Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Among eight patients with unilateral hydronephrosis and hypertension, peripheral plasma renin activity was normal in seven and borderline high in one. Four patients had hydronephrotic/contralateral kidney renin ratios of greater than 1.5, suggesting excessive renin release from the diseased kidney, and ratios between contralateral kidney and peripheral blood of less than 1.2, indicating suppressed renin production in the contralateral kidney. Nephrectomy normalized blood pressure in each of these patients. Two patients had hydronephrotic/contralateral kidney renin ratios of less than or equal to 1.3 or contralateral kidney/periphery ratios of greater than 1.2, suggesting ischemia of the contralateral kidney; pyeloplasty or nephrectomy, or both, failed to improve the hypertension. Postoperative changes in blood pressure correlated with changes in peripheral renin (r = 0.90; P less than 0.01). These data suggest that hypertension associated with unilateral hydronephrosis is partly renin-dependent; and renal vein renin values are helpful in selecting patients for surgery.
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PMID:Curable hypertension with unilateral hydronephrosis. Studies on the role of circulating renin. 90 42

Among 337 male patients who were hospitalized because of chronic ischemia of the leg, 103 (=30.6%) were shown to suffer from concomitant occlusive vascular disease of supraaortic branches. This was evaluated by simple examination like auscultation, bilateral blood pressure measurements, and palpation of pulses. In 52% the patients history revealed dizziness, hemiparesis and transient ischemic attacks (TIA). Arteriell hypertension promotes supraaortic vascular diseases as is shown by a relative frequency of 0.52 in contrast to 0.39. Combined occlusions of the iliac and femoropopliteal arteries are accompanied by supraaortic vascular disease in 40%, in femoropopliteal occlusion alone in only 20%. If the basic diagnostic approach is improved by directional ultra-sonic examinations of the carotid arteries, approximately 20% of all patients with advanced vascular disease of the iliac and femoropopliteal arteries have to be operated on for cerebrovascular disease.
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PMID:[The frequency of the combination of arterial occlusive disease in supraaortic and leg range. An analysis in the patient population of a vascular surgical department (author's transl)]. 92 53

Studies of the pulmonary circulation in normal man, performed with external radiation detectors, have shown that pulmonary blood volume is about 10% of total blood volume. Pulmonary blood volume was unchanged in patients with acute or chronic left atrial hypertension and in normal persons during expansion of total blood volume in spite of marked increases in pulmonary vascular pressures. However, pulmonary blood volume was greatly increased in patients with polycythemia rubra vera and a large total blood volume and in patients with a left to right shunt but normal pulmonary intravascular pressure. Studies of regional myocardial perfusion with injection of xenon-133 solution into the left coronary artery revealed localized areas of ischemia distal to stenotic lesions even when the patient was at rest. During angina produced by pacing, more severe ischemia occurred, thus suggesting that functional factors reduce local perfusion below resting levels. In patients with "variant" angina, intravenous injection of thallium-201 chloride during spontaneous attacks has revealed large cold areas in myocardial scintigrams not present under control conditions, thus suggesting severe transmural reduction of perfusion in heart muscle corresponding to S-T segment elevation in the electrocardiogram.
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PMID:Pathophysiologic studies of the pulmonary and coronary circulations in man. 99 14

With the aid of Xe133 injected into the anterior tibial muscle a study was made of the state of muscular circulation in 50 patients with decompensated diabetes mellitus and in 23 patients after the compensation of the disease was reached. There was a marked reduction of the muscular circulation in the majority of the patients at rest and also a fall of the adaptive possibilities of the vessels in response to the physical loading under conditions of artificially induced ischemia. Compensation of diabetes against the background of complex therapy (vasodilating, antisclerotic, lipotropic agents, polyvitamins, potassium salts) promoted but an insignificant improvement of the circulation at rest. The extent of disturbances of the muscular circulation depended on the severity, the character of the course of the disease, the patient's age, and the presence of vascular affections. Adaptive possiblities of the vessels in diabetic patients became more pronounced with the development of hypertension. The character of diabetes treatment produced no significant influence on the extent of the circulatory disturbances in the muscles.
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PMID:[State of the muscular blood circulation in diabetes mellitus]. 102 80

