds in eating habit as salt-heavier was presented in indoor laborers (p-trend = 0.048, especially for women (p-trend = 0.001. No clear trend presented in men. Conclusively, sex-specific occupational disparities exist in the association between self-reported salt-eating habit and hypertension in older individuals. Overlooking the potential moderating role of sex and occupation might affect the relationship between sodium intake and hypertension.

  14. [The influence of carbon dioxide baths differing in the total mineralization levels on the functional state of the cardiovascular system of the patients presenting with hypertensive disease associated with coronary heart disease].

    Science.gov (United States)

    L'vova, N V; Tupitsyna, Iu Iu; Badalov, N G; Krasnikov, V E; Lebedeva, O D

    2013-01-01

    The results of the study on the influence of carbon dioxide baths differing in the total mineralization levels on the clinical course of hypertensive disease associated with coronary heart disease and on various functional systems of the body. The data obtained provide an insight into the role of salt concentrations (10 and 20 g/l) in carbon dioxide bath water (1.2 g/l) applied for the traditional treatment of the patients with hypertensive disease associated with concomitant coronary heart disease and musculoskeletal pathology. Highly mineralized bath water has a greater influence on the functional state of the cardiovascular system by causing a more pronounced decrease in peripheral vascular resistance and hypotensive effect. Baths with a salt concentration of 20 g/l markedly reduced pain and had anti-inflammatory effect in the patients with pathology of support and locomotor organs.

  15. Arterial hypertension in chronic glomerulonephritis. An analysis of 310 cases.

    Science.gov (United States)

    Danielsen, H; Kornerup, H J; Olsen, S; Posborg, V

    1983-06-01

    310 cases of glomerulonephritis classified morphologically according to the criteria of the WHO were analyzed retrospectively in order to determine the frequency of arterial hypertension. The overall prevalence of arterial hypertension was 61%. Hypertension was most frequent and severe in membranoproliferative and sclerotic glomerulonephritis, but often mild and transient in extracapillary glomerulonephritis. Hypertension usually developed during the early stages of the disease when kidney function was well preserved and in only 16% was hypertension first seen during the uremic stage. No correlation was found between hypertension and the presence of the nephrotic syndrome. During dialysis, hypertension was present in 78%; in 90% of these patients hypertension was "controllable" and in 10% it was "uncontrollable".

  16. A CASE OF IDIOPATHIC PULMONARY ARTERIAL HYPERTENSION IN MALE

    Directory of Open Access Journals (Sweden)

    Poongavanam Paranthaman

    2016-08-01

    Full Text Available Primary Pulmonary Hypertension is a rare disease occurring in 1-2 per million population. It is 2-4 times more common in female. Idiopathic or primary pulmonary hypertension is defined as a disorder with no identifiable cause in which resting mean pulmonary artery pressure in adults is above 25 mmHg and 30 mmHg with exercise. Idiopathic or primary pulmonary hypertension is diagnosed after ruling out all the possible secondary causes of pulmonary hypertension. We are presenting a case of middle-aged male who presented with dyspnoea and on further evaluation found to have primary pulmonary hypertension, which is uncommon in male

  17. Insulin Resistance and Hypertension

    Institute of Scientific and Technical Information of China (English)

    张建华; 张春秀

    2002-01-01

    Summary: The insulin sensitivity in hypertensive patients with normal glucose tolerance (NGT),impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM) and the insulin resistance(IR) under the disorder of glucose metabolism and hypertension were studied. By glucose toler-ance test and insulin release test, insulin sensitivity index (ISI) and the ratio of area under glucosetolerance curve (AUCG) to area under insulin release curve (AUC1) were calculated and analyzed.The results showed that ISI was decreased to varying degrees in the patients with hypertension,the mildest in the group of NGT with hypertension, followed by the group of IGT without hyper-tension, the group of IGT with hypertension and DM (P=0). There was very significant differ-ence in the ratio of AUCG/AUC1 between the hypertensive patients with NGT and controls (P=0). It was concluded that a significant IR existed during the development of IGT both in hyperten-sion and nonhypertension. The increase of total insulin secretion (AUC1) was associated with non-hypertension simultaneously. IR of the hypertensive patients even existed in NGT and was wors-ened with the deterioration of glucose metabolism disorder, but the AUC1 in the HT groupchanged slightly. A relative deficiency of insulin secretion or dysfunction of β-cell of islet existed inIGT and DM of the hypertensive patients.

  18. Secondary Hypertension in Pregnancy.

    Science.gov (United States)

    Malha, Line; August, Phyllis

    2015-07-01

    Hypertension is a common medical complication of pregnancy. Although 75-80 % of women with preexisting essential hypertension will have uncomplicated pregnancies, the presence of secondary forms of hypertension adds considerably to both maternal and fetal morbidity and mortality. Renovascular hypertension, pheochromocytoma, and Cushing's syndrome in particular are associated with accelerating hypertension, superimposed preeclampsia, preterm delivery, and fetal loss. Primary aldosteronism is a more heterogeneous disorder; there are well-documented cases where blood pressure and hypokalemia are improved during pregnancy due to elevated levels of progesterone. However, superimposed preeclampsia, worsening hypertension, and early delivery are also reported. When possible, secondary forms of hypertension should be diagnosed and treated prior to conception in order to avoid these complications.

  19. Metabolomics in hypertension.

    Science.gov (United States)

    Nikolic, Sonja B; Sharman, James E; Adams, Murray J; Edwards, Lindsay M

    2014-06-01

    Hypertension is the most prevalent chronic medical condition and a major risk factor for cardiovascular morbidity and mortality. In the majority of hypertensive cases, the underlying cause of hypertension cannot be easily identified because of the heterogeneous, polygenic and multi-factorial nature of hypertension. Metabolomics is a relatively new field of research that has been used to evaluate metabolic perturbations associated with disease, identify disease biomarkers and to both assess and predict drug safety and efficacy. Metabolomics has been increasingly used to characterize risk factors for cardiovascular disease, including hypertension, and it appears to have significant potential for uncovering mechanisms of this complex disease. This review details the analytical techniques, pre-analytical steps and study designs used in metabolomics studies, as well as the emerging role for metabolomics in gaining mechanistic insights into the development of hypertension. Suggestions as to the future direction for metabolomics research in the field of hypertension are also proposed.

  20. Hyponatremic hypertensive syndrome - a retrospective cohort study

    Science.gov (United States)

    Mukherjee, Devdeep; Sinha, Rajiv; Akhtar, Md Shakil; Saha, Agni Sekhar

    2017-01-01

    AIM To ascertain the frequency of hyponatremic hypertensive syndrome (HHS) in a cohort of children with hypertensive emergency in a tertiary pediatric hospital. METHODS A retrospective review was undertaken among children with hypertensive emergency admitted in our tertiary children hospital between June 2014 and December 2015 with an aim to identify any children with HHS. Three children with HHS were identified during this period. RESULTS The 3 patients with HHS presented with hypertensive emergency. They were initially managed with Labetalol infusion and thereafter switched to oral anti-hypertensives (combination of Nifedipine sustained release, Hydralazine and Beta Blocker). All 3 were diagnosed to have unilateral renal artery stenosis. One child was lost to follow up, whereas the other 2 underwent renal angioplasty which was followed with normalization of blood pressure. CONCLUSION Despite activation of renin angiotensin axis secondary to renal artery stenosis, these groups of children have significant hyponatremia. Renal re-vascularisation produces excellent results in most of them. PMID:28101450

  1. Pharmacotherapy for mild hypertension

    Directory of Open Access Journals (Sweden)

    Diana Diao

    Full Text Available BACKGROUND: People with no previous cardiovascular events or cardiovascular disease represent a primary prevention population. The benefits and harms of treating mild hypertension in primary prevention patients are not known at present. This review examines the existing randomized controlled trial (RCT evidence. OBJECTIVE: Primary objective: To quantify the effects of antihypertensive drug therapy on mortality and morbidity in adults with mild hypertension (systolic blood pressure (BP 140-159 mmHg and/or diastolic BP 90-99 mmHg and without cardiovascular disease. METHODS: Search: We searched CENTRAL (2011, Issue 1, MEDLINE (1948 to May 2011, EMBASE (1980 to May 2011 and reference lists of articles. The Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effectiveness (DARE were searched for previous reviews and meta-analyses of anti-hypertensive drug treatment compared to placebo or no treatment trials up until the end of 2011. Selection criteria: RCTs of at least 1 year duration. Data collection and analysis: The outcomes assessed were mortality, stroke, coronary heart disease (CHD, total cardiovascular events (CVS, and withdrawals due to adverse effects. MAIN RESULTS: Of 11 RCTs identified 4 were included in this review, with 8,912 participants. Treatment for 4 to 5 years with antihypertensive drugs as compared to placebo did not reduce total mortality (RR 0.85, 95% CI 0.63, 1.15. In 7,080 participants treatment with antihypertensive drugs as compared to placebo did not reduce coronary heart disease (RR 1.12, 95% CI 0.80, 1.57, stroke (RR 0.51, 95% CI 0.24, 1.08, or total cardiovascular events (RR 0.97, 95% CI 0.72, 1.32. Withdrawals due to adverse effects were increased by drug therapy (RR 4.80, 95% CI 4.14, 5.57, ARR 9%. AUTHORS' CONCLUSIONS: Antihypertensive drugs used in the treatment of adults (primary prevention with mild hypertension (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg have not been

  2. Pharmacotherapy for mild hypertension

    Directory of Open Access Journals (Sweden)

    Diana Diao

    2012-01-01

    Full Text Available BACKGROUND: People with no previous cardiovascular events or cardiovascular disease represent a primary prevention population. The benefits and harms of treating mild hypertension in primary prevention patients are not known at present. This review examines the existing randomized controlled trial (RCT evidence. OBJECTIVE: Primary objective: To quantify the effects of antihypertensive drug therapy on mortality and morbidity in adults with mild hypertension (systolic blood pressure (BP 140-159 mmHg and/or diastolic BP 90-99 mmHg and without cardiovascular disease. METHODS: Search: We searched CENTRAL (2011, Issue 1, MEDLINE (1948 to May 2011, EMBASE (1980 to May 2011 and reference lists of articles. The Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effectiveness (DARE were searched for previous reviews and meta-analyses of anti-hypertensive drug treatment compared to placebo or no treatment trials up until the end of 2011. Selection criteria: RCTs of at least 1 year duration. Data collection and analysis: The outcomes assessed were mortality, stroke, coronary heart disease (CHD, total cardiovascular events (CVS, and withdrawals due to adverse effects. MAIN RESULTS: Of 11 RCTs identified 4 were included in this review, with 8,912 participants. Treatment for 4 to 5 years with antihypertensive drugs as compared to placebo did not reduce total mortality (RR 0.85, 95% CI 0.63, 1.15. In 7,080 participants treatment with antihypertensive drugs as compared to placebo did not reduce coronary heart disease (RR 1.12, 95% CI 0.80, 1.57, stroke (RR 0.51, 95% CI 0.24, 1.08, or total cardiovascular events (RR 0.97, 95% CI 0.72, 1.32. Withdrawals due to adverse effects were increased by drug therapy (RR 4.80, 95% CI 4.14, 5.57, ARR 9%. AUTHORS' CONCLUSIONS: Antihypertensive drugs used in the treatment of adults (primary prevention with mild hypertension (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg have not been

  3. Inflammation in the pathophysiology of essential hypertension.

    Science.gov (United States)

    Montecucco, Fabrizio; Pende, Aldo; Quercioli, Alessandra; Mach, François

    2011-01-01

    In spite of the huge amount of research recently performed in this area, the pathogenesis of human hypertension remains elusive. Thus, hypertension has to be defined as "essential" for the majority of patients with high blood pressure. Given the lack of animal models useful to investigate essential hypertension, we analyze and discuss both clinical and basic research studies indicating that essential hypertension should be considered as a potential multifactorial inflammatory disease. The pathophysiology of essential hypertension might result from interactions between genetic and environmental factors. Morphological abnormalities in the renal parenchyma and arteries have also been shown to determine hypertension. Inflammatory processes might induce renal vasoconstriction, ischemia and injury that can sustain systemic hypertension. Arterial and tubulointerstitial infiltration of inflammatory cells in response to renal damage might further increase renal and vascular alterations through the production of oxidants and other soluble inflammatory mediators. The present review gives an update regarding the latest research on the possible direct role of inflammation in the pathophysiology of essential hypertension.

  4. Lack of awareness of erectile dysfunction in many men with risk factors for erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Magee Michelle

    2010-11-01

    Full Text Available Abstract Background Men with erectile dysfunction often have concurrent medical conditions. Conversely, men with these conditions may also have underlying erectile dysfunction. The prevalence of unrecognized erectile dysfunction in men with comorbidities commonly associated with erectile dysfunction was determined in men invited to participate in a double-blind, randomized, placebo-controlled trial of sildenafil citrate. Methods Men ≥30 years old presenting with ≥1 erectile dysfunction risk factor (controlled hypertension, hypercholesterolemia, smoking, metabolic syndrome, stable coronary artery disease, diabetes, depression, lower urinary tract symptoms, obesity [body mass index ≥30 kg/m2] or waist circumference ≥40 inches, and not previously diagnosed with erectile dysfunction were evaluated. The screening question, "Do you have erectile dysfunction?," with responses of "no," "yes," and "unsure," and the Erectile Function domain of the International Index of Erectile Function (IIEF-EF were administered. Results Of 1084 men screened, 1053 answered the screening question and also had IIEF-EF scores. IIEF-EF scores indicating erectile dysfunction occurred in 71% (744/1053, of whom 54% (399/744 had moderate or severe erectile dysfunction. Of 139 answering "yes," 526 answering "unsure," and 388 answering "no," 96%, 90%, and 36%, respectively, had some degree of erectile dysfunction. The mean±SD (range number of risk factors was 2.9 ± 1.7 (3-8 in the "yes" group, 3.2 ± 1.7 (3-9 in the "unsure" group, and 2.6 ± 1.5 (2-8 in the "no" group. Conclusion Although awareness of having erectile dysfunction was low, most men with risk factors had IIEF-EF scores indicating erectile dysfunction. Erectile dysfunction should be suspected and assessed in men with risk factors, regardless of their apparent level of awareness of erectile dysfunction. Trial registration ClinicalTrials.gov Identifier NCT00343200.

  5. Factor V Leiden and post thromboembolic pulmonary hypertension.

    Science.gov (United States)

    Naudziūnas, Albinas; Miliauskas, Skaidrius

    2003-01-01

    Literature review and original data concerning the most common cause of inherited thrombophilia - activated protein C resistance have been presented. One hundred and three patients with confirmed venous thromboembolism have been investigated for activated protein C resistance with 2 ( nd ) generation "Diagnostica Stago" test. Activated protein C resistance has been found in 22.3 % cases. In the group of 70 healthy unselected men and women, matched by sex and age, this mutation has been found in 7.1% cases. Out of 101 patients with pulmonary thromboembolism confirmed by pulmoangiography or perfusion lung scan, 78 have been investigated by Doppler echocardioscopy in order to detect pulmonary hypertension after 1.5 months. Statistically significant correlation between age and pulmonary artery pressure has been found. No correlation between pulmonary artery pressure and activated protein C resistance has been detected.

  6. Hypertensive Crisis, Burden, Management, and Outcome at a Tertiary Care Center in Karachi

    OpenAIRE

    Aysha Almas; Ayaz Ghouse; Ahmed Raza Iftikhar; Munawwar Khursheed

    2014-01-01

    Objectives. Hypertension, if uncontrolled, can lead to hypertensive crisis. We aim to determine the prevalence of hypertensive crisis, its management, and outcome in patients presenting to a tertiary care center in Karachi. Methods. This was a cross-sectional study conducted at the Aga Khan University, Karachi, Pakistan. Adult inpatients (>18 yrs) presenting to the ER who were known hypertensive and had uncontrolled hypertension were included. Results. Out of 1336 patients, 28.6% (387) had un...

  7. 天津市北辰区老年人高血压现况及相关因素研究%Research on Present Condition and its Related Factors of Hypertension in Aged Population in Beichen District in Tianjin

    Institute of Scientific and Technical Information of China (English)

    李晓娜; 王德征

    2011-01-01

    Objective To explore the distribution characteristics and risk factors of hypertension in aged population in Beichen district in Tianjin. Methods During July to October 2008, 5 254 subjects aged 60 years or above who were receiving physical examination were selected by using Probability Proportional to Size (PPS) Cluster Sampling method; The data was analyzed by both single factor and multiple factors unconditional Logistic regression analysis using SPSS software version 11.5. Results The standardized prevalence rate of hypertension in aged population in Beichen district was 57.55%. The multiple factor Logistic analysis showed that risk factors of hypertension included age, economic type, family history of hypertension, BMI, waist circumference, more fertility number and diabetes, and their Ors were respectively as 1.040, 0.601, 1.972, 1.373, 1.454, 1.377 and 2.717. Conclusion Hypertension prevalence was higher in the studied district. Prevalence of hypertension could be reduced by controlling weight, rational diet, reducing alcohol intake and proper physical activity.%目的 了解天津市北辰区老年人高血压分布特征及危险因素,为老年人高血压的预防控制提供依据.方法 采用等容量比例整群随机抽样方法抽取2008年7-10月天津市北辰区接受健康体检的60周岁及以上老年人5 254例为研究对象,采用SPSS 11.5软件包进行单因素和多因素Logistic回归分析.结果 调查人群高血压标化患病率为57.55%,男性和女性患病率差异无显著性,多因素非条件Logistic回归分析结果显示,年龄、经济类型、高血压家族史、BMI、腰围、生育次数、现患糖尿病是老年人高血压主要危险因素,OR值分别为1.040、0.601、1.972、1.373、1.454、1.377和2.717.结论 天津市北辰区老年人的高血压患病率较高,高血压的危险因素有高龄、地区经济类型(农村)、有高血压家族史、BMI分组(肥胖超重)、腰围分组(腹部肥胖)、

  8. Gender differences in hypertension control among older korean adults: Korean social life, health, and aging project.

    Science.gov (United States)

    Chu, Sang Hui; Baek, Ji Won; Kim, Eun Sook; Stefani, Katherine M; Lee, Won Joon; Park, Yeong-Ran; Youm, Yoosik; Kim, Hyeon Chang

    2015-01-01

    Controlling blood pressure is a key step in reducing cardiovascular mortality in older adults. Gender differences in patients' attitudes after disease diagnosis and their management of the disease have been identified. However, it is unclear whether gender differences exist in hypertension management among older adults. We hypothesized that gender differences would exist among factors associated with hypertension diagnosis and control among community-dwelling, older adults. This cross-sectional study analyzed data from 653 Koreans aged ≥60 years who participated in the Korean Social Life, Health, and Aging Project. Multiple logistic regression was used to compare several variables between undiagnosed and diagnosed hypertension, and between uncontrolled and controlled hypertension. Diabetes was more prevalent in men and women who had uncontrolled hypertension than those with controlled hypertension or undiagnosed hypertension. High body mass index was significantly associated with uncontrolled hypertension only in men. Multiple logistic regression analysis indicated that in women, awareness of one's blood pressure level (odds ratio [OR], 2.86; p=0.003) and the number of blood pressure checkups over the previous year (OR, 1.06; p=0.011) might influence the likelihood of being diagnosed with hypertension. More highly educated women were more likely to have controlled hypertension than non-educated women (OR, 5.23; p=0.013). This study suggests that gender differences exist among factors associated with hypertension diagnosis and control in the study population of community-dwelling, older adults. Education-based health promotion strategies for hypertension control might be more effective in elderly women than in elderly men. Gender-specific approaches may be required to effectively control hypertension among older adults.

  9. Nuclear medicine imaging in the evaluation of endocrine hypertension

    Directory of Open Access Journals (Sweden)

    Punit Sharma

    2012-01-01

    Full Text Available Endocrine hypertension forms a small (< 5% but curable subset of patients with hypertension. Common endocrine causes of hypertension include pheochromocytoma, Cushing′s syndrome, primary hyperaldosteronism, and thyroid disorders. Nuclear medicine imaging plays an important role in evaluation of patients with endocrine hypertension. It has established role in patients of pheochromocytoma/paraganglioma, Cushing′s syndrome, aldosteronism, and thyroid disorders. We present a brief overview of role of nuclear medicine imaging in endocrine hypertension. Development of newer radiotracers might further broaden the role of nuclear medicine in these patients.

  10. Of little yellow men and a fear of the light.

    Science.gov (United States)

    Naha, Kushal; Vivek, G; Shetty, Ranjan K; Shastry, Barkur Ananthakrishna

    2013-08-13

    We report the case of a 65-year-old woman presenting with recurrent vomiting for 3 days. She had been previously diagnosed with an atrial septal defect and was on treatment with diuretics and digoxin for paroxysmal supraventricular tachycardia. The clinical examination was consistent with an atrial septal defect with severe pulmonary hypertension. Electrocardiography showed complete heart block with ST-segment changes suggestive of digitalis toxicity. Transthoracic echocardiography confirmed Eisenmengerisation. Serum digoxin levels were elevated. Following hospitalisation, she was diagnosed with photophobia when she persistently asked for ambient lighting to be switched off. Most interestingly, the patient kept reporting seeing little yellow men, which was how she perceived the attending doctors. Cessation of digoxin therapy led to progressive abatement of her symptoms.

  11. Hypertensive crisis in children.

    Science.gov (United States)

    Chandar, Jayanthi; Zilleruelo, Gastón

    2012-05-01

    Hypertensive crisis is rare in children and is usually secondary to an underlying disease. There is strong evidence that the renin-angiotensin system plays an important role in the genesis of hypertensive crisis. An important principle in the management of children with hypertensive crisis is to determine if severe hypertension is chronic, acute, or acute-on-chronic. When it is associated with signs of end-organ damage such as encephalopathy, congestive cardiac failure or renal failure, there is an emergent need to lower blood pressures to 25-30% of the original value and then accomplish a gradual reduction in blood pressure. Precipitous drops in blood pressure can result in impairment of perfusion of vital organs. Medications commonly used to treat hypertensive crisis in children are nicardipine, labetalol and sodium nitroprusside. In this review, we discuss the pathophysiology, differential diagnosis and recent developments in management of hypertensive crisis in children.

  12. The prevalence of hypertension in older Mexicans and Mexican Americans.

    Science.gov (United States)

    Salinas, Jennifer J; Eschbach, Karl A; Markides, Kyriakos S

    2008-01-01

    To evaluate the prevalence of hypertension in older Mexicans in the United States and Mexico. Stratified by sex, logistic regression models to predict physician-diagnosed hypertension were conducted by using the Hispanic Established Populations for Epidemiologic Study of the Elderly (wave 3) and the Mexican Health and Aging Study (age > or =70 years) datasets. Older Mexican and Mexican American women have a greater prevalence of hypertension than their male counterparts. Mexican women who have migrated to the United States and returned to Mexico have similarly high rates of hypertension as their female counterparts in the United States. After adjusting for demographic characteristics, diabetes, obesity, alcohol use, and smoking, older Mexican women who have migrated to the United States are at increased risk for hypertension. Conversely, immigrant older Mexican American men are at significantly lower odds of hypertension. Sex differences exist in hypertension risk for older Mexicans and Mexican Americans living in the United States and Mexico. Older women who migrate to the United States are at a particular risk for hypertension in Mexico.

  13. Vitamin D and hypertension: Prospective study and meta-analysis

    Science.gov (United States)

    Qi, Dan; Nie, Xiao-lu; Wu, Shouling; Cai, Jun

    2017-01-01

    Objectives The study sought to determine the link between vitamin D concentrations and incident hypertension in prospective study and meta-analysis. Methods The study was embedded in the Kailuan Study, a population-based cohort of adults that contains underground miners. In 2012, we studied 2,456 men and women free of prevalent hypertension, age 21 to 67 at baseline. Serum 25-hydroxyvitamin D was measured from previously frozen baseline samples using ELISA (Enzyme-Linked ImmunoadSorbent Assay). We use the logistic regression analysis to estimate the odd radio (ORs) 95% confidence intervals (CIs) for 25-hydroxyvitamin D [25(OH)D] concentrations with incident hypertension. To help place our new data in context, we conducted a systemic review and meta-analysis of previous prospective reports of vitamin D and hypertension. Results During a median follow-up of 2 years, 42.6% of the cohort (n = 1047) developed hypertension. Compared with the 25-hydroxyvitamin D >30ng/ml, 25-hydroxyvitamin D vitamin D deficiencies and incident hypertension (HRs = 1.235 (95% CI: 1.083 to 1.409, p = 0.002)). Conclusion Lower serum 25-hydroxyvitamin D concentrations were not associated with a greater risk of incident hypertension. More research is needed to further determine the role of 25-hydroxyvitamin D in hypertension prevention and therapy. PMID:28358827

  14. Diagnostic accuracy of C-terminal fragment of type I procollagen in detection of hidden heart failure in hypertensive males

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    Kolesnyk M.Yu.

    2015-03-01

    Full Text Available Purpose: to estimate diagnostic accuracy of C-terminal fragment of type I procollagen (PICP in hypertensive males with hidden chronic heart failure (CHF. The study included 220 men with uncomplicated arterial hypertension (mean age 52 (46-58 years. The control group consisted of 40 healthy men of similar age. Ambulatory blood pressure monitoring, transthoracic echocardiography and speckle tracking echocardiography was performed to all participants. All patients underwent treadmill test with post-exercise evaluation of left ventricular (LV filling pressure by tissue Doppler Е/е' ratio to reveal hidden CHF. The post-exercise Е/е'≥13 was considered to be pathological. PICP levels in plasma were determined by ELISA. The PICP concentration was significantly higher in men with hypertension (132,3 (81,3-216,8 ng/ml as compared with healthy subjects (93.2 (64,7-133 ng/ml (p=0,0068. The presence of LV hypertrophy did not affect the level of PICP (p=0,58. 16 patients presented pathological result of diastolic stress test revealing signs of hidden heart failure. PICP concentration was 2-fold higher in these individuals as compared with other patients (p=0.01. The ROC-analysis revealed, that optimal cut-off point is 170.2 ng/ml for PICP to detect hidden CHF (area under curve – 0,68±0,08; 95% confidence interval – 0,61-0,74; sensitivity – 68,7%, specificity – 69,6%. The PICP level exceeding 170,2 ng/mL testifies to hidden CHF in hypertensive males.

