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

A long-term study was done by means of interative fluorangiography on microvascular retinal permeability versus the blood pressure control carried out in 11 patients with a diastolic blood pressure of greater than or equal to 130 mm Hg and with retinal exudates, haemorrhages and oedema. No matter what the original disease was (i.e., essential, renovascular, endocrine hypertension or chronic nephropathy with terminal renal failure) the increased permeability appeared to be critically connected with the blood pressure level. Our results confirm that hypertension per se might be the cause of vascular permeability changes.
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PMID:The close interrelationship between increased vascular retinal permeability and blood pressure level. Evidence from retinal fluorangiography. 59 57

We assessed the role of the renin-angiotensin system in the response of the renal circulation to restriction of sodium intake in 38 normal patients. Both saralasin (10 to 30 ng/kg/min), an angiotensin antagonist, and SQ 20881 (30 to 300microgram/kg), a converting enzyme inhibitor, induced a dose-related increase in renal blood flow (xenon 133 washout) only when the resin-angiotension system was activated by restriction of sodium intake to 10 MEq/day. Increasing doses of saralasin (100 to 1,000 ng/kg/min) reduced renal blood flow, presumably due to the angiotensin-like action of this partial agonist. The renal vascular response to SQ 20881 paralleled the endocrine response: An identical threshold dose (30 microgram/kg) increased renal blood flow and reduced plasma angiotensin II concentration, which fell despite a progressive rise of plasma renin activity. Plasma bradykinin concentration did not change in response to SQ 20881, which also blocks kininase II. Both agents also induced a small but consistent and statistically significant reduction in arterial blood pressure, which will be important in assessing the pathogenetic significance of a blood pressure reduction in patients with hypertension. This study indicates that angiotensin mediates the renal vascular response to restriction of salt intake in normal man and provides an approach to assessing the role played by angiotensin in the pathogenesis of functional renal disease.
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PMID:Renal vascular response to interruption of the renin-angiotensin system in normal man. 59 39

Blood pressure should be routinely measured in all infants and children. Measurements should be performed with an appropriate size cuff and observed pressures compared to normal values for age. Elevated blood pressure is seen in one to ten percent of children, depending on the age group surveyed and the definition of hypertension selected. Thirty to fifty percent of children with elevated blood pressures are asymptomatic. The remainder have symptoms which are nonspecific, including headaches, visual disturbances, seizures, congestive heart failure, and facial palsy. Hypertension in children, unlike hypertension in the adult, usually has a definite cause which often responds to adequate medical and/or surgical treatment. For this reason, children with well-confirmed hypertension should be thoroughly evaluated. The most common causes of hypertension found in children are renal disease (pyelonephritis, vascular disease, structural malformations) and coarctation of the aorta. An approach to the child with transient or persistent hypertension is described. Diagnostic studies should be individualized and should follow clinical clues where possible. Medical management of the child with acute hypertension is discussed.
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PMID:Elevated blood pressures in infants and children. 62 65

Haematuria in children is either of glomerular or nonglomerular origin. In the latter case intravenous urography should always be performed. A renal biopsy is indicated if unexplained haematuria persists for at least one year or if an unfavorable prognosis is indicated by the appearance of hypertension, significant proteinuria or persistently low levels of serum complement (C3). The importance of screening the families of haematuric patients is emphasized. More than half of our cases with persistent or intermittent haematuria undergoing renal biopsy showed no or only minimal glomerular changes. In other children with a similar clinical picture more severe histological lesions were detected. In any case the kidney tissue obtained by biopsy should be examined by immunofluorescence and by electron microscopy. One of the most frequent causes for persistent or intermittent haematuria during childhood is Berger's disease (IgA/IgG nephropathy).
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PMID:[Haematuria in children. I. Differential diagnosis of haematuria in childhood (author's transl)]. 63 89

The changes in plasma renin activity (PRA) and plasma aldosterone concentration (PA) in response to dietary sodium restriction and upright posture were evaluated in 7 patients with juvenile-type, insulin-dependent, uncomplicated diabetes mellitus and in 5 healthy volunteers. All patients had normal blood pressure, 24-hour urine protein excretion and endogenous creatinine clearance. Renal sodium conservation and concentrating ability were grossly normal and 5 patients so tested, had normal renal acidification. PRA and PA were normal in every subject suggesting that abnormalities of the renin-aldosterone axis are late complications of diabetes mellitus usually associated with hypertension and nephropathy or neuropathy.
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PMID:Renin-aldosterone responsiveness in uncomplicated juvenile-type diabetes mellitus. 64 May 77

