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

Bumetanide was compared with furosemide in a total of 43 outpatients with edema due to renal disease, selected from three clinics following a uniform protocol. By random selection, 31 patients received 1 to 10 mg/day bumetanide, and 12 received 40 to 400 mg/day furosemide for at least six months. The patients were evaluated clinically, by standard laboratory tests, as well as by ECG, audiometry, eye examination, and mammary examination. Pooled statistical analysis of the results was done. Edema, body weight, and abdominal girth were reduced during both treatments. There was no significant difference in the mean response to the two diuretic agents by the two sided probability test in the other parameters studied, e.g., supine and standing blood pressure and pulse, serum electrolytes (sodium, potassium, chloride), and uric acid. There were no differences in liver function tests, hematology, or chest x-ray, and no remarkable effects on hearing. Gynecomastia improved in some patients while being treated with bumetanide after spironolactone was discontinued. Adverse reactions in patients on bumetanide which were considered possibly or probably related to the drug were muscle cramps (two patients); and vertigo, headache, muscle pain, urticaria, chest pain, arthritis, dehydration, postural hypotension, and leg cramps (one each). Laboratory abnormalities in both groups were generally those that could be attributed to the pharmacologic action of the diuretics or due to the patients' underlying disease states. No drug-related adverse effects were noted in ECG, ophthalmologic examinations, or chest x-rays. Two patients in the furosemide group had a probably or possibly drug-related loss of hearing sensitivity. In summary, bumetanide appeared to be as safe and as efficacious as furosemide in controlling edema and hypertension in patients with renal disease.
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PMID:Long-term bumetanide treatment of patients with edema due to renal disease. Cooperative studies. 704 Apr 92

Hyperosmolar agents are a primary therapeutic modality employed in the treatment of traumatic intracranial hypertension. Profound hyperosmolarity accompanied by systemic dehydration is a potentially serious problem when these drugs are used repeatedly for control of intracranial pressure. Because glycerol, a water-soluble alcohol, is metabolized in the liver, its dehydrating capacity may be reduced in comparison to other agents. A series of 15 patients were treated with oral glycerol (0.5 to 1.0 gm/kg) with only minor changes in serum electrolytes, glucose, and urea nitrogen. Serum osmolarity rose from a baseline of 305 mOsm/liter to 355 mOsm/liter after 10 days of therapy. Glycerol was found to be effective and safe when employed in this protocol and proved to be a valuable adjunct to the standard methods available for control of intracranial hypertension.
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PMID:Oral glycerol for the treatment of traumatic intracranial hypertension. 705 29

Experiments were performed to evaluate the effect of dehydration on neurohypophyseal hormone secretion, both vasopressin and oxytocin, fluid balance, and blood pressure in male spontaneously hypertensive rats (SHR) and their normotensive controls, Wistar Kyoto (WKY). Metabolic studies showed that the antidiuretic response to dehydration (24 and 48 hours of water deprivation) was significantly depressed (p less than 0.01) in the hypertensive animals. They responded inappropriately to dehydration with a greater loss of water and sodium and a larger increase in hematocrit. In contrast, the vasopressin response (both urinary excretion and plasma levels) was increased. The peak plasma levels were 25.3 pg/ml (SHR) compared to 16.6 pg/ml (WKY), while the urinary excretion was 22.5 ng/24 hrs (SHR) vs 9.0 ng/24 hrs (WKY). Dehydration also elicited a stimulation of oxytocin secretion, with no differences observed in the responses of the groups. Blood pressure was significantly greater in the SHR and it did not change during dehydration. These results provide further support for the idea that hypertension is associated with abnormalities in the control of fluid/electrolyte balance.
Hypertension
PMID:Neurohypophyseal response to dehydration in the spontaneously hypertensive rat. 706 Nov 23

An increase in the weight of the thyroid gland, accompanied by reductions in uptake and release of 1311, serum T3 and reverse T3 concentrations and an increase in serum TSH concentration, occurs during the development of renal hypertension in rats. Renal function, as assessed by BUN, serum and urinary creatinine concentrations, and ability to concentrate urine during dehydration, is depressed. The kidneys of both normotensive and renal hypertensive rats contain a thyroid depressing factor (TDF) which inhibits uptake of 131I both in vivo and in vitro as well as inhibiting the lactoperoxidase enzyme in vitro. The kidneys of renal hypertensive rats contain less, and the serum more, TDF than those of normotensive rats. Whether TDF is produced as a result of hypertension per se or as a result of renal damage accompanying hypertension remains for further study. TDF appears to be a peptide with a molecular weight in the range of 400 to 419 daltons.
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PMID:Renal-thyroid interrelationship in normotensive and hypertensive rats. 707 Feb 20