  15. Arterial–ventricular coupling and parameters of vascular stiffness in hypertensive patients: Role of gender

    Science.gov (United States)

    Bruno, Rosa Maria; Buralli, Simona; Barzacchi, Marta; Dal Canto, Elisa; Ghiadoni, Lorenzo; Taddei, Stefano

    2017-01-01

    Objective Non-invasive estimation of arterial–ventricular coupling has been extensively used for the evaluation of cardiovascular performance, however, a relative small amount of data is available regarding arterial–ventricular coupling and its components in hypertension. The present study was designed to investigate the relationship between left ventricular elastance, arterial elastance, parameters of vascular stiffness and the influence of gender in a population of hypertensive individuals. Methods In 102 patients, trans-thoracic cardiac ultrasound, parameters of aortic stiffness (carotid-femoral pulse wave velocity) and wave reflection (augmentation index) were recorded. Ultrasound images of common carotid arteries were acquired for the assessment of intima-media thickness as well as carotid compliance and distensibility coefficient. Results Mean age was 61 years, 32% diabetes, 56% dyslipidemia, 9% previous cardiovascular events; women (n = 32) and men were superimposable for cardiovascular risk factors prevalence. In the population, ventricular elastance was significantly correlated with arterial elastance (r = 0.887), age (r = 0.334), gender (r = −0.494), BMI (r = −0.313), augmentation index (r = 0.479) (all p arterial elastance and gender were independently associated with ventricular elastance in multiple regression models adjusted for confounding factors. Gender-specific analysis revealed that arterial elastance and augmentation index remained statistically significant associated with ventricular elastance in men (r = 0.275, p = 0.04); instead augmentation index was no longer significant (r = 0.052, p = 0.77) in the female sex. Conclusions In hypertensive patients, main determinants of ventricular elastance are arterial elastance, as an integrated index of arterial vascular load, and gender; however, pressure augmentation might play an additional role in men. PMID:28210489

  16. TCM Dietotherapy for Hypertension

    Institute of Scientific and Technical Information of China (English)

    DENG Zi; DUAN Shu-min

    2010-01-01

    @@ Hypertension is a common cardiovascular disease with a group of symptoms and signs, mainly the increased blood pressure of the arteries.It may be primary or secondary.The former, accounting for90%, refers to an independent disease mainly manifested by increased blood pressure with the cause unknown.Primary hypertension is related to nervousness, emotional fluctuation, heredity, obesity and high-salt diet.Secondary hypertension is one of the manifestations in certain disorders.

  17. Hypertension og hyperlipidaemi

    DEFF Research Database (Denmark)

    Hansen, Henrik Steen; Larsen, Mogens Lytken

    2009-01-01

    Hypertension and hyperlipidemia are well-established and partially overlapping risk factors for cardiovascular disease. Analyses of cardiovascular morbidity in relationship to changes in blood pressure and in serum cholesterol levels have shown that combined reduction of both risk factors...... are important to achieve a reduction in morbidity. Statins have been shown to be effective in preventing both coronary and cerebrovascular events in both hypertensive and normotensive cases. Consequently, most recent guidelines recommend that statin treatment be considered in hypertensive patients aged less...

  18. Obesity-Related Hypertension

    OpenAIRE

    Re, Richard N.

    2009-01-01

    Obesity-associated arterial hypertension is characterized by activation of the sympathetic nervous system, activation of the renin-angiotensin system, and sodium retention, among other abnormalities. In this review, the following 3 facets of the obesity/hypertension nexus will be discussed: the potential mechanisms by which obesity can lead to elevated arterial pressure, the interaction of obesity with the sequelae of hypertension, and the therapies that are believed to optimally treat obesit...

  19. Prevalence of hypertension in Mexico City and San Antonio, Texas.

    Science.gov (United States)

    Haffner, S; González Villalpando, C; Hazuda, H P; Valdez, R; Mykkänen, L; Stern, M

    1994-09-01

    Few data are available on the prevalence of hypertension in Mexico. We compared the prevalence of mild hypertension (systolic blood pressure > or = 140 mm Hg and/or diastolic blood pressure > or = 90 mm Hg and/or use of antihypertensive medications) in 1500 low-income Mexican Americans who participated in the San Antonio Heart Study and 2280 low-income Mexicans who participated in the Mexico City Diabetes Study. The crude prevalence of mild hypertension was 17.1% in Mexican men versus 24.4% in Mexican American men (P = .001) and 17.4% in Mexican women versus 22.0% in Mexican American women (P = .005). After adjustment for age, body mass index (BMI), waist-to-hip ratio (WHR), non-insulin dependent diabetes mellitus (NIDDM), educational attainment, and percent native American genetic admixture (Caucasian and native American), the odds ratio (Mexico City/San Antonio) was 0.55 (95% CI, 0.39, 0.77; P women. In a pooled model including both men and women, the odds ratio was 0.67 (95%, CI, 0.53, 0.84; P < .001). In the pooled model, city, age, female sex, NIDDM, BMI, WHR, and low educational attainment were significantly related to the prevalence of hypertension. The causes for these differences in hypertension prevalence are not known but may reflect a less modernized lifestyle in Mexico City, including greater physical activity, less obesity, and the consumption of a high-carbohydrate, low-fat diet.

  20. 42. Hypertension: Morbidity review

    Directory of Open Access Journals (Sweden)

    Hamzullah khan

    2015-10-01

    Conclusions: hypertension is a major modifiable risk factor for coronary artery disease, stroke, eye abnormalities and end stage renal disease, which require proper counseling and management of patients.

  1. Dopamine receptor and hypertension.

    Science.gov (United States)

    Zeng, Chunyu; Eisner, Gilbert M; Felder, Robin A; Jose, Pedro A

    2005-01-01

    Dopamine plays an important role in the pathogenesis of hypertension by regulating epithelial sodium transport and reactive oxygen and by interacting with vasopressin, renin-angiotensin, and the sympathetic nervous system. Decreased renal dopamine production and/or impaired dopamine receptor function have been reported in hypertension. Disruption of any of the dopamine receptors (D(1), D(2), D(3), D(4), and D(5)) results in hypertension. In this paper, we review the mechanisms by which hypertension develops when dopamine receptor function is perturbed.

  2. The Prevalence of Cardiac Risk Factors in Men with Localized Prostate Cancer Undergoing Androgen Deprivation Therapy in British Columbia, Canada

    Directory of Open Access Journals (Sweden)

    Margot K. Davis

    2015-01-01

    Full Text Available Background. While androgen deprivation therapy (ADT reduces the risk of prostate cancer-specific mortality in high-risk localized prostate cancer, it adversely affects cardiovascular (CV risk factor profiles in treated men. Methods. We retrospectively reviewed the charts of 100 consecutive men with intermediate- or high-risk localized prostate cancer referred to the British Columbia Cancer Agency for ADT. Data on CV risk factors and disease were collected and Framingham risk scores were calculated. Results. The median age of the study cohort was 73 years. Established cardiovascular disease was present in 25% of patients. Among patients without established CV disease, calculated Framingham risk was high in 65%, intermediate in 33%, and low in 1%. Baseline hypertension was present in 58% of patients, dyslipidemia in 51%, and diabetes or impaired glucose tolerance in 24%. Hypertension was more prevalent in the study cohort than in an age- and sex-matched population sample (OR 1.74, P=0.006; diabetes had a similar prevalence (OR 0.93, P=0.8. Conclusions. Patients receiving ADT have a high prevalence of cardiovascular disease and risk factors and are more likely to be hypertensive than population controls. Low rates of CV risk screening suggest opportunities for improved primary and secondary prevention of CV disease in this population.

  3. New and Old Mechanisms Associated with Hypertension in the Elderly

    Directory of Open Access Journals (Sweden)

    Petra J. Mateos-Cáceres

    2012-01-01

    Full Text Available Hypertension is a widely prevalent and important risk factor for cardiovascular diseases that increase with aging. The hallmark of hypertension in the elderly is increased vascular dysfunction. However, the molecular mechanisms by which increased blood pressure leads to vascular injury and impaired endothelial function are not well defined. In the present paper, we will analyze several mechanisms described in the scientific literature involved in hypertension in the elderly as endothelial dysfunction, increased oxygen delivery to tissues, inflammation, cellular apoptosis, and increased concentration of active metabolites. Also, we will focus on new molecular mechanisms involved in hypertension such as telomeres shortening, progenitor cells, circulating microparticles, and epigenetic factors that have appeared as possible causes of hypertension in the elderly. These molecular mechanisms may elucidate different origin for hypertension in the elderly and provide us with new targets for hypertension treatment.

  4. Masked Hypertension: How to Identify and When to Treat?

    Science.gov (United States)

    Rizzoni, Damiano

    2016-09-01

    Approximately one out of 7-8 individuals with normal blood pressure (BP) in the clinic or doctor's office and one third of patients with chronic kidney disease with normal clinic BP have elevated ambulatory BP (masked hypertension). Patients with masked hypertension have an increased risk for target organ damage and a two-fold increased risk for cardiovascular events compared to patients with normal clinic and ambulatory BP. Despite this elevated risk for adverse outcomes, patients with masked hypertension have been excluded from hypertension trials because of their normal clinic BP. It is still unknown whether the reduction in target organ damage and adverse cardiovascular outcomes associated with treatment of hypertension extends to patients with masked hypertension. Ongoing and planned interventional studies will provide an answer to this crucial question in a few years. At present, it seems reasonable to follow the suggestion of current European guidelines, that lifestyle measures and drug treatment should be considered in the presence of masked hypertension.

  5. Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011-2012.

    Science.gov (United States)

    Nwankwo, Tatiana; Yoon, Sung Sug; Burt, Vicki; Gu, Quiping

    2013-10-01

    The overall prevalence of hypertension has not changed appreciably since 2009-2010. The age-adjusted prevalence of hypertension among U.S. adults was 29.1% in 2011-2012. Among adults with hypertension in 2011-2012, 82.8% were aware of their hypertension, 75.7% were currently taking medication to lower their blood pressure, and 51.9% had their blood pressure controlled to less than 140/90 mm Hg. Men and women had similar prevalence and awareness of hypertension, but more women than men were treating their hypertension and had it under control. Young adults aged 18-39 continued to have lower awareness, treatment, and control of their hypertension compared with older adults. Hypertension prevalence was still highest among non-Hispanic black adults. However, awareness, treatment, and control of hypertension were similar among non-Hispanic black, non-Hispanic white, and Hispanic adults. Non-Hispanic Asian adults had a lower prevalence of awareness than the other race and Hispanic origin groups, and lower treatment than non-Hispanic white and non-Hispanic black adults. However, hypertension control was similar among non-Hispanic Asian adults and the other race and Hispanic origin groups. Hypertension is a common and manageable chronic condition. Based on recent national data from 2011-2012, treatment of hypertension exceeded the Healthy People 2020 target goal of 69.5%. However, the control of hypertension has neither met the goal of the Healthy People 2020 (61.2% by 2020) nor the Million Hearts Initiative (65% by 2017). These results provide evidence for continued efforts to improve the management of hypertension in order to attain these goals. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  6. Chiropractic management of a hypertensive patient.

    Science.gov (United States)

    Plaugher, G; Bachman, T R

    1993-10-01

    Although many chiropractors may treat patients who have concomitant hypertensive disease, there is a paucity of literature on the nuances of case management for these patients. We report a patient who underwent a course of chiropractic care with a previous diagnosis of chronic essential hypertension. A 38-yr-old male presented for chiropractic care with complaints of hypertension, drug-related side effects and lower back pain. He was also receiving concurrent medical care for his hypertension. The patient received specific contact, short lever arm spinal adjustments as the primary mode of chiropractic care. During the course of chiropractic treatment, the patient's need for hypertensive medication was reduced. The patient's medical physician gradually withdrew the medication over 2 months. Specific contact short lever arm spinal adjustments may cause a hypotensive effect in a medicated hypertensive patient that may lead to complications (e.g., hypotension). Since a medicated hypertensive patient's blood pressure may fall below normal while he or she is undergoing chiropractic care, it is advised that the blood pressure be closely monitored and medications adjusted, if necessary, by the patient's medical physician.

  7. Single dose regorafenib-induced hypertensive crisis.

    Science.gov (United States)

    Yilmaz, B; Kemal, Y; Teker, F; Kut, E; Demirag, G; Yucel, I

    2014-06-01

    Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the gastrointestinal (GI) tract. Regorafenib is a new multikinase inhibitor and is approved for the treatment of GISTs in patients who develop resistance to imatinib and sunitinib. The most common drug-related adverse events with regorafenib are hypertension, hand-foot skin reactions, and diarrhea. Grade IV hypertensive side effect has never been reported after a single dose. In this report, we present a case of Grade IV hypertensive side effect (hypertensive crisis and seizure) after a single dose of regorafenib. A 54-year-old male normotensive GIST patient was admitted to the emergency department with seizure and encephalopathy after the first dosage of regorafenib. His blood pressure was 240/140 mmHg upon admission. After intensive treatment with nitrate and nitroprusside, his blood pressure returned to normal levels in five days. Regorafenib was discontinued, and he did not experience hypertension again. This paper reports the first case of Grade IV hypertension after the first dosage of regorafenib. We can suggest that hypertension is an idiosyncratic side effect unrelated to the dosage.

  8. [Adrenal tumors as a cause of hypertension].

    Science.gov (United States)

    Grimaldi, Franco

    2010-01-01

    Hypertension is one of the main risk factors for cardiovascular diseases, which today are the primary cause of mortality in developed countries. To decrease the mortality and morbidity due to cardiovascular disease, it is necessary to treat hypertension correctly on the basis of an accurate diagnosis. A secondary cause of hypertension must be suspected if it is severe or resistant to treatment, if there is a sudden increase in blood pressure in a patient hitherto well controlled, or if it develops in childhood or in a person under 30 years of age, especially if not obese and without a family history of hypertension. In these instances the frequency of hypertension varies from 1-5% for mild to moderate to 10-20% for severe or refractory hypertension. One of the principal causes of secondary hypertension is related to adrenal gland tumors or dysfunctions such as Cushing's syndrome, primary aldosteronism (Conn's syndrome) and pheochromocytoma. This paper will discuss the clinical presentation and diagnostic tests pertinent to these neoplasms, organ damage assessment, utilization of imaging techniques, and the medical and surgical options.

  9. Enhanced hypoxic pulmonary vasoconstriction in hypertension.

    Science.gov (United States)

    Guazzi, M D; Alimento, M; Berti, M; Fiorentini, C; Galli, C; Tamborini, G

    1989-02-01

    In this study, we tested the hypothesis that hypoxic pulmonary vasoconstriction may be enhanced in systemic hypertension. The hypothesis took origin from the following two considerations: alveolar hypoxia constricts the pulmonary vessels by enhancing the Ca2+ penetration across sarcolemma of the smooth muscle cells and systemic high blood pressure is associated with an elevation of tone and reactivity of the lung vessels, which seems to depend on an excessive cytosol free Ca2+ concentration due to alterations in sodium handling and in the Na+-Ca2+ exchange system. These considerations suggest the possibility that the disorders in the biochemistry of smooth muscle contraction in hypertension facilitate the rise of cytosol Ca2+ concentration during alveolar hypoxia, thus resulting in a potentiation of the vasoconstrictor properties of this stimulus. In 43 hypertensive and 17 normotensive men, pulmonary arteriolar resistance has been evaluated during air respiration and after 15 minutes of breathing 17%, 15%, and 12% oxygen in nitrogen. Curves relating changes in pulmonary arteriolar resistance to oxygen breathing contents had similar configuration in the two populations but in hypertension were steeper and significantly shifted to the left, reflecting a lower threshold and an enhanced reactivity. This pattern was not related to differences in severity of the hypoxic stimulus, plasma catecholamine concentration, or hypocapnia and respiratory alkalosis induced by hypoxia and probably was not mediated through alpha-receptor activation. Calcium channel blockade with nifedipine was able to almost abolish both the normotensive and the hypertensive pulmonary vasoconstriction reaction. These findings support the hypothesis that hypoxic pulmonary vasoconstriction may be enhanced in systemic hypertension.

  10. Family history of hypertension and arterial elasticity characteristics in healthy young people.

    Science.gov (United States)

    Zhou, Lin; Chen, Yuanyuan; Sun, Ningling; Liu, Xirong

    2008-05-01

    Family history of hypertension is a primary predictor of high blood pressure (BP). This study attempted to determine whether there is a gradual increase in BP and an early change in arterial elasticity characteristics between young healthy individuals with or without a family history of hypertension and whether or not this increase is apparent in males as well as in females. A total of 270 normotensive healthy individuals (112 men and 158 women, aged 16 to 30 years) with or without a family history of hypertension, participated in conventional BP measurement and completed questionnaires covering basic information and a detailed family history of cardiovascular disease. Large arterial (capacitive) compliance (C1) and small arterial (oscillatory or reflective) compliance (C2) were derived from HDI/PulseWave CR-2000 (Hypertension Diagnostics, Minneapolis, USA). Based on family history information about parents and grandparents, three groups were formed: subjects with at least one hypertensive parent (group A), subjects with only hypertensive grandparents (group B), and subjects with normotensive parents and grandparents (group C). Men in group A had lower C1 and C2 along with higher systolic BP (SBP), diastolic BP (DBP), and heart rate than men in group C. Those in group B had intermediate C1, C2 and BP levels. C1 had a linear relationship with SBP, DBP, and heart rate. In the logistic regression model of family history of hypertension, C2 was lower in young normotensive males with parental hypertension (B = -0.315, exp B = 0.73, p = 0.03), independently of SBP, DBP, and heart rate. Among females, subjects with parental hypertension had higher systolic, mean arterial pressure, and pulse pressure (p young non-hypertensive subjects may be a risk factor for hypertension and may contribute to the progression to hypertension later in life.

  11. Twenty-four hour urinary urea excretion and 9-year risk of hypertension : the PREVEND study

    NARCIS (Netherlands)

    Tielemans, Susanne M. A. J.; Geleijnse, Johanna M.; van Baak, Marleen A.; Engberink, Marielle F.; Brink, Elizabeth J.; de Jong, Paul E.; Gansevoort, Ronald T.; Bakker, Stephan J. L.

    2013-01-01

    Objectives:It is not yet clear whether dietary protein could help maintaining a healthy blood pressure (BP). We investigated the association between total protein intake, estimated from 24-h urinary urea excretion, and incident hypertension in Dutch men and women.Methods:We analyzed data of 3997 men

  12. Intraoperative pulmonary hypertension occurred in an asymptomatic patient with pre-existent liver cirrhotic and portal hypertension

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Portopulmonary hypertension (PPH) is clinically defined as the development of pulmonary arterial hypertension complicated by portal hypertension, with or without advanced hepatic disease. Physical signs may be absent in mild to moderate PPH and only appear in a hyperdynamic circulatory state. Similar signs of advanced liver disease can be observed in severe PPH, with ascites and lower extremity edema. Pulmonary hypertension is usually diagnosed after anesthetic induction during liver transplantation (LT). We present intraoperative pulmonary hypertension in a 41-year-old male patient with hepatic cirrhosis. Since this patient had no preoperation laboratory data supporting the diagnosises of pulmonary hypertension and was asymptomatic for a number of years, it was necessary to send him to the intensive care unit after operation. Further study should be focued on the diagnosis and treatment of pulmonary arterial hypertension in order to reduce its mortality.

  13. EPOXYEICOSATRIENOIC ACID ANALOG ATTENUATES ANGIOTENSIN II HYPERTENSION AND KIDNEY INJURY

    Directory of Open Access Journals (Sweden)

    Md. Abdul Hye Khan

    2014-09-01

    Full Text Available Epoxyeicosatrienoic acids (EETs contribute to blood pressure regulation leading to the concept that EETs can be therapeutically targeted for hypertension and the associated end-organ damage. In the present study, we investigated anti-hypertensive and kidney protective actions of an EET analog, EET-B in angiotensin II (ANG II-induced hypertension. EET-B was administered in drinking water for 14 days (10mg/kg/d and resulted in a decreased blood pressure elevation in ANG II hypertension. At the end of the two-week period, blood pressure was 30 mmHg lower in EET analog-treated ANG II hypertensive rats. The vasodilation of mesenteric resistance arteries to acetylcholine was impaired in ANG II hypertension; however, it was improved with EET-B treatment. Further, EET-B protected the kidney in ANG II hypertension as evidenced by a marked 90% decrease in albuminuria and 54% decrease in nephrinuria. Kidney histology demonstrated a decrease in renal tubular cast formation in EET analog-treated hypertensive rats. In ANG II hypertension, EET-B treatment markedly lowered renal inflammation. Urinary monocyte chemoattractant protein-1 excretion was decreased by 55% and kidney macrophage infiltration was reduced by 52% with EET-B treatment. Overall, our results demonstrate that EET-B has anti-hypertensive properties, improves vascular function, and decreases renal inflammation and injury in ANG II hypertension.

  14. Epoxyeicosatrienoic acid analog attenuates angiotensin II hypertension and kidney injury.

    Science.gov (United States)

    Khan, Abdul Hye; Falck, John R; Manthati, Vijaya L; Campbell, William B; Imig, John D

    2014-01-01

    Epoxyeicosatrienoic acids (EETs) contribute to blood pressure regulation leading to the concept that EETs can be therapeutically targeted for hypertension and the associated end organ damage. In the present study, we investigated anti-hypertensive and kidney protective actions of an EET analog, EET-B in angiotensin II (ANG II)-induced hypertension. EET-B was administered in drinking water for 14 days (10 mg/kg/d) and resulted in a decreased blood pressure elevation in ANG II hypertension. At the end of the two-week period, blood pressure was 30 mmHg lower in EET analog-treated ANG II hypertensive rats. The vasodilation of mesenteric resistance arteries to acetylcholine was impaired in ANG II hypertension; however, it was improved with EET-B treatment. Further, EET-B protected the kidney in ANG II hypertension as evidenced by a marked 90% decrease in albuminuria and 54% decrease in nephrinuria. Kidney histology demonstrated a decrease in renal tubular cast formation in EET analog-treated hypertensive rats. In ANG II hypertension, EET-B treatment markedly lowered renal inflammation. Urinary monocyte chemoattractant protein-1 excretion was decreased by 55% and kidney macrophage infiltration was reduced by 52% with EET-B treatment. Overall, our results demonstrate that EET-B has anti-hypertensive properties, improves vascular function, and decreases renal inflammation and injury in ANG II hypertension.

  15. Streptozotocin induced diabetes in lyon hypertensive rats

    Institute of Scientific and Technical Information of China (English)

    LeaEMONNOT; JeanSASSARD; MingLO

    2004-01-01

    AIM: Lyon hypertensive (LH) rats, compared to their normotensive controls (LL) exhibit an increased blood pressure (BP)associated with a marked proteinuria and a metabolic syndrom including elevated plasma lipids and insulin/glucose ratio. The aim of the present work was to determine wether a type 2 diabetes could be induced in LH rats so as to obtain a model suitable for study of the relationships between diabetes and hypertension.

  16. Lakridsinduceret hypertension og hypokaliæmi

    DEFF Research Database (Denmark)

    Nielsen, Mette Lundgren; Pareek, Manan; Andersen, Inger

    2012-01-01

    Consumption of large amounts of liquorice can cause hypertension and hypokalaemia. Liquorice contains glycyrrhetinic acid, which inhibits the enzyme 11 beta-hydroxysteroid dehydrogenase type 2, and ultimately leads to an apparent mineralocorticoid excess syndrome. This case report describes a 50...... year-old woman presenting with hypertension and hypokalaemia-induced limb paresis due to chronic liquorice ingestion. The patient was treated with potassium supplementation and spironolactone. Her blood pressure and electrolyte status normalised within a month after cessation of liquorice intake....

  17. [Pathophysiology of hypertension in chronic kidney disease].

    Science.gov (United States)

    Sawicka, Magdalena; Jędras, Mirosław

    2014-01-01

    Hypertension is both an important cause and consequence of chronic kidney disease (CKD). It is present in 80-85% of the patients. The article summarizes the main pathogenetic factors of hypertension in CKD such as: sodium retention, increased activity the renin-angiotensin-aldosterone system and sympathetic nervous system, impaired nitric oxide synthesis and endothelium-mediated vasodilatation, oxidative stress, disorders of calcium metabolism and parathyroid hormone secretion, vascular calcification and increased arterial stiffness.

  18. Hypertension in pregnancy: An unresectable mediastinal pheochromocytoma.

    Science.gov (United States)

    Gazala, Sayf; Switzer, Noah; Bédard, Eric L R

    2016-02-01

    Hypertension is a relatively common occurrence during pregnancy, which usually has a benign course with an excellent prognosis. However, physicians caring for pregnant women should have a high index of suspicion for underlying medical conditions that could lead to a more perilous outcome. Herein, we present the case of a pregnant woman who was found to have uncontrollable hypertension late in her pregnancy, secondary to a mediastinal pheochromocytoma, which was deemed unresectable at the time of exploration after her delivery.

  19. Hastigt progredierende synstab ved idiopatisk intrakraniel hypertension

    DEFF Research Database (Denmark)

    Skau, Maren; Jensen, Rigmor; Milea, Dan

    2009-01-01

    Idiopathic intracranial hypertension (IIH) is a condition of increased intracranial pressure of unknown aetiology. Slowly progressing visual defects secondary to papilloedema are well-known complications. Rapidly progressing visual loss is rare. A case of acute and rapidly progressing visual loss...... in idiopathic intracranial hypertension is presented. Rapid recognition and treatment of IIH is important, and may occasionally prompt acute surgical treatment. Udgivelsesdato: 2009-Jan...

  20. Socio-demographic inequalities in the prevalence, diagnosis and management of hypertension in India: analysis of nationally-representative survey data.

