Dronabinol reduces signs and symptoms of idiopathic intracranial hypertension: a case report.

A case is presented in which a woman diagnosed with a longstanding history of idiopathic intracranial hypertension reported improvement of frontal headaches, photophobia, transient blindness, enlarged blind spots, and tinnitus after smoking marijuana. All these symptoms and signs were associated with increased intracranial pressure (220-425 mm of water). Treatment with dronabinol at a dose of 10 mg twice a day, then reduced to 5 mg twice a day, relieved all of her symptoms. Previously noted papilledema and enlargement of blind spots also resolved, and this, in the absence of psychoactive effect or weight gain.

Obesity, smoking, and multiple cardiovascular risk factors in young adult African Americans.

OBJECTIVES: To examine the associations between the combination of obesity and tobacco use and total cardiovascular risk score in young adult African Americans. DESIGN: A cross-sectional study of 323 African-American men (N = 117) and women (N = 206) aged 20-46 years. METHODS: Age, height, weight, and data on smoking behavior were obtained, as well as measurements of blood pressure, serum lipids, and measurements from an oral glucose tolerance test (OGTT). A cardiovascular risk score was calculated from the above data. RESULTS: Fasting insulin, fasting blood glucose, and blood glucose at 120 minutes of OGTT were significantly higher in obese (body mass index [BMI] > or = 30 kg/m2) men. Obese men also had significantly higher LDL cholesterol, lower HDL cholesterol and higher total risk scores. Obese women had significantly higher blood pressure, higher fasting insulin, lower LDL cholesterol, and higher total risk scores. Among the members of this cohort, 65% of men and 79% of women were obese and/or smoked. Of those who were obese and/or smoked, 68% of the men and 82% of the women had at least one other cardiovascular risk factor. CONCLUSIONS: The modifiable risk factors of obesity and smoking were present in a large majority of these young adult African Americans in association with other cardiovascular risk factors.

Glucose tolerance and cardiovascular risk in young adult African Americans.

BACKGROUND: Patients with type 2 diabetes have higher rates of cardiovascular events. Among African Americans, there is a higher prevalence of both cardiovascular disease and type 2 diabetes. Few studies have examined longitudinally the change in glucose tolerance in younger adult African Americans. METHODS: To examine the longitudinal relationship of glucose tolerance with other cardiovascular risk factors, 30 African American men and women aged 20 to 43 years were examined twice at an interval of 4 to 5 years. Cardiovascular risk factors, glucose tolerance, and insulin sensitivity (determined from euglycemic hyperinsulinemic clamp procedure) were assessed at each examination. Known diabetics were excluded from initial enrollment. The relationship of glucose tolerance status (normal, impaired, or diabetic glucose tolerance) to body mass index, blood pressure, cholesterol, and insulin sensitivity were further investigated. RESULTS: Initial oral glucose tolerance test identified 24 of 130 (18.5%) subjects with impaired glucose tolerance and 2 of 130 (1.5%) subjects with diabetes. Of the remaining 104 subjects with normal glucose tolerance, subsequent 5-year examination detected 31 (29.8%) with impaired glucose tolerance and 5 (4.8%) with diabetes. Those who later developed diabetes had higher mean systolic blood pressure (133 versus 121, P = 0.037) at exam 1. By exam 2, those with abnormal glucose tolerance had worse cardiovascular risk profiles and increased insulin resistance (P < 0.001). CONCLUSION: Conversion to abnormal glucose tolerance is relatively frequent in young adult African Americans. Deterioration in glucose tolerance may be preceded by higher systolic blood pressure and is accompanied by worsening of other cardiovascular risk factors and insulin resistance.

The association between hypertension and other cardiovascular risk factors in young adult African Americans.

Hypertension is a major cause of cardiovascular disease in African Americans. The excess morbidity and mortality due to cardiovascular disease in African Americans compared to Caucasians is not well explained. The purpose of this study was to examine the association between hypertension and other cardiovascular risk factors in young adult African Americans. A risk factor scoring system was developed, based on national guidelines for obesity, smoking, cholesterol levels, glucose tolerance, and blood pressure. Data from a previously studied cohort of 206 women and 117 men were analyzed for the association of hypertension with other risk factors. Among women, risk factor intensification is due to impaired glucose tolerance and obesity. Among men, intensification appears to be related to all major risk factor categories. These findings indicate that among hypertensive African Americans there is an amplification of other risk factors. The data also support the clinical management of multiple risk factors as well as the achievement of blood pressure control.