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

Hypertension is a common disease and plays an important role as a potentially remediable contributor to cardiovascular causes of death in the community. In moderate to severe hypertension recent treatment has improved morbidity and mortality substantially, but it is disappointing that despite this myocardial infarction still stands as an important cause of death. In this regard it is encouraging that beta adrenergic blockade may be useful not only in lowering blood pressure, but also possibly in reducing independently the risk of myocardial infarction and/or sudden death in some patients. In mild hypertension the number of patients is large and the possible beneficial effect of treatment less well-established, so that there is a clear need for further research in order to define patients at relatively high risk in this group.
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PMID:Essential hypertension--the starting point for improved drug treatment. 1 14

From analyses of the effectiveness of beta-blocker monotherapy in relation to the patient's age and to pre-treatment renin determinations an antihypertensive drug program is proposed in which beta-blockers form the cornerstone. Patients with essential hypertension can be subdivided into groups with low (19%), normal (59%), or high (23%) renin sodium index. The proportion with low renin hypertension increases with age. Patients with high renin fall into two categories: younger patients with fairly mild hypertension and older pateients with more severe hypertension and signs of renal disease. The antihypertensive efficacy of beta-blocker monotherapy is best in high renin forms, good but less consistent in normal renin patients and uniformly bad in low renin hypertensives. In relation to age, beta-blockers normalized blood pressure (larger than or equal to 95 mmHg diastolic) in three-quarters of the younger than 40-year-olds, in about half of those aged 40--60 years, but in only 20% of those aged over 60 years. On this basis, it is postulated that the older patients with a low renin exhibit a relatively hypoadrenergic state while those with a normal or high renin--for a given age and elevated pressure--have a relatively increased adrenergic nervous activity. Because the beta-blockers have a potent suppressive action on the renin-angiotensin system--and, as a consequence, on angiotensin vasoconstriction, aldosterone volume expansion and central stimulatory feedback mechanisms--their antihypertensive mode of action may be linked to an important extent, though not exclusively, to renin suppression.
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PMID:A beta-blocker-based antihypertensive drug program guided by age and renin. 1 22

Complications of hypertension are by far the greatese preventable public health problem in many of the developed countries of the world. Pharmacologic interventions which primarily involve drug interactions are the generally available and effective means of preventing or delaying these hypertensive complications. Mechanisms of beneficial antihypertensive drug interactions involve simultaneous reduction or control of blood volume (diuretic agents) and decrease of peripheral resistance. Reduction of peripheral resistance without producing intolerable side effects has recetnly been achieved by a complex drug interaction. This interaction involves simultaneous vasodilation and inhibition by beta-adrenergic blocking agents of reflex activation of the renin-angiotensin axis. Clonidine, by effects similar to propranolol, can substitute for propranolol in some patients, or add to the beneficial effects of this important drug interaction.
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PMID:Additive effect of beta-adrenergic blockers in combination with vasodilators in lowering blood pressure. 1 26

Takayasu's aortitis is an arterial inflammatory disease of arteries of unknown etiology. Fainting is a common symptom and has been attributed to ypersensitivity of the baroreflex. We studied baroreflex sensitivity in 11 patients with Takayasu's aortitis and compared it with that of eight control subjects of comparable age. Baroreflex sensitivity was assessed by determining the slope of a regression line relating the rise of systolic arterial pressure to the prolongation of the R-R interval of the electrocardiogram during a transient rise of arterial pressure induced by an intravenous injection of phenylephrine. The average baroreflex slope of patients with Takayasu's arteritis (4.0 +/- 0.8 msec/mm Hg) was significantly less than that of control subjects (10.7 +/- 0.8 msec/mm Hg, P less than 0.001). Reduced baroreflex sensitivity in patients with Takayasu's aortitis may be due to the hardening of the arteries where baroreceptors lie, or to hypertension and/or cardiac disease which was present in most of the patients included in this study. Patients with Takayasu's aortitis who complained of fainting also showed the reduced baroreflex sensitivity. This indicates that fainting in this disease is not likely to be caused by the hyperreactivity of the baroreceptors as is commonly postulated.
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PMID:Baroreflex sensitivity in patients with Takayasu's aortitis. 1 92

Although the role of renin in hypertension continues to be incompletely defined, recent progress in the chemistry of renin has been considerable. Extensive purifications of hog kidney renin and the renin-like mouse submaxillary gland enzyme have been achieved. Various inhibitory peptides based on tetradecapeptide renin substrate have been useful in renin kinetic studies and in renin affinity chromatography. Classification of renin as an acid protease results from its marked inhibition by pepstatin and from the discovery that free carboxyl at the active site is essential for activity in human and hog kidney and mouse submaxillary gland enzymes. The presence of pseudorenin in all tissues has limited the use of model peptides as renin substrates in plasma and crude tissue extracts, since the proteolytic properties of the two enzymes are nearly identical. The existence of renin in multiple, chromatographically separable forms has been known. More recently inactive forms have been found in plasma, amniotic fluid, and hog and rabbit kidneys. Prolonged storage or treatment with acid, trypsin, or pepsin causes activation; in some instances the conversion is from a higher than normal molecular weight. The implications of these findings with respect to the renin-angiotensin system need much further investigation.
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PMID:New developments in our knowledge of the chemistry of renin. 1 50

