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

Plasma concentrations of the recently isolated potent vasoconstrictory peptide endothelin were measured in 382 patients. The investigations were performed by means of a sensitive radioimmunoassay specific for Endothelin-1, 2. The results from 110 healthy volunteers displayed a normal range of 44.67 +/- 3.51 pg/ml. Significantly raised levels were found in 33 patients with chronic end-stage renal failure both before and after hemodialysis. In contrast, 35 patients with compensated renal insufficiency did not differ from the normals. Sixty-five patients after kidney transplantation revealed significantly elevated levels, as did 27 patients with acute myocardial infarction, 8 after coronary bypass surgery, and 5 with liver cirrhosis. The mean values of 27 patients with untreated hypertension, 22 with secondary hypertension, of various causes and 16 with coronary artery disease were comparable to the normal population. The values were significantly decreased in 9 pregnant women with hypertension and proteinuria. A marked decline was found in 5 patients with systemic lupus erythematodes, while 20 patients with rheumatoid arthritis demonstrated only a slight decrease. The pathophysiological role of endothelin as a local or circulating hormone in regulating systemic blood pressure or release of other hormones remains to be determined.
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PMID:[Plasma endothelin in normal probands and patients with nephrologic-rheumatologic and cardiovascular diseases]. 221 2

The powdered bark of Maquira sclerophylla is consumed as snuff in north Brazil. Both the crude and the purified hydrosoluble extract (WP) injected i.p. in the dose range of 0.05-0.5 g/kg induced hyperexcitability, tremors, motor incoordination, ataxia, quietness and muscle relaxation in rats. The effects were progressive, dose-related and reversed after 30 min. Anesthetized rats, guinea-pigs and dogs injected with the purified extract (10-50 mg/kg, i.v.) showed a biphasic change of carotid blood pressure. The early and transient hypotension was blocked by atropine but not by vagotomy: the secondary hypertension was long lasting and sustained for over 30 min. The hypertension was shortened but not blocked after ganglionic blockade or reserpine treatment. Either pithing or alpha receptor blockade with yohimbine reduced both effects of the extract. Guinea-pigs and dogs were more responsive than rats and died by heart arrest. Incubation of WP (20 micrograms/ml) increased both the rate and force of contraction of isolated guinea-pig right atria by 2 and 5 times, respectively. Propranolol (4 micrograms/ml) blocked the chronotropic effect but did not decrease the inotropic effect. In electrically driven guinea-pig left atria, WP (10 micrograms/ml) increased the force of contraction by 80% and the maximum rate of force development by 60%, but did not change the time to peak tension, the time to 50% relaxation, or the rate of relaxation. These cardiovascular effects resemble those of digitalis-like drugs. Cardenolides were detected in WP by phytochemical screening.
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PMID:Pharmacology of an Indian-snuff obtained from Amazonian Maquira sclerophylla. 221 23

The rate of Na-Li countertransport was studied in inpatients with essential hypertension (n = 59), chronic diffuse glomerulonephritis (n = 30), chronic pyelonephritis (n = 26), renovascular hypertension (n = 15) and in those with associated renovascular hypertension and essential hypertension (n = 4). Multiple regression analysis has demonstrated that age, body weight and blood plasma lipids do not make any significant contribution to dispersion of the counter transport rate. The mean rate of countertransport in patients with essential hypertension turned out much higher than that in patients with secondary hypertensions. Repeated examinations have shown that in every man, the countertransport rate remains unchanged for 1.5 yr. It is not affected either by hypotensive therapy or surgical treatment. In inpatients with secondary hypertension and low rates of countertransport, high arterial pressure (AP) drops after surgical treatment of the kidneys, renal vessels or adrenals. Surgical treatment of patients with secondary hypertension and high rates of countertransport does not lead to any material decrease of AP. It is assumed that the rate of Na-Li countertransport can be used for diagnosing associated secondary hypertensions and essential hypertension and prediction of AP lowering after surgical treatment.
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PMID:[Na-Li countertransport and the diagnosis of hypertension and combined hypertension and renal artery stenosis]. 221 10

Seventy patients, aged 1-20 years, were seen at Jordan University Hospital with high blood pressure (BP) over a 3-year period. BP values ranged from 140 to 230 mmHg for systolic pressure and from 90 to 130 mmHg for diastolic pressure. Essential hypertension was seen in only 6 patients (8.6%); secondary hypertension (n = 64 or 91.4%) was due to renal parenchymal diseases (RPD) in 46 patients (65.7%), reno-vascular lesions in 8 (11.4%), renal transplantation in 5 (7.2%), teenage pregnancy in 4 (5.7%), and phaeochromocytoma in 1 patient (1.4%). The aetiologies of RPD were as follows: end-stage renal disease requiring dialysis in 14 patients, acute glomerulonephritis in 14, idiopathic nephrotic syndrome in 10, chronic renal insufficiency in 5, and polycystic kidney in 3 patients. Surgical cure of hypertension was achieved in 5 of the children with reno-vascular lesions and in the patient with phaeochromocytoma.
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PMID:Hypertension in Jordanian children: a retrospective analysis of 70 cases. 224 23

Non-invasive ambulatory blood pressure monitoring was performed in a consecutive series of 87 subjects with recently detected mild uncomplicated hypertension. Obese subjects, diabetics and those with secondary hypertension were excluded. Ambulatory pressures were recorded on a day of usual activity. Average ambulatory systolic and diastolic pressures were significantly lower than referral pressures determined in clinics or screening sites and initial pressures taken by the monitors. Whereas men (57) and women (30) had similar referral and initial pressures, average ambulatory systolic pressure was significantly higher in men; diastolic pressure was not different. Men also had a significantly higher fraction of ambulatory systolic pressures greater than 140 mmHg compared to women. Fifty-six percent of the men and 80% of the women had average ambulatory systolic pressures less than 140 mmHg and diastolic pressures less than 90 mmHg; the difference between the sexes was significant (chi 2 = 6.99, P less than 0.01). Thus, in mild hypertension, women have lower average systolic pressure than men during ordinary daily activity. These results may account for lower long-term cardiovascular morbidity in hypertensive women compared with men.
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PMID:Differences in ambulatory blood pressure between men and women with mild hypertension. 225 84

