Change in symptoms of hypertensive patients after referral to hospital clinic.

Abstract

and the Grove Health Centre, London At theirfirst visit to a hospital clinic 178 patients referred with a diagnosis of hypertension were given a self-administered questionnaire. They received a similar questionnaire 12 months later. Of the 178 patients 99 were not initially on treatment. Similarly 78 normotensive subiects were drawn randomly from the local population and sent a second questionnaire 10 months later. The symptoms at the first visit of the normotensive controls, the untreated hypertensive patients, and 477 patients on long-term treatment in the hypertension clinic were compared. Treated and untreated hypertensive patients complained more of nocturia and also of unsteadiness either on standing or in the morning. Treated hypertensives complained more of sleepiness, dry mouth, diarrhoea, and, in men, impotence and failure of ejaculation. Similarly, untreated hypertensives complained of excessive depression, blurred vision, and waking headache.Fifty-five of the normotensive sutbects and 110 of the newly referred hypertensive patients responded to the second questionnaire. The proportions losing and gaining symptoms were calculated together with the proportions always complaining and never complaining of a symptom. Hypertensive patients tended ts lose the complaints of unsteadiness and headache but to gain the symptoms of vivid dreams, a slow walking pace, and diarrhoea. The net improvement for a symptom was defined as the excess ofpatients who lost a symptom over those who gained the symptom, expressed as a percentage. Over thefollow-up period the control subjects had a net improvement averaged over 14 symptoms of +2.4 per cent. A similar result was obtained for the hypertensive patients of +2.0 per cent, the symptoms lost being balanced by those gained. The changes in symptoms with time were related to the changes in blood pressure and it is suggested that only headache, 'unsteadiness, lightheadedness, orfaintness' and nocturia can actually resultfrom raised blood pressure and then only in a proportion of patients complaining of these symptoms. Treating mild hypertension is expected to reduceThe present paper compares the symptoms of morbidity and mortality and also perhaps symptoms. normal controls and hypertensive patients newly On the other hand, the patients have to take referred to hospital as recorded in the questionmedicine daily which may produce side effects. To naires at their first visit and after 10 to 12 months. provide more information on the symptoms caused The results are compared with a previous survey of by hypotensive therapy we devised a self-adminis-hospital patients on long-term treatment (Bulpitt tered questionnaire on those symptoms thought to and Dollery, 1973). be related to the level of blood pressure and on those of the known side effects of hypotensive drugs (Bulpitt, Dollery, and Came, 1974

Headache is not more frequent among patients with moderate to severe hypertension

“…Despite of being usually accepted as a potential cause of headache, 13 the association between severe hypertension and headache was predominantly described in previous studies, not controlling for confounding and for the awareness of hypertension. [22][23][24][25] It has been suggested that the awareness of the diagnosis may be a reason for the higher frequency of headache among patients with hypertension. 7,8 Since almost all participants of our study knew that they had hypertension, this potential bias on the association between the diagnosis of hypertension and the complaint of headache was naturally controlled.…”

Sexual dysfunction related to antihypertensive agents: results from the animal model

“…In this connection, the cofactorial role of endothelial dysfunction and decreased nitric oxide synthesis has been evaluated 9 and of considerable clinical relevance is the erectile dysfunction reported in untreated hypertensive men. 10,11 In such a situation, the problem gets further compounded by a prescribed antihypertensive, if impotence is one of its known adverse effects. 12 While there is no denying the risk of isolated erectile dysfunction in untreated cases, 4 it is often not recognised whether the impairment in controlled hypertension is due to the in¯uence of disease, drugs or both.…”

Central hemodynamics, vascular stiffness, and nocturia in patients with type 2 diabetes

“…Since T2DM is independently related with nocturia, other factors apart from glucose metabolism must be present to cause this effect. Indeed, it was previously demonstrated that systemic diseases, such as hypertension, has been shown to be another factor related with nocturia both in normal [7][8][9][10] and in patients with T2DM. [12][13][14] However, in all these studies, peripheral BP measurements were evaluated.…”

“…[1][2][3][4] Although not all 5,6 but some studies have also shown that elevated blood pressure (BP) was another factor related with nocturia. [7][8][9][10] In patients with type 2 diabetes mellitus (T2DM), nocturia may be observed. Indeed not in all, 11 but some studies have shown that T2DM is associated with nocturia.…”