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

Modern, views are presented on the pathogenesis of arterial hypertension in certain diseases of endocrine glands. In patients with phaeochromocytoma, virilizing tumours, acromegaly, in Cushing's disease, and in Conn's syndrome at the present state of knowledge it is not possible to formulate unequivocal conclusions concerning the effects of renin-angiotensin-aldosterone system on the mechanism of arterial hypertension development in these endocrinopathies.
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PMID:[The renin-angiotensin-aldosterone (RAA) system in endocrine diseases]. 225 31

The purpose of this study was to evaluate the effect of clonidine--an alpha 2-adrenergic agonist--and naloxone--an opiate antagonist--on pituitary hormone release. The study involved 43 women: 20 menopausal women, 9 untreated women with ACTH-dependent Cushing's disease, and 14 healthy women. Serum GH, ACTH, LH, FSH, TSH, cortisol, and plasma beta-endorphin concentrations were measured with RIA methods. A significant increase in GH and a significant decrease in ACTH and in cortisol was observed after clonidine injection in healthy women. Clonidine caused a significant decrease in LH concentration in the luteal phase of the menstrual cycle. However, naloxone induced the opposite effect on pituitary hormone release. In Cushing's disease, ACTH significantly decreased in response to clonidine. In postmenopausal women with hypertension a decrease in blood pressure, a marked decrease in the number of hot flashes, as well as a diminution in amplitude and frequency of LH pulsatility was found. Conclusions are as follows: (1) Clonidine may be useful in the treatment of hypertensive menopausal women; and (2) a diminution in ACTH, beta-endorphin, and cortisol release in response to clonidine was observed in Cushing's disease.
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PMID:The effect of clonidine on pituitary hormone secretion in physiological and pathological states. 245 86

The activity of converting enzyme was determined in 19 patients with Cushing's disease using Friedland and Silverstein technique. Statistically significant increase in the activity of this enzyme was noted in the majority of the examined patients in comparison with healthy subjects. Therefore, inhibitors of the converting enzyme (Captopril) are justified in the treatment of the arterial blood hypertension in Cushing's disease.
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PMID:[Activity of angiotensin converting enzyme (ACE) in cushing's disease]. 255 63

The authors studied 8 patients (4 males and 4 females) with Cushing's syndrome due to ectopic ACTH secretion. Chronological age ranged from 15 to 45 years and duration of the disease ranged from 3 to 48 months. All patients presented typical signs of Cushing's syndrome, blood hypertension, and four of them had hyperpigmentation of the skin. Five patients had fasting hyperglycemia and all patients but one had serum hypokalemia (serum K = 2.2 to 3.9mEq/l). The circadian rhythm of cortisol was absent in all patients and basal cortisol levels were elevated in all patients but one. Basal ACTH levels evaluated in 7 patients were elevated in 6 (29 to 1050 pg/ml-MRC). One patient presented normal depression of urinary 17-OH after two days of dexamethasone and normal increase of urinary 17-OH and serum 11-dexycortisol after methyrapone. Four patients had carcinoid tumor (3 thymic and 1 bronchial), two had pancreatic islets cell tumors, one had bilateral pheochromocytoma and medular carcinoma of the thyroid, and one had oat cell carcinoma of the lung and medular carcinoma of the thyroid. Thoracic X-rays identified the ectopic ACTH secretion tumor in four cases, all confirmed by CT scan. Abdominal CT showed a difuse enlargement of the adrenals in seven cases and bilateral nodules in one case (pheochromocytomas). Six patients died within 3 years of the diagnosis. The authors concluded that clinical and hormonal findings could mislead the findings of ACTH ectopic secretion and Cushing's disease, and suggest that thoracic X-rays and CT scans of the skull, thorax, and abdome should be done in all cases of Cushing's syndrome.
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PMID:[Cushing syndrome due to ectopic ACTH secretion]. 255 51

