Hypertension and heart failure

Unlabeled Uses Management of heart failure, hypertension and/or renal crisis in scleroderma... 

Sodium bicarbonate (eg, baking soda, Alka Seltzer) reacts rapidly with HC1 to produce carbon dioxide and NaCl. Formation of carbon dioxide results in gastric distention and belching. Unreacted alkali is readily absorbed, potentially causing metabolic alkalosis when given in high doses or to patients with renal insufficiency. Sodium chloride absorption may exacerbate fluid retention in patients with heart failure, hypertension, and renal insufficiency. 

The corticosteroids are administered with caution in older adults because they are more likely to have preexisting conditions such as congestive heart failure, hypertension, osteo-poros s and arthritis which may be worsened by the use of such agents The nurse monitors older adults for exacerbation of existing conditionsduring corticosteroid therapy. In addition, lower dosages may be needed because of the effects of aging, such as decreased muscle mass renal function, and plasma volume. 

National and international trends over the past 15 years depict modest improvements in the treatment and/or control of blood pressure (BP) for hypertensive patients. This observation is made despite efforts to promote awareness, treatment, and the means available to aggressively manage high blood pressure. Over 65 million Americans have hypertension, which was listed as the primary cause of death for over 261,000 individuals in the United States in 2002.1 Hypertension is also a significant cause of end-stage renal disease and heart failure. National and international organizations continually refine their recommendations of how... 

Patients with asymptomatic left ventricular systolic dysfunction and hypertension should be treated with P-blockers and ACE inhibitors. Those with heart failure secondary to left ventricular dysfunction and hypertension should be treated with drugs proven to also reduce the morbidity and mortality of heart failure, including P-blockers, ACE inhibitors, ARBs, aldosterone antagonists, and diuretics for symptom control as well as antihypertensive effect. In African-Americans with heart failure and left ventricular systolic dysfunction, combination therapy with nitrates and hydralazine not only affords a morbidity and mortality benefit, but may also be useful as antihypertensive therapy if needed.66 The dihydropyridine calcium channel blockers amlodipine or felodipine may also be used in patients with heart failure and left ventricular systolic dysfunction for uncontrolled blood pressure, although they have no effect on heart failure morbidity and mortality in these patients.49 For patients with heart failure and preserved ejection fraction, antihypertensive therapies that should be considered include P-blockers, ACE inhibitors, ARBs, calcium channel blockers (including nondihydropyridine agents), diuretics, and others as needed to control blood pressure.2,49... 

Automaticity of cardiac fibers is controlled in part by activity of the sympathetic and parasympathetic nervous systems. Enhanced activity of the sympathetic nervous system may result in increased automaticity of the SA node or other automatic cardiac fibers. Enhanced activity of the parasympathetic nervous system tends to suppress automaticity conversely, inhibition of activity of the parasympathetic nervous system increases automaticity. Other factors may lead to abnormal increases in automaticity of extra-SA nodal tissues, including hypoxia, atrial or ventricular stretch [as might occur following long-standing hypertension or after the development of heart failure (HF)], and electrolyte abnormalities such as hypokalemia or hypomagnesemia. 

Angiotensin-II AT, Human cDNA Artherosderosis, cardiac hypertrophy, congestive heart failure, hypertension, myocardial infarction, renal disease, cancer, diabetes, obesity, glaucoma, cystic fibrosis, Alzheimer s disease, Parkinson s disease Smooth muscle contraction, cell proliferation and migration, aldosterone and ADH release, central and peripheral sympathetic stimulation, extracellular matrix formation, tubular sodium retention, neuroprotection... 

The treatment of the complications of CRF may occur before or during dialysis. They include pericarditis, congestive heart failure, hypertension, hemopoietic abnormalities and renal osteodystrophy. 

In heart diseases like hypertension, heart failure, ischemia, and hypertrophic cardiomyopathy (HCM) as well as dilated cardiomyopathies (DCM), total myocardial jS-AR density is reduced [90-94], A selective reduction of p -ARs without change of P2-AR density is often observed in the failing human heart [89], Therefore, there is a clinical need for the noninvasive assessment of p-AR density in vivo. PET is capable of assessing receptor concentrations in vivo, provided that a radioligand radiolabeled with a positron emitter specifically and selectively binds to the target receptor, and metabolism of the radiotracer does not occur in target tissue. 

Rare adverse effects include heart failure, hypertension, hypotension, pancreatitis, GI hemorrhage, and dyspnea. The patient also may develop autoimmune antibodies. 

