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

Malignant hypertension was induced in rats by aortic ligation above the left renal artery. After 7- and 28-day periods of hypertension, the characteristics of the vascular disease were studied and the kidney below the aortic ligation was removed. The blood pressure and the vascular disease were reexamined at the end of the first and fourth weeks after nephrectomy. The evolution of the vascular disease was assessed in the contralateral kidney, in the heart, and in the superior mesentery. The results obtained allowed the following conclusions: 1) when the predominant lesions are of fibrinoid necrosis and moderate intimal hyperplasia without fibromucoid changes (initial phase), the hypertension and the hypertensive vascular disease are completely reversible after the nephrectomy; 2) when the predominant lesions are proliferative endarteritis with fibromucoid changes (chronic phase), neither the hypertension nor the vascular disease are reversible after the left nephrectomy and during the period of follow-up. Therefore, the type of vascular lesion seems to be one important determinant of the reversibility of the hypertensive process after nephrectomy.
Hypertension
PMID:Metaischemic (post-Goldblatt) hypertensive vascular disease in rats. 746 92

We examined the state of blood pressure, peripheral arterial circulation and changes of polycardiogram before and after three hour work of 160 workers professionally exposed to noise and vibrations. They were divided into two sub-groups regarding physical recreational activity (walking, swimming or running), with the average load level from 60% to 80% of maximal oxygen consumption. 85 workers made up the control group. They were not exposed to noise and vibrations at work. The gathered results show that the prevalence of the arterial hypertension and obliterating endarteritis is statistically significantly higher in the group of workers exposed to noise and vibrations and that these professional damages cause important hemodynamic changes of cardiovascular system, but also that permanent physical recreational activity (swimming, running or walking) can prevent such effects.
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PMID:[The effect of noise and vibration on the cardiovascular system in exposed workers and possibilities of preventing their harmful effects]. 756 25

Sneddon's syndrome is a rare disease characterised by cerebrovascular ischaemic attacks and generalised livedo. Since previous observations, other symptoms were described: involvement of heart, of kidney, arterial hypertension, complicated obstetric or gynaecologic history in women. Prognosis is highly variable, depending on extent and speed of progression of cerebrovascular changes, which can lead to severe permanent mental deterioration. In livedo, histopathology shows pathological changes of small to medium-sized dermal arteries in a distinct time sequence: an early phase localized in endothelium followed by a late fibrotic phase. No specific laboratory findings are found. Recently some cases were reported in association with antiphospholipids antibodies. The etiopathogeny of Sneddon's syndrome is still unknown and could result from different processes: progression to an autoimmune disease such as lupus erythematosus, primitive endarteritis obliterans, or a new clinical expression of the antiphospholipid antibodies syndrome. At present, none of the therapeutic modalities provides significant improvement.
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PMID:[Sneddon syndrome]. 770 55

Coarctation of the aorta is a constriction of the aorta located near the ligamentum arteriosum and the origins of the left subclavian artery. This condition may be associated with other congenital disease. The mean age of death for persons with this condition is 34 years if untreated, and is usually due to heart failure, aortic dissection or rupture, endocarditis, endarteritis, cerebral hemorrhage, ischemic heart disease, or concomitant aortic valve disease in uncomplicated cases. Symptoms may not be present in adults. Diminished and delayed pulses in the right femoral artery compared with the right radial or brachial artery are an important clue to the presence of a coarctation of the aorta, as are the presence of a systolic murmur over the anterior chest,bruits over the back, and visible notching of the posterior ribs on a chest x-ray. In many cases a diagnosis can be made with these findings. Two-dimensional echocardiography with Doppler interrogation is used to confirm the diagnosis. Surgical repair and percutaneous intervention are used to repair the coarctation; however, hypertension may not abate. Because late complications including recoarctation, hypertension, aortic aneurysm formation and rupture, sudden death, ischemic heart disease, heart failure, and cerebrovascular accidents may occur, careful follow-up is required.
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PMID:Coarctation of the aorta: a secondary cause of hypertension. 1518 99

