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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spontaneous (not experimentally induced) systemic hypertension was detected in 5 male dogs that were examined because of apparent blindness caused by intraocular hemorrhage and/or retinal detachment. Secondary causes of hypertension, including renal, adrenal, and thyroid disease, were investigated. Four of the dogs had glomerulonephropathy, renal insufficiency, and proteinuria. Four dogs had compensatory cardiac hypertrophy. Hypertension in 4 of 5 dogs was associated with glomerulosclerosis with chronic renal insufficiency, bilateral adrenocortical hyperplasia, adrenocortical adenoma with renal amyloidosis, and immune-mediated glomerulonephritis with chronic renal insufficiency, respectively. The fifth dog was determined to have essential hypertension. The dogs were treated for their primary diseases. Sodium restriction alone was inadequate to reduce blood pressure; 4 of the dogs also required antihypertensive medications.
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PMID:Spontaneous systemic hypertension in dogs: five cases (1981-1983). 317 Mar 25

We describe a patient with multicentric small bowel carcinoids, severe hypertension, primary hyperparathyroidism, and multiple parathyroid adenomas. Intense uptake of I-131 metaiodobenzylguanidine (MIBG) occurred in a parathyroid adenoma. There was no biochemical evidence of catecholamine secretion by the tumor but elevated serum levels of parathyroid hormone were demonstrated. We suspect that occasional parathyroid adenomas, like other APUDomas, may give false positive results when MIBG imaging is used to search for pheochromocytomas. This observation supports the inclusion of the parathyroid chief cells in the amine precursor uptake and decarboxylation (APUD) cell system.
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PMID:I-131 metaiodobenzylguanidine uptake in a parathyroid adenoma. 318 Jun 8

Intracellular concentration of sodium ([Na]i) and potassium ([K]i), and the ouabain sensitive sodium efflux rate constant (ERCos) in erythrocytes were determined in patients with primary aldosteronism, before and after the surgical removal of the adrenocortical adenoma and in comparison to those in healthy controls. Without treatment, [Na]i was higher and ERCos was lower in patients with primary aldosteronism than in controls (10.60 +/- 0.96 vs. 8.25 +/- 0.89 mmol/l cells, p less than 0.01; 0.156 +/- 0.040 vs. 0.255 +/- 0.047/hour, p less than 0.01, respectively). After the surgery, [Na]i was decreased to 7.70 +/- 0.64 mmol/l cells and ERCos was increased to 0.273 +/- 0.031/hour and these values were similar to those in controls. [K]i in primary aldosteronism was not affected by the surgery (from 96.79 +/- 2.03 to 98.8 +/- 3.84 mmol/l cells) and was not different from that in controls (99.11 +/- 3.42 mmol/l cells). In 2 patients, normalization of the serum potassium following an oral potassium chloride supplement caused only partial improvement in [Na]i and ERCos. These results suggest that an inhibition of sodium pump activity resulting in elevated [Na]i may play an important role in the pathogenesis of high blood pressure in patients with primary aldosteronism.
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PMID:Intracellular sodium and potassium concentrations in erythrocytes of patients with primary aldosteronism. 319 58

19-Nor-deoxycorticosterone is a newly recognized mineralocorticoid which has been associated with some forms of genetic, experimental, and human hypertension. To further examine this relationship, specific inhibitors of 19-nor-deoxycorticosterone biosynthesis must be developed. Since 19-hydroxylation is the pivotal step in both 19-nor-deoxycorticosterone biosynthesis and aromatization of androgens to estrogens, we evaluated an aromatase inhibitor, 4-hydroxyandrost-4-ene-3,17-dione on the inhibition of 19-hydroxylation in both rat and human adrenal mitochondria in vitro and 19-nor-deoxycorticosterone production and blood pressure in spontaneously hypertensive rats in vivo. Adrenal mitochondria from 48 male Sprague-Dawley rats and 1 patient with an aldosterone-producing adenoma were incubated in the presence of deoxycorticosterone substrate both with and without 4-hydroxyandrost-4-ene-3,17-dione. 4-Hydroxyandrost-4-ene-3,17-dione produced significant inhibition of 19-hydroxy-deoxycorticosterone production in both rat and human adrenal mitochondria, with a smaller and not significant inhibition of corticosterone and 18-hydroxy-corticosterone. 4-Hydroxyandrost-4-ene-3,17-dione given subcutaneously to spontaneously hypertensive rats lowered 19-nor-deoxycorticosterone by 69% and completely abolished hypertension compared to Wistar-Kyoto controls. These data demonstrate that 4-hydroxyandrost-4-ene-3,17-dione is a specific inhibitor of 19-hydroxylase, that it lowers 19-nor-deoxycorticosterone production and prevents hypertension in the spontaneously hypertensive rat. These studies reinforce the possible pathogenic significance of 19-nor-deoxycorticosterone in hypertension in spontaneously hypertensive rats.
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PMID:Selective 19-hydroxylase inhibition by an aromatase inhibitor, 4-hydroxyandrostenedione. 320 87