    Science.gov (United States)

    Moser, Kath A; Agrawal, Sutapa; Davey Smith, George; Ebrahim, Shah

    2014-01-01

    Hypertension is a major contributing factor to the current epidemic of cardiovascular disease in India. Small studies suggest high, and increasing, prevalence especially in urban areas, with poor detection and management, but national data has been lacking. The aim of the current study was to use nationally-representative survey data to examine socio-demographic inequalities in the prevalence, diagnosis and management of hypertension in Indian adults. Using data on self-reported diagnosis and treatment, and blood pressure measurement, collected from 12,198 respondents aged 18+ in the 2007 WHO Study on Global Ageing and Adult Health in India, factors associated with prevalence, diagnosis and treatment of hypertension were investigated. 22% men and 26% women had hypertension; prevalence increased steeply with body mass index (<18.5 kg/m(2): 18% men, 21% women; 25-29.9 kg/m(2): 35% men, 35% women), was higher in the least poor vs. poorest (men: odds ratio (95%CI) 1.82 (1.20 to 2.76); women: 1.40 (1.08 to 1.81)), urban vs. rural men (1.64 (1.19 to 2.25)), and men recently vs. never using alcohol (1.96 (1.40 to 2.76)). Over half the hypertension in women, and 70% in men, was undetected with particularly poor detection rates in young urban men, and in poorer households. Two-thirds of men and women with detected hypertension were treated. Two-thirds of women treated had their hypertension controlled, irrespective of urban/rural setting or wealth. Adequate blood pressure control was sub-optimal in urban men. Hypertension is very common in India, even among underweight adults and those of lower socioeconomic position. Improved detection is needed to reduce the burden of disease attributable to hypertension. Levels of treatment and control are relatively good, particularly in women, although urban men require more careful attention.

  1. Hypertension after clonidine withdrawal.

    Science.gov (United States)

    Husserl, F E; deCarvalho, J G; Batson, H M; Frohlich, E D

    1978-05-01

    Rebound hypertension occurred in two patients upon clonidine withdrawal. Treatment of the hypertensive crisis consists of both alpha- and beta-adrenergic receptor blockade, reserpine, or the reintroduction of clonidine. With effective control of pressure during the crisis, long-term antihypertensive therapy must be resumed.

  2. Hypertension and liver disease

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2004-01-01

    Arterial hypertension is a common disorder with a frequency of 10% to 15% in subjects in the 40- to 60-year age group. Yet most reports find the prevalence of arterial hypertension in patients with chronic liver disease (cirrhosis) much lower. In this review, we consider the alterations in systemic...

  3. Hypertension Briefing: Technical documentation

    OpenAIRE

    Institute of Public Health in Ireland

    2012-01-01

    Blood pressure is the force exerted on artery walls as the heart pumps blood through the body. Hypertension, or high blood pressure, occurs when blood pressure is constantly higher than the pressure needed to carry blood through the body. This document details how the IPH uses a systematic and consistent method to produce prevalence data for hypertension on the island of Ireland.

  4. Hypertension (High Blood Pressure)

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Hypertension (High Blood Pressure) KidsHealth > For Teens > Hypertension (High Blood Pressure) A ... rest temperature diet emotions posture medicines Why Is High Blood Pressure Bad? High blood pressure means a person's heart ...

  5. Pregnancy and pulmonary hypertension

    NARCIS (Netherlands)

    Pieper, Petronella G.; Lameijer, Heleen; Hoendermis, Elke S.

    2014-01-01

    Pulmonary hypertension during pregnancy is associated with considerable risks of maternal mortality and morbidity. Our systematic review of the literature on the use of targeted treatments for pulmonary arterial hypertension during pregnancy indicates a considerable decrease of mortality since a pre

  6. Pulmonary Hypertension Overview

    Science.gov (United States)

    ... chest X-ray, a breathing test called a pulmonary function test and an echocardiogram (sometimes called an “echo”). Your doctor may also need to do other tests to find out whether another medical condition is causing your pulmonary hypertension. TreatmentHow is pulmonary hypertension treated?If the ...

  7. Noncirrotisk intrahepatisk portal hypertension

    DEFF Research Database (Denmark)

    Dam Fialla, Annette; Havelund, Troels

    2007-01-01

    Non-cirrhotic intrahepatic portal hypertension is characterized by portal hypertension in the absence of liver cirrhosis or portal vein thrombosis. The disease is common in the East and rarely seen in the West. Two cases with oesophageal varices are described. The histopathology is heterogeneous...

  8. Hypertension og hjernen

    DEFF Research Database (Denmark)

    Christensen, Hanne; Strandgaard, Svend

    2009-01-01

    Hypertension is a major and modifiable risk factor of stroke and dementia. Hypertension causes remodelling of the cerebral resistance vessels, impairing their tolerance to very low blood pressure. In primary prevention of stroke, the effect of beta-blockers is inferior to other classes...

  9. Noncirrotisk intrahepatisk portal hypertension

    DEFF Research Database (Denmark)

    Dam Fialla, Annette; Havelund, Troels

    2007-01-01

    Non-cirrhotic intrahepatic portal hypertension is characterized by portal hypertension in the absence of liver cirrhosis or portal vein thrombosis. The disease is common in the East and rarely seen in the West. Two cases with oesophageal varices are described. The histopathology is heterogeneous...... but includes vascular lesions and portal fibrosis. Patient management follows the current recommendations for variceal bleeding....

  10. Hypertension in Iranian Urban Population, Epidemiology, Awareness, Treatment and Control

    Directory of Open Access Journals (Sweden)

    SM Namayandeh

    2011-09-01

    Full Text Available Background: To assess the epidemiological characteristics of hypertensive patients in urban population of Yazd, A cen­tral city in Iran.Methods: This cross sectional study was conducted from 2005-2006 and carried out on population aging 20-74 years. It is a part of the phase I of Yazd healthy heart program that it is a community interventional study for prevention of car­diovascular disease. Data obtained from questionnaires were analyzed by SPSS version 13. P value less than 0.05 were consid­ered significant level.Results: This study comprised of 2000 participants that 847 (42.5% were diagnosed as being hypertensive. After age ad­justment, prevalence of hypertension was 25.6% (23.3% for women and 27.5% for men (P< 0.001. Age, Total cho­lesterol, LDL-cholesterol, triglyceride, fasting blood glucose, impaired glucose tolerance test, body mass index and waist were significantly higher in the hypertensive groups. 53.7% of hypertensive cases were aware of own condition, 45% were treated, and 33.9% of treated were controlled (30.7% and 35.4% in men and women re­spectively. In other word, 24% of all hypertensives (aware or unaware about own blood pressure condition were treated and only 8% of them were controlled. Men significantly had less awareness (P< 0.001, lower tendency to take medi­cation (P< 0.001, and less were controlled (P= 0.046.Conclusion: We understand high prevalence, low awareness, treatment, and control of hypertension and higher preva­lence of other traditional metabolic risk factors in these cases. It seems that urgent preventional studies should be con­ducted in this population.

  11. Hypertension Canada's 2016 Canadian Hypertension Education Program Guidelines for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension.

    Science.gov (United States)

    Leung, Alexander A; Nerenberg, Kara; Daskalopoulou, Stella S; McBrien, Kerry; Zarnke, Kelly B; Dasgupta, Kaberi; Cloutier, Lyne; Gelfer, Mark; Lamarre-Cliche, Maxime; Milot, Alain; Bolli, Peter; Tremblay, Guy; McLean, Donna; Tobe, Sheldon W; Ruzicka, Marcel; Burns, Kevin D; Vallée, Michel; Prasad, G V Ramesh; Lebel, Marcel; Feldman, Ross D; Selby, Peter; Pipe, Andrew; Schiffrin, Ernesto L; McFarlane, Philip A; Oh, Paul; Hegele, Robert A; Khara, Milan; Wilson, Thomas W; Penner, S Brian; Burgess, Ellen; Herman, Robert J; Bacon, Simon L; Rabkin, Simon W; Gilbert, Richard E; Campbell, Tavis S; Grover, Steven; Honos, George; Lindsay, Patrice; Hill, Michael D; Coutts, Shelagh B; Gubitz, Gord; Campbell, Norman R C; Moe, Gordon W; Howlett, Jonathan G; Boulanger, Jean-Martin; Prebtani, Ally; Larochelle, Pierre; Leiter, Lawrence A; Jones, Charlotte; Ogilvie, Richard I; Woo, Vincent; Kaczorowski, Janusz; Trudeau, Luc; Petrella, Robert J; Hiremath, Swapnil; Drouin, Denis; Lavoie, Kim L; Hamet, Pavel; Fodor, George; Grégoire, Jean C; Lewanczuk, Richard; Dresser, George K; Sharma, Mukul; Reid, Debra; Lear, Scott A; Moullec, Gregory; Gupta, Milan; Magee, Laura A; Logan, Alexander G; Harris, Kevin C; Dionne, Janis; Fournier, Anne; Benoit, Geneviève; Feber, Janusz; Poirier, Luc; Padwal, Raj S; Rabi, Doreen M

    2016-05-01

    Hypertension Canada's Canadian Hypertension Education Program Guidelines Task Force provides annually updated, evidence-based recommendations to guide the diagnosis, assessment, prevention, and treatment of hypertension. This year, we present 4 new recommendations, as well as revisions to 2 previous recommendations. In the diagnosis and assessment of hypertension, automated office blood pressure, taken without patient-health provider interaction, is now recommended as the preferred method of measuring in-office blood pressure. Also, although a serum lipid panel remains part of the routine laboratory testing for patients with hypertension, fasting and nonfasting collections are now considered acceptable. For individuals with secondary hypertension arising from primary hyperaldosteronism, adrenal vein sampling is recommended for those who are candidates for potential adrenalectomy. With respect to the treatment of hypertension, a new recommendation that has been added is for increasing dietary potassium to reduce blood pressure in those who are not at high risk for hyperkalemia. Furthermore, in selected high-risk patients, intensive blood pressure reduction to a target systolic blood pressure ≤ 120 mm Hg should be considered to decrease the risk of cardiovascular events. Finally, in hypertensive individuals with uncomplicated, stable angina pectoris, either a β-blocker or calcium channel blocker may be considered for initial therapy. The specific evidence and rationale underlying each of these recommendations are discussed. Hypertension Canada's Canadian Hypertension Education Program Guidelines Task Force will continue to provide annual updates.

  12. Chronic thromboembolic pulmonary hypertension.

    Science.gov (United States)

    Schölzel, B E; Snijder, R J; Mager, J J; van Es, H W; Plokker, H W M; Reesink, H J; Morshuis, W J; Post, M C

    2014-12-01

    Chronic pulmonary thromboembolic disease is an important cause of severe pulmonary hypertension, and as such is associated with significant morbidity and mortality. The prognosis of this condition reflects the degree of associated right ventricular dysfunction, with predictable mortality related to the severity of the underlying pulmonary hypertension. Left untreated, the prognosis is poor. Pulmonary endarterectomy is the treatment of choice to relieve pulmonary artery obstruction in patients with chronic thromboembolic pulmonary hypertension and has been remarkably successful. Advances in surgical techniques along with the introduction of pulmonary hypertension-specific medication provide therapeutic options for the majority of patients afflicted with the disease. However, a substantial number of patients are not candidates for pulmonary endarterectomy due to either distal pulmonary vascular obstruction or significant comorbidities. Therefore, careful selection of surgical candidates in expert centres is paramount. The current review focuses on the diagnostic approach to chronic thromboembolic pulmonary hypertension and the available surgical and medical therapeutic options.

  13. Hypertension in pregnancy.

    Science.gov (United States)

    Vest, Amanda R; Cho, Leslie S

    2014-03-01

    Hypertensive disorders of pregnancy represent the second commonest cause of direct maternal death and complicate an estimated 5-10 % of pregnancies. Classification systems aim to separate hypertension similar to that seen outside pregnancy (chronic and gestational hypertension) from the potentially fatal pregnancy-specific conditions. Preeclampsia, HELLP syndrome, and eclampsia represent increasing severities of this disease spectrum. The American College of Obstetricians and Gynecologists' 2013 guidelines no longer require proteinuria as a diagnostic criterion, because of its variable appearance in the disease spectrum. The cause involves inadequate cytotrophoblastic invasion of the myometrium, resulting in placental hypoperfusion and diffuse maternal endothelial dysfunction. Changes in angiogenic and antiangiogentic peptide profiles precede the onset of clinical preeclampsia. Women with preeclampsia should be closely monitored and receive magnesium sulfate intravenously if severe features, HELLP syndrome, or eclampsia occur. Definitive therapy is delivery of the fetus. Hypertension in pregnancy increases future maternal risk of hypertension and cardiovascular disorders.

  14. [Hypertension and arteriosclerosis].

    Science.gov (United States)

    Sasamura, Hiroyuki; Itoh, Hiroshi

    2011-01-01

    Hypertension is a known risk factor for arteriosclerosis, and causes both atherosclero= sis of medium-large arteries and arteriolosclerosis of the arterioles. Elevated blood pressure causes damage to the endothelium and vascular wall through both mechanical and humoral factors. We and others have shown that inhibition of the renin-angiotensin system at a 'critical period' during the development of hypertension results in a permanent suppression of hypertension in animal models. We have also reported that high-dose renin-angiotensin inhibition results in regression of hypertension, possibly by regression of renal arteriolar hypertrophy. These results suggest that understanding the process of arterial remodeling may play a key role in the development of new strategies for prevention and regression of hypertension and arteriosclerosis.

  15. Overweight, adipocytokines and hypertension

    DEFF Research Database (Denmark)

    Seven, Ekim; Husemoen, Lise L N; Wachtell, Kristian

    2014-01-01

    , adiponectin, and CRP levels with both prevalent and 5-year incident hypertension (IHT) in a general population of Danish adults (n = 5,868, 51.3% women, mean age 45.8 ± 7.9 years). RESULTS: We recorded 2195 prevalent and 379 incident cases of hypertension. In models including leptin, CRP, adiponectin, sex......OBJECTIVE: The adipocytokines, leptin, adiponectin, and interleukin-6, which stimulate liver C-reactive protein (CRP) production, are regarded as potential candidate intermediates between adipose tissue and overweight-induced hypertension. METHODS: We examined the associations between leptin.......023) in the fully adjusted model. The population attributable risk estimate of IHT owing to overweight was 31%. CONCLUSION: Leptin, but not adiponectin or CRP, may play a mediating role in overweight-induced hypertension. However, as BMI was a strong independent predictor of hypertension, other factors than leptin...

  16. Hypertension in pregnancy.

    Science.gov (United States)

    Lindheimer, Marshall D; Taler, Sandra J; Cunningham, F Gary

    2010-01-01

    Hypertension complicates 5% to 7% of all pregnancies. A subset of preeclampsia, characterized by new-onset hypertension, proteinuria, and multisystem involvement, is responsible for substantial maternal and fetal morbidity and is a marker for future cardiac and metabolic disease. This American Society of Hypertension (ASH) position paper summarizes the clinical spectrum of hypertension in pregnancy, focusing on preeclampsia. Recent research breakthroughs relating to etiology are briefly reviewed. Topics include classification of the different forms of hypertension during pregnancy, and status of the tests available to predict preeclampsia, and strategies to prevent preeclampsia and to manage this serious disease. The use of antihypertensive drugs in pregnancy, and the prevention and treatment of the convulsive phase of preeclampsia, eclampsia, with intravenous MgSO(4) is also highlighted. Of special note, this guideline article, specifically requested, reviewed, and accepted by ASH, includes solicited review advice from the American College of Obstetricians and Gynecologists.

  17. Positive Portrayals of Feminist Men Increase Men's Solidarity with Feminists and Collective Action Intentions

    Science.gov (United States)

    Wiley, Shaun; Srinivasan, Ruhi; Finke, Elizabeth; Firnhaber, Joseph; Shilinsky, Alyssa

    2013-01-01

    The present study examined whether positive portrayals of feminist men could increase men's sense of solidarity with feminists and, through it, their intentions to engage in collective action in support of women. A sample of 102 mostly White men between the ages of 18 and 63 was recruited from Mechanical Turk, an online crowdsourcing marketplace.…

  18. The incidental relationship between serum ferritin levels and hypertension.

    Science.gov (United States)

    Ryoo, Jae-Hong; Kim, Sun Yong; Oh, Chang-Mo; Park, Sung Keun; Kim, Eugene; Park, Se-Jin; In Yu, Jae; Kim, Min-Gi; Choi, Yong-Sung; Ko, Taeg Su

    2015-03-15

    Although several studies have shown an association between ferritin level and hypertension, only a few studies have investigated the longitudinal relationship between them. Thus, we evaluated the incidental risk for hypertension according to baseline ferritin level. A total of 7104 healthy Korean men matched by a propensity score, who had participated in a medical health check-up program in 2005, were followed up from 2005 to 2010. They were divided into four groups according to baseline serum ferritin level (first quartile-fourth quartile). The incidence of hypertension was compared among the four groups, and the Cox-proportional hazard model was used to assess whether the development of hypertension was associated with higher baseline serum ferritin level. A total of 1252 (17.6%) cases had newly developed hypertension during the 26,339.5 person-years of follow-up between 2006 and 2010. The adjusted hazard ratios (HRs) (95% confidence intervals, CIs) for incident hypertension were 1.00 (reference), 1.09 (0.91-1.30), 1.21 (1.01-1.45) and 1.28 (1.07-1.52), respectively (P for trend=0.003) through the quartiles of serum ferritin levels, respectively, after adjusting for multiple confounders. For the log-transformed serum ferritin levels as a continuous variable, adjusted HRs and 95% CIs for HTN were 1.15 (1.02-1.29). Elevated serum ferritin level was independently associated with the incidental risk for hypertension in Korean men. This finding suggests the value of elevated ferritin level as an early predictor of hypertension. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. ASSOCIATION OF GENE POLYMORPHISMS OF THE RENIN-ANGIOTENSIN SYSTEM AND ENDOTHELIAL DYSFUNCTION WITH DEVELOPMENT AND SEVERITY OF PORTAL HYPERTENSION IN PATIENTS WITH CHRONIC HEPATITIS C

    Directory of Open Access Journals (Sweden)

    O. V. Taratina

    2016-01-01

    Full Text Available Background: At present, much attention is paid to genetic factors explaining the clinical course of chronic hepatitis C. Aim: To evaluate an association of the gene polymorphisms involved in the formation of endothelial dysfunction (NOS3 894G/T, CYBA 242C/T, MTHFR 677C/T and encoding components of the renin-angiotensin system (ATR1 1166A/C, AGT (-6G/T and 235M/T with development and severity of portal hypertension syndrome in patients with chronic hepatitis C. Materials and methods: 162 patients with chronic hepatitis C and HCV-related cirrhosis (114 women and 48 men were divided into the following groups: no portal hypertension (n = 98, "compensated" (n = 19 and "decompensated" (n = 45 portal hypertension. The gene polymorphisms were assessed by molecular genetic methods. Results: TT genotype of CYBA was more common in patients with portal hypertension than in those without (odds ratio (OR for TT = 3.59, p = 0.031. This difference becomes larger when comparing the decompensated portal hypertension group with the no portal hypertension group (OR TT = 5.46, p = 0.009. Other gene polymorphisms were not associated with development or decompensation of portal hypertension. Multivariate analysis of the impact of genetic, clinical and demographic factors showed that portal hypertension was associated primarily with patients age at the time of the study (Wald's х2 = 14.99 and with their body mass index (Wald's х2 = 4.35. After exclusion of these population-wide risk factors from the model, the development of portal hypertension correlated with the carriage of 235TT genotype of CYBA (Wald's х2 = 6.07, OR = 4.29 and (-6AA genotype AGT (Wald's х2 = 4.73, OR = 4.13, as well as with the lack of protective 235TT genotype AGT (Wald's х2 = 4.06, OR = 0.33. The combined effects of the studied gene polymorphisms on decompensation of the portal hypertension in patients with chronic HCV infection were similar. Conclusion: The development and increase in

  20. Management of hypertensive disorders in pregnancy.

    Science.gov (United States)

    Moussa, Hind N; Arian, Sara E; Sibai, Baha M

    2014-07-01

    Hypertensive disorders are the most common medical complication of pregnancy, with an incidence of 5-10%, and a common cause of maternal mortality in the USA. Incidence of pre-eclampsia has increased by 25% in the past two decades. In addition to being among the lethal triad, there are likely up to 100 other women who experience 'near miss' significant maternal morbidity that stops short of death for every pre-eclampsia-related mortality. The purpose of this review is to present the new task force statement and novel definitions, as well as management approaches to each of the hypertensive disorders in pregnancy. The increased understanding of the pathophysiology of hypertension in pregnancy, as well as advances in medical therapy to minimize risks of fetal toxicity and teratogenicity, will improve our ability to prevent and treat hypertension in pregnancy. Fetal programming and fetal origins of adult disease theories extrapolate the benefit of such therapy to future generations.

  1. Phytotherapy of hypertension and diabetes in oriental Morocco.

    Science.gov (United States)

    Ziyyat, A; Legssyer, A; Mekhfi, H; Dassouli, A; Serhrouchni, M; Benjelloun, W

    1997-09-01

    In order to select the main medicinal plants used in folk medicine to treat arterial hypertension and/or diabetes, a survey was undertaken in different areas of oriental Morocco. The patients (370 women and 256 men) were divided into three groups: diabetics (61%), hypertensives (23%) and hypertensive diabetic persons (16%). On average, 67.51% of patients regularly use medicinal plants. This proportion is perceptibly the same in all groups and does not depend on sex, age and socio-cultural level. This result shows that phytotherapy is widely adopted in northeastern Morocco. For diabetes, 41 plants were cited, of which the most used were Trigonella foenum-graecum L. (Leguminosae), Globularia alypum L. (Globulariaceae), Artemisia herba-alba Asso. (Compositae), Citrullus colocynthis (L.) Schrad. (Cucurbitaceae) and Tetraclinis articulata Benth. (Cupressaceae). In the hypertension's therapy 18 vegetal species were reported, of which the most used were Allium sativum L. (Liliaceae), Olea europea L. (Oleaceae), Arbutus unedo L. (Ericaceae), Urtica dioica L. (Urticaceae) and Petroselinum crispum A.W. Hill (Apiaceae). Among the 18 species used for hypertension, 14 were also employed for diabetes. Moreover, these two diseases were associated in 41% of hypertensives. These findings suggest that hypertension observed in this region would be in a large part related to diabetes.

  2. [Analysis of risk factors for hypertension in Colima, Mexico].

    Science.gov (United States)

    Espinoza-Gómez, Francisco; Ceja-Espíritu, Gabriel; Trujillo-Hernández, Benjamín; Uribe-Araiza, Tania; Abarca-de Hoyos, Pilar; Flores-Vázquez, Diana P

    2004-12-01

    To evaluate the possible association that age, sex, excess weight, family history of hypertension, alcoholism, and sedentary lifestyle have with hypertension in the adult population of the city of Colima, Mexico. This was a population-based analytic cross-sectional study. A structured survey was used with 280 adults older than 30 years of age who were living in the city of Colima in 2001 and 2002. The variables studied were sex, age, weight, height, family history of hypertension, engaging in physical exercise, smoking, and consuming alcohol. Blood pressure (BP) was measured with the auscultatory method. Borderline or doubtful measurements were checked again four or five days later. Hypertension was defined as systolic BP > or = 140 mm Hg and diastolic blood pressure > or = 90 mm Hg, or as the person being under antihypertensive treatment. The odds ratios (ORs) of the variables studied were calculated, along with their 95% confidence intervals (95% CIs). The association between the variables and hypertension was estimated through logistic regression, and their interaction through the coefficient of the interaction products. The overall prevalence of hypertension was 28.6%. The prevalence was higher in men than in women (42.1% vs. 19.2%; OR = 3.04, 95% CI: 1.8 to 5.2) and in people older than 49 years than in people 30 to 49 years old (36.8% vs. 21.9%; OR = 2.07, 95% CI: 1.22 to 3.50). A family history of hypertension and excess weight were associated with hypertension, while physical exercise had a protective effect (OR = 0.45; 95% CI: 0.23 to 0.86). There was interaction between hypertension and age > or = 50 years, a family history of hypertension, overweight, and physical exercise, especially among women. The prevalence of hypertension in Colima is very similar to that for Mexico as a whole. The strong association that hypertension had with male gender, regardless of the other variables, emphasizes the need for promoting prevention campaigns that focus more on

  3. Sex and acute stroke presentation.

    Science.gov (United States)

    Labiche, Lise A; Chan, Wenyaw; Saldin, Kamaldeen R; Morgenstern, Lewis B

    2002-11-01

    We determine whether a sex difference exists for acute stroke emergency department presentation. The TLL Temple Foundation Stroke Project is a prospective observational study of acute stroke management that identified 1,189 validated strokes in nonurban community EDs from February 1998 to March 2000. Structured interview of the patient and the person with the patient at symptom onset identified the symptom or symptoms that prompted the patient to seek medical attention. Interview data were available for 1,124 (94%) patients. A physician blinded to sex classified the reported symptoms into 14 categories. Nontraditional stroke symptoms were reported by 28% of women and 19% of men (odds ratio 1.62; 95% confidence interval 1.2 to 2.2). Nontraditional stroke symptoms, pain (men 8%, women 12%) and change in level of consciousness (men 12%, women 17%), were more often reported by women. Traditional stroke symptoms, imbalance (men 20%, women 15%) and hemiparesis (men 24%, women 19%), were reported more frequently by men. Trends were also found for women to present with nonneurologic symptoms (men 17%, women 21%) and men to present with gait abnormalities (men 11%, women 8%). There was no sex difference in the mean number of symptoms reported by an individual patient. This study suggests that a sex difference exists in reporting of acute stroke symptoms. Women with validated strokes present more frequently with nontraditional stroke symptoms than men. Recognition of this difference might yield faster evaluation and management of female patients with acute stroke eligible for acute therapies.