The renal diseases which cause systemic hypertension in the first two decades of life differ from the adult in their incidence and etiology. Seventeen patients (11 days to 20 years old), studied angiographically, demonstrated a wide spectrum of renal pathology including arterial thrombosis, fibromuscular hyperplasia, vasculitis, neurofibramatosis, cystic disease, pyelonephritis, Page kidney, and congenital anomalies.
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PMID:Spectrum of angiographically demonstrable renal pathology in young hypertensive patients. 1 99

The management of hypertension with current hypotensive drugs on the South African pharmaceutical market is reviewed. The advent of the use of beta-adrenergic blocking agents and vasodilators in the treatment of hypertension is promising.
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PMID:Medical treatment of hypertension. 1 23

The authors report the values of mean hemispheric blood-flow and cerebral arterial consumption they found in 34 neurosurgical comatous cases in acute state. In basal conditions, mean values of mean hemispheric bloodflow and oxygen consumption are lowered. There seems to be a relation between the values found and the comatous stage on one hand, the prognosis on the other hand. The cerebral response to hypercapnia (16 assays) allows to separate 2 groups, one with a noticeable improvement of cerebral bloodflow, the other with only a minimal response. There was no significant variation of cerebral oxygen consumption in both group. Cerebral response to CO2 seems to be clearly related to the stage of coma (low in the most severe cases) but pronostic incidence remained uncertain. A hypertensive test by means of Aramine (18 assays) allows to separate 3 groups : 1 group (8 cases) where the mean hemispheric bloodflow remained stable during hypertension as did the cerebral oxygen consumption -(autoregulation remained unchanged), 1 group (4 cases) where mean hemispheric bloodflow and cerebral oxygen consumption were lowered (excessive autoregulation), 1 group (6 cases) where mean hemispheric bloodflow increases clearly while under Aramine perfusion (loss of autoregulation). Those dynamic tests, either hypercapnic or hypertensive, allow, in comparing oxygen consumption variations with cerebral bloodflow variations, the distinction between : patients where metabolic autoregulation seems maintained (good prognosis) - (10 cases), patients where metabolic regulation is lost with either "luxury perfusion" (14 cases) - poor prognosis, or "insufficient perfusion" (10 cases). The authors are discussing the treatment concerning those last mentioned patients.
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PMID:[Value of cerebral metabolic exploration in post-traumatic coma states in the acute phase]. 1 86

1. Activity of peripheral and central catecholaminergic neurons was studied in spontaneously hypertensive rats (SHR) and deoxycorticosterone (DOCA)-salt hypertensive rats. 2. In young SHR (4 weeks) the plasma values of bpth noradrenaline and dopamine-beta-hydroxylase activity were increased compared with those of normotensive rats of the Wistar/Kyoto strain. Total catecholamines (mostly adrenaline) were not significantly different. 3. In the adrenal glands of 2-weeks-old and 4-weeks-old SHR activities of tyrosine hydroxylase, dopamine-beta-hydroxylase, phenylethanolamine-N-methyl transferase were decreased, compared to Wistar/Kyoto rats. 4. The adrenaline-forming enzyme was elevated in the A1 and A2 regions of the brain stem of 4-weeks-old SHR and in the A1 region of adult DOCA-salt hypertensive rats. 5. In the adrenal glands of adult DOCA-salt hypertensive rats tyrosine hydroxylase activity was increased. 6. These results implicate peripheral noradrenaline-containing neurons and central adrenaline-containing neurons in the development of genetic and experimental hypertension in rats.
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PMID:Peripheral and central catecholaminergic neurons in genetic and experimental hypertension in rats. 1 56

Serial plasma unconjugated estradiol-17 beta was measured by a radioimmunoassay method in 26 cases of hypertensive disorder of pregnancy, 13 cases of poor obstetric history and 4 cases of intra-uterine growth retardation. There was considerable overlap of hormonal values between pregnancies, resulting in delivery of normal fetuses and those with dysmature fetuses. Serial estimation of estradiol-17 beta were not found to be useful in the prediction of intra-uterine death, although low values were obtained after fetal death has occurred. Estradiol-17 beta estimation appeared to be an unreliable index of fetoplacental function.
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PMID:Plasma estradiol-17 beta as an index of fetoplacental function. 1 13


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