• 제목/요약/키워드: arterial hypertension

검색결과 241건 처리시간 0.022초

우리나라 폐동맥고혈압환자에 대한 Bosentan과 Iloprost의 비용-효용 분석 (Cost-Utility Analysis of Bosentan Versus Iloprost in Korean Patients with Pulmonary Arterial Hypertension)

  • 손현순;이태진
    • 약학회지
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    • 제54권2호
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    • pp.126-133
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    • 2010
  • This study was conducted to analyze cost-utility of bosentan versus iloprost indicated for pulmonary arterial hypertension (PAH) in a Korean healthcare setting from a payer's perspective. We constructed a Markov model to estimate total costs and outcomes for 1-year time horizon in a hypothetical cohort of 50-year-old patients with PAH. Base analysis showed that bosentan resulted in KW 5.5 billions saving and 18 quality-adjusted life year (QALY) gains per 100 patients compared to iloprost. Bosentan as a dominant strategy was found to be robust through various sensitivity analyses.

Multiple Recurrent Cerebral Hemorrhages Related to Cerebral Amyloid Angiopathy with Arterial Hypertension

  • Jung, Jae-Hyun;Shin, Dong-Ah;Gong, Tae-Sik;Kwon, Chang-Young
    • Journal of Korean Neurosurgical Society
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    • 제39권6호
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    • pp.447-450
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    • 2006
  • Cerebral amyloid angiopathy[CAA] is characterized by the deposition of amyloid ${\beta}-protein$ in the walls of small to medium-sized arteries of the leptomeninges and cerebral cortex. While often asymptomatic, CAA can develop into intracerebral hemorrhage facilitated by arterial hypertension. We report the case of a 52-year-old man with CAA and arterial hypertension who developed recurrent cerebral hemorrhages on three different occasions and in multiple non-overlapping loci over a period of nine years. Based on our findings, we recommend brain biopsies for all patients undergoing evacuation of multiple recurrence or atypical pattern intracerebral hemorrhages.

산화질수(Nitric Oxide) 중단 후의 반동성폐고혈압 (Rebound Pulmonary Hypertension After Nitric Oxide Withdrawal)

  • 이현우;이재웅;현성열;박철현;박국양;이경천
    • Journal of Chest Surgery
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    • 제33권2호
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    • pp.132-138
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    • 2000
  • Background: Inhaled nitric oxide therapy causes selective pulmonary vasodilation in congenital heart diseases with pulmonary hypertension. However discontinuation of inhaled nitric oxide therapy may be complicated by abrupt life-threatening rebound pulmonary hypertension(RPH) The purpose of this study was to prevent by comparing group I(without RPH n=13) and group II(with RPH n=6) to determine the risk factors involved inthe development of the RPH. Material and Method: Between Januarty 6, 1998 and April 14, 1999. we studied 19 consecutive children who were treated with inhaled nitric oxide for clinically significant pulmonary hypertension after an open heart surgery for congenital heart disease. the ratio of males and females was 12:7 ranging in age from 10 days to 6040 days(16 years) To identify the effects of nitric oxide between two groups we measured heart rate mean and systolic pulmonary arterial pressure mean and systolic systemic arterial pressure central venous pressure pH paO2/FiO2 and O2 saturation before and after the initiation and just before the withdrawal of the inhaled nitric oxide. result: In 6 of 19 patients(32%) withdrawal of inhaled nitric oxide caused RPH. In the two groups inhaled nitrix oxide decreased in pulmonary arterial pressure(PAP) without decreasing the systemic arterial pressure(SAP) and increased PaO2/FiO2 Compared with patients who had no RPH(group I) patients who had RPH(group II) were older in age (1204$\pm$1688 versus 546$\pm$1654 days p<0.05) received less nitric oxide therapy(34$\pm$18 versus 67$\pm$46 hours p<0.05) has shorter weaning process(5$\pm$3 versus 15一13 hours p<0.05) and received lowerconcentration of initial nitric oxide supply(11$\pm$8 versus 17$\pm$8 ppm p>0.05) and lower concentration just before the withdrawal nitric oxide(4.2$\pm$2.6 versus 5.6$\pm$2.6 ppm, p>0.05) Conclusion : We speculate that older age shorter of nitric oxide therapy shorter weaning process are the risk factors of RPH.

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The effect of oral glucose tolerance testing on changes in arterial stiffness and blood pressure in elderly women with hypertension and relationships between the stage of diabetes and physical fitness levels

