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

A study of 35 patients with uncomplicated essential hypertension (EH) (labile hypertension, stages IB-IIA or stable hypertension, stage IIB) demonstrated a higher rate of Na+-Li+ countertransport in patients with hypertensive hereditary predisposition to EH (group 1), as compared to those with unaggravated heredity (group 2). A suppression of plasma renin activity (53%), and a higher rate of hyperlipoproteinemia (55%) were observed in group 1, as opposed to group 2 where Na+-Li+ countertransport was lower, plasma renin activity was normal, and hyperlipoproteinemia occurred in 33%. There was a direct correlation between Na+-Li+ countertransport and renin-angiotensin-aldosterone components in group 2. A conclusion is made that aggravated heredity, RAAS components and hyperlipoproteinemia should be taken into account in the assessment of Na+-Li+ countertransport in hypertensive patients.
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PMID:[Study of the relation of various genetic and pathophysiologic factors participating in the regulation of blood pressure in patients with hypertension]. 266 4

Platelet activation factor (PAF)-, ADP and vasopressin-induced increments of platelet Ca2+ concentration were measured by quin-2 in 64 patients with essential hypertension and 16 normal donors. Basal concentration of free Ca2+ was 87 +/- 4 nM in donors, 106 +/- 5 nM in patients with labile hypertension (LH) and 122 +/- 6 nM in those with stable hypertension (SH) (p less than 0.01). PAF, ADP and vasopressin, added to platelets, increased [Ca]in by 448 +/- 58, 397 +/- 66, and 277 +/- 50 nM, respectively, in the donors, by 473 +/- 57, 479 +/- 54 and 195 +/- 32 nM, in LH patients, and by 607 +/- 85, 584 +/- 73 and 245 +/- 41 nM in SH patients. There were no significant variations between the three samples, using the ANOVA test. In 20 patients, whose both parents had essential hypertension, [Ca]in increment was 738 +/- 8 nM for PAF, 682 +/- 90 nM for ADP, and 320 +/- 61 nM for vasopressin. In 19 patients, who admitted to no essential hypertension in the family, these parameters were significantly lower: 310 +/- 40 nM for PAF, 389 +/- 61 nM for ADP, and 147 +/- 26 nM for vasopressin. The demonstrated changes may be making an important contribution to the maintenance of elevated vascular tone and provide an evidence in favor of a genetically-predetermined EH variety.
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PMID:[Receptor-dependent regulation of the concentration of Ca2+ in the cytoplasm of thrombocytes in hypertensive patients]. 284 37

The authors studied the effect of adrenocorticotropic hormone (ACTH), potassium and plasma renin activity on blood aldosterone in normal subjects as well as in patients with essential hypertension (of a labile and stable course) and hyperaldosteronism (primary and idiopathic). It was demonstrated that in normal subjects and patients with labile essential hypertension, the secretion of aldosterone was simultaneously stimulated by the renin-angiotensin system (RAS) and the hypothalamus-adenopituitary. The RAS dominated in normal conditions whereas in labile hypertension the hypothalamus-adenopituitary system was predominant. In stable hypertension, the RAS and hypothalamus-pituitary influenced aldosterone secretion in an equal degree. Hyperaldosteronism was associated with the most pronounced deviations in the relationship between stimulants and aldosterone. In addition to decreased plasma levels of renin activity and potassium, the corticotropic activity of the hypothalamus-adenopituitary was increased during the first 10 years of the disease, while later on the function of this system became inhibited. The highest ACTH levels were recorded in idiopathic hyperaldosteronism.
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PMID:[Concentration of adrenocorticotrophic hormone and aldosterone secretion in essential hypertension and hyperaldosteronism]. 298 49

Automated ambulatory blood pressure monitoring is a safe new technique that allows a more exact assessment of the diagnosis and treatment of hypertension than has been possible previously. It should be of great value in helping avoid unnecessary pharmacologic treatment of certain patients and in tailoring therapy to individual needs. Further research is needed to determine the role of ambulatory monitoring in the detection of hypertension, in the assessment of cardiovascular symptoms, and in the definition and treatment of labile hypertension. Because this technique has been developed subsequent to the research that underlies our current understanding of the effect of hypertension and the treatment of hypertension on cardiovascular disease, further prospective studies are needed to confirm its value in predicting hypertensive complications. A growing body of evidence indicates that ambulatory blood pressure may be a much more powerful predictor of cardiovascular risk than conventional blood pressure measurements.
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PMID:Ambulatory blood pressure measurements: practical considerations, methodology, feasibility, and implications in the management of hypertension. 328 61

Current evidence suggests that the sympathetic nervous system plays a predominant role in some fraction of essential hypertension. Patients in whom such mechanisms are likely to be operative are young people with mild or labile hypertension. These mechanisms are expressed clinically through orthostatic hypertension, rapid heart rate, modestly elevated cardiac output, and normal or slightly elevated peripheral vascular resistance. The vascular resistance is inappropriately high for the level of cardiac output, and this is reflected in a mildly elevated blood pressure. This evidence carries therapeutic implications and suggests that sympatholytic drugs should be the first line of therapy. An additional pressor mechanism may arise from increased sympathetic activity along renal efferent nerves that impairs sodium excretion and another possible mechanism is stimulation of brain centers through impulses from the kidneys carried in renal afferent nerves.
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PMID:Essential hypertension: neural considerations. 330 9

