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

The effects of prostaglandin E1 on fluid and sodium excretion, creatinine clearance and renin release were examined in 26 hypertensive patients including 9 cases of essential hypertension, 10 of renovascular hypertension and 7 of primary aldosteronism. When prostaglandin was infused intravenously in a total dose of 120 mug in 60 min, urine volume was increased in 70% of cases, and sodium excretion in 61%, but little changes were observed in creatinine clearance. The most prominent diuresis and natriuresis were obtained in primary aldosteronism (mean increase was 319% in urinary volume, and 222% in sodium output). The average increases in urinary volume were 61% in patients with essential hypertension and 97% in renovascular hypertension. And urinary output of sodium was increased by 63% in the former and 56% in the latter. The remarkable renal effects of prostaglandin E1 in primary aldosteronism were completely abolished after the administration of spironolactone. Significant elevation of plasma renin activity resulted from prostaglandin E1 infusion in essential hypertension, while no constant effect was obtained in renovascular hypertension and primary aldosteronism. The present experiments indicate that prostaglandin E1 has different effects on the kidney according to the types of hypertension and the effects correlate closely with patient's status of extracellular fluid volume or sodium balance.
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PMID:Renal effects of prostaglandin E1 in hypertensive patients. 118 18

Urinary kallikrein excretion was measured in 21 healthy subjects and 44 patients with various types of hypertension. The kallikrein activity was determined by the method of esterolytic assay. The excretion rates in normal subjects were 112.9 +/- 11.1 (S.E.) EU/day. The kallikrein excretion was decreased in patients with essential hypertension, the mean estimated values were 75.2 +/- 10.0 EU/day. In this disease, however, an enhancement of urinary kallikrein was observed after sodium depletion. An obvious increase in kallikrein excretion was found in the primary aldosteronism. In primary aldosteronism and renovascular hypertension, one of the secondary aldosteronisms, there was a good correlation between the urinary kallikrein output and the urinary sodium excretion. The present data indicate that the renal kallikrein-kinin system, one of the renal antihypertensive factors, is suppressed in essential hypertension and is under the influence of mineralocorticoid levels.
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PMID:Urinary kallikrein excretion and sodium metabolism in hypertensive patients. 118 19

In 24 cases of primary aldosteronism and 30 cases of Cushing's syndrome, the incidence of preoperative hypertension and postoperative improvement of hypertension was investigated. All the cases of primary aldosteronism showed preoperative hypertension. Postoperative improvement of hypertension was observed in 21 out of those 24 cases. In 14 of these 21 cases, hypertension improved within 1 month postoperatively. In Cushing's syndrome, 23 out of 30 cases showed preoperative hypertension which improved in 20 cases postoperatively. They needed longer periods of time before improvement of hypertension than the cases of primary aldosteronism. The pathological findings in renal biopsy specimens seem to be correlated with postoperative improvement of hypertension in both diseases.
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PMID:Postoperative improvement of hypertension in primary aldosteronism and Cushing's syndrome. 118 34

Hyperaldosteronism due to aldosteronoma is a rare but potentially curable form of pediatric hypertension. We have presented a patient who had symptoms of enuresis and fatigue, and in whom the diagnosis was suggested by low serum potassium and persistent hypertension. Diagnosis was confirmed by increased plasma and urinary aldosterone and decreased plasma renin. The tumor was localized with the aid of adrenal venography and catheterization, which showed greatly increased plasma aldosterone levels in the right adrenal vein. The pathologic findings were totally reversed by right adrenalectomy. The clinical picture and results following surgical removal of aldosterone-producing tumors in six children are reviewed.
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PMID:Aldosteronoma in a child with localization by adrenal vein aldosterone: collective review of the literature. 120 77

In 16 patients with hypokalemic hypertension the combination of abnormally high and unsuppressible plasma aldosterone with low or undetectable renin activity led to the diagnosis of primary aldosteronism. To differentiate between aldosterone producing adenoma and idiopathic bilateral hyperplasia, determination of aldosterone concentration in both adrenal veins was performed in 12 patients. In 4 of these patients the two forms of primary aldosteronism could not be differentiated as in these cases only one of the two adrenal veins simultaneously showing an abnormally high aldosterone concentration could be canulated. Plasma aldosterone and plasma cortisol were determined overnight (20.00-8.00 h) at short time intervals in 8 patients with adenoma, 1 patient with carcinoma of the adrenal cortex and 3 patients with bilateral hyperplasis. In all patients with adenoma a significant correlation between aldosterone and cortisol was observed (p less than 0.05-0.001) whereas no correlation was seen in the patients with hyperplasia and carcinoma. The clinical importance of these findings is that in the presence of ACTH-dependent secretion of aldosterone the site of the adenoma can be predicted even when blood from only one adrenal vein is obtained.
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PMID:[Primary aldosteronism: diagnosis, laterality and regulation of hormone secretion]. 121 58