This article discusses coarctation of the aorta in the adult. Effective treatments for coarctation have come from surgery since 1945 and from interventional cardiology since 1982. Long-term outcome data are available only for surgical approaches. Thirty-year survival rate is 72% to 82%. Complications include recoarctation or residual coarctation, hypertension, aneurysms at the repair site, spinal cord injury. Other sequelae include bicuspid aortic valve disease, ascending aortic aneurysm, premature coronary disease, and infective endocarditis or endarteritis. Interventional catheter therapy is now the preferred therapy for recurrent coarctation, when the anatomy permits and necessary skills are available. Its use in native or unoperated coarctation is less well established. Treatment may be with balloon angioplasty alone or with a stent. Outcomes are good in skilled hands, but residual or recurrent coarctation with resultant hypertension and repair site aneurysms can occur. Catheter treatment can cause death from aortic rupture and dissection, but mortality compares favorably with surgery if coarctation is recurrent, and perhaps for initial treatment.
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PMID:Treatment of coarctation and late complications in the adult. 1608 83

Cholesterol crystal embolization (CCE) is a dreaded complication of radiology, vascular surgery, and/or anticoagulation in patients with atherosclerosis and ulcerated aortic plaques. It also represents a cause of early graft failure and of poor results of renal artery surgery. Crystals lodge in small caliber renal arteries, where they induce early, transitory thrombosis followed by delayed, definitive obstruction by endarteritis, accompanied by evidence of inflammation and eosinophilia. Massive CCE leads to early oligoanuria. In subacute forms, renal insufficiency is often delayed by weeks or months following the triggering event. A third, chronic subset of CCE is easily mistaken for atherosclerotic renal ischemia and/or nephrosclerosis. The kidney is rarely the sole organ involved in acute/subacute forms, in which the central nervous system, the coronary arteries, the spinal cord, and the mesenteric and pancreatic blood supply compromise represent the main causes of death. Cutaneous, retinal, and muscle involvement allow diagnosis by inspection or scarcely invasive biopsies in about 80% of cases, whereas renal biopsy as the only diagnostic procedure is required in 20% of cases. Prevention is based on avoidance of endovascular radiology maneuvers, vascular surgery, and excess anticoagulation in atherosclerotic patients. Treatment of acute/subacute forms of renal insufficiency consisting of stopping anticoagulation and forbidding any new radiologic and/or vascular surgery procedure; treating hypertension with angiotensin 2 antagonists and vasodilators, strict volemic control by loop diuretics and ultrafiltration, along with parenteral nutrition and prednisone, has been credited with improved outcome. Iloprost may obtain favorable results. Statins definitely ameliorate the renal and patient's prognosis.
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PMID:Cholesterol crystal embolism: diagnosis and treatment. 1702 71

Classifications of the clinical forms of arterial hypertension (AH) are aimed at differentiating it on etiological grounds; we propose a classification that is based on the common pathogenesis of hydrodynamic pressure elevation in the intravascular pool of the intercellular medium, i.e. arterial blood pressure (BP). We believe that there are only three options for hydrodynamic pressure elevation in a mechanical model of the cardiovascular system: 1) a decrease in the volume of the arterial bed at a constant volume of intravascular fluid; 2) an increase in the volume of intravascular fluid at a constant volume of the vascular bed; and 3) increased blood flow resistance at constant volumes of the vascular bed and intravascular fluid. These options cover all clinical forms of AH in which AP increase is governed by common mechanisms. The first option can be related to AH occurring in pheochromoblastoma, glucocorticoid hyperproduction and psychoemotional stress. The second is associated with AH developing in excessive NaCl consumption with food, increased aldosterone production in Conn's syndrome (primary aldosteronism) and reduced production of atrial natriuretic peptide by phylogenetically modified myocytes of the right atrium. The third option can be linked to all forms of increased peripheral blood flow resistance in the arterial bed occurring in coarctation of the aorta, renovascular hypertension, impaired flow (endothelium)-dependent vasodilation and moderate spasm of muscular arterioles, arterial wall lesion in atherosclerosis, atheromatosis and atherothrombosis, Takayasu syndrome, and obliterating endarteritis. Elevation of BP in erythemia, under the effect of leukocyte colony-stimulating factor and after injection of a recombinant erythropoietin can also be regarded within the frames of the third option. From the viewpoint of general biology, all forms of AH developing against the background of impaired biological function of transcytosis (macropinocytosis) and crossing by food substrates and humoral mediators of bilayer structures between the common and local pools of the intercellular medium, i.e. blood-brain barrier can be referred to as a hematoencephalitic form. Arterial hypertension developing in impaired transcytosis across the blood-brain barrier (endothelium+ astrocytes bilayer), an encephalopathic form; endothelium+ podocytes bilayer, a renal form; endothelium+trophoblasts, placental AH; endothelium +/- pheumocytes, pulmonary AH; and endothelium+intimal macrophages, atherosclerosis-related AH. Normal AP points to: 1) the physiological level of transcytosis between all pools of the intercellular medium; 2) the absence of peripheral blood flow resistance in the arterial bed; 3) normal function of muscle arterioles; and 4) the physiological levels of metabolic processes in all paracrine cell communities in vivo.
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PMID:[Phylogenetic, pathogenetic fundamentals and a role of clinical biochemistry in classification of arterial hypertension]. 2005 74

