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Hypertension Only (hypertension + only)
Selected AbstractsResidual risk for acute stroke in patients with type 2 diabetes and hypertension in primary care: Skaraborg Hypertension and Diabetes ProjectDIABETES OBESITY & METABOLISM, Issue 5 2006K. Junga Aim:, The aim of this study was to investigate the risk of acute stroke in subgroups of patients treated for hypertension and type 2 diabetes in primary care. Methods:, Patients with hypertension only (n = 695), type 2 diabetes only (n = 181) or both (n = 240), who consecutively attended an annual control in primary care in Skara, Sweden during 1992,1993, were evaluated for cardiovascular disease risk factors and enrolled in this study. Subjects with neither hypertension nor type 2 diabetes (n = 824) who participated in a population survey in the same community served as controls. Possible events of acute stroke through 2002 were validated using hospital records and death certificates. Results:, During a mean follow-up time of 8.4 years, 190 first events of acute stroke, fatal or non-fatal, were ascertained. Risk factor levels were generally higher in all patient categories than in controls. Stroke risk was significantly increased in all male patients: hazard ratio 4.2 (95% CI 2.1,8.4) in patients with both conditions, 3.3 (1.5,7.0) in those with type 2 diabetes alone and 2.8 (1.5,5.3) in those with hypertension alone (adjusted for age, total cholesterol, current smoking, BMI and physical activity). Corresponding findings in women were 2.9 (1.5,5.8) in patients with type 2 diabetes only and 2.4 (1.2,4.7) in those with both conditions. However, in women with hypertension only, a significant risk was seen first when subjects were truncated at 85 years of age. There were too few fatal stroke events for conclusive results on stroke mortality. Conclusions:, A considerable risk of acute stroke remains in patients with type 2 diabetes and hypertension. Strategies for stricter multiple risk factor interventions should be implemented in primary care. [source] Endothelial-Independent Prevention of High Blood Pressure in L-Name-Treated Rats by Angiotensin II type I Receptor Antisense Gene TherapyEXPERIMENTAL PHYSIOLOGY, Issue 4 2003Phyllis Y. Reaves It has previously been established that a single systemic administration of retroviral vector containing angiotensin II type I receptor antisense (AT1R-AS) in the neonatal spontaneously hypertensive rat (SHR) prevents development of hypertension, and in addition cardiac hypertrophy and endothelial dysfunction. However, these studies could not determine whether the effects of AT1R-AS on high blood pressure (BP) and endothelial function were independent. Angiotensin receptor blockers have been shown to reduce BP in the L-NAME (N , -nitro-L-arginine methyl ester hydrochloride)-induced rat model of hypertension. Our objective in the present study was to use the L-NAME model of hypertension to determine whether AT1R-AS treatment would lower high BP and attenuate cardiac hypertrophy under conditions of permanent endothelial damage. A single bolus of LNSV-AT1R-AS viral particles in neonatal Wistar-Kyoto (WKY) rats was without affect on basal BP. Efficacy of the transgene incorporation was assessed by observing a significant reduction in angiotensin-induced dipsogenic response in the AT1R-AS-treated animals. Introduction of L-NAME in the drinking water for 10 weeks resulted in the establishment of hypertension only in the WKY rats treated with vector alone. These hypertensive (BP, 179 ± 4 mmHg) animals showed a 17% increase in heart weight/body weight ratio and a 60% reduction in ACh-induced vasorelaxation in phenylephrine-preconstricted arteries. The L-NAME-induced high BP and cardiac hypertrophy were attenuated in rats expressing AT1R-AS. However, endothelial dysfunction could not be prevented with the antisense therapy. These observations demonstrate that attenuation of endothelial dysfunction is not a prerequisite for the antihypertensive effects of AT1R-AS treatment. [source] Hypertension during pregnancy in South Australia, Part 2: Risk factors for adverse maternal and/or perinatal outcome , results of multivariable analysisAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 5 2004Sophie A. VREEBURG Abstract Objective:, To identify factors associated with adverse pregnancy outcomes among women with hypertension during pregnancy Design:, A population-based retrospective multivariable analysis using the South Australian perinatal data collection. Methods:, Perinatal data on 70 386 singleton births in 1998,2001 were used in multivariable analyses on three groups: all women combined, all hypertensive women and women with pregnancy hypertension only, in order to identify independent risk factors for requirement for level II/III care, preterm birth, small for gestational age (SGA) birth and maternal length of stay greater than 7 days. Results:, The risks for the four morbidities were all increased among women with hypertension compared with normotensive women. Those with pre-existing hypertension had the lowest risk (with odds ratios (OR) 1.26,2.90). Pregnancy hypertension held the intermediate position (OR 1.52,5.70), while superimposed pre-eclampsia was associated with the highest risk (OR 2.00,8.75). Among women with hypertension, Aboriginality, older maternal age, nulliparity and pre-existing or gestational diabetes increased the risk for level II/III nursery care, preterm birth and prolonged hospital stay. Smokers had shorter stays, which may be related to their decreased risk of having a Caesarean section or operative vaginal delivery. Asian women, Aboriginal women, smokers and unemployed women had an increased risk for having an SGA baby, while women with pre-existing or gestational diabetes had a reduced risk. Conclusions:, Among hypertensive pregnant women, nulliparity, older maternal age, Aboriginality, unemployment and diabetes are independent risk factors for one or more major adverse pregnancy outcomes. Smoking does not always worsen the outcome for hypertensive women except for SGA births. [source] Prospective study of the incidence and outcome of intra-abdominal hypertension and the abdominal compartment syndromeBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 5 2002Dr J. J. Hong Background: Intra-abdominal hypertension has been recognized as a source of morbidity and mortality in the traumatized patient following laparotomy. Multiple organ dysfunction attributable to intra-abdominal hypertension has been called the abdominal compartment syndrome. The epidemiology and characteristics of these processes remain poorly defined. Methods: Intra-abdominal pressure was measured prospectively in all patients admitted to a trauma intensive care unit over 9 months. Data were gathered on all patients with intra-abdominal hypertension. Results: Some 706 patients were evaluated. Fifteen (2 per cent) of 706 patients had intra-abdominal hypertension. Six of the 15 patients with intra-abdominal hypertension had abdominal compartment syndrome. Half of the patients with abdominal compartment syndrome died, as did two of the remaining nine patients with intra-abdominal hypertension. Patients with abdominal compartment syndrome had a mean intra-abdominal pressure of 42 mmHg compared with 26 mmHg in patients with intra-abdominal hypertension only (P < 0·05). Conclusion: The incidence of intra-abdominal hypertension and abdominal compartment syndrome was 2 and 1 per cent respectively. Intra-abdominal hypertension did not necessarily lead to abdominal compartment syndrome, and often resolved without clinical sequelae. Abdominal compartment syndrome did not occur in the absence of earlier laparotomy. Abdominal compartment syndrome was associated with a marked increase in intra-abdominal pressure (above 40 mmHg). © 2002 British Journal of Surgery Society Ltd [source] | ||||||||||