The secondary, nonrenal forms of hypertension principally include pheochromocytoma, hyperaldosteronism, hypercortisolism, iatrogenic hypertension following medication, and hypertension related to overindulgence. Other very rare secondary forms of hypertension will not be considered here. Pheochromocytoma is the most dangerous of all the forms of hypertension. Diagnosis of the underlying cause of endocrine-derived hypertension is achieved by hormone analysis. Due to the small size of endocrine tumors, their exact localization can often not be established by sonography, such that CT or MR are the examinations of choice. Scintigrams are only necessary in special cases. For tumor localization in Cushing's disease, hormone measurements from the petrosal sinus are occasionally required. Medication, and above all, continual alcohol consumption, play an increasing role in the etiology of hypertension.
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PMID:[Diagnosis of extrarenal, secondary forms of hypertension]. 269 54

Few studies have examined the effect of the weak mineralocorticoids corticosterone, 18-hydroxycorticosterone and 18-hydroxydeoxycorticosterone on the pathogenesis of hypertension in Cushing's disease. Therefore we measured plasma levels of these mineralocorticoids together with plasma aldosterone, plasma renin activity and the aldosterone secretion rate in 12 patients with Cushing's disease and in seven patients with essential hypertension. Plasma levels of aldosterone, corticosterone, 18-hydroxycorticosterone and 18-hydroxydeoxycorticosterone and the aldosterone secretion rate were similar in both groups of patients. Plasma renin activity, determined after 4 h of ambulation, was significantly higher in Cushing's disease than in essential hypertension. We conclude that it is unlikely that either aldosterone or the weak mineralocorticoids corticosterone, 18-hydroxycorticosterone and 18-hydroxydeoxycorticosterone play a specific role in the pathogenesis of hypertension in Cushing's disease.
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PMID:Do weak mineralocorticoids affect the pathogenesis of hypertension in Cushing's disease? 269 26

Primary empty sella is a neuroanatomical condition which is more common in middle aged obese multiparous females with long-standing hypertension. Usually there are no symptoms, but occasionally nonspecific headache may be present. Hormone studies are commonly normal in these patients, although several functional hypothalamic and pituitary abnormalities have been reported. We report a 64-year-old female with primary empty sella in whom Cushing's disease was diagnosed. The association of both disorders is exceptional.
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PMID:[Cushing's disease in a patient with primary empty sella turcica]. 275 43

The results of the study of depressor (PGE+A) and pressor (PGF2 alpha) prostaglandins in the blood plasma and of PGE2 and PGF2 alpha excretion in the urine of 52 patients with an acute stage of Itsenko-Cushing disease are presented. It has been established that the different components of the PG system have dissimilar changes: the absence of differences in the content of depressor and significant increase in pressor PG, which may be the cause of hypertension in Itsenko-Cushing disease. Stress due to insulin hypoglycemia and furosemide load brought about disturbances in the reaction of the PG system, which were more pronounced in the system pressor component. Disturbances of the PG system which were more pronounced in the presence of stable hypertension were established in all patients.
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PMID:[Prostaglandins in Itsenko-Cushing syndrome]. 277 63

Pregnancy in patients with Cushing's syndrome is rare. It is associated with a high fetal loss, increased frequency of preterm labour and excessive maternal morbidity. We describe a patient who became pregnant while investigations for hypertension were being done. Cushing's disease was diagnosed and the patient had transsphenoidal pituitary surgery at 22 weeks gestation. To our knowledge this is the first time this operation has been done during pregnancy for this condition. Cushing's disease was controlled, but because of worsening hypertension, she had a caesarean section at 30 weeks gestation. Subsequently her blood pressure fell and her hydrocortisone replacement therapy is being withdrawn. Her daughter is now thriving after initial problems with pneumothoraces.
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PMID:Successful management of Cushing's disease during pregnancy by transsphenoidal adenectomy. 332 96

The presence of hypertension in domestic animals is poorly described. Values for hypertension were established in dogs using a direct blood pressure measurement. A protocol was devised to recognize and characterize primary (essential) and secondary hypertension. Essential hypertension was associated with marked elevations in blood pressure and can be shown to be a hereditary disease in dogs. Secondary hypertension is more common and most frequently associated with Cushing's disease and renal failure. Treatment to reduce blood pressure in both groups can be achieved using pharmacologic agents which are more effective than sodium restriction alone. Hypertension appears to be an underdiagnosed disease in dogs. The significance of chronic hypertension in dogs in terms of vascular pathology is not yet clear.
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PMID:Hypertension and renal function. 357 94


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