1. In 7 patients with hypertension, aldosteronism, and low plasma renin (6 patients with a solitary adrenal adenoma, 1 patient with bilateral adrenal hyperplasia) circulatory reflexes (Valsalva's maneuver, head-up tilt and cold pressure test) were examined. Furthermore, the reactivity to the pressor action of tyramine and norepinephrine was determined. For comparison 10 patients with essential hypertension were studied. 2. In 4 of the 7 patients with primary aldosteronism no overshoot following Valsalva's maneuver could be observed. Compared to the patients with essential hypertension the mean overshoot in the patients with primary aldosteronism was significantly reduced. The decrease in blood pressure during head-up tilt was significantly more pronounced in the patients with primary aldosteronism. However, both groups did not differ in their reaction to the cold pressure test. In the patients with primary aldosteronism responsiveness to tyramine was significantly reduced compared to the patients with essential hypertension. No significant difference was observed in the reactivity to norepinephrine between both groups studied. 3. The results point towards a disturbance of the sympathetic nervous system in patients with primary aldosteronism.
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PMID:[Circulatory reflexes in primary aldosteronism (author's transl)]. 121 78

The AA. have applied the diazoxide test for the screening of primary hiperaldosteronism to 22 nephropatic patients suffering from hypertension and with different degrees of renal function. In 22 patients an increase in PRA and aldosterone values always followed the diazoxide infusion. Only one patient, likely suffering from primary aldosteronism, showed no increase in PRA and aldosterone values. The diazoxide infusion had no influence on renal, pancreatic and cardiovascular function. Therefore, this can be considered as a valid test easy to be performed in a short time, also in nephropatic patients who are very sensitive to pharmacological noxae.
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PMID:[Diazoxide test in the diagnosis of arterial hypertension: modifications in the levels of renin and aldosterone in blood of patients with various restrains of the renal function]. 122 45

The radioimmunological dosages of renin and of aldosterone are used nowadays in clinical practice for research purposes only. The measurement of activity of plasma renin may be considered a significant indication of the concentration of the enzime in plasma and, indirectly, of its secretion. Several factors take a part in the regulation of renin secretion (mean arterial pressure, introduction of sodium and potassium, the sympathetic nervous system, ADH and concentration of angiotensin II in plasma). In pathological conditions such factors may cause alteration of the renin-angiotensin II system, thus determining hyperreninisms and hyporeninisms, whether associated with arterial hypertension or not. Several factors take a part on aldosterone secretion too (ACTH, sodiaemia, potassiaemia, renin-angiotensin II system). In pathological conditions the alteration of the regulation system may lead to hyperaldosteronism or to hypoaldosteronism of primary or secondary type. A survey of recent research on the physiopathology of the renin-aldosterone system is also given.
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PMID:[Renin and aldosterone]. 123 75

Investigations conducted by the authors have made it certain that biosynthesis of cortico steroids from progesterone-C14 in rats of Ocamoto (SHR) line with hereditary-conditioned hypertension at chronic stage of the disease does not experience any substantial changes. At the same time, an acute emotional (immobilization) stress results in greater changes in the biosynthesis of corticosteroids, metabolism of aldosterone and its blood content in the SHR rats as compared to control, normotensive ones of the Wistar line. Hyperaldosteronism revealed in the SHR rats becomes particularly intensive in response to an additional neurogenic stimulation. An important role in the mechanism of its development plays reduced metabolism of aldosterone in the liver of the SHR rats, especially in response to a stress.
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PMID:[Functional state and reactivity of the adrenal cortex in rats with hereditarily conditioned hypertension]. 124 69

Urinary kallikrein excretion is reduced in patients with hypertension of unknown etiology. In addition, the excretion of this renal, kinin-forming enzyme was found to be elevated in hypertensive patients with primary aldosteronism. Aldosterone regulates kallikrein excretion, as normal subjects show increased kallikrein excretion in response to a low sodium intake, high potassium intake, or the synthetic mineralocorticoid, fludrocortisone, whereas kallikrein excretion falls during treatment with spironolactone. The relationship between kallikrein excretion and aldosterone activity may directly reflect the intrarenal activity of the kallikrein-kinin system, as determined by studies of kallikrein levels from isolated renal cells or of plasma kinin levels in man in response to postural changes or saline loads. Some patients with essential hypertension do not show a normal increase in kallikrein excretion in response to low dietary sodium intake despite an apparently normal aldosterone response, suggesting that there may be a defect in the renal kallikrein-kinin system in these patients. Whether these findings are of pathogenetic significance in human hypertensive disease remains to be determined.
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PMID:Relationships among urinary kallikrein, mineralocorticoids and human hypertensive disease. 124 55


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