  4. Measures and men

    CERN Document Server

    Kula, Witold

    2014-01-01

    Measures and Men, considers times and societies in which weighing and measuring were meaningful parts of everyday life and weapons in class struggles. Originally published in 1986. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These paperback editions preserve the original texts of these important books while presenting them in durable paperback editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heri

  5. Consumption of High-Polyphenol Dark Chocolate Improves Endothelial Function in Individuals with Stage 1 Hypertension and Excess Body Weight

    Directory of Open Access Journals (Sweden)

    Lívia de Paula Nogueira

    2012-01-01

    Full Text Available Background. Hypertension and excess body weight are important risk factors for endothelial dysfunction. Recent evidence suggests that high-polyphenol dark chocolate improves endothelial function and lowers blood pressure. This study aimed to evaluate the association of chocolate 70% cocoa intake with metabolic profile, oxidative stress, inflammation, blood pressure, and endothelial function in stage 1 hypertensives with excess body weight. Methods. Intervention clinical trial includes 22 stage 1 hypertensives without previous antihypertensive treatment, aged 18 to 60 years and presents a body mass index between 25.0 and 34.9 kg/m2. All participants were instructed to consume 50 g of chocolate 70% cocoa/day (2135 mg polyphenols for 4 weeks. Endothelial function was evaluated by peripheral artery tonometry using Endo-PAT 2000 (Itamar Medical. Results. Twenty participants (10 men completed the study. Comparison of pre-post intervention revealed that (1 there were no significant changes in anthropometric parameters, percentage body fat, glucose metabolism, lipid profile, biomarkers of inflammation, adhesion molecules, oxidized LDL, and blood pressure; (2 the assessment of endothelial function through the reactive hyperemia index showed a significant increase: 1.94 ± 0.18 to 2.22 ± 0.08, P=0.01. Conclusion.In individuals with stage 1 hypertension and excess body weight, high-polyphenol dark chocolate improves endothelial function.

  6. Consumption of High-Polyphenol Dark Chocolate Improves Endothelial Function in Individuals with Stage 1 Hypertension and Excess Body Weight

    Science.gov (United States)

    Nogueira, Lívia de Paula; Knibel, Marcela Paranhos; Torres, Márcia Regina Simas Gonçalves; Nogueira Neto, José Firmino; Sanjuliani, Antonio Felipe

    2012-01-01

    Background. Hypertension and excess body weight are important risk factors for endothelial dysfunction. Recent evidence suggests that high-polyphenol dark chocolate improves endothelial function and lowers blood pressure. This study aimed to evaluate the association of chocolate 70% cocoa intake with metabolic profile, oxidative stress, inflammation, blood pressure, and endothelial function in stage 1 hypertensives with excess body weight. Methods. Intervention clinical trial includes 22 stage 1 hypertensives without previous antihypertensive treatment, aged 18 to 60 years and presents a body mass index between 25.0 and 34.9 kg/m2. All participants were instructed to consume 50 g of chocolate 70% cocoa/day (2135 mg polyphenols) for 4 weeks. Endothelial function was evaluated by peripheral artery tonometry using Endo-PAT 2000 (Itamar Medical). Results. Twenty participants (10 men) completed the study. Comparison of pre-post intervention revealed that (1) there were no significant changes in anthropometric parameters, percentage body fat, glucose metabolism, lipid profile, biomarkers of inflammation, adhesion molecules, oxidized LDL, and blood pressure; (2) the assessment of endothelial function through the reactive hyperemia index showed a significant increase: 1.94 ± 0.18 to 2.22 ± 0.08, P = 0.01. Conclusion.In individuals with stage 1 hypertension and excess body weight, high-polyphenol dark chocolate improves endothelial function. PMID:23209885

  7. Sinistral Portal Hypertension. A Case Report

    Directory of Open Access Journals (Sweden)

    Dinesh Singhal

    2006-11-01

    Full Text Available Sinistral portal hypertension is a clinical syndrome of gastric variceal hemorrhage in the setting of splenic vein thrombosis due to a primary pancreatic pathology. The distinguishing features from other forms of portal hypertension are preserved liver function and a patent extrahepatic portal vein. The important causes include acute and chronic pancreatitis, pancreatic pseudocysts and pancreatic carcinomas. Benign pancreatic neoplasms only rarely cause sinistral portal hypertension. Splenic vein thrombosis complicates 7-20% of patients having pancreatitis or a pancreatic pseudocyst; however, bleeding occurs in only approximately 5% of patients. The diagnosis of sinistral portal hypertension is achieved by a combination of gastroscopy, liver function tests, ultrasound examination (with Doppler and/or contrast-enhanced CT scan of the abdomen.A mere demonstration of sinistral portal hypertension does not warrant intervention. An expectant management is justifiable in asymptomatic patients with pancreatitis. However, concomitant splenectomy may be considered in patients undergoing operative treatment of symptomatic chronic pancreatitis if sinistral portal hypertension and gastroesophageal varices are present. In patients presenting with gastric variceal hemorrhage, splenectomy (with treatment for the primary pancreatic pathology, e.g. distal pancreatectomy is curative with excellent long term results.

  8. Cigarette smoking and hypertension. Factors independently associated with blood hyperviscosity and arterial rigidity.

    Science.gov (United States)

    Levenson, J; Simon, A C; Cambien, F A; Beretti, C

    1987-01-01

    The effects of cigarette smoking and hypertension on hemorheological variables (blood viscosity over a wide range of shear rates, plasma viscosity, microhematocrit, and plasma protein concentration) and on arterial stiffness (pulse wave velocity) were investigated in 33 normotensive men and 81 mild to moderately hypertensive men. Of these, 22 normotensive and 24 hypertensive subjects were cigarette smokers. Cigarette smoking and hypertension were independently associated with higher blood viscosity at all studied shear rates (from 0.2 to 241 sec-1) as well as with higher plasma viscosity, hematocrit, and pulse wave velocity. At constant hematocrit levels, hypertension remained associated with a higher blood viscosity, while the association with cigarette smoking disappeared. Normotensive smokers had the same increase of blood and plasma viscosity and pulse wave velocity as hypertensive nonsmokers. No interactive effects of hypertension or cigarette smoking on blood or arterial variables were observed, suggesting that the effect of these two factors on blood and vascular rheology are cumulative. Smoking and hypertension may change the flow properties of the blood and the behavior of the arterial wall and this may explain the arterial damage observed in cigarette smokers and hypertensive patients.

  9. [Health behaviours among men age > 50 years with reference to risk factors cardiovascular diseases].

    Science.gov (United States)

    Jóźwiak, Paulina; Szmagaj, A

    2012-01-01

    World Health Organization includes the eight main risk factors, which causes about 61% of cardiovascular deaths. These factors are: tobacco and alcohol use, high blood pressure, high body mass index, abnormal blood lipid levels, high blood glucose, a diet high in saturated fat and low in fruit and vegetable intake and physical inactivity. Thanks to them it's possible to expect probability of illness and its complication. Particularly exposed to cardiovascular morbidity are those patients who have multiple risk factors. The investigated group consisted of 114 male patients, who lived in Poznan. The authors analyzed lifestyle factors (smoking, prophylactic examination, exercise and leisure activities and diet), which were compared with laboratory and diagnostic tests plus selected individual characteristics of respondents. Answers distribution within the group are presented as percentages. The aim of the study was to analyze health behaviors among men age > 50 years related to risk factors cardiovascular diseases. Results shows that most of the study group had overweight or obesity and their daily physical activity was confined only to the work in the garden or walking. There were 33% of men with BMI>30, which increases their risk of heart attack twice. Incidence of hypertension was related to obesity, high blood cholesterol and high triglyceride levels. Vascular interventions occurs more frequently among daily smokers and former smokers. More than half of study group with hypertension stopped smoking because of their diseases. Men who declared healthy lifestyle more frequently perform prophylactic control tests and examination. Mostly three or four risk factors were found among study group. For the men after 50 there should be implemented more prophylactic programs, to encourage lifestyle changes and eliminate risk factors.

  10. Reactive oxygen species and dopamine receptor function in essential hypertension.

    Science.gov (United States)

    Zeng, Chunyu; Villar, Van Anthony M; Yu, Peiying; Zhou, Lin; Jose, Pedro A

    2009-04-01

    Essential hypertension is a major risk factor for stroke, myocardial infarction, and heart and kidney failure. Dopamine plays an important role in the pathogenesis of hypertension by regulating epithelial sodium transport and by interacting with vasoactive hormones and humoral factors. However, the mechanisms leading to impaired dopamine receptor function in hypertension states are not clear. Compelling experimental evidence indicates a role of reactive oxygen species (ROS) in hypertension, and there are increasing pieces of evidence showing that in conditions associated with oxidative stress, which is present in hypertensive states, dopamine receptor effects, such as natriuresis, diuresis, and vasodilation, are impaired. The goal of this review is to present experimental evidence that has led to the conclusion that decreased dopamine receptor function increases ROS activity and vice versa. Decreased dopamine receptor function and increased ROS production, working in concert or independent of each other, contribute to the pathogenesis of essential hypertension.

  11. HPV in men.

    Science.gov (United States)

    D'Hauwers, K W M; Tjalma, W A A

    2008-01-01

    To collect information about HPV in men and the (possible) correlation with HVP infection in women. Review of the literature. An overview of HPV-related penile and anal malignancies in men and the risk factors of acquiring HPV. In men HPV is also partially responsible for anogenital malignancies. Although the prevalence of HPV-related malignancies in men is much lower than in women, it is useful to gain more knowlege. Especially knowing if men are really the HPV reservoir and transmitters for women can make a difference in deciding whether men should also be screened for HPV and if they are good candidates for vaccination.

  12. Mechanisms responsible for pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ Pulmonary hypertension is a pathophysiologic process characterized by progressive elevation of pulmonary vascular resistance and right heart failure, which is a common complication of many diseases. Pulmonary hypertension with no apparent causes (unknown etiology) is termed primary pulmonary hypertension or, more recently, idiopathic pulmonary arterial hypertension (IPAH).

  13. Anesthesia and pulmonary hypertension.

    Science.gov (United States)

    McGlothlin, Dana; Ivascu, Natalia; Heerdt, Paul M

    2012-01-01

    Anesthesia and surgery are associated with significantly increased morbidity and mortality in patients with pulmonary hypertension due mainly to right ventricular failure, arrhythmias, postoperative hypoxemia, and myocardial ischemia. Preoperative risk assessment and successful management of patients with pulmonary hypertension undergoing cardiac surgery involve an understanding of the pathophysiology of the disease, screening of patients at-risk for pulmonary arterial hypertension, analysis of preoperative and operative risk factors, thorough multidisciplinary planning, careful intraoperative management, and early recognition and treatment of postoperative complications. This article will cover each of these aspects with particular focus on the anesthetic approach for non-cardiothoracic surgeries.

  14. Conjugal violence: a comparison of violence against men by women and women by men.

    Science.gov (United States)

    Thureau, S; Le Blanc-Louvry, I; Thureau, S; Gricourt, C; Proust, B

    2015-04-01

    Because few studies demonstrated the types of violence performed by women, the aim of our study was to access violence men against women as well as women against men. A retrospective study was performed based on all the medical certificates for victims who consulted our centre specialized in assault victims. Eleven percent of the victims were men (81 men, 626 women). Episodes of violence were most often repeated against women than men (p men than women (p men, 64% women) and severe in 5% of cases i.e. fractures, with no difference in gender. Three cases of sexual assault and one case of chemical submission was observed in women. Insults were made more often by men than by women (p men (p men than in 65% women (p domestic violence occur less frequently in men than in women. Men present more often with injuries that are less severe compared to those observed in women. In contrast, the psychological impact is less frequent in men. Also episodes of violence were most often repeated when the aggressor was a man.

  15. The interlinked depression, erectile dysfunction, and coronary heart disease syndrome in older men: a triad often underdiagnosed.

    Science.gov (United States)

    Tan, Robert S; Pu, Shou-Jin

    2003-01-01

    The prevalence of depression, erectile dysfunction (ED), and coronary heart disease (CHD) increases with age, and the symptoms related to these three illnesses are closely interlinked. The term "DEC syndrome" is introduced to refer to this triad of comorbid conditions. When a patient presents with one component of the DEC syndrome, physicians should also screen for the other two components. Studies have shown that depression may predispose an individual to an increased risk of developing CHD, and older men with CHD are more likely to be depressed. Likewise, patients with ED are more likely to be clinically depressed, and patients with clinical depression often have ED. Furthermore, patients presenting with ED are often hypertensive, and thus have a significantly higher prevalence of cardiovascular complications. Multifactorial problems require multifactorial approaches, and the care of older men can improve if physicians are aware of this interlinked syndrome.

  16. Causes of Resistant Hypertension Detected by a Standardized Algorithm

    Directory of Open Access Journals (Sweden)

    Livia Beatriz Santos Limonta

    2012-01-01

    Full Text Available Resistant hypertension (RH is characterized by blood pressure above 140 × 90 mm Hg, despite the use, in appropriate doses, of three antihypertensive drug classes, including a diuretic, or the need of four classes to control blood pressure. Resistant hypertension patients are under a greater risk of presenting secondary causes of hypertension and may be benefited by therapeutical approach for this diagnosis. However, the RH is currently little studied, and more knowledge of this clinical condition is necessary. In addition, few studies had evaluated this issue in emergent countries. Therefore, we proposed the analysis of specific causes of RH by using a standardized protocol in Brazilian patients diagnosed in a center for the evaluation and treatment of hypertension. The management of these patients was conducted with the application of a preformulated protocol which aimed at the identification of the causes of resistant hypertension in each patient through management standardization. The data obtained suggest that among patients with resistant hypertension there is a higher prevalence of secondary hypertension, than that observed in general hypertensive ones and a higher prevalence of sleep apnea as well. But there are a predominance of obesity, noncompliance with diet, and frequent use of hypertensive drugs. These latter factors are likely approachable at primary level health care, since that detailed anamneses directed to the causes of resistant hypertension are applied.

  17. [Hypertension during pregnancy--how to manage effectively?].

    Science.gov (United States)

    Klocek, Marek; Czarnecka, Danuta

    2015-01-01

    Arterial hypertension affects 5-10% of all pregnant women and may be present in women with pre-existing primary or secondary chronic hypertension, and in women who develop newonset hypertension in the second half of pregnancy. Hypertensive disorders during pregnancy carry risks for the woman and the baby. Hypertension in pregnancy is diagnosed when SBP is > or = 140 or/and DBP > or = 90 mmHg. According to the guidelines, the decision to start pharmacological treatment of hypertension in pregnancy depends on the type of hypertension: in pregnancy-induced hypertension, developing after 20 weeks of pregnancy (with or without proteinuria) drug treatment is indicated when BP is > or = 140/90 mmHg, in chronic hypertension observed before pregnancy pharmacotherapy is indicated when BP is > or = 150/95 mmHg. For pregnant women with severe hypertension (> or =160 / 110 mmHg) antihypertensive therapy should be initiated immediately. Oral methyldopa, labetalol, other beta-adrenoreceptor blockers and calcium channel blockers are used most commonly. In pre-eclampsia parental labetalol, nitroglycerine, urapidyl and other drugs may also be needed.

  18. Relationship between lupus anticoagulant (LAC) and pregnancy-induced hypertension.

    Science.gov (United States)

    Matsumoto, T; Sagawa, N; Ihara, Y; Kobayashi, F; Itoh, H; Mori, T

    1995-01-01

    Lupus anticoagulant (LAC), a serum antiphospholipid autoantibody, is believed to be one of the causes of infertility or fetal loss. The purpose of the present study was to evaluate the role of LAC in the pathogenesis of hypertension during pregnancy. In this study, 20 pregnant women with hypertension were classified into two groups: 14 patients who did not have hypertension before the pregnancy but developed it during the pregnancy (pregnancy-induced hypertension; Group A) and 6 patients who had hypertensive or renal disease before the pregnancy, and developed further hypertension during the pregnancy (pregnancy-aggravated hypertension; Group B). A LAC coagulation assay was performed, and the presence of LAC in each group was compared. All 14 patients in group A were LAC-negative. In contrast, 3 of the 6 patients in group B were LAC-positive, and had clinical autoimmune diseases. The incidence of pregnancy-induced hypertension was also examined in 15 pregnancies from 9 LAC-positive women who had a history of repeated fetal loss but no systemic autoimmune disease (Group C). None of these 15 pregnancies had hypertensive complications, even when they reached term. In the placentas of LAC-positive women, no characteristic changes other than fibrinoid degeneration and microscopic infarction were observed upon histological examination. These results suggest that LAC does not relate with the onset of hypertension during pregnancy.

  19. Serum uric acid in new and recent onset primary hypertension

    Directory of Open Access Journals (Sweden)

    N N Anand

    2015-01-01

    Full Text Available Introduction: Hyperuricemia is common among adults with prehypertension, especially when the microalbuminuria is present. Hyperuricemia precedes the development of hypertension. Aim: (1 To find the association of hyperuricemia in new-onset hypertensive patients. (2 To find the association of hyperuricemia in hypertensive patients with regard to gender and risk factors such as smoking and central obesity. Material and Methods: A total of 50 adults aged between 20 and 50 years who had mild early hypertension were selected for the study. Fifty controls without hypertension were enrolled and investigated. Results: The association between uric acid (UA and hypertension was analyzed using Student′s t-test and statistical difference were assessed using Pearson coefficient. The study showed a significant difference in UA between the hypertensive subjects and the normotensive controls. There was not a significant difference between waist abnormality, smoking and UA in cases. Males have a higher degree of hyperuricemia than females in hypertensive patients. Conclusion: Serum UA is strongly associated with blood pressure (BP in new and recent onset primary hypertension. The remarkable association of UA with BP in adults is consistent with recent animal model data and the hypothesis that the UA might have a pathogenic role in the development of hypertension.

  20. Osteoporosis in Men

    Science.gov (United States)

    ... not supported by your browser. Home Osteoporosis Men Osteoporosis in Men Publication available in: PDF (71 KB) ... as life expectancy continues to rise. What Causes Osteoporosis? Bone is constantly changing—that is, old bone ...

  1. When Men Meet

    DEFF Research Database (Denmark)

    Bech, Henning

    men, mænd, masculinity, maskulinitet, gender, køn, homosexuality, homoseksualitet, modernity, modernitet, postmodernity, postmodernitet......men, mænd, masculinity, maskulinitet, gender, køn, homosexuality, homoseksualitet, modernity, modernitet, postmodernity, postmodernitet...

  2. Men's Health: Violence Prevention

    Science.gov (United States)

    ... Health This information in Spanish ( en español ) Violence prevention for men Get help for violence in your ... help. Return to top More information on Violence prevention for men Explore other publications and websites Are ...

  3. Men and Heart Disease

    Science.gov (United States)

    ... Pressure Salt Cholesterol Million Hearts® WISEWOMAN Men and Heart Disease Fact Sheet Recommend on Facebook Tweet Share Compartir Source: Interactive Atlas of Heart Disease and Stroke Heart Disease Facts in Men Heart disease is the leading ...

  4. Sexual Problems in Men

    Science.gov (United States)

    Many men have sexual problems. They become more common as men age. Problems can include Erectile dysfunction Reduced or lost interest in sex ... problems may also be factors. Occasional problems with sexual function are common. If problems last more than ...

  5. Obesity-Related Hypertension in Children

    Directory of Open Access Journals (Sweden)

    Tammy M. Brady

    2017-09-01

    Full Text Available Obesity and hypertension have both been on the rise in children. Each is associated with increased cardiovascular disease risk and both track into adulthood, increasing the prevalence of heart disease and related morbidity and mortality. All children should be screened for hypertension, but children with comorbid obesity may not only particularly benefit from the screening but may also prove the most challenging to screen. Increased arm circumference and conical arm shape are particularly problematic when attempting to obtain an accurate blood pressure (BP measurement. This review focuses on the unique aspects of hypertension evaluation and management in the child with comorbid obesity. Specific traditional and non-traditional risk factors that may contribute to elevated BP in children with obesity are highlighted. Current proposed pathophysiologic mechanisms by which obesity may contribute to elevated BP and hypertension is reviewed, with focus on the role of the sympathetic nervous system and the renin–angiotensin–aldosterone system. This review also presents a targeted treatment approach to children with obesity-related hypertension, providing evidence for the recommended therapeutic lifestyle change that should form the basis of any antihypertensive treatment plan in this population of at-risk children. Advantages of specific pharmacologic agents in the treatment of obesity-related hypertension are also reviewed.

  6. Therapeutic Exercise and Hypertension

    African Journals Online (AJOL)

    Nekky Umera

    focus of this review is to discuss the therapeutic efficacy of exercise on ... as high level of sodium in diet, alcohol consumption, obesity, physical inactivity, age, and .... idiopathic (essential) hypertension, there are two modes or approaches.

  7. Hypertension and liver disease

    DEFF Research Database (Denmark)

    Henriksen, Jens H; Møller, Søren

    2004-01-01

    Arterial hypertension is a common disorder with a frequency of 10% to 15% in subjects in the 40- to 60-year age group. Yet most reports find the prevalence of arterial hypertension in patients with chronic liver disease (cirrhosis) much lower. In this review, we consider the alterations in systemic......, neuropituitary release of vasopressin), and resistance to vasopressors. The vasodilatory state is mediated through nitric oxide, calcitonin gene-related peptide, adrenomedullin, and other vasodilators, and is most pronounced in the splanchnic area. This constitutes an effective (although relative) counterbalance...... to increased arterial blood pressure. Subjects with established arterial hypertension (essential, secondary) may become normotensive during the development of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin...

  8. Diabetes + Hypertension (comorbidity)

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This data set provides de-identified population data for diabetes and hypertension comorbidity prevalence in Allegheny County.

  9. High Blood Pressure (Hypertension)

    Science.gov (United States)

    ... Print Page Text Size: A A A Listen High Blood Pressure (Hypertension) Nearly 1 in 3 American adults has ... weight. How Will I Know if I Have High Blood Pressure? High blood pressure is a silent problem — you ...

  10. High Blood Pressure (Hypertension)

    Science.gov (United States)

    ... already been diagnosed with high blood pressure. Try yoga and meditation. Yoga and meditation not only can strengthen your body ... Accessed Sept. 21, 2015. Hu B, et al. Effects of psychological stress on hypertension in middle-aged ...

  11. Hydrogen sulfide in hypertension

    NARCIS (Netherlands)

    van Goor, Harry; van den Born, Joost C; Hillebrands, Jan-Luuk; Joles, Jaap A

    2016-01-01

    PURPOSE OF REVIEW: Hypertension is an important determinant of cardiovascular disease, and strict blood pressure regulation is beneficially associated with the risk for cardiovascular events or all-cause mortality. However, intensive antihypertensive treatment is not always sufficient to reach

  12. Allegheny County Hypertension Hospitalization

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This data provides hypertension prevalence data for each Zip Code in Allegheny County. The information was produced by Pennsylvania Health Care Cost Containment...

  13. Apelin and pulmonary hypertension

    DEFF Research Database (Denmark)

    Andersen, Charlotte Uggerhøj; Hilberg, Ole; Mellemkjær, Søren;

    2011-01-01

    Pulmonary arterial hypertension (PAH) is a devastating disease characterized by pulmonary vasoconstriction, pulmonary arterial remodeling, abnormal angiogenesis and impaired right ventricular function. Despite progress in pharmacological therapy, there is still no cure for PAH. The peptide apelin...... vasoconstriction, and has positive inotropic and cardioprotective effects. Apelin attenuates vasoconstriction in isolated rat pulmonary arteries, and chronic treatment with apelin attenuates the development of pulmonary hypertension in animal models. The existing literature thus renders APLNR an interesting...

  14. Hypertension and pregnancy.

    Science.gov (United States)

    Deak, Teresa M; Moskovitz, Joshua B

    2012-11-01

    Hypertension in pregnancy is increasing in prevalence and incidence and its treatment becoming more commonplace. Associated complications of pregnancy, including end-organ damage, preeclampsia, eclampsia, and postpartum eclampsia, are leading sources of maternal and fetal morbidity and mortality, requiring an emergency physician to become proficient with their identification and treatment. This article reviews hypertension in pregnancy as it relates to outcomes, with special emphasis on preeclampsia, eclampsia, and postpartum eclampsia.

  15. Idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne M; Jensen, Rigmor H

    2015-01-01

    AIMS: The aims of this article are to characterize the headache in idiopathic intracranial hypertension (IIH) and to field-test the ICHD diagnostic criteria for headache attributed to IIH. MATERIALS AND METHODS: We included 44 patients with new-onset IIH. Thirty-four patients with suspected...... tinnitus may suggest intracranial hypertension. Based on data from a well-defined IIH cohort, we propose a revision of the ICDH-3 beta diagnostic criteria with improved clinical applicability and increased sensitivity and specificity....

  16. National prevalence and associated risk factors of hypertension and prehypertension among Vietnamese adults

    NARCIS (Netherlands)

    Ha, Do T.P.; Geleijnse, J.M.; Le, M.B.; Kok, F.J.; Feskens, E.J.M.

    2015-01-01

    BACKGROUND Hypertension has recently been identified as the leading risk factor for global mortality. This study aims to present the national prevalence of hypertension and prehypertension and, their determinants in Vietnamese adults. METHODS Nationally representative data were obtained from the

  17. Fracture prevention in men

    NARCIS (Netherlands)

    Geusens, PP; Sambrook, P.N.; Lems, W.F.

    2009-01-01

    The lifetime risk of experiencing a fracture in 50-year-old men is lower (20%) than the risk in women (50%). Consequently, much less research has been carried out on osteoporosis and fracture risk in men. Differences in the risk and incidence of fractures between men and women are related to differe

  18. Domestic violence against men.

    Science.gov (United States)

    Barber, Christopher F

    This article reviews the literature relating to domestic violence against men and examines some of the reasons why men are reluctant to report violent episodes. The article focuses on men as the victims and women as the perpetrators of domestic violence and identifies gaps in service provision. The role of the nurse in supporting male victims is also discussed.

  19. Rundt om Mad Men

    DEFF Research Database (Denmark)

    Nielsen, Jakob Isak

    2011-01-01

    Artiklen gør rede for Mad Mens tilblivelse, dens populærkulturelle efterdønninger, multimediale forgreninger og værkæstetiske karakteristika. "Story Matters Here" lyder AMCs motto, men Mad Men tilbyder et bredspektret engagement, der går langt ud over at følge med i en vedkommende fortælling...

