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

The reliability of the angiotensin II (AT II)-antagonist Saralasin in the diagnosis of AT II-dependent forms of hypertension was investigated in 61 cases of hypertension of different etiology. In 14 patients, lowering of blood pressure by Saralasin suggested an AT II-dependent hypertension which could be ascertained in 8 patients (5 had undergone successful surgery) by increased levels of plasma-renin-activity (PRA), AT II, PRA-ratio in renal vein blood and by angiography. Besides, depressor reactions by Saralasin yielded additional information in three patients with renovascular hypertension but normal levels of PRA and AT II, in two patients with high renin essential hypertension and one patient with pheochromocytoma. This test seems to be valuable in the diagnosis of renin-dependent hypertension.
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PMID:[Critical analysis of the saralasintest in the diagnosis of hypertension (author's transl)]. 89 3

We reviewed the records at the Mayo Clinic for the years 1973, 1974, and 1975 to determine the number of patients with hypertension who had had operations for repair of renal artery stenosis, excision of pheochromocytoma, or resection of aldosterone-producing adenoma. During the years studied, the average numbers of procedures per year were, respectively, 46.7, 10.3, and 2.7. For the purpose of estimating the frequency of each one of these three conditions among the population of hypertensive patients examined at the Mayo Clinic, we applied age- and sex-specific incidence figures from the US National Health Survey to the 162-273 patients examined who were more than 15 years old in 1974. We estimate that there were 26,589 patients who had diastolic blood pressures equal to or greater than 95 mm Hg. The indices generated estimated that renal artery stenosis repair was done in 18/10,000 (0.18%) hypertensive patients, pheochromocytoma excision in 4/10,000 (0.04%), and aldosterone-producing adenoma resection in 1/108000 (0.01%). These indices are strikingly lower than those frequently reported elsewhere, suggesting that these conditions are truly rare among hypertensive patients seen in clinical practice.
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PMID:Frequency of surgical treatment for hypertension in adults at the Mayo Clinic from 1973 through 1975. 89 97

We report a 14-year-old boy with severe hypertension who was cured by surgical removal of a pheochromocytoma. The tumor was shown biochemically and morphologically to secrete predominantly noradrenaline. The metabolic effects noted in this patient were raised free fatty acid levels and depressed insulin levels, hyperreninemia, hypercalcemia, and hypercalciuria with normal parathyroid function. All these abnormalities returned to normal after removal of the tumor. It is suggested that these effects were mediated via beta-adrenergic stimulation of the excess noradrenaline.
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PMID:The metabolic effects of excess noradrenaline secretion from a pheochromocytoma. 90 78

A case of hypertension with simultaneous occurrence of a para-aortal pheochromocytoma and a functionally significant membranous renal artery stenosis is reported. The pheochromocytoma was excised surgically and a vein patch angioplasty was performed. Postoperatively the BP returned to normal. Three years after surgery the patient is normotensive and urinary catecholamines are normal. On the basis of this case and 27 previously reported cases of pheochromocytoma and renal artery stenosis, the possible relationship between the two conditions is discussed.
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PMID:Pheochromocytoma and renovascular hypertension. A case report on a review of the literature. 91 Jun 42

A case of pheochromocytoma of the urinary bladder is reported, and 35 perviously reported cases are analyzed. This interesting entity can present with symptoms of catecholamine excess and severe hypertensive spells (often micturition-induced) or as asymptomatic hematuria without hypertension. The present case represents the severest end of the clinical spectrum, with advancing acute retinopathy and visual loss, very high blood pressure and greatly increased catecholamine excretion. Several special precautions were utilized during diagnostic studies and surgery. On the whole, prognosis is excellent in nonmalignant cases properly handled, and the location of the tumor provides opportunity for early case finding and complete cure.
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PMID:Pheochromocytoma of the urinary bladder: a broad clinical spectrum. 92 Jun 20