Accepted causes (acute insults) and risk factors for the development of acute renal failure were defined, quantitatively assessed, and tested for statistical significance in 143 patients with acute tubular necrosis. Sixty-two percent of patients had more than one acute insult, and 48 percent had more than one suspected risk factor. Hypotension, excessive aminoglycoside exposure, pigmenturia, and dehydration were identified as highly significant acute insults, while it was concluded that sepsis and administration of radiocontrast material could not be incriminated as causes of acute tubular necrosis. An additive interaction between acute insults was demonstrated, and the severity of acute renal failure was related to the number and severity of acute insults. Patients with oliguric renal failure had more severe acute insults than patients with nonoliguric renal failure. Preexisting renal disease and chronic hypertension were significant risk factors, the latter only when hypotension had been one of the acute insults. An age of more than 59 years, gout and/or chronic hyperuricemia, diabetes, and long-term diuretic administration were not found to be significant risk factors.
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PMID:Acute renal failure. Multivariate analysis of causes and risk factors. 711 78

To identify any relationship between diabetes mellitus and high salt intake in the production of hypertension, we studied the effect of a regular and high salt diet on blood pressure in rats made diabetic with alloxan. The diabetic animals developed marked hyperglycemia, glycosuria, and azotemia out of proportion to changes in glomerular filtration rate. Non-diabetic rats and diabetic rats on a high salt intake in excess of 14 mEq/day developed modest but significant increases in blood pressure, while diabetic rats on a regular diet did not. We conclude that diabetic rats have no greater susceptibility to salt-induced hypertension than rats receiving only salt. Although it is possible that dehydration may have served to attenuate blood pressure increases in our diabetic animals, the diabetic state per se does not appear to result in severe hypertension in the rat regardless of sodium intake.
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PMID:Blood pressure of alloxan diabetic rats at regular and high salt intake. 724 77

1. Plasma concentration of arginine vasopressin, plasma osmolality and packed cell volume were measured in stroke-prone spontaneously hypertensive rats (SHRSP) and in normotensive Wistar-Kyoto (WKY) rats at different ages. 2. In young and in adolescent SHRSP, at 6, 9 and 12 weeks of age, plasma concentration of vasopressin was diminished as compared with age-matched WKY rats (P less than 0.01), whereas, in 18-week-old rats, the difference was not significant (P greater than 0.05). In contrast, in 24-week-old rats, plasma vasopressin was elevated as compared with WKY rats of the same age (P less than 0.01). 3. In none of the age groups did plasma osmolality differ between the two strains of rats, but in all groups packed cell volume in SHRSP was higher than in WKY rats. 4. During a 48 h period of dehydration, plasma vasopressin concentrations increased similarly in SHRSP and in WKY rats of 6 and 12 weeks of age respectively. 5. It is concluded that vasopressin does not contribute to the development of high blood pressure in SHRSP rats. The reduced plasma concentration of vasopressin may account for the decreased plasma and blood volume and the slightly elevated plasma sodium concentration observed in young SHRSP rats.
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PMID:Vasopressin in the plasma of stroke-prone spontaneously hypertensive rats. 726 51

A study was performed to investigate the neurohypophyseal dopaminergic axis in terms of its biosynthetic activity and possible changes associated with spontaneous hypertension (SHR). An in vitro system was used in which isolated neuro-intermediate lobes were incubated with the catecholamine precursor, 3H-tyrosine. Dopamine (DA) content and 3H-DA were monitored using electrochemical detection coupled with high pressure liquid chromatographic separation. A time course study showed that there was significant incorporation of 3H-tyrosine into 3H-DA. In the SHR, both neurohypophyseal DA content and biosynthetic activity were reduced. Tissue levels of 3H-DA decreased from 651 to 297 dpm/posterior pituitary. A test of the effect of dehydration on neurohypophyseal dopaminergic activity revealed that water deprivation (48 hrs) caused an increase in DA biosynthesis in the hypertensive, but not the normotensive animal. This may have been due to a greater stimulation of the neurohypophyseal axis in the SHR since these animals showed significantly higher plasma vasopressin levels and hematocrits in response to dehydration. These results demonstrate that the neurohypophysis contains an active dopaminergic system which is altered in genetic hypertension.
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PMID:Neurohypophyseal dopamine biosynthesis in the spontaneously hypertensive rat. 733 97

A patient with suspected exogenous hyperadrenocorticism and hypertension was treated with cessation of steroids, a low-sodium diet, and moderate doses of diuretics. Hypertension persisted, and severe dehydration and hyponatremia developed, but all responded to normal saline administered intravenously. The concurrence of (1) hypoadrenocorticism and its attendant fluid and electrolyte disturbances, (2) the use of diuretics, and (3) an intact renin-angiotensin system was responsible for the exaggerated and seemingly paradoxical responses. Selection of diuretics should be made cautiously and careful patient monitoring is imperative when compromised adrenocortical function is suspected.
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PMID:Unusual blood pressure response in a patient with secondary adrenocortical insufficiency. 743 55

Two patients who developed massive pulmonary oedema, profound vasoconstriction and hypertension followed by hypotension after Atrax Robustus envenomation are described. The pulmonary oedema is due to increased pulmonary capillary membrane permeability which may be due to neurogenic or toxic causes. Use of artificial ventilation with high level PEEP, isoprenaline and high dose steroids allowed support of the patients during volume replacement with albumin. When the circulation was stable and airway frothing ceased, conventional dehydration therapy further improved lung function. Both patients were discharged well.
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PMID:Atrax robustus envenomation. 745 9


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