  20. SUK- A companion to promoting well-being among overweight hypertensive older people : Health seeking behavior among overweight hypertensive older people

    OpenAIRE

    Seesawang, Junjira

    2011-01-01

    Health seeking behaviour is important in older people with hypertension and overweight, in terms of managing health factors that are related to their health and illness. However, health seeking behaviour of Thai older people is not well documented. This qualitative study aimed to describe health seeking behaviour of overweight hypertensive older people. Seven older women and three men participated in this study through purposive sampling. Qualitative data were gathered via in-depth interviews...

  1. Capsaicin and arterial hypertensive crisis.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo; La Rosa, Felice Carmelo; La Rocca, Roberto

    2010-10-08

    Chili peppers are rich in capsaicin. The potent vasodilator calcitonin gene-related peptide (CGRP) is stored in a population of C-fiber afferents that are sensitive to capsaicin. CGRP and peptides released from cardiac C fibers have a beneficial effect in myocardial ischemia and reperfusion. It has been reported that capsaicin pretreatment can deplete cardiac C-fiber peptide stores. Furthermore, it has also been reported that capsaicin-treated pigs have significantly increased mean arterial blood pressure compared with controls, and that the decrease in CGRP synthesis and release contributes to the elevated blood pressure. A case has also been reported of an arterial hypertensive crisis in a patient with a large ingestion of peppers and chili peppers the day before. We present a case of an arterial hypertensive crisis in a 19-year-old Italian man with an abundant ingestion of peppers and of chili peppers the preceding day. This case describes an unusual pattern of arterial hypertensive crisis due to capsaicin. Copyright © 2008 Elsevier Ireland Ltd. All rights reserved.

  2. Resistant Hypertension and Chronotherapy

    Science.gov (United States)

    Prkacin, Ingrid; Balenovic, Diana; Djermanovic-Dobrota, Vesna; Lukac, Iva; Drazic, Petra; Pranjic, Iva-Klara

    2015-01-01

    Resistant hypertension is defined as blood pressure that remains above 140/90 mmHg in spite of the continuous use of three antihypertensive agents in optimal dose, including diuretic, and lifestyle changes. According to data from United States of America and Europe, the prevalence ranges from 10 up to 30% in patients with hypertension. Numerous biological and lifestyle factors can contribute to the development of resistant hypertension: medications, volume overload, obesity, diabetes mellitus, older age, renal parenchymal and renovascular disease, primary aldosteronism, obstructive sleep apnea, pheochormocytoma, Cushing’s syndrome, thyroid diseases, aortic coarctation. For diagnosing patient’s history is important, assessing compliance, regular blood pressure measurement, physical examination, biochemical evaluation and noninvasive imaging. The evaluation including 24h ambulatory monitoring of blood pressure (ABPM) in the identification of “non-dipper” hypertension. Non-dipper has particular importance and the prevalence of abnormally high sleep blood pressure is very often in chronic kidney patients. Therapeutic restoration of normal physiologic blood pressure reduction during night-time sleep (circadial variation) is the most significant independent predictor of decreased risk and the basis for the chronotherapy. The resistant hypertension treatment is achieved with nonpharmacological and pharmacological approach, treating secondary hypertension causes and invasive procedures. PMID:26005390

  3. An evidence-based practice case study: white coat hypertension.

    Science.gov (United States)

    Richardson, Mary Ellis

    2015-01-01

    White coat hypertension, also referred to as isolated clinical hypertension, is a condition in which blood pressure rises in the medical setting due to anxiety. White coat hypertension causes no more than 15 mmHg increase in systolic blood pressure or 7 mmHg increase in diastolic blood pressure in normotensive patients, and these increases in blood pressures should return to baseline within 3 visits to the medical provider. In this case, a 77-year-old white man presented to preoperative testing, with a blood pressure of 265/101 mmHg, claiming to have white coat hypertension. This case discusses the interventions implemented for this particular patient and the misdiagnosis and misperceptions of white coat hypertension by both clinicians and patients. This article also addresses recommendations for diagnosis, treatment options, and follow-up for patients with true white coat hypertension.

  4. A Rare Cause of Secondary Hypertension: Conn Syndrom

    Directory of Open Access Journals (Sweden)

    Samet Sayilan

    2016-01-01

    Full Text Available Hypertension, is classified as primary (essential or secondary based on whether there is an identifiable cause. When it is determined a certain underlying cause of hypertension it is categorized as secondary hypertension. Conn%u2019s syndrome (primary hyperaldosteronism, a disorder of adrenal cortex characterized by exces aldosterone secretion, is an endocrine disorder that causes hypertension and it is seen in about 0.1% of all patients with hypertension. It can be caused by either unilateral disease (i.e. adenoma in one adrenal gland or bilateral disease (i.e. hyperplasia in both adrenal glands. Conn%u2019s syndrome secondary to bilateral adrenal adenoma, a cause of secondary hypertension, was presented in this articleas it is rarely reported in the literature.

  5. Study of the relationship between aggression and chronic diseases (diabetes and hypertension).

    Science.gov (United States)

    Tilov, Boris; Semerdzhieva, Maria; Bakova, Desislava; Tornyova, Biyanka; Stoyanov, Drozdstoi

    2016-06-01

    This study focused on the widely examined psychosomatic diseases - diabetes mellitus and arterial hypertension as chronic conditions. The Buss-Perry validated questionnaire was used in it to measure aggression in Bulgarian conditions. To study aggression as a predictor and a connection of the chronic diseases diabetes and hypertension. The number of the studied people was 142: 54 (38%) men and 88 (62%) women. Thirty-six of them had musculoskeletal disorders (77.8% women and 22.2% men), 54 had diabetes mellitus (29% women and 25% men) and 52 had hypertension (31% women and 21% men). During the statistical analysis of the data, the results from the Buss-Perry questionnaire were compared in the group of patients with hypertension and diabetes mellitus with chronic diseases, related to musculoskeletal disorders. The study revealed that there was a statistically significant difference in 95% of the cases between anger, hostility in patients with diabetes, hypertension and musculoskeletal disorders. The highest levels of physical aggression were observed in patients with arterial hypertension, M = 17.32 ± 0.86. The highest average levels of verbal aggression were observed in patients with diabetes, M = 15.24 ± 0.64. The highest levels of anger were observed with patients with hypertension, M = 17.96 ± 0.90, and hostility - in patients with hypertension, M = 19.15 ± 0.86. The comparison between the four Aggression Questionnaire scales showed statistically significant differences between the patients with musculoskeletal disorders and the ones with hypertension and diabetes. © 2015 John Wiley & Sons, Ltd.

  6. Chronic Thromboembolic Pulmonary Hypertension: Treat the Patient Not the Haemodynamics

    Directory of Open Access Journals (Sweden)

    Ben Dunne

    2012-01-01

    Full Text Available Chronic thromboembolic pulmonary hypertension (CTEPH is a disabling condition that is being increasingly recognised. It is unique as a cause of pulmonary hypertension in that it is surgically curable. We wish to highlight the importance of recognition and early referral of any patient who may have CTEPH even in the absence of resting pulmonary hypertension as excellent results can be achieved by restoring pulmonary vascular anatomy, reducing exercise-induced pulmonary hypertension, and reducing dead-space ventilation. We present a case that illustrates these points and discuss our experience as a referral centre for CTEPH.

  7. Interplay of overweight and insulin resistance on hypertension development.

    Science.gov (United States)

    Lytsy, Per; Ingelsson, Erik; Lind, Lars; Arnlöv, Johan; Sundström, Johan

    2014-04-01

    Obesity and hypertension are associated, possibly through causal pathways involving insulin resistance and metabolic derangements. We aimed to investigate in a whites sample if overweight or obese persons without insulin resistance are at risk of developing hypertension or blood pressure progression. In a meta-analysis, using multivariable-adjusted mixed-effects logistic regression models, we investigated the risks of hypertension development and blood pressure progression by combinations of relative weight classes and presence or absence of insulin resistance (defined as highest vs. lower three quartiles using the homeostatic model assessment method) in the Uppsala Longitudinal Study of Adult Men (n = 2322) and the Prospective Investigation of the Vasculature in Uppsala Seniors studies (n = 1066). These two samples, consisting mainly of middle-aged and elderly men, provided 1846 observations for the development of hypertension in normotensive individuals and 4223 observations for progressing to a higher blood pressure stage. During a median of 10 years of follow-up, 884 (47.9%) developed hypertension and 1639 (38.8%) progressed to a higher blood pressure stage. Overweight or obese persons without insulin resistance had an increased risk of hypertension development [odds ratio (OR) 1.46, 95% confidence interval 1.14-1.88] and blood pressure progression (OR 1.32, 1.10-1.59) compared with normal-weight persons without insulin resistance. According to this study, being overweight or obese without insulin resistance increases the risk of hypertension and blood pressure progression. This adds to the evidence that overweight and obesity may be harmful per se, and that overweight and obesity without glucometabolic derangements are not benign conditions.

  8. Occupational noise exposure and the risk of hypertension.

    Science.gov (United States)

    Stokholm, Zara A; Bonde, Jens Peter; Christensen, Kent L; Hansen, Ase M; Kolstad, Henrik A

    2013-01-01

    Noise may increase the risk of hypertension, but findings are inconsistent with respect to both community and occupational noise exposure. We used a large sample of noise-exposed industrial trades to analyze the association of occupational noise exposure and the risk of hypertension. The 7-year prospective cohort study included 145,190 workers from 625 companies representing 10 industrial trades and 100 companies from the finance sector. They were followed from 2001 to 2007 by record linkage with several Danish national registries. Full-shift noise exposure levels, measured in a random subset of 710 workers at the start and the end of follow-up, ranged from 70 to 86 dB(A); based on this information, historical levels back to the 1960s were estimated. Hypertension (defined by the prescription of antihypertensive medication or a hospital discharge diagnosis of hypertension) was regressed on the trade mean sound levels (LAEq) adjusting for a number of covariates. Women had increased rate ratios for hypertension when comparing blue-collar industrial workers with white-collar financial workers (adjusted rate ratio = 1.17 [95% confidence interval = 1.09-1.26]). For men, the corresponding relative risk value was 1.06 (0.98-1.14). Within blue-collar industrial workers, however, increasing noise exposure level was not associated with an increasing risk of hypertension among either men or women. Our study shows no increased risk of hypertension with exposure to noise in the lower half of the 80-90 dB(A) range.

  9. Cerebral blood flow autoregulation in hypertension and effects of antihypertensive drugs

    DEFF Research Database (Denmark)

    Barry, David; Lassen, N A

    1984-01-01

    If antihypertensive treatment, especially emergency blood pressure lowering, is always to be safe, more thought should be given to autoregulation of cerebral blood in the hypertensive patient. This topic is reviewed in the present article, in the hypertensive patient. This topic is reviewed...... in the present article, particular emphasis being placed on the resetting of the lower limit of autoregulation to higher pressure in hypertension and the effects of acute administration of anti-hypertensive drugs on CBF and CBF-autoregulation....

  10. Primary pulmonary hypertension.

    Science.gov (United States)

    Rashid, A; Lehrman, S; Romano, P; Frishman, W; Dobkin, J; Reichel, J

    2000-01-01

    Primary pulmonary hypertension (PPH) is a condition characterized by sustained elevation of pulmonary artery pressure (PAP) without demonstrable cause. The most common symptom at presentation is dyspnea. Other complaints include fatigue, chest pain, syncope, leg edema, and palpitations. Right heart catheterization is diagnostic, showing a mean PAP >25 mmHg at rest and >30 mmHg during exercise, with a normal pulmonary capillary wedge pressure. In the National Institutes of Health-PPH registry, the median survival period was 2.8 years. Treatment is aimed at lowering PAP, increasing cardiac output, and decreasing in situ thrombosis. Vasodilators have been used with some success in the treatment of PPH. They include prostacyclin, calcium-channel blockers, nitric oxide and adenosine. Anticoagulation has also been advised for the prevention of deep vein thrombosis, pulmonary embolism, and in situ thromboses of the lungs. New drug treatments under investigation include L-arginine, plasma endothelin-I, and bosentan. Use of oxygen, digoxin, and diuretics for symptomatic relief have also been recommended. Patients with severe PPH refractory to medical management should be considered for surgery.

  11. Clinical characteristics of idiopathic portal hypertension

    Institute of Scientific and Technical Information of China (English)

    Ozgur Harmanci; Yusuf Bayraktar

    2007-01-01

    Idiopathic portal hypertension is one of the interesting causes of portal hypertension. Even in very developed medical centers, this disorder is still one of the most important misdiagnoses of clinical practice. To inexperienced physicians, presenting esophageal varices and upper gastrointestinal bleeding usually prompt an unfortunate diagnosis of cirrhosis. A heterogenous clinical presentation and progression of this disorder should be recognized by physicians, and management should be directed towards some specific problems confined to this disorder. Although a genetic basis and other factors are implicated in its pathogenesis, exact underlying mechanism(s) is (are) unknown. In this review, we discuss the heterogeneity of idiopathic portal hypertension, its etiopathogenesis, clinical presentation and management issues. With the expectation of an excellent prognosis, a practicing gastroenterologist should be aware that "not all varices mean cirrhosis".

  12. [Sodium and hypertension].

    Science.gov (United States)

    de Wardener, H E

    1996-09-01

    Over several million years the human race was programmed to eat a diet which contained about 15 mmol of sodium (1 g of sodium chloride) per day. It is only five to ten thousand years ago that we became addicted to salt. Today we eat about 150 mmol of sodium (9-12 g of salt) per day. It is now apparent that this sudden rise in sodium intake (in evolutionary terms) is the most likely cause for the rise in blood pressure with age that occurs in the majority of the world's population. Those which consume less than 60 mmol/day do not develop hypertension. The reason for the rise in sodium intake is not known but it is probable that an important stimulus was the discovery that meat could be preserved by immersion into a concentrated salt solution. This seemingly miraculous power endowed salt with such magical and medicinal qualities that it became a symbol of goodness and health. It was not until 1904 Ambard and Beaujard suggested that on the contrary dietary salt could be harmful and raise the blood pressure. At first the idea did not prosper and it continues to be opposed by a diminishing band. The accumulated evidence that sodium intake is related to the blood pressure in normal man and animals and in inherited forms of hypertension has been obtained from experimental manipulations and studies of human populations. The following observation links sodium and hypertension. An increase in sodium intakes raises the blood pressure of the normal rat, dog, rabbit, baboon, chimpanzee and man. Population studies have demonstrated a significant correlation between sodium intake and the customary rise in blood pressure with age. The development of hypertensive strains of rats has revealed that the primary genetic lesion which gives rise to hypertension resides in the kidney where it impairs the urinary excretion of sodium. There is similar but less convincing evidence in essential hypertension. The kidney in both essential hypertension and hypertensive strains of rats share a

  13. Hypertension in pregnancy: A community-based study

    Directory of Open Access Journals (Sweden)

    Bharti Mehta

    2015-01-01

    Full Text Available Background: Hypertensive disorders during pregnancy occur in women with preexisting primary or secondary chronic hypertension, and in women who develop new-onset hypertension in the second half of pregnancy. The present study was undertaken to study the prevalence and correlates of hypertension in pregnancy in a rural block of Haryana. Materials and Methods: This cross-sectional study was carried out in the all 20 subcenters under Community Health Center (CHC Chiri, Block Lakhanmajra. All the pregnant women registered at the particular subcenter at a point of time of visit were included in the study. Appropriate statistical tests were used for analysis. Results: A total of 931 pregnant women were included in the present study. Prevalence of hypertension in pregnancy was found to be 6.9%. Maternal age ΃25 years, gestational period ͳ20 weeks, history of cesarean section, history of preterm delivery, and history of hypertension in previous pregnancy were found to be significantly associated with prevalence of hypertension in pregnancy. Conclusion: Nearly one in 14 pregnant women in rural areas of Haryana suffers from a hypertensive disorder of pregnancy. Early diagnosis and treatment through regular antenatal checkup is a key factor to prevent hypertensive disorders of pregnancy and its complications.

  14. Prevalence of Hypertension and Association of Obesity with Hypertension in School Ggoing Children of Surat City, Western India

    Directory of Open Access Journals (Sweden)

    Salvi S. Shah

    2013-08-01

    Full Text Available Purpose: The association of obesity with hypertension has been recognized for the decades which are the important risk factors for the cardiovascular disease. So the purpose of the present study was to determine association of obesity with hypertension in school going children of Surat. Methodology: School going children aged between 12-18 years, of five schools in Surat were selected for the study. Height and weight were measured and BMI was calculated. Blood pressure measurements were taken as per recommendation of American heart society and family history of hypertension has also been assessed. Hypertension was considered if blood pressure is more than 95th percentile according to the update of task force report and Obesity was diagnosed by BMI for age. Results: Of 682 children, 8.94% were obese and 20.09% were hypertensive. Conclusion: Obesity is strongly associated with hypertension in children and both together may risk factors for later coronary disease.

  15. Hypertensive emergencies in children: identification and management of dangerously high blood pressure.

    Science.gov (United States)

    Constantine, E; Merritt, C

    2009-04-01

    The prevalence of hypertension in the pediatric population is rising, coincident with the rise in childhood obesity worldwide. While most hypertensive children do not require emergent care, hypertensive urgencies and emergencies may be encountered in the outpatient clinic, the emergency department or the inpatient ward. To avoid the life-threatening complications associated with both hypertension and its treatment, the treating physician should be familiar with the presentation and management of pediatric hypertension. This review will serve to examine some of the important aspects of pediatric hypertensive urgencies and emergencies, including common causes, important features of diagnosis and options for medical management.

  16. Personality of Polish gay men and women

    Directory of Open Access Journals (Sweden)

    Marcin Kwiatkowski

    2015-12-01

    Full Text Available Background Sexuality is a part of one’s identity and personality that is shaped under the influence of biological and environmental factors and interactions with society. The results of research conducted so far and concerning the personality traits of gay men and women are not consistent, and only a small number of them concern the Polish population. Hence the objective of the present research was to provide personality profiles of men and women with different sexual orientations. Participants and procedure The participants (N = 346 included 84 gay women, 82 gay men, 95 heterosexual women and 85 heterosexual men. The following measures were used: a survey developed by the author, the Kinsey Scale, the EPQ-R (Eysenck Personality Questionnaire Revised adapted by Brzozowski and Drwal (1995, and the Sixteen-factor Personality Questionnaire of Cattell adapted by Nowakowska (1970. Results The results support the hypothesis that gay women and heterosexual men share similar personality traits, while gay men have more diverse traits, similar to the traits typical for heterosexual women and men. In particular, personalities of gay men are described by such traits as progressive attitude, independence, or willingness to take risks, which means traits linked to factor Q1. The highest values of that factor are observable in the case of gay men, as compared to gay women, and also in comparison with heterosexual men and women. Conclusions Sexual orientation is responsible for differences in personality traits of the studied group to a greater extent than their biological sex.

  17. MENX and MEN4

    Directory of Open Access Journals (Sweden)

    Natalia S. Pellegata

    2012-01-01

    Full Text Available Multiple endocrine neoplasias are autosomal dominant disorders characterized by the occurrence of tumors in at least two endocrine glands. Two MEN syndromes have long been known and are well characterized: the MEN type 1 (MEN1 and type 2 (MEN2. These syndromes are caused by germline mutations in the MEN1 and RET genes, respectively, and have a different tumor spectrum. Recently, a variant of the MEN syndromes arose spontaneously in a rat colony and was named MENX. Affected animals consistently develop multiple endocrine tumors, with a spectrum that shares features with both MEN1 and MEN2 human syndromes. Genetic studies identified a germline mutation in the Cdkn1b gene, encoding the p27 cell cycle inhibitor, as the causative mutation for MENX. Capitalizing on these findings, heterozygous germline mutations in the human homologue, CDKN1B, were searched for and identified in patients with multiple endocrine tumors. As a consequence of this discovery, a novel human MEN syndrome, named MEN4, was recognized, which is caused by mutations in p27. Altogether, these studies identified Cdkn1b/CDKN1B as a novel tumor susceptibility gene for multiple endocrine tumors in both rats and humans. Here we review the characteristics of the MENX and MEN4 syndromes and we briefly address the main function of p27 and how they are affected by MENX/4-associated mutations.

  18. Impact of primary hypertension on hematuria of the patients with benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    GUO Li-jun; TANG Yuan; GUO Chao-ming; ZHANG Xiang-hua

    2010-01-01

    Background Both benign prostatic hyperplasia (BPH) and primary hypertension are common in the elderly men. The purpose of this study was to investigate the possible effect of primary hypertension on the hematuria in patients with BPH.Methods All patients who underwent transurethral resection of prostate or opening operation had confirmed diagnoses of BPH histologically. comparative analysis of packet was used to analyze the incidence of hematuria in 423 BPH patients with or without hypertension. Immunostaining of CD34 and vascular endothelial growth factor (VEGF) was carried out in tissues of 50 cases of simple BPH and 50 cases of BPH accompanied with hypertension. Results The incidence of hematuria in the BPH with hypertension was significantly higher than that in the simple BPH (P<0.01). Furthermore, the incidence of hematuria in patients who had hypertension for more than 10 years was clearly higher than that in the patients who had hypertension for less than 10 years (P <0.01). Both microvessel density (MVD) based on CD34 immunostaining and VEGF expression were significantly higher in the BPH tissues of patients with hypertension than that in the simple BPH (P<0.01, P<0.05).Conclusions Long-term hypertension may significantly increase the incidence of hematuria in patients with both BPH and hypertension. Increased MVD level and VEGF expression may account for the higher incidence of hematuria in these patients.

  19. Hypertension-related alterations in white matter microstructure detectable in middle age.

    Science.gov (United States)

    McEvoy, Linda K; Fennema-Notestine, Christine; Eyler, Lisa T; Franz, Carol E; Hagler, Donald J; Lyons, Michael J; Panizzon, Matthew S; Rinker, Daniel A; Dale, Anders M; Kremen, William S

    2015-08-01

    Most studies examining associations between hypertension and brain white matter microstructure have focused on older adults or on cohorts with a large age range. Because hypertension effects on the brain may vary with age, it is important to focus on middle age, when hypertension becomes more prevalent. We used linear mixed-effect models to examine differences in white matter diffusion metrics as a function of hypertension in a well-characterized cohort of middle-aged men (n=316; mean, 61.8 years; range, 56.7-65.6). Diffusion metrics were examined in 9 tracts reported to be sensitive to hypertension in older adults. Relative to normotensive individuals, individuals with long-standing hypertension (>5.6 years) showed reduced fractional anisotropy or increased diffusivity in most tracts. Effects were stronger among carriers than among noncarriers of the apolipoprotein E ε4 allele for 2 tracts connecting frontal regions with other brain areas. Significant differences were observed even after adjustment for potentially related lifestyle and cardiovascular risk factors. Shorter duration of hypertension or better blood pressure control among hypertensive individuals did not lessen the adverse effects. These findings suggest that microstructural white matter alterations appear early in the course of hypertension and may persist despite adequate treatment. Although longitudinal studies are needed to confirm these findings, the results suggest that prevention-rather than management-of hypertension may be vital to preserving brain health in aging.

  20. HYPERTENSION-RELATED ALTERATIONS IN WHITE MATTER MICROSTRUCTURE DETECTABLE IN MIDDLE AGE

    Science.gov (United States)

    McEvoy, Linda K.; Fennema-Notestine, Christine; Eyler, Lisa T.; Franz, Carol; Hagler, Donald J.; Lyons, Michael J.; Panizzon, Matthew S.; Rinker, Daniel A; Dale, Anders M.; Kremen, William S.

    2015-01-01

    Most studies examining associations between hypertension and brain white matter microstructure have focused on older adults or on cohorts with a large age range. Since hypertension effects on the brain may vary with age it is important to focus on middle age, when hypertension becomes more prevalent. We used linear mixed effect models to examine differences in white matter diffusion metrics as a function of hypertension in a well-characterized cohort of middle-aged men (N=316, mean 61.8 years; range 56.7–65.6). Diffusion metrics were examined in nine tracts reported to be sensitive to hypertension in older adults. Relative to normotensive individuals, individuals with longstanding hypertension (> 5.6 years) showed reduced fractional anisotropy or increased diffusivity in most tracts. Effects were stronger among carriers than non-carriers of the apolipoprotein E ε4 allele for two tracts connecting frontal regions with other brain areas. Significant differences were observed even after adjustment for potentially-related lifestyle and cardiovascular risk factors. Shorter duration of hypertension or better blood pressure control among hypertensive individuals did not lessen the adverse effects. These findings suggest that microstructural white matter alterations appear early in the course of hypertension and may persist despite adequate treatment. Although longitudinal studies are needed to confirm these findings, the results suggest that prevention—rather than management—of hypertension may be vital to preserving brain health in aging. PMID:26056337

  1. Understanding minority patients’ beliefs about hypertension to reduce gaps in communication between patients and clinicians

    Science.gov (United States)

    Kronish, Ian M; Leventhal, Howard; Horowitz, Carol R

    2011-01-01

    Our objective was to gain a better understanding of minority patients’ beliefs about hypertension and to use this understanding to develop a model to explain gaps in communication between patients and clinicians. Eighty-eight hypertensive Black and Latino adults from four inner-city primary care clinics participated in focus groups to elucidate views on hypertension. Participants believed that hypertension was a serious illness in need of treatment. Participants’ diverged from the medical model in their beliefs about the time-course of hypertension (believed hypertension was intermittent); causes of hypertension (believed stress, racism, pollution, and poverty were the important causes); symptoms of hypertension (believed hypertension was primarily present when symptomatic); and treatments for hypertension (preferred alternative treatments that reduced stress over prescription medications). Participants distrusted clinicians who prioritized medications that did not directly address their understanding of the causes or symptoms of hypertension. Patients’ models of understanding chronic asymptomatic illnesses such as hypertension challenge the legitimacy of lifelong, pill-centered treatment. Listening to patients’ beliefs about hypertension may increase trust, improve communication, and encourage better self-management of hypertension. PMID:22235822

  2. Cuminum cyminum, a dietary spice, attenuates hypertension via endothelial nitric oxide synthase and NO pathway in renovascular hypertensive rats.