The effect of alterations of blood pressure and heart rate on segmental dyskinesis induced by coronary artery ligation and the influence of such manipulations on the magnitude of recovery of the syskinetic segment during subsequent coronary artery reperfusion were evaluated in 77 open-chest dogs. Wall motion was recorded by ultrasound reflected directly from the ischemic myocardial segment. Acute ischemia produced characteristic regional abnormalities in wall motion: aneurysmal bulging occurred during isometric contraction and wall velocity was markedly reduced during ventricular ejection. During 69 minutes of ischemia, a control group of dogs underwent no interventions and showed no further changes in wall motion. Tachycardia induced by atrial pacing during ischemia had no significant effect. Arterial hypertension during ischemia caused a marked reduction in wall velocity when methoxamine was used: 14 plus or minus 2 (SE) mm/sec (ischemia alone) to 6 plus or minus 1 mm/sec (ischemia + drug). In contrast, norepinephrine improved wall velocity: 11 plus or minus 2 mm/sec (ischemia alone) to 25 plus or minus 4 mm/sec (ischemia + drug). Hypertension caused by infusion of phenylephrine gave intermediate results, as did hypotension induced by either nitroprusside or hemorrhage during the ischemic period. After 60 minutes the drugs were stopped, the coronary ligation released, and the ischemic myocardium reperfused. The relative order of improvement of wall velocity with reperfusion was 11 plus or minus 2 mm/sec (ischemia alone) to 24 plus or minus 3 mm/sec (reperfusion) in the group that received norepinephrine, 12 plus or minus 3 mm/sec to 20 plus or minus 3 mm/sec in the control group with no intervention durin ischemia, 13 plus or minus 2 mm/sec to 20 plus or minus 1 mm/sec in the nitroprusside group, 9 plus or minus 2 mm/sec in the phenylephrine group, and 14 plus or minus 2 mm/sec to 12 plus or minus 1 mm/sec in the methoxamine group. The aneurysmal bulging during isometric contraction also was reduced to a greater degree by reperfusion in the group that received norepinephrine during the ischemic period than it was in the groups undergoing other interventions during ischemia. We conclude that drug-induced elevations in arterial blood pressure can have different effects on the syskinetic motion of acutely ischemic myocardium and on the degree of recovery following reperfusion depending on the particular agent used.
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PMID:Effect of alterations of arterial blood pressure and heart rate on segmental dyskinesis during acute myocardial ischemia and following coronary reperfusion. 107 94

Three patients with severe hypertension secondary to renal artery stenosis were treated by renal autotransplantation. Of these 3 patients 2 had solitary kidneys and 1 had 2 renal arteries to each kidney, all of which were stenosed. Renal autotransplantation with hypothermia of the kidney was performed in all 3 patients rather than the more conventional arterial bypass or endarterectomy because 1) hypothermic preservation permitted a prolonged ischemia time and 2) there was improved exposure for the vascular anastomosis. Postoperatively 2 patients remained normotensive without drugs for 9 and 12 months and 1 patient died of septicemia not directly related to the autotransplant. All 3 patients required expansion of the intravascular volume postoperatively to overcome the loss of vasoconstrictor substances following restoration of renal blood flow.
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PMID:Renal autotransplantation using hypothermic storage and pulsatile perfusion. 109 39