The urinary excretion of free noradrenaline (NA), adrenaline (A), dopamine (DA), the DA/NA ratio in the urine, plasma renin activity (PRA) and their mutual relationship were investigated in 71 patients suffering from different types of arterial hypertension. In spite of the fact that the mean values of excreted catecholamines, with the exception of pheochromocytoma, lie within the range of values found in healthy controls, certain differences were found in spectrum of excreted catecholamines. In patients with labile, malignant and renovascular hypertension and in pheochromcytoma the higher mean excretion of NA and the low DA/NA ratio was accompanied by the higher PRA in comparison with fixed benign essential hypertension. On the other hand, in hypertension with low PRA (essential hypertension with suppressed renin and Conn's syndrome) a low excretion of NA and high DA/NA ratio was found. There was a significant, if not even very close negative correlation between the PRA and DA/NA ratios both in recumbent and upright position. The rise of PRA on standing up was followed by an increased excretion of NA while the excretion of DA did not change or decreased. Hence the DA/NA ratio when standing up showed a decreasing tendency as compared with values when lying down. Application of the beta-blocker Inderal decreased the PRA and the blood pressure not only in juvenile hypertensive patients with hyperkinetic circulation but also in the early phases of renovascular hypertension. It thus appears that endogenous catecholamines, first of all the ratio between the renin-inhibiting DA and the renin-stimulating NA, participate as one of several factors in the regulation of secretion and of the plasma levels of renin not only in juvenile hypertensive patients with hyperkinetic circulation but also in other types of hypertension.
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PMID:Relationship between plasma renin activity and urinary catecholamines in various types of hypertension. 97 8

The content of total metabolizing sodium was studied in 74 patients with hypertension of different genesis, using the Na24-isotope dilution technique. Among these patients 31 had essential hypertension, 43--symptomatic hypertension (40--renal, and 3--adrenal). In Stage IB and IIA hypertension, a reduction of the level of total metabolizing sodium and its increased urine excretion were found. At late stages of essential hypertension, like in symptomatic renal hypertension, normal levels of total metabolizing sodium were found, or a slight tendency towards its elevation. In cases of adrenal hypertension (Conn's syndrome, pheochromocytoma) the level of total metabolizing sodium is significantly elevated. No correlation was seen between the levels of total metabolizing sodium, and plasma and erythrocytes sodium. The decrease of total metabolizing sodium at early stages of essential hypertension must be an adaptative reaction of the body, which is proved by the increased urine excretion of sodium.
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PMID:[Content of total metabolic sodium in arterial hypertension of varying origin]. 97 79

The plasma volume (PV) was determined in 109 patients with chronic arterial hypertension (AH) by 131I-labeled serumalbumin, expressing the results in ml/cm body height. An attempt was made to establish a statistical correlation between PV and diastolic pressure (DP). In essential AH three types of PV were found: normal, hypovolemic and hypervolemic; in hypertensive patients with stenosis of the renal aorta and in those with pheochromocytoma PV was slightly diminished; in hyperaldosteronism it was increased. In AH due to renal parenchymatous lesions the mean PV values were normal, a positive correlation being found between PV and DP (r + 0.929 and p = 0.05) in contrast to the other types of AH, where r was non significant or negative (stenosis of the renal artery, pheochromocytoma, malignant AH).
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PMID:Plasma volume in chronic arterial hypertension. 99 23

A case of right adrenal pheochromocytoma in an 8-yr-old boy and its successful surgical management are described. Clinical and statistical data are given for this form and its symptomatology and aetiopathogenesis are illustrated. Particular stress is laid on the occasionally misunderstood importance of the part played by continuous hypertension. Early diagnosis and surgery are essential to avoid the onset of serious cardiocirclatory complications.
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PMID:[Pheochromocytoma in childhood. Report of a case of a familial type in an 8-year-old boy]. 111 18

A long-term study of established hypertension helped identify a well defined group of 10 patients who differed both clinically and hemodynamically from 59 patients with the more frequent form of this disease. Their cardiac output was significantly increased (P less than 0.001) despite a severe elevation of arterial pressure (average 212/125 mm Hg plus or minus 13.5/7.3[standard error[). All had labile hypertension of long standing (16.2 years average) that was difficult to control and always symptomatic; in all, the diagnosis of pheochromocytoma had to be specifically excluded. Increased myocardial contractility was suggested by (1) significant elevation of the rate of rise of isovolumic pressure (P less than 0.001), and (2) high ratio of cardiac output to cardiopulmonary volume (P less than 0.005). Beta adrenergic blockade with propranolol helped to alleviate symptoms and to control tachycardia but failed by itself to reduce arterial pressure.
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PMID:Hyperkinetic heart in severe hypertension: a separate clinical hemodynamic entity. 112 21


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