    Science.gov (United States)

    Kalaivani, Periyathambi; Saranya, Ramesh Babu; Ramakrishnan, Ganapathy; Ranju, Vijayan; Sathiya, Sekar; Gayathri, Veeraraghavan; Thiyagarajan, Lakshmi Kantham; Venkhatesh, Jayakothanda Ramaswamy; Babu, Chidambaram Saravana; Thanikachalam, Sadagopan

    2013-01-01

    Cuminum cyminum (CC) is a commonly used spice in South Indian foods. It has been traditionally used for the treatment and management of sleep disorders, indigestion, and hypertension. The present study was carried out to scientifically evaluate the anti-hypertensive potential of standardized aqueous extract of CC seeds and its role in arterial endothelial nitric oxide synthase expression, inflammation, and oxidative stress in renal hypertensive rats. Renal hypertension was induced by the two-kidney one-clip (2K/1C) method in rats. Systolic blood pressure (SBP), plasma nitrate/nitrite, carotid-eNOS, renal-TNF-α, IL-6, Bax, Bcl-2, thioredoxin 1 (TRX1), and thioredoxin reductase 1 (TRXR1) mRNA expressions were studied to demonstrate the anti-hypertensive action of CC. Cuminum cyminum was administered orally (200 mg/kg b.wt) for a period of 9 weeks; it improved plasma nitric oxide and decreased the systolic blood pressure in hypertensive rats. It also up-regulated the gene expression of eNOS, Bcl-2, TRX1, and TRXR1; and down-regulated Bax, TNF-α, and IL-6. These data reveal that CC seeds augment endothelial functions and ameliorate inflammatory and oxidative stress in hypertensive rats. The present report is the first of its kind to demonstrate the mechanism of anti-hypertensive action of CC seeds in an animal model of renovascular hypertension.

  3. Impaired Leydig cell function in infertile men

    DEFF Research Database (Denmark)

    Andersson, A-M; Jørgensen, N; Frydelund-Larsen, L

    2004-01-01

    To investigate whether an impaired Leydig cell function is present in severely oligospermic men, serum testosterone (T), LH, estradiol (E(2)), and SHBG levels in 357 idiopathic infertile men were compared with levels in 318 proven fertile men. In addition, the T/LH ratio, E(2)/T ratio...... of the fertile levels.Thus, the group of infertile men showed significant signs of impaired Leydig cell function in parallel to their impaired spermatogenesis. The association of decreased spermatogenesis and impaired Leydig cell function might reflect a disturbed paracrine communication between the seminiferous......, and calculated free T index (cFT) were compared between the two groups.A shift toward lower serum T levels, cFT, and T/LH ratio and higher serum LH, E(2), and E(2)/T levels was observed in the group of infertile men. On average, the infertile men had 18, 26, and 34% lower serum T, cFT, and T/LH levels...

  4. Pulmonary arterial hypertension in pregnancy.

    Science.gov (United States)

    Običan, Sarah G; Cleary, Kirsten L

    2014-08-01

    Pulmonary hypertension is a medical condition characterized by elevated pulmonary arterial pressure and secondary right heart failure. Pulmonary arterial hypertension is a subset of pulmonary hypertension, which is characterized by an underlying disorder of the pulmonary arterial vasculature. Pulmonary hypertension can also occur secondarily to structural cardiac disease, autoimmune disorders, and toxic exposures. Although pregnancies affected by pulmonary hypertension and pulmonary arterial hypertension are rare, the pathophysiology exacerbated by pregnancy confers both high maternal and fetal mortality and morbidity. In light of new treatment modalities and the use of a multidisciplinary approach to care, maternal outcomes may be improving.

  5. [Hypertensive crisis in kidney patients].

    Science.gov (United States)

    Scrivano, Jacopo; Giuliani, Anna; Pettorini, Laura; Punzo, Giorgio; Mene', Paolo; Pirozzi, Nicola

    2011-01-01

    The classification and management of hypertensive crisis have been recently reviewed in the context of both European and American guidelines. The key points for proper blood pressure control in severe arterial hypertension are: 1 - Distinction between urgent intervention and emergencies 2 - Choice of the best drug(s) 3 - Choice of the correct route of administration. In patients with renal disease, beside the common causes of hypertension/ hypertensive crises, kidney-specific causes should be taken into account such as renal parenchymal hypertension, renovascular hypertension, sclerodermic crises, and preeclampsia.

  6. Endocrine hypertension in small animals.

    Science.gov (United States)

    Reusch, Claudia E; Schellenberg, Stefan; Wenger, Monique

    2010-03-01

    Hypertension is classified as idiopathic or secondary. In animals with idiopathic hypertension, persistently elevated blood pressure is not caused by an identifiable underlying or predisposing disease. Until recently, more than 95% of cases of hypertension in humans were diagnosed as idiopathic. New studies have shown, however, a much higher prevalence of secondary causes, such as primary hyperaldosteronism. In dogs and cats, secondary hypertension is the most prevalent form and is subclassified into renal and endocrine hypertension. This review focuses on the most common causes of endocrine hypertension in dogs and cats.

  7. Diet quality is associated with obesity and hypertension in Australian adults: a cross sectional study.

    Science.gov (United States)

    Livingstone, Katherine M; McNaughton, Sarah A

    2016-10-01

    Poor diet, characterized by a low diet quality score, has been associated with greater prevelence of obesity and hypertension. However, the evidence is inconsistent across diet quality scores and by sex. The aim was to investigate the relationship between diet quality and obesity and hypertension. Adults (n = 4908; age 45.2 ± 0.24 years) were included from the cross-sectional Australian Health Survey 2011-2013. Two 24-h dietary recalls were used to derive the dietary guideline index (DGI) and recommended food score (RFS). Logistic regression investigated relationships between diet quality score and odds ratio of obesity, hypertension and obesity-associated hypertension. In the highest tertile of DGI, but not RFS, individuals were less likely to be obese (men: OR 0.64, CI: 0.45, 0.92, P-trend = 0.014; women: 0.68, 0.48, 0.96, P-trend = 0.025) and to have central adiposity (men: 0.68, 0.48, 0.97, P-trend = 0.030; women: 0.53, 0.37, 0.77, P-trend = 0.001) compared with the lowest tertile. Men, but not women, in the highest tertile of DGI and RFS were less likely to be hypertensive (DGI: 0.56, 0.37, 0.85, P-trend = 0.006; RFS: 0.62, 0.41, 0.94, P-trend = 0.021) compared with the lowest tertile. In men with obesity, but not normal weight men or women, those in the highest tertile of DGI were less likely to be hypertensive (0.53, 0.36, 0.78, P-trend = 0.001) compared with the highest tertile. Higher diet quality, as estimated using DGI, was associated with lower odds ratio of obesity in men and women. Odds ratio of hypertension was lower in men, but not women, with a high diet quality score compared with a low score, while obesity-associated hypertension was only associated with diet quality score in men with obesity. Longitudinal studies are needed to evaluate whether diet quality predicts risk of obesity and hypertension.

  8. Stroke-prone renovascular hypertensive rats

    Institute of Scientific and Technical Information of China (English)

    曾进胜; 贷如训; 苏镇培

    2000-01-01

    Purpose To summarized the methods for establishment, characteristics of vascular lesions in brain and heart and thc application of stroke-pronc renovascular hypertensive rats (RHRSP). Background Spontaneously hypcrtensivc rats (STR) and subtypes of SH R, especially stroke-prone spontaneously hypertensive rats (SHRSP) are considered as most important animal models at present for the studies of hypertension and its complications in heart and brain, evcn SHRSP arc considered as thc unique animal model in which prcvention of stroke can be studied cxperimentally Howcver, the applications of SHR and SHRSP are limited because of the effects of genetic deficits and thc difficulties with breeding Theretore, most of the researches on experimental stroke have been performed on the animal models with normotcnsion and normal structure of cerebral vessels. In fact, there are great differences in structure of cerebrovesscls, autoregulation of cerebral blood flow and extent of lesions in brain tissue, even the reaction to the medication after ischemia between the animals with extcnsive arteriosclerosis and with normal cerebral blood vessels. Obviously, thc relevancc of experimental stroke on normal animals to the stroke on cerebral arteriosclerotic patients clinically remains dubious. Data sources and methods Most published original articles about RHRSP in our laboratory were reviewed Results After the renal arteries were constricted bilaterally with ring-shape silver clips, the stroke-prone rcnovascular hypertensive rats were established. Hypertension was produced in all RHRSP(100%).The peak of blood pressure in RHRSP reached 29.1 ±3.0kPa. The lesions of cerebral arteries and arterioles and the damage of cerebral capillary structure by hypertension were observed in the RHRSP. The incidence of spontaneous stroke was 56.4% with in 40 weeks after the renal artery constriction. Left ventricular hypertrophy and small coronary arterial lesions in myocardium were discovered in all

  9. Renovascular hypertension and intrarenal artery aneurysms in a preschool child

    Energy Technology Data Exchange (ETDEWEB)

    Hobbs, David J.; Barletta, Gina-Marie; Bunchman, Timothy E. [Michigan State University College of Human Medicine, Grand Rapids, MI (United States); Helen DeVos Children' s Hospital, Pediatric Nephrology, Dialysis and Transplantation, Grand Rapids, MI (United States); Mowry, Jeanne A. [Oregon Health Sciences University, Pediatric Nephrology, Northwest Permanente, P.C. and Doernbecher Children' s Hospital, Portland, OR (United States)

    2009-09-15

    Renovascular hypertension from renal artery aneurysmal formation is a rare complication of fibromuscular dysplasia. Few data exist to direct the management of intrarenal artery aneurysms in pediatric patients. We report the presentation, diagnosis and management of renovascular hypertension and intrarenal aneurysmal disease in a preschool child. (orig.)

  10. Pregnancy-induced hypertension in a rat heterogeneity model.

    NARCIS (Netherlands)

    J.W.M. Hutten

    1988-01-01

    textabstractThis thesis presents an approach to develop pregnancy-induced hypertension (PIH) in animals by means of an immunologic model. Hypertensive pregnancy disorders in man may be considered a clinical expression of maladaptation in pregnancy. Maladaptation disease develops early in

  11. Hypertension in postmenopausal women: how to approach hypertension in menopause.

    Science.gov (United States)

    Modena, Maria Grazia

    2014-09-01

    During fertile life women are usually normo or hypotensive. Hypertension may appear during pregnancy and this represents a peculiar phenomenon increasing nowadays for delay time of pregnancy. Gestational hypertension appears partially similar to hypertension in the context of metabolic syndrome for a similar condition of increased waste circumference. Parity, for the same pathogenesis, has been reported to be associated to peri and postmenopausal hypertension, not confirmed by our study of parous women with transitional non persistent perimenopausal hypertension. Estrogen's deficiency inducing endothelial dysfunction and increased body mass index are the main cause for hypertension in this phase of life. For these reasons lifestyle modification, diet and endothelial active drugs represent the ideal treatment. Antioxidant agents may have a role in prevention and treatment of hypertension. In conclusion, hypertension in women represents a peculiar constellation of different biological and pathogenic factors, which need a specific gender related approach, independent from the male model.

  12. Migraine and hypertension

    Directory of Open Access Journals (Sweden)

    G. R. Tabeeva

    2015-01-01

    Full Text Available Investigations of a relationship between migraine and hypertension are being continued. In spite of numerous studies, the association of some types of migraine (migraine with aura and migraine without aura with hypertension has not been fully elucidated. This issue is particularly relevant since these forms differ both clinically and pathophysiologically. Of even greater importance are the analysis and prediction of associations between migraine and cardiovascular diseases (ischemic stroke, myocardial infarction, coronary heart disease. The review deals with the clinical and pathophysiological features of the relationship between hypertension and migraine. There is evidence for the anatomic and functional correlation between the antinociceptive system and blood pressure (BP regulation control. It has been speculated that the increase in pain threshold is not the result of just hypertension as a disease, but it is caused by elevated BP-related hypalgesia. The efficacy of antihypertensive drugs is the fact that supports the association between hypertension and endothelial dysfunction. Identification of groups of patients having migraine and a high cardiovascular risk will allow timely early primary prevention and therapy. Introduction of a stratification approach at diagnostic stages may cause a reduction in cardiovascular morbidity and mortality rates.

  13. Dopamine receptors and hypertension.

    Science.gov (United States)

    Banday, Anees Ahmad; Lokhandwala, Mustafa F

    2008-08-01

    Dopamine plays an important role in regulating renal function and blood pressure. Dopamine synthesis and dopamine receptor subtypes have been shown in the kidney. Dopamine acts via cell surface receptors coupled to G proteins; the receptors are classified via pharmacologic and molecular cloning studies into two families, D1-like and D2-like. Two D1-like receptors cloned in mammals, the D1 and D5 receptors (D1A and D1B in rodents), are linked to adenylyl cyclase stimulation. Three D2-like receptors (D2, D3, and D4) have been cloned and are linked mainly to adenylyl cyclase inhibition. Activation of D1-like receptors on the proximal tubules inhibits tubular sodium reabsorption by inhibiting Na/H-exchanger and Na/K-adenosine triphosphatase activity. Reports exist of defective renal dopamine production and/or dopamine receptor function in human primary hypertension and in genetic models of animal hypertension. In humans with essential hypertension, renal dopamine production in response to sodium loading is often impaired and may contribute to hypertension. A primary defect in D1-like receptors and an altered signaling system in proximal tubules may reduce dopamine-mediated effects on renal sodium excretion. The molecular basis for dopamine receptor dysfunction in hypertension is being investigated, and may involve an abnormal posttranslational modification of the dopamine receptor.

  14. Management of diabetic hypertensives

    Directory of Open Access Journals (Sweden)

    Jai Ganesh

    2011-01-01

    Full Text Available Hypertension occurs twice as commonly in diabetics than in comparable nondiabetics. Patients with both disorders have a markedly higher risk for premature microvascular and macrovascular complications. Aggressive control of blood pressure (BP reduces both micro- and macrovascular complications. In diabetic hypertensives, angiotensin converting enzyme inhibitors (ACEIs are the first line in management of hypertension, and can be replaced by angiotensin II receptor blockers (ARBs if patients are intolerant of them. Recent studies suggest ARBs to be on par with ACEI in reducing both macro- and microvascular risks. Adding both these agents may have a beneficial effect on proteinuria, but no extra macrovascular risk reduction. Thiazides can also be used as first line drugs, but are better used along with ACEI/ARBs. Beta-blockers [especially if the patient has coronary artery disease] and calcium channel blockers are used as second line add-on drugs. Multidrug regimens are commonly needed in diabetic hypertensives. Achieving the target BP of <130/80 is the priority rather than the drug combination used in order to arrest and prevent the progression of macro- and microvascular complications in diabetic hypertensives.

  15. Nonnarcotic analgesics and hypertension.

    Science.gov (United States)

    Gaziano, J Michael

    2006-05-01

    In 2004, individuals in the United States spent >$2.5 billion on over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) and filled >100 million NSAID prescriptions. The most commonly used OTC analgesics include aspirin, acetaminophen, and nonaspirin NSAIDs. Nonnarcotic analgesics are generally considered safe when used as directed but do have the potential to increase blood pressure in patients with hypertension treated with antihypertensives. This is important because hypertension alone has been correlated with an increased risk of cardiovascular disease or stroke. Small increases in blood pressure in patients with hypertension also have been shown to increase cardiovascular morbidity and mortality. Therefore, when nonnarcotic analgesics are taken by patients with hypertension, there may be important implications. This review explores the potential connection among analgesic agents, blood pressure, and hypertension, and discusses possible mechanisms by which analgesics might cause increases in blood pressure. This is followed by a summary of data on the relation between analgesics and blood pressure from both observational and randomized trials.

  16. Persistent Hiccups—An Unusual Presentation of Bilateral Pheochromocytoma without Syndromic Association: A Case Report

    Directory of Open Access Journals (Sweden)

    Nitin Aherrao

    2012-01-01

    Full Text Available Pheochromocytoma is a rare catecholamine-producing tumor arising from chromaffin tissue in the adrenal medulla, occurring in less than 0.2 percent of patients with hypertension. The mean age at diagnosis is about 40 years. Pheochromocytomas are commonly inherited as features of multiple endocrine neoplasia type 2 or several other pheochromocytoma-associated syndromes and have variable clinical presentation. Among the presenting symptoms, episodes of palpitations, headaches, and profuse sweating are typical and constitute a classic triad. We report a case of a 17-year-old male patient with rare bilateral pheochromocytoma presenting with persistent hiccups for 4 months and blurring of vision for 1 week, later followed by hypertensive crisis. There was neither family history of pheochromocytoma nor any classic symptoms. Patient was diagnosed with bilateral pheochromocytoma without any syndromic association. But still this patient needs to be followed for future development of medullary carcinoma of thyroid because it could be an initial presentation of MEN 2A/2B/VHL syndromes. Our paper highlights the importance of maintaining a high level of suspicion for persistent hiccups and careful clinical screening for hypertension even in absence of associated syndromes of pheochromocytoma and classical symptoms to achieve prompt diagnosis and to avoid improper management.

  17. [Hypertensive crisis: pathogenesis, clinic, treatment].

    Science.gov (United States)

    Vertkin, A L; Topolianskiĭ, A V; Abdullaeva, A U; Alekseev, M A; Shakhmanaev, Kh A

    2013-01-01

    Contemporary data on mechanisms of development, types, and clinical picture of hypertensive crisis (HC) are presented. Algorithms of rational therapy of uncomplicated and complicated HC are considered. Appropriateness of the use in HC of antihypertensive drugs with multifactorial action is stressed. These drugs include urapidil - an antihypertensive agent with complex mechanism of action. Blocking mainly the postsynaptic 1-adrenoreceptors urapidil attenuates vasoconstrictor effect of catecholamines and decreases total peripheral resistance. Stimulation of 5HT1-receptors of medullary vasculomotor center promotes lowering of elevated vascular tone and prevents development of reflex tachycardia.

  18. Alternating facial paralysis in a girl with hypertension: case report

    National Research Council Canada - National Science Library

    Bağ, Özlem; Karaarslan, Utku; Acar, Sezer; Işgüder, Rana; Unalp, Aycan; Öztürk, Aysel

    2013-01-01

    ... idiopatic Bell's palsy whenever a child admits with acquired facial weakness. In this report, we present an eight year old girl, presenting with recurrent and alternant facial palsy as the first symptom of systemic hypertension...

  19. Knowing hypertension and diabetes

    DEFF Research Database (Denmark)

    Whyte, Susan Reynolds

    2016-01-01

    In Uganda, hypertension and diabetes have only recently been included in the health policy agenda. As they become treatable disorders, they take on more distinct contours in people's minds. This article relates knowledge about these two conditions to health institutions and technology for diagnos......In Uganda, hypertension and diabetes have only recently been included in the health policy agenda. As they become treatable disorders, they take on more distinct contours in people's minds. This article relates knowledge about these two conditions to health institutions and technology...... for diagnosing and treating them. The response to the AIDS epidemic in Uganda provides an important context for, and contrast with, the emergence of hypertension and diabetes as social phenomena. Ethnographic fieldwork shows the interplay between experience of these conditions and the political economy...

  20. Hypertension and Atrial Fibrillation

    DEFF Research Database (Denmark)

    Dzeshka, Mikhail S.; Shahid, Farhan; Shantsila, Alena

    2017-01-01

    Atrial fibrillation (AF) is the most prevalent sustained arrhythmia found in clinical practice. AF rarely exists as a single entity but rather as part of a diverse clinical spectrum of cardiovascular diseases, related to structural and electrical remodeling within the left atrium, leading to AF o...... of complications as the first clinical manifestation of the disease. Antithrombotic prevention in AF combined with strict blood pressure control is of primary importance, since stroke risk and bleeding risk are both greater with underlying hypertension....... onset, perpetuation, and progression. Due to the high overall prevalence within the AF population arterial hypertension plays a significant role in the pathogenesis of AF and its complications. Fibroblast proliferation, apoptosis of cardiomyocytes, gap junction remodeling, accumulation of collagen both...... in atrial and ventricular myocardium all accompany ageing-related structural remodeling with impact on electrical activity. The presence of hypertension also stimulates oxidative stress, systemic inflammation, rennin-angiotensin-aldosterone and sympathetic activation, which further drives the remodeling...

  1. [Hypertension and heart].

    Science.gov (United States)

    Hennersdorf, Marcus G; Strauer, Bodo E

    2006-03-22

    The term hypertensive heart disease covers the entities left ventricular hypertrophy, microangiopathy, diastolic and systolic dysfunction, und increased risk of arrhythmias. From the pathophysiological point of view this is caused by hypertrophy of cardiac myocytes, interstitial fibrosis and media hypertrophy of the arterioles. As an earliest sign of hypertensive heart disease a microangiopathy can be diagnosed. Also a diastolic dysfunction can be found as an early change. In further persisting arterial hypertension left ventricular hypertrophy develops (often asymmetric), and later a systolic dysfunction. Clinically, the patients suffer from angina pectoris, dyspnea and rhythm disorders. Left ventricular hypertrophy is associated with an increased risk of ventricular malignant arrhythmias. Thus, the main therapeutic principle should be antihypertensive therapy with the goal of regression of hypertrophy and, as a consequence, a decreased mortality risk.

  2. Snakes and Hypertension.

    Science.gov (United States)

    Miller, Edward D

    2017-02-01

    Inhibition of Angiotensin Conversion in Experimental Renovascular Hypertension. By Miller ED Jr, Samuels A, Haber E, and Barger AC. Science 1972; 177:1108-9. Reprinted with permission from AAAS.Constriction of the renal artery and controlled reduction of renal perfusion pressure is followed by a prompt increase in systemic renin activity and a concomitant rise in blood pressure in trained, unanesthetized dogs. The elevated blood pressure induced by the renal artery stenosis can be prevented by prior treatment with the nonapeptide Pyr-Trp-Pro-Arg-Pro-Gln-Ile-Pro-Pro, which blocks conversion of angiotensin I to angiotensin II. Further, the nonapeptide can restore systemic pressure to normal in the early phase of renovascular hypertension. These results offer strong evidence that the renin- angiotensin system is responsible for the initiation of hypertension in the unilaterally nephrectomized dog with renal artery constriction.

  3. High consumption of salt-fermented vegetables and hypertension risk in adults: a 12-year follow-up study.

    Science.gov (United States)

    Song, Hong Ji; Park, Seon-Joo; Jang, Dae Ja; Kwon, Dae Young; Lee, Hae-Jeung

    The aim of this study was to investigate the causal relationship between high consumption of salt-fermented vegetables and hypertension risk in adults. Data came from the Korean Genome and Epidemiology Study, an ongoing community-based cohort study that began in 2001. In the final analysis, a total of 5,932 participants (men=2,822, women=3,110) was included. Daily energy, nutrient, and major salt-fermented vegetables for Korean (kimchi) intakes were assessed using a semi-quantitative food frequency questionnaire. Relative risks and 95% CIs associated with kimchi intake by gender and body mass index (BMI) were estimated using the multivariate Cox proportional hazards regression model. Out of the 5,932 participants, 1,798 (905 men, 893 women) developed hypertension during the 12-year follow-up period. A significant difference in baseline BMI was shown between the non-hypertension and hypertension groups. There was no significant difference with regard to the risk of developing hypertension across quintiles for total kimchi intake and quartile or quartiles for specific kimchi intake in multivariate models by gender and baseline BMI. The trend for increased risk of hypertension according to increasing quartile of watery kimchi intake was significant for obese men in the multivariate model (phypertension. The trend for increased risk of hypertension according to increasing quartile of watery kimchi intake was significant only in obese men.

  4. Micoplasma hominis, Ureaplasma urealyticum y bacterias aeróbicas en el semen de hombres que consultan por infertilidad Micoplasma hominis, Ureaplasma urealyticum and aerobic bacteria present in the semen from men attending infertility service

    Directory of Open Access Journals (Sweden)

    Bertha Victoria Rodríguez Pendás

    2013-04-01

    .Introduction: human semen infections can alter the sperm quality and be associated to male infertility disorders. Objectives: to determine the frequency of infections from Micoplasma hominis, Ureaplasma urealyticum and other aerobic bacteria in the semen of men who attended the infertility service, and to identify whether there is some relation between the detected infections and the altered semen quality variables or not. Methods: a cross-sectional descriptive study was performed to evaluate semen samples from 140 men aged 20 to 45 years, who attended the infertility service at the National Institute of Endocrinology. According to the WHO guidelines, a complete spermiogram including leukocytospermia was performed in order to determine the qualitative and quantitative variables in the semen. The semen samples were cultured in blood agar and in chocolate agar at 37oC under CO2 environment to find out possible aerobic bacteria. To this end, a set of reagents known as Mycoplasma System Plus was used, allowing the culture, the identification, the semi-quantitative count and the antibiogram of urogenital mycoplasms/ureaplasms. The ethical aspects were allowed for; the results were analyzed through percentage estimations and the chi square test. Results: out of the 140 evaluated semen samples, 58 (41.4 % showed some infection, 37 of them were caused by Ureaplasma urealyticum (25.7 %, 2 by Micoplasma hominis (1.4 % and 19 by the aerobic bacteria (13.8 %. When making a comparison of the qualitative and quantitative variables of the semen from infected and non-infected subjects, there were not any statistically significant differences in the evaluated variables of the sperm quality. Conclusions: the total frequency of infections in the studied sample was relatively high, but was not associated to altered seminal variables.