Alpha-adrenoceptor antagonists are used as antihypertensives and to reduce afterload in the treatment of heart failure. Urapidil and, to a lesser extent, ketanserin are used in the treatment of essential hypertension and acute perioperative hypertension. In contrast to other vasodilators urapidil does not increase intracranial pressure when given intravenously, making it preferable for use in neurosurgical interventions. The effects of the excessive catecholamine concentrations in patients with phaeochromocytoma can be treated by the non-selective ol- and o2-adrenoceptor antagonists phentolamine or phenoxybenzamine. 

Severe acute heart failure, hypertensive crisis, controlled hypotension during anaesthesia and severe peri-operative hypertension. 

Spironolactone Block aldosterone receptor in renal collecting tubule Increase Na and decrease excretion poorly understood reduction in heart failure mortality Aldosteronism, heart failure, hypertension ... 

At higher doses, cocaine can produce undesirable effects, including tremor, emotional lability, restlessness, irritability, paranoia, panic, and repetitive stereotyped behavior. At even higher doses, it can induce intense anxiety, paranoia, and hallucinations, along with hypertension, tachycardia, ventricular irritability, hyperthermia, and respiratory depression. In overdose, cocaine can cause acute heart failure, stroke, and seizures. Acute intoxication with cocaine produces these various clinical effects, depending on the dose these effects are mediated by inhibition of the dopamine transporter and in turn by the effects of excessive dopamine activity in dopamine synapses, as well as by norepinephrine and serotonin in their respective synapses. 

Native Americans used hawthorn as a diuretic for kidney and bladder disorders and to treat stomachaches, stimulate appetite, and improve circulation. The flowers and berries have astringent properties and can be used to treat sore throats in the form of haw jelly or haw marmalade. Today, hawthorn is promoted for the treatment of heart failure, hypertension, arteriosclerosis, angina pectoris, Buerger s disease, paroxysmal tachycardia, heart valve murmurs, sore throat, skin sores, diarrhea, and abdominal distention. 

Angiotensin II is an octapeptide, which was initially described as a potent vasoconstrictor agent. However, its functions have since been expanded to include regulation of cell growth, inflammation, electrolyte and water balance, hormone secretion, sympathetic nervous system activity, differentiation, and apoptosis. The discovery that it is produced both systemically and locally was instrumental in establishing a pivotal role for the peptide in several disease states, including hypertension, coronary heart disease, myocarditis, congestive heart failure, atherosclerosis, and nephrosclerosis. 

Anthocyanins are a class of flavonoids separated from proanthocyani-dins. Anthocyanins have been known to be highly protective and therapeutic against especially age-related diseases such as hypertension, cardiac infraction and cerebral infarction. Additionally, because the colors of anthocyanins could help to ease psychic and physical troubles or tiredness, the anthocyanins could not only relax us, but also the colors themselves could prevent and remedy many diseases, especially, age-related diseases such as hypertension, heart failure, stroke and diabetes. Generally, anthocyanins have antioxidant properties, which could protect and enhance our body systems with bioactive abilities such as the immuno-, anticancer-, antimicrobial potencies and others. 

The CHADS2 scheme awards 1 point each for congestive heart failure, hypertension, age > 75 years and diabetes mellitus and 2 points for prior stroke or TIA. 

Thiamin that is not bound to plasma proteins is rapidly filtered at the glomerulus. Diuresis increases the excretion of the vitamin, and patients who are treated with diuretics are potentially at risk of thiamin deficiency. Some of the diuretics used in the treatment of hypertension may also inhibit cardiac (and other tissue) uptake of thiamin, thus further impairing thiamin status, which may be a factor in the etiology of heart failure (Suter and Vetter, 2000). 

Gavras I, Manolls AJ, Gayras H. The alpha2-adrenerglc receptors In hypertension and heart failure experimental and clinical studies. J Hypertens. 2001 19 2115-24. 

Diuretics are highly efficient drugs for the treatment of edema associated with congestive heart failure. They are also used to increase the volume of urine excreted by the kidneys [9]. For example, duranide, 81, a dichlorinated benzene disulfonamide, is an oral carbonic anhydrase inhibitor. Duranide reduces intraocular pressure by partially suppressing the secretion of aqueous humor [11]. Diuril, 82, has an antihypertensive activity and is issued to control blood pressure [9]. Edecrin, 83, is an unsaturated ketone derivative of an aryloxyacetic acid. Edecrin is used in the treatment of the edema associated with congestive heart failure, renal disease, and cirrhosis of the liver [11]. Amiloride, 84, is also used as an adjunctive treatment with thiazide diuretics in congestive heart failure hypertension. 

Hawthorn is promoted for use in heart failure, hypertension, arteriosclerosis, angina pectoris, Buerger s disease, paroxysmal tachycardia (6), heart valve murmurs, sore throat, skin sores, diarrhea, and abdominal distention (7). 

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