The use of ABPM allows an improved assessment of blood pressure (BP) and therefore of the individual cardiovascular risk. It is able to identify patients who truly need therapy more exactly. Mostly patients with white coat hypertension who don't need therapy are identified. Furthermore, ABPM correlates more closely to target organ damage and to cardiovascular morbidity and mortality. This may be helpful to treat especially those patients who truly need therapy. BP exhibits a typical circadian rhythm with the highest values during the early morning hours and a decline during the night. A change of the day/night rhythm during shift work leads to an adaptation of BP rhythm. The early morning rise of BP and heart rate is accompanied by hemodynamic, rheological and biochemical alterations, which together may contribute to the increased frequency of vascular complications during the morning hours. The nightly decline of BP is often absent in patients with secondary hypertension and cardiac or renal organ damage. A lack of the nocturnal BP decline should therefore lead to further patients' evaluation. Elevated nocturnal BP seems to worsen the prognosis. ABPM offers better individual control of BP in patients on treatment and therefore is helpful to optimize the treatment. A more exact individual BP control during the awakening and sleeping period is possible as well as an avoidance of overtreatment. Patients could be protected both from prescription of too many drugs and from lowering BP too much. A further advantage lies in an improved control of patients with nocturnal hypertension.
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PMID:[The significance of 24-hour blood pressure monitoring in the diagnosis and therapy of arterial hypertension]. 228 May 76

The case of a 63-year-old patient in whom serious hypertension of recent onset was recalcitrant to conventional anti-hypertensive therapy is reported. Clinical and biohumoral data suggested a form of nephro-vascular hypertension. This clinical case led to a review of the clinical and diagnostic criteria of this by means rare form of secondary hypertension. The correctness of the diagnostic and therapeutic approach was confirmed by the normalisation of plasma renin levels and by the good control of arterial pressure after right nephrectomy (rendered indispensable after the angiographic finding of complete stenosis of the right renal artery).
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PMID:[Renovascular hypertension: a clinical dilemma]. 228 Aug 82

Studies of the pathobiologic consequences of high blood pressure in childhood, as well as those following blood pressure levels into young adulthood, indicate that early intervention in the natural history of essential hypertension is warranted. In an exploratory study of the concept, 95 children out of 1604 (aged 8 to 18 years), who persistently scored higher than the 90th percentile for blood pressure over a 4-month period, considering the race, sex, and height of the children, were studied. Five series of replicate measurements with 30 total observations were obtained. Children with evidence of secondary hypertension were excluded. The study children were randomly divided into treatment (n = 48) and high-comparison (n = 47) groups. Treatment consisted of low-dose combined drug therapy (propranolol and chlorthalidone) with an educational program directed towards hypertension and dietary and exercise modification. Monthly follow-up was continued for 30 months. Significant systolic (-3.59 mm Hg) and diastolic (-1.73 mm Hg) changes were noted up to 30 months (p less than 0.05) with minimal side effects. Furthermore, analyses suggested that the blood pressure change, at least in the first month, was mostly attributable to drug therapy. Moreover, the mechanism of blood pressure change appeared to be race-specific, with whites having pulse rate changes and blacks having significant weight changes, which were associated with blood pressure change. This trial shows further research is warranted to determine optimum approaches for early treatment of essential hypertension to prevent future hypertensive disease.
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PMID:Combined low-dose medication and primary intervention over a 30-month period for sustained high blood pressure in childhood. 230 54

The distribution of specific proteins in erythrocyte membranes was studied in patients with essential hypertension (EH) (n = 44), secondary hypertension of renal genesis (n = 42), and healthy persons (n = 44). Densitograms of gel analyzed after electrophoresis of erythrocyte ghosts showed a twofold increase in polypeptide levels in EH patients as compared to those in health persons: the band being 4.5 (Mw = 52-59 kD) and 6 (Mw = 35 kD), respectively. Radioimmunoassay has demonstrated that the amount of monoclonal antibodies bound to fragmented erythrocyte membranes from EH patients is greater by at least 28% than that in healthy persons. Patients with secondary arterial hypertension of renal genesis showed no significant difference in monoclonal antibody binding as compared to the controls.
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PMID:[Changes in the levels of erythrocyte membrane proteins in hypertension]. 233 59

There is substantial evidence to show that correction of the causes of secondary forms of hypertension usually but certainly not always restores blood pressure to normal. We have analyzed the effect of age on the response of the blood pressure to the removal of the cause of hypertension in groups of patients with primary aldosteronism, renovascular hypertension, Cushing's syndrome and hypothyroid hypertension. In the patients studied, surgical or medical elimination of the mechanism responsible for the hypertension when the patients were below the age of 40 reduced diastolic blood pressure 1 to 2 years later to below 90 mm Hg in 24 of 25 patients. In the patients who were treated when they were over 40 years of age, blood pressure remained above 90 mm Hg after corrective treatment in 23 of 61 individuals (38%). In the 4 groups studied there was a significant correlation between age and post-treatment systolic and/or diastolic blood pressure. The findings indicate the importance of correcting secondary hypertension at an early age.
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PMID:Effect of age on response of secondary hypertension to specific treatment. 235 Apr 75


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