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

The association between blood pressure and coronary artery disease may be caused by a concurrence of atherogenic biochemical abnormalities in hypertensive patients, i.e., the metabolic cardiovascular syndrome (increased total cholesterol, triglycerides, and insulin; decreased high-density lipoprotein (HDL) cholesterol; and insulin resistance, glucose intolerance, and blood platelet dysfunction). There are numerous reports of sympathetic nervous system overactivity in hypertensive subjects that could be of importance for the pathophysiology of the high blood pressure. Plasma catecholamines have metabolic hormonal effects at concentrations slightly above low normal resting levels. Even transiently and certainly chronically raised plasma catecholamine levels may cause biochemical abnormalities. Catecholamines may raise total cholesterol, triglycerides, and insulin, decrease HDL cholesterol, and cause insulin resistance and glucose intolerance, and recent evidence supports an in vivo influence of epinephrine on blood platelets, causing dysfunction in hypertensive subjects. Thus, the sympathetic nervous system may modulate the metabolic cardiovascular syndrome in essential hypertension. Hypertensive subjects may respond to environmental stimuli with larger sympathoadrenal responses than normal subjects. Furthermore, emotional stress has been associated with coronary artery disease. Thus, the metabolic hormonal effects of catecholamines, by causing the metabolic cardiovascular syndrome, may be the crucial link between "stress" and cardiovascular disease.
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PMID:The sympathetic nervous system may modulate the metabolic cardiovascular syndrome in essential hypertension. 128 68

Arterial blood pressure reactivity to the emotional stress and brain alpha 1-adrenoreceptors concentrations were studied in hypertensive (ISIAH strain) and normotensive (Wistar strain) rats and their F1 and F2 hybrids. Significant correlations between the stress-induced increase in the arterial blood pressure and the amount of alpha 1-adrenoreceptors in hypothalamus (+0.46) and medulla (+0.38) were found in the F2. This cosegregation may point to the significant role of genetically determined peculiarities of expression of alpha 1-adrenoreceptors in brain regions during pathogenesis of arterial hypertension in the ISIAH strain.
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PMID:[Genetic correlation between the arterial pressure response during emotional stress and the alpha1-adrenoreceptor concentration in brain regions]. 133 28

The authors present their experiences concerning the effect of extrarenal factors on the results of radionuclide examination. Functional and functional-morphological examinations of the kidneys and urinary tract can be negatively affected particularly by emotional stress, orthostasis, dehydration, increased kidney motility, address administered drugs during examination (diuretics), drug treatment of the primary disease, muscular strain, cold, pain, increased pressure in the vicinity of the kidney, hypertension, hypotension, as well as further conditions. Radionuclide methods can objectify these processes, the given negative effects can however be presumed to occur also at other examination procedures of the kidney and urinary tract. The conditions of examinations have thus to be optimized and standardized. The examining physician has to know which drugs the patient is receiving and he has to know their effect on renal function.
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PMID:[The effect of extrarenal factors on certain functions of the kidney and urinary tract. A radionuclide study]. 139 43

All patients with unstable angina should be admitted to a coronary or an intensive care unit. There should be an attempt to classify the patient according to the proposed Braunwald nomenclature. If the patient has a secondary cause for unstable angina (e.g., tachyarrhythmia, heart failure, fever, thyrotoxicosis, severe hypertension, hypoxia, unusual emotional stress, or anemia), this condition should be treated initially with therapy specific for that etiology. If the patient does not have a secondary etiology, therapy should be initiated with nitrates, preferably intravenous nitroglycerin. Heparin should be concomitantly administered. If the patient cannot receive heparin, aspirin should be initiated. All patients should receive beta-blockers. If the patient cannot take a beta-blocker, a calcium antagonist (probably diltiazem) should be initiated. However, if the patient is refractory to beta-blockers, the dihydropyridine nifedipine should be added. Failure to all pharmacologic interventions necessitates a progressive invasive approach dictated by the potential surgical risk of the patient. Long-term aspirin and beta-blockers should be strongly considered.
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PMID:Pharmacotherapy of unstable angina. 158 55

Systemic administration of yohimbine augments sympathetic outflow and blocks presynaptic alpha 2-adrenergic receptors, releasing the sympathetic neurotransmitter norepinephrine (NE) into the bloodstream. The present study examined sympathoadrenal and hemodynamic responses to yohimbine in 19 patients with essential hypertension and 19 normotensive control subjects. Baseline mean values for arterial NE, epinephrine, dihydroxyphenylglycol (the main intraneuronal metabolite of NE), spillover of NE into arterial plasma, and corticotropin did not differ between the hypertensive and normotensive groups. Yohimbine (0.125 mg/kg i.v. bolus followed by 0.001 mg/kg/min infusion for a total of 15 minutes) increased mean arterial pressure in all but one subject (by 13 +/- 2% [SEM] in the normotensive and 17 +/- 2% in the hypertensive group) and increased arterial NE levels in all subjects (by 253 +/- 50 pg/ml in the normotensive and 312 +/- 51 pg/ml in the hypertensive group). Among hypertensive patients, pressor, cardiac, output, and arterial NE responses were distributed bimodally. Patients with large hemodynamic and NE responses to yohimbine typically reported a history of anxiety, depression, or other psychopathology and of marked pressor or tachycardic episodes during emotional stress. In the hypertensive and normotensive groups, baseline arterial NE concentrations predicted the magnitude of pressor responses to yohimbine (r = 0.59, r = 0.54,p less than 0.01), whereas baseline mean arterial pressure was unrelated to the pressor response. A yohimbine challenge test can identify patients with pressor hyperresponsiveness and can distinguish patients with pressor hyperresponsiveness due to excessive sympathoadrenal reactivity from patients with enhanced postsynaptic responsiveness to endogenous NE.
Hypertension 1991 Nov
PMID:Sympathetic reactivity during a yohimbine challenge test in essential hypertension. 165 75

