Arterial occlusive disease hypertension

Unlabeled Uses Treatment of atherosclerosis, gangrene, pain due to severe peripheral arterial occlusive disease, pulmonary hypertension... 

First- and second-trimester abortion Cervical reopening Induction of labor Augmentation of labor Postpartum hemorrhage Ectopic pregnancy Lactation suppression In gastrointestinal disease Peptic ulceration Liver transplantation Chemotherapy-induced mucosal lesions In cardiovascular disease Congenital cardiac malformations Raynaud s syndrome Chronic obstructive pulmonary disease Adult respiratory distress syndrome Pulmonary hypertension Arterial occlusive disease Extracorporeal circulation In urology Erectile dysfunction... 

In cardiovascular disease Congenital cardiac malformations Raynaud s syndrome Chronic obstructive pulmonary disease Adult respiratory distress syndrome Pulmonary hypertension Arterial occlusive disease Extracorporeal circulation... 

Vascular risk factors previous stroke, hypertension, diabetes, contralateral internal cerebral artery occlusion, peripheral vascular disease... 

Ischemic strokes account for around 80-85% of all strokes and are caused by arterial vascular occlusions rarely occlusion in the cerebral venous system may result in ischemic and/or hemorrhagic stroke. Arterial occlusions resulting from cerebral embolism are the most common causes of ischemic strokes, and by about one week after stroke as many as 70-90% of occlusions will have spontaneously recanalized. Emboli typically originate from atherosclerotic stenoses in the internal carotid artery or from sources in the heart such as clots in the left atrium or the left ventricle. Hypertension-induced vascular disease of the small perforating intracerebral arteries is a common cause of lacunar strokes. A classification of the major stroke subtypes is shown in Table 31.1. 

Aberrant thrombus formation and deposition on blood vessel walls imderlies the pathogenesis of acute cardiovascular disease states which remain the principal cause of morbidity and mortality in the industrialized world [1,2,3]. Plasma proteins, proteases and specific cellular receptors that participate in hemostasis have emerged as important risk considerations in thrombosis and thromboembolic disorders. The clinical manifestations of the above disease states include acute coronary artery and cerebrovascular syndromes, peripheral arterial occlusion, deep vein thrombosis and pulmonary/renal embolism [3]. The most dilabilitating acute events precipitated by these disorders are myocardial infarction and stroke. In addition, the interplay between hemostatic factors and hypertension (4) or atherosclerosis (5) dramatically enhances the manifestation of these pathologic states. 

Vasculogenic (arterial and venogenic) Hypertension, atherosclerosis, diabetes mellitus, trauma, Peyronie s disease Impaired veno-occlusion, inadequate arterial inflow... 

In a review of studies describing target organ damage in African patients with essential hypertension, it was demonstrated that occlusive disease of the central and peripheral arteries is an important complication of essential hypertension. Although smoking, hypercholes-terolaemia, and diabetes played an important role in the pathogenesis of central and peripheral vascular disease, this condition is more frequently seen in hjrpertensive than in normotensive patients (19). 

Compared to normotensives, hypertensive persons develop a marked excess of the major cardiovascular diseases. In the age group 45-74, they develop at least twice as much occlusive peripheral artery disease, about three times as much coronary disease, more than four times as much congestive [heart] failure and over seven times the incidence of brain infarction as normotensives. 

Atheromatous medium-sized arteries at the base of the brain, particularly the vertebral and basilar arteries, may become affected by dolichoectasia. The arteries are widened, tortuous and elongated and may be visualized on MRI or, if the walls are calcified, on CT. Dolichoectasia is usually found in elderly patients with hypertension and diabetes and it may cause stroke through embolization of thrombus or by occlusion of small branch arteries. In younger patients, it should raise the possibility of Fabry s disease. 

Apart from surgical and interventional therapy of occlusive carotid artery disease, the major approach to preventing vascular disease and subsequent stroke is to pay close attention to the control of modifiable risk factors such as hypertension, smoking, diabetes, and hypercholesterolemia. Coumadin, an anticoagulant, is effective for the primary and secondary prevention of stroke in patients with atrial fibrillation. Aspirin, clopidogrel, and the combination of aspirin and cUpyridamole have been proven to be effective for secondary stroke prevention along with the antihypertensive combination of indap-amide and perindopril. 

The APT 1994 overview thus established conclusively the value of antiplatelet therapy for a wide range of patients at high risk of occlusive arterial disease. The proportional reductions in vascular events were shown to be similar in men and women, in middle age and old age, in hypertensive and normotensive patients, and in diabetic and non-diabetic patients (8). 

Cerebrovascular disease is a consequence of hypertension. A neurologic assessment can detect either gross neurologic deficits or a slight hemiparesis with some incoordination and hyperreflexia that are indicative of cerebrovascular disease. Stroke can result from lacunar infarcts caused by thrombotic occlusion of small vessels or intracerebral hemorrhage resulting from ruptured microaneurysms. Transient ischemic attacks secondary to atherosclerotic disease in the carotid arteries are common in hypertensive individuals. 

Dyslipidemia with no specific genetic defect Hypertension Peripheral artery disease Occlusive arterial disease... 

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