Nonspecific aortoarteritis or Takayasu's disease (TD) is a chronic pan endarteritis of unknown origin involving the aorta and its major branches affecting young adults especially women. The disease is more common in eastern Asian countries. Hypertension in these patients generally reflects as renal artery stenosis, which is seen in 28-75% of patients. Surgical revascularization is occasionally needed in patients with failed medical management or endovascular interventions. We report two cases of Takayasu's arteritis in young women where renal revascularization was done using free internal iliac artery hepatorenal bypass graft with excellent control of hypertension in the postoperative period.
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PMID:Hepatorenal bypass using autogenous, free internal iliac artery graft: An attractive alternative to revascularize the right kidney in Takayasu's disease. 2291 39

A 27-year-old man presented at the emergency room with hemoptysis. His blood pressure was 180/100 mm Hg, and he had no history of hypertension. Chest radiographs showed bilateral infiltration, suggestive of alveolar hemorrhage. His laboratory data were consistent with acute kidney injury. His serum creatinine level increased abruptly; therefore, renal biopsy was performed. Steroid pulse therapy was administered because of a strong suspicion of immune-mediated pulmonary renal syndrome. Renal biopsy showed proliferative endarteritis, fibrinoid necrosis, and intraluminal thrombi in the vessels without crescent formation or necrotizing lesions. Steroid pulse therapy rapidly tapered and stopped. His serum creatinine level gradually decreased with strict blood pressure control. Ten months after discharge, his blood pressure was approximately 120/80 mm Hg with a serum creatinine level of 1.98 mg/dL. Pulmonary renal syndrome is generally caused by an immune-mediated mechanism. However, malignant hypertension accompanying renal insufficiency and heart dysfunction causing end-organ damage can create a pulmonary hemorrhage, similar to pulmonary renal syndrome caused by an immune-mediated mechanism. The present case shows that hypertension, a common disease, can possibly cause pulmonary renal syndrome, a rare condition.
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PMID:Malignant hypertension with an unusual presentation mimicking the immune mediated pulmonary renal syndrome. 2307 27

Takayasu's arteritis (TA) is rare, chronic progressive, pan-endarteritis involving the aorta and its main branches, with a specific predilection for young Asian women. Anaesthesia for TA patients is complicated by their severe uncontrolled hypertension, extreme arterial blood pressure differentials, aortic regurgitation (AR), end-organ dysfunction, stenosis/aneurysms of major blood vessels and difficulties encountered in monitoring arterial blood pressure. We present the usefulness of ultrasound during anaesthetic management of a 35-year-old woman posted for emergency caesarean section due to intra-uterine growth retardation, foetal tachycardia in active labour, who was already diagnosed to have TA along with moderate AR and uncontrolled hypertension, using epidural technique. The use of intra-operative doppler helped resolve the initial dilemma about the diagnosis and treatment of the differential blood pressure between the affected and the normal upper limb in the absence of prior arteriogram.
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PMID:Utility of intra-operative ultrasound in choosing the appropriate site for blood pressure monitoring in Takayasu's arteritis. 2371 70


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