  • Lee, Jaesong;Park, Wonil;Sung, Eunsook;Kim, Bokbeom;Kim, Nahyun;Park, Saejong;Shin, Chulho;Park, Jonghoon
    • 운동영양학회지
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    • 제24권4호
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    • pp.34-43
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    • 2020
  • [Purpose] The purpose of this study was to assess changes in blood glucose level, blood pressure, and arterial stiffness after a 75 g oral glucose tolerance test (OGTT) in elderly women aged over 65 years with hypertension and either normal glycemic control, impaired fasting glucose tolerance, or diabetes mellitus. We also wished to investigate the relationship between stages of diabetes and physical fitness. [Methods] A total of 24 elderly women with hypertension were assigned to a control group (CON; n=7), impaired fasting glucose group (IFG; n=9), and diabetes mellitus group (DM; n=8). In each group, blood glucose level, brachial ankle pulse wave velocity (PWV), and blood pressure were measured at baseline as well as 60 and 120 minutes after a 75 g OGTT. Physical fitness factors such as hand grip strength, balance test, 4 m gait speed test, chair stand test, short physical performance battery, and 6-minute walking test were subsequently assessed. [Results] In all three groups, blood glucose levels were significantly increased at 60 and 120 minutes after a 75 g OGTT. In the DM group, blood glucose levels were significantly higher before and after a 75 g OGTT than in the CON group. In the CON group, PWV was significantly increased at 60 minutes after a 75 g OGTT; however, there were no changes in other groups after glucose ingestion. In the CON group, systolic and diastolic blood pressures were significantly decreased at 60 and 120 minutes after a 75 g OGTT compared to baseline. However, there was no change in blood pressure after ingestion in the DM group. The IFG group had greater grip strength than the CON group; however, there were no differences in other variables between the groups. [Conclusion] After a 75 g OGTT, elderly women with hypertension and diabetes maintain higher blood glucose levels compared to those with hypertension alone. Unlike elderly women with hypertension alone, those with hypertension and diabetes did not show changes in arterial stiffness and blood pressure after a 75 g OGTT. Therefore, elderly women with hypertension and diabetes may not be able to control their blood vessels following a 75 g OGTT due to impaired vascular endothelial function. Moreover, there was no association between diabetes stage and physical fitness in elderly women with hypertension.

인영(人迎)(ST9) 침자(鍼刺)가 백려(白鼠)의 혈압(血壓) 및 심박수(心博數)에 미치는 영향(影響) (The effect of acupuncture of Inyong(ST9) on the mean arterial pressure and heart rate in the rat)

  • 윤여충;김정상;박석천;나창수
    • 대한한방내과학회지
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    • 제18권2호
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    • pp.160-166
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    • 1997
  • To evaluate the effect of acupuncture on the hypertension, the study was done by acupuncture on bilateral Inyong(ST9) with rats which are normal and acutely increased hypertensive. The results are as follows: 1. Under the normal condition, the acupuncture on bilateral Inyong caused a quick drop of mean arterial pressure(MAP), but heart rate(HR) was not changed significantly. 2. To increase the blood pressure, acutely epinephrine was administered and it caused a increase in both MAP and HR. With acupuncture, the MAP was decreased while HR did not show a significant change. In conclusion, the acupuncture was somewhat effective in lowering the mean arterial pressure in the rat.

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폐쇄성 수면 무호흡 증후군과 폐동맥 고혈압에서 엔도텔린-1의 역할 (The Role of Endothelin-1 in Obstructive Sleep Apnea Syndrome and Pulmonary Hypertension)

  • 최영미
    • 수면정신생리
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    • 제17권2호
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    • pp.69-74
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    • 2010
  • Obstructive sleep apnea syndrome is associated with significant cardiovascular morbidity and increased mortality. However, it was controversial whether obstructive sleep apnea syndrome could cause pulmonary hypertension. The controversy was resolved by several studies that have shown pulmonary hypertension in 20% to 40% of patients with obstructive sleep apnea syndrome without underlying other cardiopulmonary diseases and reductions in pulmonary arterial pressure in patients with obstructive sleep apnea syndrome after treatment with nocturnal continuous positive airway pressure. Recent studies provide strong evidence for endothelial dysfunction in obstructive sleep apnea syndrome and pulmonary hypertension. Endothelin-1 is a 21 amino acid peptide with diverse biologic activity such as highly potent vasoconstrictor and mitogen regulator that may play a key role in obstructive sleep ap-nea syndrome and pulmonary hypertension. Continuous positive airway pressure therapy is moderately effective in reducing pulmonary arterial pressure. Further researches are needed to assess the therapeutic efficacy of pharmacologic therapy with agents that inhibit the action of endothelin-1 in obstructive sleep apnea syndrome patients with pulmonary hypertension.

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대시호탕(大柴胡湯)이 고혈압과 수축혈관에 미치는 영향 (Effects of DaeSiHo-Tang extract on Hypertension and Arterial Contraction)

  • 여운홍;조학준;김호현
    • 동의생리병리학회지
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    • 제19권6호
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    • pp.1573-1579
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    • 2005
  • This study was undertaken to define the effect of DaeSiHo-Tang extract on the hypertension in spontaneous hypertensive rat and norepinephrine-induced arterial contraction in rabbit. Systolic blood pressure and blood velocity were significantly attenuated by administration of DaeSiHo-Tang extract. but blood flow and renin-angiotensin-aldosterone system unaffected by DaeSiHo-Tang extract. The relaxation effect of DaeSiHo-Tang extract was dependent on the presence of endothelium, showing that DaeSiHo-Tang extract-induced relaxation was not observed in the strips without endothelium. The endothelium-dependent relaxation induced by DaeSiHo-Tang extract was decreased by the pretreatment of $N{\omega}$-nitro-L-arginine or methylene blue, but it was not observed in the strips pretreated with indomethacin or tetraethylammonium chloride. When $Ca^{2+}$ was applied, the strips which were contracted by norepinephrine in a $Ca^{2+}$-free solution, arterial contraction was increased. But pre-treatment of DaeSiHo-Tang extract inhibited contractile response to $Ca^{2+}$. These results indicate that antihypertensive effect of DaeSiHo-Tang extract is due to descend arterial resistance by the arterial relaxation through the formation of nitric oxide in the vascular endothelial cells.