A 34-yr-old woman with hypertension (142/102 mmHg), hypokalemia, high plasma and urinary aldosterone and low plasma renin activity was studied. A left adrenal tumor and enlarged right adrenal gland were demonstrated by adrenal venography. During administration of dexamethasone (2 mg daily, for 3 weeks), urinary aldosterone excretion decreased abruptly from 22.5 to 9-11 micrograms/day, serum potassium increased and blood pressure fell to 120-130/80-90 mmHg. After left adrenalectomy, all manifestations improved with no medication. The resected adrenal gland revealed clear cell adenoma and micronodular adrenocortical hyperplasia. The patient was considered to be a rare case of glucocorticoid-suppressible hyperaldosteronism with an aldosterone-producing adenoma.
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PMID:A case of glucocorticoid-suppressible hyperaldosteronism with aldosterone producing adenoma. 320 6

Plasma ouabain-like immunoreactivity, which has been supposed to be associated with hypertension, was significantly higher in five patients with primary aldosteronism than in age-matched normotensive subjects. High plasma levels of ouabain-like immunoreactivity decreased to normal after removal of adenoma. Extracts of adenoma tissue did not contain any apparent ouabain-like immunoreactivity. Anti-ouabain antibody used in this study did not cross-react with aldosterone, cortisol, corticosterone, arachidonic acid or lysophosphatidylcholine. Hypertension, hypokalemia, a high plasma aldosterone level and low plasma renin activity were also normalized after surgery. These results indicate that hyperaldosteronism induces the high plasma level of ouabain-like immunoreactivity and this is associated in part with high blood pressure (BP) in primary aldosteronism.
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PMID:Normalization of high plasma level of ouabain-like immunoreactivity in primary aldosteronism after removal of adenoma. 323 14

A study was made of 9 patients with primary aldosteronism due to aldosterone-producing adenoma (APA) and 8 subjects with idiopathic adrenal hyperplasia (IHA) to clarify the pathogenesis of sustained hypertension after surgical or non-surgical treatment. Following each treatment, a complete improvement of hypertension was obtained in 12 patients (6 APA, 6 IHA), while 5 (3 APA, 2 IHA) showed still hypertensive status. Renal or renovascular lesions were prominent only in the hypertension-unchanged group. Under regular sodium diet, the ratio of urinary excretion of sodium to creatinine of this hypertensive group was significantly lower than that of the hypertension-improved group. However, the results of other renal function tests were similar in both groups. After respective treatments, suppressed plasma renin activity and elevated plasma aldosterone concentration were improved in all patients. In addition, patients of both groups showed normal response of the renin-aldosterone system following diuretic and dietary induced sodium and volume depletion. Based on these findings, renal or renovascular lesions appear to play an important role in the pathogenesis of maintenance of hypertension in this disorder after respective treatments.
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PMID:Therapeutic results of primary aldosteronism with special reference to renal or renovascular lesions. 328 72