  5. Acute cardiovascular effect of 1,25-dihydroxycholecalciferol in essential hypertension

    DEFF Research Database (Denmark)

    Jespersen, B; Randløv, A; Abrahamsen, Jimmi

    1998-01-01

    A role for vitamin D in the pathophysiology of essential hypertension has frequently been suggested, but acute direct effects on blood pressure, cardiac output, renal hemodynamics, or hormones have not previously been demonstrated. The rapid effects of 1,25-dihydroxycholecalciferol (1,25-D) were...... assessed over 120 min after a bolus injection (0.02 microg/kg body weight) in eight men with essential hypertension and in nine healthy men. A placebo group of 10 healthy men was also included. Ionized calcium was monitored closely during the study, and was kept constant with a clamping technique....... In the hypertensive patients, a transient increase in blood pressure and a reciprocal fall in cardiac output measured by a CO2 rebreathing technique (-15%, P

  6. Men in Feminised Workplaces

    DEFF Research Database (Denmark)

    Warming, Kenn

    »Male nurses – Is that really what It’s called?« »Aren’t all male hairdressers gay?« »All preschool educators do is to wipe children’s bums, isn’t it?« »Cleaning is a job for women, not for menMen working in women’s professions often give rise to a lot of prejudices. But why? Are these men less...... masculine than other men? Or do they rather represent a new, more tolerant and less stereotypical male gender role? If less restricted by stereotypes, are men then eager to challenge traditional dichotomised perceptions of man/masculinity and woman/femininity? By means of analyses of interviews with more...... than 160 Bulgarian, Danish, Italian and Polish men working in traditional women’s occupations, this publication tries to answer some of these questions....

  7. Hypertension og det metaboliske syndrom

    DEFF Research Database (Denmark)

    Olsen, Michael Hecht; Jeppesen, Jørgen; Larsen, Mogens Lytken

    2009-01-01

    The metabolic syndrome is a relatively prevalent condition characterized by co-existence of several metabolic and cardiovascular risk factors including hypertension. Patients with hypertension have an increased risk of developing the metabolic syndrome which, in turn, increases the cardiovascular...

  8. Pulmonary arterial hypertension : an update

    NARCIS (Netherlands)

    Hoendermis, E. S.

    2011-01-01

    Pulmonary arterial hypertension (PAH), defined as group 1 of the World Heart Organisation (WHO) classification of pulmonary hypertension, is an uncommon disorder of the pulmonary vascular system. It is characterised by an increased pulmonary artery pressure, increased pulmonary vascular resistance

  9. Lung Transplantation for Pulmonary Hypertension

    Science.gov (United States)

    ... the page. Answers about Lung Transplantation for PULMONARY HYPERTENSION Part One: Overview From the development of epoprostenol ... decades, expansion of medical treatment of pulmonary arterial hypertension (PAH) has improved survival and quality of life ...

  10. Immune mechanisms in hypertension.

    Science.gov (United States)

    De Ciuceis, Carolina; Rossini, Claudia; La Boria, Elisa; Porteri, Enzo; Petroboni, Beatrice; Gavazzi, Alice; Sarkar, Annamaria; Rosei, Enrico Agabiti; Rizzoni, Damiano

    2014-12-01

    Low grade inflammation may have a key role in the pathogenesis of hypertension and cardiovascular disease. Several studies showed that both innate and adaptive immune systems may be involved, being T cells the most important players. Particularly, the balance between Th1 effector lymphocytes and Treg lymphocytes may be crucial for blood pressure elevation and related organ damage development. In the presence of a mild elevation of blood pressure, neo-antigens are produced. Activated Th1 cells may then contribute to the persistent elevation of blood pressure by affecting vasculature, kidney and perivascular fat. On the other hand, Tregs represent a lymphocyte subpopulation with an anti-inflammatory role, being their activity crucial for the maintenance of cardiovascular homeostasis. Indeed, Tregs were demonstrated to be able to protect from blood pressure elevation and from the development of organ damage, including micro and macrovascular alterations, in different animal models of genetic or experimental hypertension. In the vasculature, inflammation leads to vascular remodeling through cytokine activity, smooth muscle cell proliferation and oxidative stress. It is also known that a consistent part of ischemia-reperfusion-induced acute kidney injury is mediated by inflammatory infiltration and that Treg cell infusion have a protective role. Also the central nervous system has an important role in the maintenance of cardiovascular homeostasis. In conclusion, hypertension development involves chronic inflammatory process. Knowledge of cellular and molecular players in the progression of hypertension has dramatically improved in the last decade, by assessing the central role of innate and adaptive immunity cells and proinflammatory cytokines driving the development of target organ damage. The new concept of role of immunity, especially implicating T lymphocytes, will eventually allow discovery of new therapeutic targets that may improve outcomes in hypertension and

  11. Oxidative stress and hypertension.

    Science.gov (United States)

    Harrison, David G; Gongora, Maria Carolina

    2009-05-01

    This review has summarized some of the data supporting a role of ROS and oxidant stress in the genesis of hypertension. There is evidence that hypertensive stimuli, such as high salt and angiotensin II, promote the production of ROS in the brain, the kidney, and the vasculature and that each of these sites contributes either to hypertension or to the untoward sequelae of this disease. Although the NADPH oxidase in these various organs is a predominant source, other enzymes likely contribute to ROS production and signaling in these tissues. A major clinical challenge is that the routinely used antioxidants are ineffective in preventing or treating cardiovascular disease and hypertension. This is likely because these drugs are either ineffective or act in a non-targeted fashion, such that they remove not only injurious ROS Fig. 5. Proposed role of T cells in the genesis of hypertension and the role of the NADPH oxidase in multiple cells/organs in modulating this effect. In this scenario, angiotensin II stimulates an NADPH oxidase in the CVOs of the brain, increasing sympathetic outflow. Sympathetic nerve terminals in lymph nodes activate T cells, and angiotensin II also directly activates T cells. These stimuli also activate expression of homing signals in the vessel and likely the kidney, which attract T cells to these organs. T cells release cytokines that stimulate the vessel and kidney NADPH oxidases, promoting vasoconstriction and sodium retention. SFO, subfornical organ. 630 Harrison & Gongora but also those involved in normal cell signaling. A potentially important and relatively new direction is the concept that inflammatory cells such as T cells contribute to hypertension. Future studies are needed to understand the interaction of T cells with the CNS, the kidney, and the vasculature and how this might be interrupted to provide therapeutic benefit.

  12. Hypertension and renovascular disease

    DEFF Research Database (Denmark)

    Hasbak, P; Ibsen, H; Jensen, Lars Thorbjørn

    2002-01-01

    The clinical value of renal vein renin sampling (RVRS) as a prognostic tool in the treatment of renovascular hypertension was evaluated. One hundred consecutive patients were included over a 4-year period of time. About half of the patients (49%) were treated interventionally by PTRA (21%), nephr......The clinical value of renal vein renin sampling (RVRS) as a prognostic tool in the treatment of renovascular hypertension was evaluated. One hundred consecutive patients were included over a 4-year period of time. About half of the patients (49%) were treated interventionally by PTRA (21...

  13. Erectile Dysfunction and Hypertension: Impact on Cardiovascular Risk and Treatment

    Directory of Open Access Journals (Sweden)

    Valter Javaroni

    2012-01-01

    Full Text Available Erectile dysfunction (ED is a common complaint in hypertensive men and can represent a systemic vascular disease, an adverse effect of antihypertensive medication or a frequent concern that may impair drug compliance. ED has been considered an early marker of cardiovascular disease. The connection between both conditions seems to be located in the endothelium, which may become unable to generate the necessary dilatation in penile vascular bed in response to sexual excitement, producing persistent impairment in erection. On the other hand, the real influence of antihypertensive drugs in erectile function still deserves discussion. Therefore, regardless of ED mechanism in hypertension, early diagnosis and correct approach of sexual life represent an important step of cardiovascular evaluation which certainly contributes for a better choice of hypertension treatment, preventing some complications and restoring the quality of life.

  14. Hypertension and obesity in adults living in a high HIV prevalence rural area in South Africa.

    Directory of Open Access Journals (Sweden)

    Abraham Malaza

    Full Text Available Hypertension and excess body weight are major risk factors of cardiovascular morbidity and mortality in developing countries. In countries with a high HIV prevalence, it is unknown how increased antiretroviral treatment and care (ART coverage has affected the prevalence of overweight, obesity, and hypertension. We conducted a health survey in 2010 based on the WHO STEPwise approach in 14,198 adult resident participants of a demographic surveillance area in rural South Africa to investigate factors associated with hypertension and excess weight including HIV infection and ART status. Women had a significantly higher median body mass index (BMI than men (26.4 vs. 21.2 kg/m(2, p<0.001. The prevalence of obesity (BMI ≥ 30 kg/m(2 in women (31.3%, 95% confidence interval (CI 30.2-32.4 was 6.5 times higher than in men (4.9%, 95% CI 4.1-5.7, whereas prevalence of hypertension (systolic or diastolic blood pressure ≥ 140 or 90 mm Hg, respectively was 1.4 times higher in women than in men (28.5% vs 20.8%, p<0.001. In multivariable regression analysis, both hypertension and obesity were significantly associated with sex, age, HIV and ART status. The BMI of women and men on ART was on average 3.8 (95% CI 3.2-3.8 and 1.7 (95% CI 0.9-2.5 kg/m(2 lower than of HIV-negative women and men, respectively. The BMI of HIV-infected women and men not on ART was on average 1.2 (95% CI 0.8-1.6 and 0.4 (95% CI -0.1-0.9 kg/m(2 lower than of HIV-negative women and men, respectively. Obesity was a bigger risk factor for hypertension in men (adjusted odds ratio (aOR 2.99, 95% CI 2.00-4.48 than in women (aOR 1.64, 95% CI 1.39-1.92 and overweight (25 ≤ BMI<30 was a significant risk factor for men only (aOR 1.53 95% CI 1.14-2.06. Our study suggests that, cardiovascular risk factors of hypertension and obesity differ substantially between women and men in rural South Africa.

  15. Malignant hypertension: a preventable emergency.

    Science.gov (United States)

    van der Merwe, Walter; van der Merwe, Veronica

    2013-08-16

    The Waitemata Hypertension Clinic Database 2009-2012 (Auckland, New Zealand) was searched for patients meeting the definition of Malignant Hypertension. Eighteen of 565 patients met the criteria. All patients had essential hypertension which was either undiagnosed, untreated or undertreated. Most cases responded satisfactorily to standard drug therapy, but a number were left with significant chronic kidney disease. Malignant hypertension is a life-threatening disease which should be entirely preventable with regular blood pressure checks in primary care.

  16. Focus on prevention, diagnosis and treatment of hypertension in children and adolescents

    OpenAIRE

    Spagnolo, Amedeo; Giussani, Marco; Ambruzzi, Amalia Maria; Bianchetti, Mario; Maringhini, Silvio; Matteucci, Maria Chiara; Menghetti, Ettore; Salice, Patrizia; Simionato, Loredana; Strambi, Mirella; Virdis, Raffaele; Genovesi, Simonetta

    2013-01-01

    The European Society of Hypertension has recently published its recommendations on prevention, diagnosis and treatment of high blood pressure in children and adolescents. Taking this contribution as a starting point the Study Group of Hypertension of the Italian Society of Pediatrics together with the Italian Society of Hypertension has conducted a reappraisal of the most recent literature on this subject. The present review does not claim to be an exhaustive description of hypertension in th...

  17. Emergency hepatectomy for hepatic arteriovenous malformation combined with pulmonary hypertension in an infant

    Directory of Open Access Journals (Sweden)

    Naruhiko Murase

    2015-12-01

    Full Text Available Patients with hepatic arteriovenous malformations rarely present with pulmonary hypertension. We report the case of a 3-month-old boy who developed severe pulmonary hypertension due to a hepatic arteriovenous malformation. The use of pulmonary vasodilators to treat the patient's pulmonary hypertension worsened his high-output heart failure. This is the first case in which emergency hepatectomy rescued a patient with hepatic arteriovenous malformations who developed pulmonary hypertension.

  18. Is hypertension in adult age related to unemployment at a young age? Results from the Northern Swedish Cohort.

    Science.gov (United States)

    Nygren, Karina; Gong, Weidan; Hammarström, Anne

    2015-02-01

    The aim of this study was to analyse the relationship between early unemployment (ages 16-21 years) and adult hypertension after controlling for earlier hypertension, unemployment in adult life, risk factors for hypertension and confounders. A cohort of 927 (86.6% of the original cohort) 9th grade school-leavers was followed from 1981 until 2008. Data were collected through questionnaires, health examinations, and national registers. Univariate and multivariate logistic regression were used as primary statistical methods. At ages 21 and 43, hypertension was significantly more prevalent among men than women (p Unemployment between the ages of 16 and 21 was related to hypertension at age 43 among women but not men. The odds ratio (OR) was persistently high (OR 3.16 [95% confidence interval 1.45-6.89]) after controlling for late unemployment, hypertension at age 16, risk factors for hypertension and confounders. There was no significant relationship between exposure to early unemployment and hypertension at age 21 for women or men. From a public health perspective, youth unemployment is a societal problem in need of more attention and intervention in order to prevent long-term adverse health outcomes. © 2014 the Nordic Societies of Public Health.

  19. Rundt om Mad Men

    DEFF Research Database (Denmark)

    Nielsen, Jakob Isak

    2011-01-01

    Artiklen gør rede for Mad Mens tilblivelse, dens populærkulturelle efterdønninger, multimediale forgreninger og værkæstetiske karakteristika. "Story Matters Here" lyder AMCs motto, men Mad Men tilbyder et bredspektret engagement, der går langt ud over at følge med i en vedkommende fortælling....... Artiklen argumenterer for, at Mad Mens popularitet blandt andet skyldes, at den let lader sig knytte til service-, kultur-, og livsstilsjournalistiske stofområder....

  20. Hypertensive diabetic patients: guidelines for conduct and their difficulties

    Directory of Open Access Journals (Sweden)

    Weimar K. S. Barroso

    2003-08-01

    Full Text Available OBJECTIVE: To assess the effect of blood pressure (BP control and other cardiovascular risk factors in patients with diabetes mellitus in a referral service for the treatment of hypertension. METHODS: A retrospective study where diabetic patients (at least 2 fasting glucose levels above 126 mg/dL, use of hypoglycemic agents or insulin, or both of these were included. They were evaluated at the first appointment (M1 and at the last appointment (M2, regarding blood pressure, body mass index (BMI, use of hypertensive drugs, glycemia, total cholesterol (TC, creatinine, and potassium. RESULTS: Of 1,032 patients studied, 146 patients with a mean age of 61.6 years had diabetes, and 27 were men (18.5%. Mean follow-up was 5.5 years. BP values were 161.6 x 99.9 mmHg in M1 and 146.3 x 89.5 mmHg in M2. In M1, 10.4% of the patients did not use medications, 50.6% used just 1 drug, 30.8% used 2 drugs, and 8.2% used 3 or more drugs. In M2, these values were 10.9%, 39%, 39.7%, and 10.4%, respectively. Diuretics were the most commonly used medication, whereas angiotensin-converting enzyme inhibitors (ACE inhibitors were those drugs which presented greater increase when comparing M1 to M2 (24.6% and 41.7%, respectively. Only 17,1% reached the recommended goal (BP<130x85 mmhg. The other cardiovascular risk factors did not change significantly. CONCLUSION: Our data reinforce the necessity of a more aggressive approach in the treatment of these patients, despite the social and economic difficulties in adhering to treatment.

  1. Prevalence of Atherogenic Dyslipidemia in Spanish Hypertensive Patients and Its Relationship With Blood Pressure Control and Silent Organ Damage.

    Science.gov (United States)

    de la Sierra, Alejandro; Gorostidi, Manuel; Aranda, Pedro; Corbella, Emili; Pintó, Xavier

    2015-07-01

    To assess the prevalence of atherogenic dyslipidemia in hypertensive patients and its relationship with risk profile and blood pressure control. The study included 24 351 hypertensive patients from the Spanish Ambulatory Blood Pressure Monitoring Registry. Atherogenic dyslipidemia was defined as the presence of hypertriglyceridemia (> 150mg/dL) and low levels of high-density lipoprotein cholesterol (< 40mg/dL in men and < 46mg/dL in women). Blood pressure control was assessed by office and ambulatory monitoring. Atherogenic dyslipidemia was present in 2705 patients (11.1%). Of these, 30% had hypertriglyceridemia and 21.7% had low levels of high-density lipoprotein cholesterol. Compared with patients without these risk factors, the former group were more often male (60% vs 52%), younger (57 years vs 59 years), had other risk factors and organ damage (microalbuminuria, reduced estimated glomerular filtration rate, and left ventricular hypertrophy), worse office, diurnal, and nocturnal blood pressure values (odds ratio 1.09, 1.06, and 1.10, respectively), and the lowest nocturnal blood pressure reduction (odds ratio=1.07), despite the greater use of antihypertensive drugs. Atherogenic dyslipidemia is present in more than 10% of hypertensive patients and is associated with other risk factors, organ damage, and poorer blood pressure control. Greater therapeutic effort is needed to reduce overall risk in these patients. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  2. Telemonitoring: use in the management of hypertension

    Directory of Open Access Journals (Sweden)

    Sivakumaran D

    2014-04-01

    Full Text Available Darshi Sivakumaran,1 Kenneth Anthony Earle1,21Thomas Addison Unit, St George's Hospital, London, UK; 2Clinical Sciences, St George's University of London, London, UKAbstract: Hypertension is a major modifiable risk factor for cardiovascular, retinal, and kidney disease. In the past decade, attainment rates of treatment targets for blood pressure control in the UK and US have increased; however, <11% of adult men and women have achieved adequate blood pressure control. Technological advances in blood pressure measurement and data transmission may improve the capture of information but also alter the relationship between the patient and the provider of care. Telemonitoring systems can be used to manage patients with hypertension, and have the ability to enable best-practice decisions more consistently. The improvement in choice for patients as to where and who manages their hypertension, as well as better adherence to treatment, are potential benefits. An evidence base is growing that shows that telemonitoring can be more effective than usual care in improving attainment rates of goal blood pressure in the short-to-medium term. In addition, studies are in progress to assess whether this technology could be a part of the solution to address the health care needs of an aging population and improve access for those suffering health inequalities. The variation in methods and systems used in these studies make generalizability to the general hypertension population difficult. Concerns over the reliability of technology, impact on patient quality of life, longer-term utility and cost–benefit analyses all need to be investigated further if wider adoption is to occur.Keywords: telehealth, health surveillance, virtual-led clinic

  3. Roles of Adiponectin and Oxidative Stress in the Regulation of Membrane Microviscosity of Red Blood Cells in Hypertensive Men—An Electron Spin Resonance Study

    Directory of Open Access Journals (Sweden)

    Kazushi Tsuda

    2011-01-01

    Full Text Available This study was undertaken to investigate possible relationships among plasma adiponectin, 8-iso-prostaglandin F2α (8-iso-PG F2α: an index of oxidative stress, and membrane fluidity (a reciprocal value of microviscosity in hypertensive and normotensive men using an electron spin resonance-method. The order parameter (S for the spin-label agent (5-nitroxide stearate in red blood cell (RBC membranes was higher in hypertensive men than in normotensive men, indicating that membrane fluidity was decreased in hypertension. Plasma adiponectin and NO metabolites levels were lower in hypertensive men than in normotensive men. In contrast, plasma 8-iso-PG F2α levels were increased in hypertensive men compared with normotensive men. Plasma adiponectin concentration was correlated with plasma NO-metabolites, and inversely correlated with plasma 8-iso-PG F2α. The order parameter (S of RBCs was inversely correlated with plasma adiponectin and plasma NO metabolite levels, and positively correlated with plasma 8-iso-PG F2α, suggesting that the reduced membrane fluidity of RBCs might be associated with hypoadiponectinemia, endothelial dysfunction, and increased oxidative stress. In a multivariate regression analysis, adiponectin and 8-iso-PG F2α were significant determinants of membrane fluidity of RBCs after adjustment for general risk factors. These results suggest that adiponectin and oxidative stress might have a close correlation with rheologic behavior and microcirculation in hypertension.

  4. EMERGENCY STATES IN ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    M. A. Gurevich

    2014-01-01

    Full Text Available The article describes in detail potential emergency states in patients with different stages of arterial hypertension with special attention to diagnosis and rational management of hypertensive crisis. Differentiated approach to management of different forms of hypertensive crisis is specified.

  5. Hypertension--forekomst og behandling

    DEFF Research Database (Denmark)

    Ibsen, Hans; Jørgensen, Torben; Jensen, Gorm B

    2009-01-01

    Hypertension is the most important modifiable risk factor for cardiovascular disease. However, less than half of all hypertensives have their blood pressure reduced to relevant goals. The prevalence of hypertension in Denmark was found to be between 26% and 40% of the adult population. Just over...

  6. Idiopathic Noncirrhotic Portal Hypertension: An Appraisal

    Science.gov (United States)

    Lee, Hwajeong; Rehman, Aseeb Ur; Fiel, M. Isabel

    2016-01-01

    Idiopathic noncirrhotic portal hypertension is a poorly defined clinical condition of unknown etiology. Patients present with signs and symptoms of portal hypertension without evidence of cirrhosis. The disease course appears to be indolent and benign with an overall better outcome than cirrhosis, as long as the complications of portal hypertension are properly managed. This condition has been recognized in different parts of the world in diverse ethnic groups with variable risk factors, resulting in numerous terminologies and lack of standardized diagnostic criteria. Therefore, although the diagnosis of idiopathic noncirrhotic portal hypertension requires clinical exclusion of other conditions that can cause portal hypertension and histopathologic confirmation, this entity is under-recognized clinically as well as pathologically. Recent studies have demonstrated that variable histopathologic entities with different terms likely represent a histologic spectrum of a single entity of which obliterative portal venopathy might be an underlying pathogenesis. This perception calls for standardization of the nomenclature and formulation of widely accepted diagnostic criteria, which will facilitate easier recognition of this disorder and will highlight awareness of this entity. PMID:26563701

  7. The prevalence of abdominal obesity and hypertension amongst adults in Ogbomoso, Nigeria

    Directory of Open Access Journals (Sweden)

    Isaac O. Amole

    2011-02-01

    Full Text Available Background:In many developing countries obesity and obesity-related morbidity are now becoming a problem of increasing importance. Obesity is associated with a number of disease conditions, including hypertension, type 2 diabetes mellitus, cardiovascular diseases, cancer, gallstones, respiratory system problems and sleep apnoea.Objectives: The aim of this study was to determine the prevalence of hypertension and obesity, as classified according to waist circumference (WC, and further to determine whether there was any association between abdominal obesity and hypertension amongst adults attending the Baptist Medical Centre, Ogbomoso, Nigeria.Method: A cross-sectional descriptive study of 400 adults aged 18 years or older was conducted. Blood pressure and WC measurements were taken and participants completed a standardised questionnaire.Results: A group of 400 participants were randomly selected (221 women; 179 men, with a mean age of 48.7 ± 16.6 years. The overall prevalence of obesity as indicated by WC was 33.8%(men = 8.9%; women = 53.8%. Women were significantly more sedentary than men (50.8% for men vs 62.4% for women, p < 0.05. Most of the obese participants’ families also preferred high-energy foods (85.2%, p > 0.05. Overall prevalence of hypertension amongst the study population was 50.5%, but without a significant difference between men and women (52.0% for men vs 49.3% for women, p > 0.05. The prevalence of hypertension amongst the obese subset, however, was 60.0%.Conclusion: Prevalence of abdominal obesity was found to be particularly significant amongst women in this setting and was associated with hypertension, physical inactivity and the consumption of high-energy diets.

  8. [Hypertensive emergency and urgence].

    Science.gov (United States)

    Gegenhuber, Alfons; Lenz, Kurt

    2003-12-01

    DEFINITION, PATHOPHYSIOLOGY, THERAPY: The hypertensive crisis is characterized by a massive, acute rise in blood pressure. Patients with underlying hypertensive disease usually have an increase in systolic blood pressure values > 220 mmHg and diastolic values > 120 mmHg. The severity of the condition, however, is not determined by the absolute blood pressure level but by the magnitude of the acute increase in blood pressure. Thus, in the presence of primarily normotensive baseline values (such as those in eclampsia), even a systolic blood pressure > 170 mmHg may lead to a life-threatening condition. The most important causes are non-compliance (reduction or interruption of therapy), inadequate therapy, endocrine disease, renal (vessel) disease, pregnancy and intoxication (drugs). The management of this condition greatly depends on whether the patient has a hypertensive crisis with organ manifestation (hypertensive emergency) or a crisis without organ manifestation (hypertensive urgency). By documenting the medical history, the medical status and by simple diagnostic procedures, the differential diagnosis can be established at the emergency site within a very short period of time. In the absence of organ manifestations (hypertensive urgency) the patient may have non-specific symptoms such as palpitations, headache, malaise and a general feeling of illness in addition to the increase in blood pressure. In a hypertensive urgency the patient's blood pressure should not be reduced within a few minutes but within a period of 24 to 48 hours. Such adjustment can be achieved on an out-patient basis, however, only if the patient can be followed up adequately for early detection of a renewed attack. In the absence of follow-up facilities, the patient's blood pressure should be reduced over a period of 4 to 6 hours, if necessary in an out-patient emergency service. While intravenous medication is given preference when a rapid effect is desired, oral medication may be used for

  9. Low prevalence of hypertension with pharmacological treatments and associated factors

    Directory of Open Access Journals (Sweden)

    Helena Gama

    2013-06-01

    Full Text Available OBJECTIVE: To assess the determinants of the lack of pharmacological treatment for hypertension. METHODS: In 2005, 3,323 Mozambicans aged 25-64 years old were evaluated. Blood pressure, weight, height and smoking status were assessed following the Stepwise Approach to Chronic Disease Risk Factor Surveillance. Hypertensives (systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg and/or antihypertensive drug therapy were evaluated for awareness of their condition, pharmacological and non-pharmacological management, as well as use of herbal or traditional remedies. Prevalence ratios (PR were calculated, adjusted for sociodemographic characteristics, cardiovascular risk factors and non-pharmacological treatment. RESULTS: Most of the hypertensive subjects (92.3%, and nearly half of those aware of their condition were not treated pharmacologically. Among the aware, the prevalence of untreated hypertension was higher in men {PR = 1.61; 95% confidence interval (95%CI 1.10;2.36} and was lower in subjects under non-pharmacological treatment (PR = 0.58; 95%CI 0.42;0.79; there was no significant association with traditional treatments (PR = 0.75; 95%CI 0.44;1.26. CONCLUSIONS: The lack of pharmacological treatment for hypertension was more frequent in men, and was not influenced by the presence of other cardiovascular risk factors; it could not be explained by the use of alternative treatments as herbal/traditional medicines or non-pharmacological management. It is important to understand the reasons behind the lack of management of diagnosed hypertension and to implement appropriate corrective actions to reduce the gap in the access to healthcare between developed and developing countries.