중증 폐동맥고혈압이 동반된 만성폐쇄성폐질환 1 예 (Chronic Obstructive Pulmonary Disease with Severe Pulmonary Hypertension - A Case Report -)

  • 박찬서;진현정;김석민;손창우;유성근;정진홍;이관호
    • Journal of Yeungnam Medical Science
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    • 제25권1호
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    • pp.50-57
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    • 2008
  • Pulmonary hypertension is an increase in blood pressure in the pulmonary artery, pulmonary vein or pulmonary capillaries. Depending on the cause, pulmonary hypertension can be a severe disease with markedly decreased exercise tolerance and right-sided heart failure. Pulmonary hypertension can present as one of five different types: arterial, venous, hypoxic, thromboembolic, or miscellaneous. Chronic obstructive pulmonary disease with severe pulmonary hypertension is a rare disease. A 52-year-old man presented with a complaint of aggravating dyspnea. The mean pulmonary arterial pressure was 61.5 mmHg by Doppler echocardiogram. The patient was prescribed diuretics, digoxin, bronchodilator, sildenafil, bosentan and an oxygen supply. However, he ultimately died of cor pulmonale. Thus, diagnosis and early combination therapy are important.

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Metastasis Risk Reduction Related with Beta-Blocker Treatment in Mexican Women with Breast Cancer

  • Parada-Huerta, E;Alvarez-Dominguez, TP;Uribe-Escamilla, R;Rodriguez-Joya, JF;Ponce-Medrano, JA Diaz;Padron-Lucio, S;Alfaro-Rodriguez, A;Bandala, C
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권6호
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    • pp.2953-2957
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    • 2016
  • Background: Breast Cancer (BCa) is the most common malignant tumour in Mexican women. In BCa, several studies have linked ${\beta}2-adrenergic$ receptor activation with increased tumour growth and progression as related with Epinephrine-NorEpinephrine (E-NE) stimulation. The aim of this study was to describe Beta-Blocker (BB) treatment related with reduction of the risk of metastasis in Mexican patients with BCa. Materials and Methods: We collected data of 120 patients seen at the High-Specialty Naval General Hospital in Mexico City (HOSGENAES), all of these with a histopathological diagnosis of BCa. Four groups of patients were divided as follows: without Systemic Arterial Hypertension (SAH); with SAH treatment with non-selective BB; with SAH treatment with selective BB, and with SAH treatment with other antihypertensive drugs. Chi-square, Mantel-Haenszel, Student t, and ANOVA tests were performed for data analysis. Results: On average, patients were $54.8{\pm}11.8$ years of age. Risk factors such as smoking and consuming alcohol exhibited a frequency of 33 and 36.5% respectively. Clinical stages III- IV were found in 50% of patients, while, 30% of patients had arterial hypertension (n=29 and N=96, respectively) and 17.5% used BB. One hundred percent of patients with arterial hypertension treated with BB for ${\beta}1$ - and ${\beta}2$ -adrenergic-receptors did not present metastasis globally, but patients treated with ${\beta}1$ BB presented 30% of metastasis while patients treated with no BB or without SAH had around 70% of metastasis. Conclusions: In Mexican patients with BCa and SAH treated with non-selective (${\beta}1$- and ${\beta}2-adrenergic$ receptors) BB, a decrease in the risk for metastasis was observed at the time of diagnosis.

Therapeutic implications of microRNAs in pulmonary arterial hypertension

  • Lee, Aram;McLean, Danielle;Choi, Jihea;Kang, Hyesoo;Chang, Woochul;Kim, Jongmin
    • BMB Reports
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    • 제47권6호
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    • pp.311-317
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    • 2014
  • microRNAs (miRNAs) are a class of small, non-coding RNAs that play critical posttranscriptional regulatory roles typically through targeting of the 3'-untranslated region of messenger RNA (mRNA). Mature miRNAs are known to be involved in global cellular processes, such as differentiation, proliferation, apoptosis, and organogenesis, due to their capacity to target multiple mRNAs. Thus, imbalances in the expression and/or activity of miRNAs are involved in the pathogenesis of numerous diseases, including pulmonary arterial hypertension (PAH). PAH is a progressive disease characterized by vascular remodeling due to excessive proliferation of pulmonary artery endothelial cells (PAECs) and pulmonary artery smooth muscle cells (PASMCs). Recently, studies have evaluated the roles of miRNAs involved in the pathogenesis of PAH in these pulmonary vascular cells. This review provides an overview of recent discoveries on the role of miRNAs in the pathogenesis of PAH and discusses the potential for miRNAs as therapeutic targets and biomarkers of PAH.