Hypertensive Attack Research Articles

Disfunción eréctil: de marcador de salud a factor de riesgo cardiovascular independiente en atención primaria

ObjectiveThe objective of this research is to analyze data from researches where erectile dysfunction (ED) is proposed as a health marker, as well as data about its involvements as independent cardiovascular risk factor. MethodThe results of the APLAUDE research (2001) are compared with the more recent ones of the AIDS-AP group (2006), both about ED as independent cardiovascular risk factor (i-CVRF). ResultsED was considered to be a health marker when detecting relevant unknown diseases: dyslipidemy (27.3%), diabetes mellitus (22%), HTN (20.4%), anxiety (18.5%) and/or depression (14.6%) and prostate disease (4%); or even several of them at the same time. As i-CVRF, the percentage of patients with pathological results was 28.89% (39) in the ED group, much higher than in the control group, 14.07% (19) (p < 0.001). This were the diseases detected with ergometry and stress echocardiography: 18 patients (13.3%) with coronary heart disease in the ED group and 3 (2.22%) in the control group (p < 0.001), 12 hypertensive attack (8.89%) in the ED group and 11 (8.15%) in the control group (NS), and 13 (9.63%) with right ventricle hypertrophy in the ED group and 8 (5.93%) in the control group (p < 0.01). ConclusionsThe results suggest a very close relationship between CVRF and ED, and show that patients with erectile dysfunction have silent ischemic cardiopathy in a much higher percentage than patients with similar profile but without erectile dysfunction, so we can consider ED as an i-CVRF.

Simultaneous Bilateral Acute Angle-closure Glaucoma in a Patient With Subarachnoid Hemorrhage

To present an unusual case of simultaneous bilateral acute angle-closure (AAC) glaucoma in a patient with subarachnoid hemorrhage due to an aneurysm involving the right middle cerebral artery. A 60-year-old woman with a clinically inexplicable bilateral nonreacting mydriasis after brain surgery underwent an ophthalmologic consultancy. The bilateral mydriasis was diagnosed as an unusual clinical presentation of simultaneous bilateral AAC glaucoma. One week after the AAC was bilaterally resolved, the patient underwent echographic examination because of the outbreak of a unilateral relapsed ocular hypertensive attack that required an ultrasound biomicroscopy (UBM) to be accurately diagnosed and treated. The bilateral AAC regressed completely after pharmacologic therapy. UBM evaluation of the eye with recurrence of the angle-closure glaucoma attack was necessary to confirm the diagnosis of unilateral relapsed angle-closure glaucoma due to an unresolved pupillary block. A viscoelastic-aided opening of the angle and peripheral surgical iridectomy were performed. UBM and tonometry were performed intraoperatively to confirm the success of the surgical treatment. The UBM allowed us to identify the pupillary block as the main mechanism involved in the pathogenesis of this unusual case of simultaneous bilateral AAC glaucoma. Despite the fact that drug-induced supraciliary uveal effusion and mydriasis due to surgical anesthesia have been frequently reported to contribute to this complication, we presumed that simultaneous intravenous administration of sedative drugs and adrenergic agonists, in a patient with individual biometric predisposing factors to the angle-closure, created the anatomic conditions which induced the pupillary block with obliteration of the trabeculum.

The relationship between blood pressure and plasma magnesium level in hypertensive patients

The aim of this study was to investigate the relationship between blood pressure and plasma magnesium levels in patients referred to the emergency department with hypertensive attack. Epidemiological evidence on the effects of magnesium on blood pressure is inconsistent. Metabolic and experimental studies suggest that magnesium may have a role in the regulation of blood pressure. Magnesium regulates various ion channels in many tissues, including those of the cardiovascular system. Magnesium is the second most abundant intracellular cation, and the important element that has numerous biological functions in the cardiovascular system. Furthermore, magnesium acts as a calcium antagonist, regulating the calcium metabolism.

Sudden bilateral hearing loss: Case report of an audiological emergency

Hypertensive encephalopathy (HE) is characterized by headache, confusion, seizures and visual disturbance and may progress to coma and death. It is an acute neurological picture caused by sudden increases of arterial pressure. Bilateral deafness is a possible symptom of HE. We describe the first case of a patient affected by a hypertensive attack associated with sudden headache and bilateral hearing loss, refractory to medical treatment, whose condition evolved into coma and rapid expiry. Sudden bilateral deafness can be a warning sign of hypertensive encephalopathy. Prompt and intensive management for HE is needed for patients with sudden bilateral deafness.

Tranylcypromine and cheese

Tranylcypromine (Parnate - SKF, and a constituent of Parstelin - SKF) is a monoamine oxidase (MAO) inhibitor which is useful as an antidepressant. The drug has an unusual side effect: attacks of paroxysmal hypertension and headache occur in a substantial proportion of patients taking it. Intracranial bleeding has occurred in at least 10 cases (W. Dorrell, Lancet Aug. 24, 1963, 414), and a number of deaths have been reported. In some patients the hypertensive attack has been related to the administration of an amphetamine or of imipramine in addition to tranylcypromine, but in most cases no trigger factor could be identified. Now cheese has come under strong suspicion. Many of the attacks have come between half an hour and 2 hours after the patient has eaten cheese (B. Blackwell, ibid.; A. R. Foster and others, ibid. Sept. 14, 1963, 587). In some cases attacks have occurred after only a few doses of the drug, in others after the patient had been taking it for many months. Phenelzine (Nardil - Warner), also an MAO inhibitor, is another drug associated with hypertensive attacks, but whether cheese plays a part in them is not clear. With tranylcypromine an attack has followed the consumption of as little as one ounce of Cheddar cheese. Whether other cheeses or indeed other food can provoke attacks is not yet known.