The causative mechanisms of hypertension were investigated by studying the renal function (pressure-natriuresis) curve in patients with primary aldosteronism (n = 6) and renovascular hypertension (n = 6). Before and after radical operation (removal of adenoma in primary aldosteronism and percutaneous transluminal angioplasty in renovascular hypertension), dietary NaCl intake was altered from 10 to 13 g/day in Week 1 to 1 to 3 g/day in Week 2. Mean arterial pressure (MAP) and urinary sodium excretion were measured on the last 3 days of each week. By restricting sodium intake before operation, MAP was reduced from 122 +/- 7 to 113 +/- 7 mm Hg (p less than 0.025) in primary aldosteronism but not in renovascular hypertension (130 +/- 6 to 128 +/- 5 mm Hg). The renal function curve was drawn by plotting urinary sodium excretion on the ordinate and MAP on the abscissa before and after operation. The slope of the curve was analyzed between the plotted points, and each curve was extrapolated to zero sodium excretion as an estimate of the degree of shift of the curve along the MAP axis. Before, as compared with after operation, the extrapolated x-intercept of the curve was shifted rightward in both primary aldosteronism (111 +/- 7 vs 87 +/- 4 mm Hg; p less than 0.025) and renovascular hypertension (128 +/- 5 vs 95 +/- 2 mm Hg; p less than 0.025) and the slope was depressed in primary aldosteronism (16 +/- 1 vs 40 +/- 17 [mEq/day]/mm Hg; p less than 0.025) but not in renovascular hypertension (130 +/- 75 vs 40 +/- 13 [mEq/day]/mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS)
Hypertension 1987 Jul
PMID:Renal function curve in patients with secondary forms of hypertension. 329 41

Primary aldosteronism due to an adrenocortical adenoma is commonly known as surgically correctable hypertension. Forty-three cases of primary aldosteronism were treated operatively at our Department between 1960 and 1985. Forty of them were operatively, found to have aldosteronoma with a mean size of 1.88 cm and weight of 2.67 g. The patients average age was 39.4 years old and the male to female ratio was 1 to 3. Adrenal phlebography, selective adrenal venous sampling, adrenal scintigraphy, CT and echography were used to preoperatively locate the tumor, and their diagnostic value was 83, 78, 76, 87 and 60%, respectively. Unilateral adrenalectomy or unilateral partial adrenalectomy was performed extraperitoneally with lumbar oblique incision in 32 of the 43 operated patients. Since the application of the preoperative diagnosing studies above mentioned, tumor localization has been clearly demonstrated in about 90% of the patients and the unilateral extraperitoneal approach is proved as a safe operative method with minimal blood loss of less than 200 ml and performed within two hours. Unilateral adrenalectomy by the flank approach has now become the operation of choice for the treatment of an aldosterone-producing adrenal adenoma.
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PMID:[Surgical management of primary aldosteronism--progress in localization studies and operative treatment]. 330 70

A personal series of 256 cases of acromegaly/gigantism seen over a 20-year period from 1963 is described. The insidious nature of the condition resulted in delay in diagnosis which was often made by a doctor when seeing the patient for an unrelated problem. Other features which commonly led to the diagnosis being made were headache, change in appearance, carpal tunnel syndrome, amenorrhoea and diabetes. The Hardy system for grading the radiological appearance of the pituitary tumour was used. Widely invasive tumours were not common but tended to occur in patients with younger age of onset and high GH levels. The occurrence of various symptoms and clinical features was noted and the changes resulting from reducing the GH level to normal. The incidence of hypertension, but not of coronary artery disease, is increased and the blood pressure may be reduced following successful treatment. The effects on the upper and lower respiratory tract are reported as well as sleep apnoea and problems associated with anaesthesia. Skin manifestations included sweating, pigmented skin tags, acanthosis nigricans and cutis verticis gyrata. In the skeletal system the incidence of kyphoscoliosis and osteoarthritis especially of the hip is reported: the question of hip replacement is discussed. Diabetes mellitus disappeared in most cases if the acromegaly was cured. In men but not in women the incidence of colloid nodular goitre was increased as was hyperthyroidism in middle-aged women. In two patients a parathyroid adenoma was present: hypercalcaemia was present in five additional patients, but the cause was not determined. The common occurrence of amenorrhoea in the younger women was noted, it was not always associated with hyperprolactinaemia, and often responded to successful treatment of the acromegaly. The association of acromegaly with hirsutism and galactorrhoea is confirmed. The incidence of impotence and loss of libid in the men is discussed: in a proportion of those in whom the acromegaly was cured, potency returned, but in a number depression occurred and what was believed to be psychogenic impotence persisted. Hyperprolactinaemia was found in 49 out of 151 patients with active acromegaly in whom the prolactin level was measured. Previous reports have indicated a doubling of death rates in acromegalics. In this series there were 47 deaths observed compared to 37.2 expected. The increased death rate was in women of all ages and in men under the age of 55, The increased deaths in the women were from cardiovascular and cerebrovascular causes and from breast cancer.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Acromegaly. 330 90


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