The value of the vascular examination cannot be over-estimated. Symptoms of vascular disease present in the foot and lower extremity may actually be manifestations of severe life-threatening disease. Symptoms, their location, and the frequency and quality of the patient's pain often provide valuable clues for the clinician's diagnosis. Central nervous system symptoms, ocular disturbances, cardiac symptoms, impotence, or constitutional disturbances may all indicate systemic arterial disease. Risk factors for this disease include smoking, hypertension, hyperlipidemia, genetic predisposition, diabetes, emotional stress, and physical inactivity. Those factors attributable to hypercoagulability and venous disease are birth control pill use, estrogen chemotherapy, obesity, prolonged immobilization, paralysis, previous thrombotic episodes, venous stasis disease, and varicose veins. An accurate bilateral assessment of blood pressure, pulses, and capillary perfusion is of critical importance. Careful inspection of the extremity for trophic changes, skin color, texture, temperature, edema, ulceration, atrophy, or paresis, will provide clues of vasculopathy. A relatively accurate assessment of circulatory status may be obtained without the use of exotic instruments. Simple tests such as the elevation and dependency tests, capillary bed return test, venous filling time test, along with blood pressure, pulse, and possibly oscillometry data are valuable in arterial evaluation. Such venous tests as inspection, percussion, Homan's sign, Trendelenburg, and Perthes' tourniquet are useful in the determination of the presence of venous disease. Fortunately, over the past few years tremendous advances have been made in the technology of the vascular laboratory. If symptoms are discovered during the vascular history and physical examination, the complete noninvasive study will provide impressive data to quantitate and specifically establish the diagnosis.
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PMID:The vascular history and physical examination. 173 54

Angioedema is a diffuse swelling of the subcutaneous or submucosal tissues that occurs in both hereditary and non-hereditary forms. It can be a temporarily disfiguring condition, but not usually a serious one unless the airway is compromised. In the majority of cases, no underlying cause can be identified. In this report, a case of "idiopathic" angioedema that occurred while performing a periodontal surgical procedure is presented. This case is interesting because the patient was on long-term use of an angiotensin-converting enzyme [ACE] inhibitor for hypertension, and recent evidence has shown that ACE inhibitors suppress the breakdown of circulating bradykinins. With high plasma levels of bradykinins, a local anesthetic, periodontal surgical procedures, or even emotional stress may trigger an attack of angioedema. Practitioners should be aware of the pharmacologic side effects of ACE inhibitors and be prepared to handle an emergency if a patient's airway becomes compromised.
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PMID:Angioedema as a complication in periodontal surgery: report of a case. 177 Apr 24

Stroke-prone spontaneously hypertensive rats (SHRSP) and normotensive Wistar-Kyoto rats (WKY) were maintained in isolation or in group to analyze the effect of isolation, one type of emotional stress, on the development of hypertension and its complications. SHRSP kept isolated during the whole or a half of the experimental period developed severer hypertension within a shorter period than those kept together with other animals throughout the experiment, and showed significantly higher incidences of cerebral stroke (40 or 33%) than the latter (8.3%). Histological and pathophysiological studies revealed pituitary-adrenal and cardiac hypertrophy accompanying more accelerated urinary epinephrine (E) excretion which indicated emotional stress caused by isolation might aggravate pathological lesions in hypertension. Neither WKY in isolation nor in groups developed hypertension, although isolated WKY had significantly heavier pituitary and adrenal glands accompanied with more accelerated urinary E and calcium excretions than WKY kept in groups.
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PMID:Aggravating effects of isolated caging on the development of hypertension and its complications in stroke-prone spontaneously hypertensive rats (SHRSP) and Wistar-Kyoto rats (WKY). 177 18

Fourteen male patients with mild hypertension, aged between 20 and 46 years (mean = 32.4 years) measured their arterial blood pressure thrice daily for 6 weeks. Prior to and after this period psychological tests were carried out, including Gough's ACL test and Spielberger's STAI questionnaire. All patients underwent also Kraeplin's test under stress conditions twice during the experiment. It was found that there is significant correlation of personality response syndromes such as: need for acceptance, inferiority complex, need for success, trust to themselves, anger and some values of blood pressure. So-called personality syndrome related to hypertension was established. Psychophysiological picture accompanying emotional stress was discussed and relationship between blood pressure values (prior to and after emotional stress) and personality syndromes were defined.
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PMID:[Individual reactions and psychophysiologic reactions in patients with mild primary hypertension]. 184 60

This study investigates the function of the hypothalamic-pituitary-adrenocortical system (HPAS) in adult rats with inherited stress-induced arterial hypertension (ISIAH rats) whose arterial blood pressure was lowered by the dopamine precursor L-DOPA treatment during early development (on days 21-25 of life). The response of the HPAS induced by emotional stress was significantly lower in intact ISIAH rats than in normotensive Wistar animals. Injections of L-DOPA on days 21-23 or 21-25 of postnatal life were followed by a long-lasting complete restoration of the emotional stress response in adult ISIAH rats. The restoring effect of L-DOPA was produced through enhancement of synthesis of the brain noradrenaline and, perhaps, adrenaline. The effect was associated with a normalization of the response of the brain adrenergic system to noradrenaline and did not relate to an increase of the plasma corticosterone level after L-DOPA administration in early ontogeny.
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PMID:Treatment with L-dopa in early life restored pituitary-adrenocortical response to emotional stress in adult rats with inherited arterial hypertension. 185 49


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