In a population of 744 diabetics composed mainly of elderly female patients, 172 developed hypertension after the onset of diabetes. Compared to normotensive diabetics, they had an increased prevalence of diabetic retinopathy (p less than 0.001), cerebral accidents, ischemic disorders of the lower limbs and a decreased glomerular filtration rate (p less than 0.05); they are frequently insulin-dependent and difficult to manage. In 173 other indivuals the diabetes emerged several years after the hypertension. This group was characterized by relatively easily controlled blood sugar and increased prevalence of angina and myocardial infarction (p less than 0.001). The association of hypercholesteremia with hypertension increases the risk of coronary disease (p less than 0.02) and, to a lesser degree, of glomerular insufficiency. The prevalence of coronary symptoms increases with obesity (p less than 0.05) while retinopathy increases with insulin dependence (p less than 0.001). From this information it may be concluded that the importance of various risk factors in the diabetic chiefly varies according to the vascular territory involved: cerebral vascular accidents occur mainly in hypertensives, while the presence of retinopathies, proteinuria and peripheral ischemia is directly related to the diabetes and particularly to insulin dependence. The risk of coronary lesions increases considerably when hypertension is added to the diabetes, with an even greater risk in the case of a diabetic, hypertensive, hypercholesterolemic nexus.
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PMID:[Factors of arterial and renal complications in diabetes]. 112 60

In the USSR, like in other countries, aorto-arteritis is no rarity. Onehundred and twentysix patients with aorto-arteritis have been studied at the A.N. Bakulev Institute for Cardio-Vascular surgery during the past 13 years (81 women and 45 men from 8 to 49 years of age). Morphologic changes consisted in inflammatory infiltration of the adventitia and, to a lesser degree, of the media as well as in reactive hyperplasia of the intima. The predominant features in the chronic stage were those of sclerosis and fibrosis of the adventitia and the media which in combination with the intimal hyperplasia resulted in stenosis or occlusion of the aorta and its main branches. The clinical picture and symptpmatology depend largely on the localization, form, and severity of the lesions. In aorto-arteritis ischemia of various organs and hypertension can be eliminated only by radical reconstructive surgery of the aorta and its branches. The most adequate restoration of the blood flow in the major vessels is provided by resection combined with replacement. It is not quite clear yet whether endarterectomy is possible and justified. Radical surgery was performed in 80 patients. In addition, different palliative and explorative operations were performed in 10 patients. The majority of patients had resection with replacement of the brachiocephalic arteries, descending thoracic aorta, abdominal aorta, renal and visceral arteries. Blood flow in the major vessels was restored in 69 patients. Early postoperative thrombosis of the prosthesis occurred in 7 patients. Immediate postoperative mortality was 13.3 percent. Sixtytwo patients were followed up from 1 to 9 years after radical surgery. Persistent normalization or significant improvement of the systemic and regional hemodynamics was found in 53 patients. Late thrombosis of the aorto-renal branch or aorto-femoral prosthesis occurred in 4 patients. There were three late deaths.
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PMID:Nonspecific aorto-arteries. 112 4

Aortic histamine synthesis of normotensive rats has been compared to that of rats rendered hypertensive via production carotid sinus ischemia and to animals additionally subjected to bilateral adrenalectomy. Results indicate that the aortic histamine-forming capacities (HFC's) of rats sacrificed 24 hr after surgical treatment were elevated 83% and 103% for hypertensive rats and those additionally subjected to adrenalectomy, respectively. At an 8-day postoperative interval, the respective aortic HFC's were elevated over control by 33% and 45%, although at this time interval animals were not considered hypertensive. This study thus offers suggestive evidence that hypertension causes increased vascular permeability by increasing the histamine-forming capacity of the vessel wall.
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PMID:Aortic histomine syntesis in experimental neurogenic hypertension. 112 33

The known risk factors for atherosclerosis do not possess the same significance in young people as in the elderly. Hypercholesterolemia, diabetes and cigarette smoking appear to have a greater bearing below the age of 50 than later, particularly in myocardial infarction but also in apoplexy. On the other hand, hypertension is an important factor in the young and, especially in the case of apoplexy, even more so in advanced age. There is marked difference with regard to preexisting heart disease, which scarcely plays a role in myocardial infarction of the younger patient but is a factor in some 50% of hemiplegia cases. Only one fifth of elderly patients with this disease have no preexisting carcdiopathy. The similarity of the risk factors in elderly patients either with or without apoplexy is due to the fact that arteriosclerosis is already established in both groups and the risk factors which give rise to ischemia, thrombosis or embolism assume prominence. The therapeutic implications are briefly discussed.
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PMID:[Risk factors and age]. 113 58


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