  10. ARTERIAL HYPERTENSION IN YOUNG PEOPLE: EFFICACY OF SYMPATHOLYTIC THERAPY

    Directory of Open Access Journals (Sweden)

    N. N. Nikitina

    2007-01-01

    Full Text Available Aim. To evaluate the effect of imidasoline agonist, rilmenidine (Albarel, on 24-hour blood pressure (BP profile and autonomic regulation of cardiovascular system in young patients with arterial hypertension (HT and exogenous constitutional obesity (ECO.Material and methods. The study included 80 men aged 18-32 ( average age 20,5 years, including 34 patients with HT and normal body weight, 36 patients with HT and ECO, 10 healthy men as a control group. All hypertensive patients were treated with rilmenidine 1-2 mg daily during 12 weeks. BP 24-hour profile and heart rate variability (HRV were estimated before and after therapy.Results. Rilmenidine monotherapy resulted in significant reduction in average 24-hour, day-time and night-time BP as well as indices of BP loading in both groups. Indices of HRV proved the initial sympathetic overdrive among hypertensive patients especially among those with ECO. This sympathetic overdrive significantly reduced after 12 weeks of therapy.Conclusion. Rilmenidine effectively controls BP and reduces sympathetic system overdrive in young hypertensive patients with ECO.

  11. [Pathophysiology and classification of pulmonary hypertension].

    Science.gov (United States)

    Sládková, H; Jansa, P; Susa, Z; Aschermann, M

    2004-09-01

    Pulmonary hypertension is present when the mean pulmonary pressure is increased above 25 mm Hg in a rest or above 30 mm Hg during exercise. It is possible to divide it from different point of view. Well known is pathophysiologic classification and Venice classification suggested by WHO symposium 2003. The rise of arterial pulmonary pressure is caused by three essential abnormalities, these are elevated pulmonary vascular resistance, blood flow and pulmonary artery wedge pressure. Vasoconstriction, remodeling of vessels and in situ trombosis are pathogenetic mechanism which contribute to rise of pulmonary hypertension.

  12. "HYPERTENSION RESULTING FROM USING BIRTHCONTROL PILLS "

    Directory of Open Access Journals (Sweden)

    A Rostami

    1976-11-01

    Full Text Available In a study on 685 healthy women who have been using birth control pills for a period of about 27 months, the following results were found: 1.Blood pressure has been increased with a rate of 1.416%. 2. The increase in arterial Wood pressure is on both the systolicand diastolic blood pressures. 3. It seems that hypertension results from the Estrogen which is present in the Pills. 4. This hypertension is not grave I and with stopping, the Pills within a maximum period of 5 months, blood pressure will return to its control level, without having any effect on the cardiac or renal function. 5. When noticing the above mentioned points, we can conclude that if a woman had previous hypertension after using birth control pills, it is less dangerous than giving birth to a baby due to not using the pills.

  13. Hypertensive crisis: clinical-epidemiological profile.

    Science.gov (United States)

    Vilela-Martin, José Fernando; Vaz-de-Melo, Renan Oliveira; Kuniyoshi, Cristina Hiromi; Abdo, André Neder Ramires; Yugar-Toledo, Juan Carlos

    2011-03-01

    Hypertensive crisis (HC) stands out as one type of acute elevation in blood pressure (BP) and can manifest as hypertensive emergency (HE-with target-organ damage (TOD)) or hypertensive urgency (HU-without TOD), usually accompanied by levels of diastolic BP ≥120 mmHg. The aim of this study was to characterize the clinical-epidemiological profile of HC over the course of 1 year in a university reference hospital and perform a review of the literature. The study was a cross-sectional study, conducted over a period of 1 year (2006) in 362 patients who presented for treatment at the emergency hospital with HC, as described above. Among all patients examined, 231 individuals met the criteria for HE and 131 met the criteria for HU. Patients with HE were older (Phypertension.

  14. Intracranial hypertension without headache in children.

    Science.gov (United States)

    Aylward, Shawn C; Aronowitz, Catherine; Reem, Rachel; Rogers, David; Roach, E Steve

    2015-05-01

    We aimed to determine the frequency of intracranial hypertension without headache in children. We retrospectively analyzed patients evaluated in a pediatric intracranial hypertension referral center. Patients were divided into 2 groups depending on whether they complained of headache at the time of presentation. Age, body mass index, and opening cerebrospinal fluid pressures were considered continuous variables and compared by Wilcoxon rank-sum test because of non-normality. A P value of .05 was considered significant. A total of 228 charts were reviewed; 152 patients met the criteria for intracranial hypertension and 22/152 patients (14.5%) met the criteria of optic nerve edema without headache. There were clinically significant differences in age and body mass index between the 2 groups. The group without headache was typically younger and not obese. The opening pressure and modified opening pressure were not clinically significant between the 2 groups. © The Author(s) 2014.

  15. Sedentary lifestyle in individuals with hypertension.

    Science.gov (United States)

    Martins, Larissa Castelo Guedes; Lopes, Marcos Venícios de Oliveira; Guedes, Nirla Gomes; Nunes, Marília Mendes; Diniz, Camila Maciel; Carvalho, Priscilla Magalhães de Oliveira

    2015-01-01

    to identify the prevalence of nursing diagnosis Sedentary lifestyle (SL) and to analyze its association with clinical indicators (CI) and related factors (RF) in patients with hypertension. cross-sectional study with 285 patients with hypertension at a reference center for outpatient care in Northeastern Brazil. To collect data it was used an instrument based on operational defi nitions of the CI and RF previously validated. Four nurses rated SL as present or absent. To evaluate the association between CI and RF with the presence of SL it was applied the chi-square test. The prevalence ratio and confi dence interval was calculated to verify the magnitude of the effect between RF and SL. SL was identifi ed in 55.8% of the sample. Five IC and six RF showed a signifi cant association with SL. the study identifi es main indicators for inference of SL as well as their possible causal factors among people with hypertension.

  16. Hypertension up to date: SPRINT to SPYRAL.

    Science.gov (United States)

    Kulenthiran, Saarraaken; Ewen, Sebastian; Böhm, Michael; Mahfoud, Felix

    2017-07-01

    Hypertension is the most common chronic cardiovascular condition with increasing prevalence all over the world. Treatment of patients at risk requires a multimodal therapeutic concept to adjust blood pressure, including systematic identification of secondary causes of hypertension or pseudo-resistance, lifestyle modification, polypharmacy, and as well as accompanying risk factors and comorbidities. The present review discusses recent studies on patients with increased cardiovascular risk potentially influencing future treatment strategies. It covers blood pressure targets in patients at risk (SPRINT), novel treatment options such as angiotensin receptor neprilysin inhibitors, discusses the treatment of patients with impaired glucose tolerance, and appreciates novelties in controlling therapy-resistant hypertension by fourth-line pharmacotherapies (PATHWAY), as well as new interventional approaches.

  17. Olfactory and erectile dysfunction association in smoking and non-smoking men.

    Science.gov (United States)

    Özmen, Süay; Dülger, Seyhan; Çoban, Soner; Özmen, Ömer Afşın; Güzelsoy, Muhammed; Dikiş, Özlem Şengören; Akdeniz, Önder

    2016-06-01

    The studies evaluating the effect of smoking on olfaction reveals opposite results. In vitro and animal studies and epidemiological evidence from volunteers and patients, demonstrated the association between olfaction and erectile functions. In smoking man the reduction of olfactory acuity could adversely affect sexuality. The aim of the present study was to investigate the relationship between erectile dysfunction (ED) and olfactory dysfunction (OD) by comparing a group of healthy adult men with a group of smoking adult men. This prospective study involved 62 volunteers, who were recruited and divided into two groups; one consisted of 35 smoking adult men, and the other included 27 healthy non-smoking men. All participants in both groups were examined in detail for any condition with the potential to cause OD. They all had a normal genitourinary system suffered from no circulatory diseases, diabetes mellitus, hypertension, coronary artery disease nor hyperlipidemia; they had no history of medication affecting genitourinary system. Butanol threshold test and sniffin' stick® (Burghart, Wedel; Germany) screening test was used to asses olfactory functions in both groups. Participants' sexual desire was assessed using an International Index of Erectile Function (IIEF-5) scale. The means of sniffin' sticks scores, butanol threshold scores and IIEF-5 scores were statistically higher in non-smoking group. Butanol threshold scores and sniffin' sticks scores are correlated statistically with IIEF-5 in non-smoking and smoking groups. This study found an association between olfaction and erectile function in smoking and non-smoking men. As far as we know this study is the third published study to show the relationship olfactory and erectile function. In the future studies electrophysiological olfactory methods could be used to confirm in large cohorts the results obtained by the psychophysical approach.

  18. Study on the Association between Body Weight and Insulin Resistance in Essential Hypertension , X- syndromes and Type- 2 Diabetes

    Institute of Scientific and Technical Information of China (English)

    王爱玲; 徐岩; 陈森

    2004-01-01

    Objective To prove the hypothesis that there are associations between body weight and insulin resistance in essential hypertension, X- syndromes and type- 2 diabetes. Methods We examined the body mass index (BMI) and insulin sensitve index (ISI) among 70 hypertensives, 39 X - syndromes, 33 type - 2 diabetes and 46 controls. To observe the relations between the degrees of obesity and LSI in all study groups. Seventy patients with hypertension [70 hypertensives, 48 men and 22 women, mean age (69.3 + 6.7) years], 39X-syndromes [27 men and 12 women, mean age (66.4+6.2) years], 33 type- 2 diabetes [21 men and 12 women, mean age (68.7±7.3) years], and 46 healthy controls [36 men and 10 women, mean age (66.1 + 6.6) years]. During study period, no patients died. Results All patients of hypertensives, X - syndromes and type - 2 diabetes have insulin resistance, BMI in all patients was singnificantly higher than in controls. The levels of blood glucose and insulin were significantly higher in obese hypertensives (BMI≥25kg/m2 ) than in those (BMI<25kg/m2 ). LSI in obese subjects with hypertension and X - syndrome were significantly lower than in no - obesities. ISI was related to BMI. Conclusion There were insulin resistance in patients of hypertension and X - syndrome. Obesity was related to lower ISI. Obesity may be an important risk factor for insulin resistance of essential hypertension and X - syndrome. ISI and BMI may be simple and specific clinical predictor for hypertension and X - syndrome patients.

  19. Challenging machismo: promoting sexual and reproductive health with Nicaraguan men.

    Science.gov (United States)

    Sternberg, P

    2000-03-01

    This article presents the results of a participatory exploration of male attitudes towards sexual and reproductive health issues in Nicaragua. Nicaraguan culture views men in a machismo concept. The study examined the knowledge, attitudes and behavior of men in relation to the social construction of masculinity: sexuality, reproduction, and fatherhood. Employing 90 men from both rural and urban communities, attitudes towards sexuality, reproduction, abortion and fatherhood were discussed. Several insights were gathered from the research, which explains men's behavior. Thus, it was deemed imperative that in empowering women by promoting sexual and reproductive health among men would require challenging male hegemony and persuading men to participate in health promotion. However, the setting and application of a men's agenda for sexual health promotion should not result in the curtailment of services for women because funds are being reallocated to men, nor should it give men the opportunity to more subtle forms of domination and exploitation.

  20. Baroreflex sensitivity and essential hypertension in adolescents.

    Science.gov (United States)

    Honzíková, N; Fiser, B

    2009-01-01

    It has been known for many years that baroreflex sensitivity is lowered in hypertensive patients. There are several known factors implicating this association, e.g. high blood pressure leads to remodeling of the carotid arterial wall, to its stiffness and to a diminished activation of baroreceptors; leptin released from a fatty tissue activates the sympathetic nervous system etc. On the other hand, low baroreflex sensitivity (BRS, usually quantified in ms/mmHg) can be inborn. Studies on primary hypertension in children and adolescents have brought new information about the role of baroreflex in the development of an early stage of primary hypertension. BRS lower than 3.9 ms/mmHg was found in 5 % of healthy subjects. This value approaches the critical value for the risk of sudden cardiac death in patients after myocardial infarction and corresponds to the value present in hypertensive patients. A decreased BRS and BRSf (baroreflex sensitivity expressed in mHz/mmHg, index independent of the mean cardiac interval), was found not only in children with hypertension, but also in those with white-coat hypertension. This is in accordance with a single interpretation. The decrease of BRS/BRSf precedes a pathological blood pressure increase. The contribution of obesity and BRS/BRSf to the development of hypertension in adolescents was also compared. Both factors reach a sensitivity and a specificity between 60 % and 65 %, but there is no correlation between the values of the body mass index and BRS either in the group of hypertensive patients or in healthy controls. If a receiver operating curve (sensitivity versus specificity) is plotted for both values together using logistic regression analysis, a sensitivity higher than 70 % and a specificity over 80 % are reached. This means that low baroreflex sensitivity is an independent risk factor for the development of primary hypertension. Studies demonstrate that adolescents with increased blood pressure and with BRS under 7 ms

  1. Effects of psychological stress on hypertension in middle-aged Chinese: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Bo Hu

    Full Text Available We examined the effect and relative contributions of different types of stress on the risk of hypertension. Using cluster sampling, 5,976 community-dwelling individuals aged 40-60 were selected. Hypertension was defined according to the Seventh Report of the Joint National Committee, and general psychological stress was defined as experiencing stress at work or home. Information on known risk factors of hypertension (e.g., physical activity levels, food intake, smoking behavior was collected from participants. Logistic regression analysis was used to determine the associations between psychological stress and hypertension, calculating population-attributable risks and 95% confidence intervals (CIs. General stress was significantly related to hypertension (odds ratio [OR] = 1.247, 95% CI [1.076, 1.446]. Additionally, after adjustment for all other risk factors, women showed a greater risk of hypertension if they had either stress at work or at home: OR = 1.285, 95% CI (1.027, 1.609 and OR = 1.231, 95% CI (1.001, 1.514, respectively. However, this increased risk for hypertension by stress was not found in men. General stress contributed approximately 9.1% (95% CI [3.1, 15.0] to the risk for hypertension. Thus, psychological stress was associated with an increased risk for hypertension, although this increased risk was not consistent across gender.

  2. Hypertension in Malaysia: An Analysis of Trends From the National Surveys 1996 to 2011.

    Science.gov (United States)

    Naing, Cho; Yeoh, Peng Nam; Wai, Victor Nyunt; Win, Ni Ni; Kuan, Lai Pei; Aung, Kyan

    2016-01-01

    This study aimed to determine trends in prevalence, awareness, and control of hypertension in Malaysia and to assess the relationship between socioeconomic determinants and prevalence of hypertension in Malaysia.The distribution of hypertension in Malaysia was assessed based on available data in 3 National Health and Morbidity Surveys (NHMSs) and 1 large scale non-NHMS during the period of 1996 to 2011. Summary statistics was used to characterize the included surveys. Differences in prevalence, awareness, and control of hypertension between any 2 surveys were expressed as ratios. To assess the independent associations between the predictors and the outcome variables, regression analyses were employed with prevalence of hypertension as an outcome variable.Overall, there was a rising trend in the prevalence of hypertension in adults ≥30 years: 32.9% (30%-35.8%) in 1996, 42.6% (37.5%-43.5%) in 2006, and 43.5% (40.4%-46.6%) in 2011. There were significant increase of 32% from 1996 to 2011 (P Malaysia improved from 1996 to 2006. A change in the control of hypertension was 13% higher in women than in men.The findings suggest that the magnitude of hypertension in Malaysia needs additional attention. Strengthening the screening for hypertension in primary health-care settings in the high-risk groups and frequent health promotion to the community to enhance individual awareness and commitment to healthy living would be of immense value.

  3. Hypertension and cardiac arrhythmias

    DEFF Research Database (Denmark)

    Lip, Gregory Y.H.; Coca, Antonio; Kahan, Thomas

    2017-01-01

    of Cardiology (ESC) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit to comprehensively review the available...

  4. Hypertension and Cardiac Arrhythmias

    DEFF Research Database (Denmark)

    Lip, Gregory Y H; Coca, Antonio; Kahan, Thomas

    2017-01-01

    ) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS) and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit of comprehensively reviewing the available evidence...

  5. Fermented milk for hypertension

    DEFF Research Database (Denmark)

    Usinger, Lotte; Reimer, Christina; Ibsen, Hans

    2012-01-01

    Fermented milk has been suggested to have a blood pressure lowering effect through increased content of proteins and peptides produced during the bacterial fermentation. Hypertension is one of the major risk factors for cardiovascular disease world wide and new blood pressure reducing lifestyle...... interventions, such as fermented milk, would be of great importance....

  6. Combination treatment for hypertension

    African Journals Online (AJOL)

    On average, one in four adults has hypertension.1 This figure is higher in certain regions of the world, .... doses favours the development of diabetes and should be ... New and old evidence strongly supports combination treatment .... cardiovascular death, stroke and myocardial infarction, cognitive function and dementia.

  7. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

    Kamper, Anne-Lise; Pedersen, Erling B; Strandgaard, Svend

    2009-01-01

    hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...

  8. [Hypertension and renal disease

    DEFF Research Database (Denmark)

    Kamper, A.L.; Pedersen, E.B.; Strandgaard, S.

    2009-01-01

    hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...

  9. What Is Pulmonary Hypertension?

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Pulmonary Hypertension - High Blood Pressure in the Heart-to-Lung System Updated:Sep ... Pressure" This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  10. Hypertension og hjertet

    DEFF Research Database (Denmark)

    Wachtell, Kristian; Andersen, Niels Holmark; Svendsen, Tage Lysbo

    2009-01-01

    of left ventricular mass is associated with substantial and significant reduction of cardiovascular morbidity and mortality. Hypertension is strongly associated with increased risk of subsequent heart failure. Meta analysis data suggests that reduction in blood pressure is also associated with very...

  11. Hypertensive Heart Disease

    DEFF Research Database (Denmark)

    Wachtell, Kristian

    2011-01-01

    Abstract Hypertensive heart disease is prevalent and during the last decade it has been determined that patients with left ventricular (LV) hypertrophy have increased cardiovascular morbidity and mortality. However, many have doubted the effectiveness of LV mass assessment because it is difficult...

  12. Hydrogen sulfide in hypertension

    NARCIS (Netherlands)

    van Goor, Harry; van den Born, Joost C.; Hillebrands, Jan-Luuk; Joles, Jaap A.

    2016-01-01

    PURPOSE OF REVIEW: Hypertension is an important determinant of cardiovascular disease, and strict blood pressure regulation is beneficially associated with the risk for cardiovascular events or all-cause mortality. However, intensive antihypertensive treatment is not always sufficient to reach normo

  13. Hypertension og hjertet

    DEFF Research Database (Denmark)

    Wachtell, Kristian; Svendsen, Tage Lysbo; Andersen, Niels Holmark

    2009-01-01

    of left ventricular mass is associated with substantial and significant reduction of cardiovascular morbidity and mortality. Hypertension is strongly associated with increased risk of subsequent heart failure. Meta analysis data suggests that reduction in blood pressure is also associated with very...

  14. Nitroglycerin kan give hypertension

    DEFF Research Database (Denmark)

    Mørup, Peter; Levinsen, Tine Holbæk; Hovind, Peter

    2011-01-01

    Hg. The conclusion was that her response was a paradoxical response to glycerylnitrate, orthostatism and a pathological response to massage of the carotid artery. This is the third reported case on paradoxical hypertension induced by glyceryl nitrates. It is speculated that dysfunction of the cerebral bloodflow...

  15. Decoding white coat hypertension.

    Science.gov (United States)

    Bloomfield, Dennis A; Park, Alex

    2017-03-16

    There is arguably no less understood or more intriguing problem in hypertension that the "white coat" condition, the standard concept of which is significantly blood pressure reading obtained by medical personnel of authoritative standing than that obtained by more junior and less authoritative personnel and by the patients themselves. Using hospital-initiated ambulatory blood pressure monitoring, the while effect manifests as initial and ending pressure elevations, and, in treated patients, a low daytime profile. The effect is essentially systolic. Pure diastolic white coat hypertension appears to be exceedingly rare. On the basis of the studies, we believe that the white coat phenomenon is a common, periodic, neuro-endocrine reflex conditioned by anticipation of having the blood pressure taken and the fear of what this measurement may indicate concerning future illness. It does not change with time, or with prolonged association with the physician, particularly with advancing years, it may be superimposed upon essential hypertension, and in patients receiving hypertensive medication, blunting of the nighttime dip, which occurs in about half the patients, may be a compensatory mechanisms, rather than an indication of cardiovascular risk. Rather than the blunted dip, the morning surge or the widened pulse pressure, cardiovascular risk appears to be related to elevation of the average night time pressure.

  16. Treatment of portal hypertension

    Institute of Scientific and Technical Information of China (English)

    Khurram Bari; Guadalupe Garcia-Tsao

    2012-01-01

    Portal hypertension is the main complication of cirrhosis and is defined as an hepatic venous pressure gradient (HVPG) of more than 5 mmHg.Clinically significant portal hypertension is defined as HVPG of 10 mmHg or more.Development of gastroesophageal varices and variceal hemorrhage are the most direct consequence of portal hypertension.Over the last decades significant advancements in the field have led to standard treatment options.These clinical recommendations have evolved mostly as a result of randomized controlled trials and consensus conferences among experts where existing evidence has been reviewed and future goals for research and practice guidelines have been proposed.Management of varices/variceal hemorrhage is based on the clinical stage of portal hypertension.No specific treatment has shown to prevent the formation of varices.Prevention of first variceal hemorrhage depends on the size/characteristics of varices.In patients with small varices and high risk of bleeding,nonselective β-blockers are recommended,while patients with medium/large varices can be treated with either β-blockers or esophageal band ligation.Standard of care for acute variceal hemorrhage consists of vasoactive drugs,endoscopic band ligation and antibiotics prophylaxis.Transjugular intrahepatic portosystemic shunt (TIPS) is reserved for those who fail standard of care or for patients who are likely to fail ("early TIPS").Prevention of recurrent variceal hemorrhage consists of the combination of β-blockers and endoscopic band ligation.

  17. Studies in portal hypertension

    NARCIS (Netherlands)

    H.R. van Buuren (Henk)

    2002-01-01

    textabstractOur work focussed on one of the most frequent and serious complications of portal hypertension i.e. variceal bleeding. In particular, studies were initiated aimed at developing a more effective therapeutic strategy for the primary and secondary prevention of variceal bleeding. Aspects of

  18. Arterial hypertension in the female world: pathophysiology and therapy.

    Science.gov (United States)

    Cadeddu, Christian; Franconi, Flavia; Cassisa, Laura; Campesi, Ilaria; Pepe, Alessia; Cugusi, Lucia; Maffei, Silvia; Gallina, Sabina; Sciomer, Susanna; Mercuro, Giuseppe

    2016-04-01

    Hypertension is a major risk factor for cardiovascular disease and outcomes in women, and antihypertensive therapy is not always successful in achieving control over the blood pressure (BP). Nonoptimal control of BP remains a crucial risk factor for cardiovascular mortality, and in women, it could be related to sex-specific factors. Historically, women have been under-represented in clinical trials; therefore, the benefits of clinical outcomes and the safety profiles of antihypertensive therapies have been studied less extensively in women. The reasons for the sex differences in BP levels are multifactorial, implying different roles of the sex hormones, the renin-angiotensin system, sympathetic activity, and arterial stiffness. A complete understanding of the pathophysiological features of these differences requires further investigation.Nevertheless, the prevalence of the use of antihypertensive agents is higher among middle-aged women than among men. Notably, in the United States, hypertensive women use more diuretics and angiotensin receptor blockers than men, whereas hypertensive men more often receive beta-blockers, calcium channel antagonists, or inhibitors of angiotensin-converting enzyme. To date, the explanations for these sex differences in the consumption of antihypertensive drugs remain unknown.

  19. Role of biographical experience and bodily sensations in patients' adaptation to hypertension

    DEFF Research Database (Denmark)

    Sångren, H; Reventlow, S; Hetlevik, I

    2009-01-01

    abilities. Patients gradually adopted behaviour and attitudes to reduce their risk of cardiovascular disease. CONCLUSION: A diagnosis of hypertension constitutes a biographical disruption and has an impact on daily life. Patients' adaptation to hypertension combines biographical and bodily experiences......OBJECTIVE: To explore patients' adaptation to hypertension and to describe its impact on their sense of body, biographical experience, approach to life and daily activities. METHODS: A qualitative interview study with nine men and eight women (age: 35-50 years) with hypertension from four general...... practices in Denmark. The informants differed in type and duration of treatment. RESULTS: Adaptation to hypertension was influenced by the patients' biographical experiences and involved changes in body perception. The process affected patients' daily activities and they actively tested their physical...

  20. Combined effects of socioeconomic position, smoking, and hypertension on risk of ischemic and hemorrhagic stroke

    DEFF Research Database (Denmark)

    Nordahl, Helene; Osler, Merete; Frederiksen, Birgitte Lidegaard

    2014-01-01

    between socioeconomic position (ie, education), smoking, and hypertension on ischemic and hemorrhagic stroke incidence by the use of the additive hazards model. RESULTS: During 14 years of follow-up, 3613 ischemic strokes and 776 hemorrhagic strokes were observed. Current smoking and hypertension were......, particularly among men: 134 (95% confidence interval, 49-219) extra cases per 100 000 person-years because of interaction, adjusted for age, cohort study, and birth cohort. There was no clear evidence of interaction between low education and hypertension. The combined effect of current smoking and hypertension......, and birth cohort. CONCLUSIONS: Reducing smoking in those with low socioeconomic position and in those with hypertension could potentially reduce social inequality stroke incidence....