Plasma prolactin response to postural change and variation in dietary sodium was evaluated in five normal volunteers and 15 patients with essential hypertension. Values at 0800 hours (11.9 +/- 3.5 ng/ml, mean +/- 1 S.D.) were uninfluenced by the duration of recumbency (10 or 34 hr) and were significantly higher than those obtained at noon (6.9 +/- 3.5 ng/ml, mean +/- 1 S.D., p less than 0.001). The latter were uninfluenced by postural change. There was no correlation between sodium intake and plasma prolactin, nor was there any apparent correlation between prolactin and plasma renin activity. There was no significant difference in prolactin concentrations between normotensive and hypertensive subjects. In 10 additional patients with unilateral renal disease, renal vein prolactin concentrations did not differ significantly from simultaneously obtained peripheral concentrations. Renal vein prolactin was uninfluenced by the presence of renal disease and did not correlate with renal blood flow. It is concluded that there is no evidence of feedback between sodium intake and prolactin in man. Human kidneys do not seem to clear significant amounts of prolactin. It appears unlikely that alterations in prolactin concentration, at least as assessed by daytime values, participate in the maintenance of either essential or renovascular hypertension. Since values at 0800 hours are frequently elevated as a reflection of preceding sleep-related peaks, sampling at 1200 hours may be preferable when search is undertaken for hypothalamic-pituitary disease.
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PMID:Plasma prolactin in essential and renovascular hypertension. 64 93

The clinical course of diabetic nephropathy was evaluated in 150 patients and the effect of hemodialysis in 68 of them. Proteinuria was the first sign of renal disease. Once renal dysfunction becomes evident, there is a rapid deterioration leading to dialysis within 3.0 +/- 0.2 years. Hypertension and circulatory congestion are common complications. The hypertension is probably volume dependent. Retinopathy was not invariably present at the onset of renal insufficiency but appeared with progression of renal failure. The course during hemodialysis was complicated by continued progression of diabetic vascular disease manifested by vascular access difficulties, worsening of retinopathy and blindness, and cardio- and cerebrovascular deaths. Mortality was higher than in nondiabetic dialysis patients.
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PMID:Diabetic nephropathy: clinical course and effect of hemodialysis. 64 44

The study involved 298 cases of chronic glomerulonephritis (GN) in adults. The results of renal biopsy were used to classify the patients into four groups: Membranous GN, 81 cases; focal glomerulo sclerosis, 80 cases; Membrano-proliferative GN, 62 cases; GN with mesangial deposits of IgA, 75 cases. The patients were observed over a period ranging from 1 month to 36 years. The average period of surveillance for each category was between 4 and 6 years. The course in each histological type was assessed on the basis of actuarial tates of renal death, of moderate renal insufficiency (plasma creatinine greater than 1.5 mg%( and of hypertension. Renal survival at 10 years was was arounds 90% for membranous GN. 85% for GN with mesangial deposits of IgA, 70% for focal glomerulo sclerosis and 50% for membrano-proliferative GN. The prognosis should be based upon a combination of histological and clinical findings. Severity of prolonged nephrotic syndrome, regardless of the histological type of the nephropathy, is worthy of emphasis. In the group fo focal glomerulo sclerosis, prognosis differs greatly in relation to the presence or absence of a nephrotic syndrome. Complete remission may be seen in the group of focal glomerulo sclerosis, and in membrano-proliferative GN despite the persistence or worsening of histological lesions seen on repeated biopsies.
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PMID:[The prognosis in primary chronic glomerulonephritis in the adult. 298 clinicopathological cases (author's transl)]. 64 78

Total cortisol levels were measured in 81 samples of amniotic fluid obtained from 72 patients in the third trimester of pregnancy; 19 of them had pre-eclampsia and the remainder had no pre-eclampsia, hypertension or renal disease. In accordance with previous studies, there was a rise in the concentration of amniotic fluid cortisol with advancing gestation; the rise was steepest after 40 weeks, the amniotic fluid cortisol levels invariably being above 700 nmol/l between 41 and 43 weeks of pregnancy. Amniotic fluid cortisol may thus be of value in diagnosing postmaturity. A relatively low correlation was found between total cortisol levels and lecithin/sphingomyelin ratios in amniotic fluid unless results were ranked for gestational age. Total cortisol concentrations in amniotic fluid obtained from patients with pre-eclampsia were significantly higher than in controls. The concentration of free cortisol in amniotic fluid changed much less than total cortisol. Thus total cortisol should be measured in studies of the fetal capacity to synthesize corticosteroids.
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PMID:Total and free cortisol in amniotic fluid during late pregnancy. 65 49

To learn more about the regulation of blood pressure in renal parenchymal disease, 57 subjects (18 normal controls, 25 patients with essential hypertension and 14 with renal parenchymal disease and hypertension) were evaluated for peripheral renin activity, 24-hour urinary kallikrein activity and whole-blood volume. Blood volumes were significantly lower in patients with essential hypertension (P less than 0.001) and those with renal disease and hypertension (P less than 0.001) than in normotensive subjects. Renin activities (measured after the subjects were standing) were also lower in patients with essential hypertension and hypertension due to renal disease (P less than 0.01 and P less than 0.02, respectively). Kallikrein activity was similar in subjects with renal disease and those with hypertension (P less than 0.05) but markedly diminished in both groups as compared with normotensive subjects (P less than 0.001 and P less than 0.01, respectively) when glomerular filtration rates were taken into account. The kallikrein-kinin system may be involved in the hypertension associated with renal parenchymal disease.
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PMID:Urinary kallikrein activity in the hypertension of renal parenchymal disease. 66 89


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