Twenty-one percent of 292 patients with untreated borderline hypertension (clinic diastolic blood pressures persistently between 90 and 104 mm Hg) were found to have normal daytime ambulatory pressures (defined from a population of normotensive subjects). These patients were defined as having "white coat" hypertension, and they were more likely to be female and younger, to weigh less, and to be more recently diagnosed than patients whose pressure was elevated both in the clinic and during ambulatory monitoring. Patients with white coat hypertension did not show a generalized increase of blood pressure lability, nor an exaggerated pressor response while at work. The phenomenon is more pronounced when blood pressure is measured by a physician than by a technician. In such patients, the pressor response may be relatively specific to the physician's office and lead to significant misclassification of hypertension.
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PMID:How common is white coat hypertension? 333 40

Urinary sodium excretion was assessed in women with essential hypertension as an indicator of dietary sodium consumption. Groups of individuals with low (below 120 mmol/day), medium and high (above 180 mmol/day) excretion were identified. Patients with high sodium excretion levels showed slower withdrawal rates, as well as high total peripheral resistance and low cardiac output values. At the labile hypertension stage, these patients demonstrated an increase in total metabolic sodium owing to its growing residual fraction, and expanded interstitial fluid volume. Changes in renin-angiotensin-aldosterone activity showed close correlation with changes in sodium balance. Urinary adrenaline and noradrenaline excretion decreased in patients with labile hypertension who had the highest sodium excretion levels, and increased considerably in stable hypertension. Hypertension was particularly severe in patients who excreted over 180 mmol sodium daily whereas patients who excreted less than 120 mmol in the presence of stable hypertension had normal values of total metabolic sodium and cardiac output, and moderately elevated peripheral vascular resistance.
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PMID:[Urinary sodium excretion in women with hypertension and various indicators of hemodynamics and pressor hormone levels]. 379 12

The concept of labile hypertension (also called borderline hypertension) has been proposed to define those patients in whom blood pressure is sometimes below, sometimes above the frontier which separates normal and high blood pressure. Current evidence does not support the individualization of this concept, since numerous studies have demonstrated a similar or even higher blood pressure variability in hypertensive patients than that found in normotensive patients. The main objective, when measuring blood pressure, is to assess the risk of a cardiovascular event. It has been shown that the average value of several blood pressure determinations provides a better estimate of cardiovascular risk, and correlates better with hypertensive target organ disease, than a single blood pressure measurement. Therefore, we propose to define these so-called labile hypertensive patients on the basis of the average and to classify them into the category of mild hypertension, the later being defined as a diastolic blood pressure between 90 and 105 mmHg on several occasions according to the WHO. The increase in cardiovascular risk carried by a mild elevation in blood pressure, either untreated or treated with general health measures, is small, approximately 3% per year. Moreover, whereas the beneficial effects of pharmacological antihypertensive therapy have been demonstrated on a whole population basis, these effects remain controversial on an individual basis. Thus, it appears justified to give these hypertensive patients general health measures advice without any pharmacological therapy during the first months of follow-up. During this time, blood pressure measurements are repeated so that blood pressure status, and thus the need for pharmacological therapy, can be assessed more precisely.
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PMID:[From labile or borderline arterial hypertension to mild hypertension. Current data and practical management]. 389 Jun 79

It is referred to the importance of bicycle-ergometric examinations for a better recognition of the hypertension with limiting value and the labile hypertension. According to time of day and the physical and psychic condition very different blood pressure values can be measured. Therefore, from this point of view blood pressure values may be compared only on the same exterior and interior conditions. The interior conditions are only little to be influenced. A standardized test method, as it is the bicycle ergometry, therefore under the same exterior conditions guarantees comparable and above all reproducible blood pressure values. Also the success of therapy under antihypertensive drugs and thus the prognosis can exactly be classified after these examinations. Furthermore it could be shown that the behaviour of the blood pressure under ergometric load with and without beta-receptor blocker is approximately the same.
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PMID:[Blood pressure and heart rate behavior of ergometrically stressed patients with and without beta receptor blocker]. 398 14

The maximal rate of ouabain sensitive Na+ (pump), the maximal rate of Na+ and K+ furosemide (co-transport), the maximal rate of Na+ lithium countertransport and the rate constant of Na+ and K+ passive permeability were determined in the following population: 27 controls, 39 labile essential hypertensive, 10 stable hypertensive children, 6 normotensive offspring of hypertensive parent (s), and 19 hypertensive secondary to renal disease. The normal values for children were determined for all these various fluxes. When a rigid technique was applied and particularly when the post loading concentration of intracellular Na+ was determined and when the cells were not swollen by Na+ loading, the technique was reliable, reproducible and our results could be compared with the results found in adults by researchers using the same rigid technical criteria. In labile hypertension, 21% of adolescents had a decreased co-transport, 17% an increased countertransport and 6% an increased Na+ leak. In stable hypertension none had a decreased co-transport, 29% had an increased countertransport and 25% had an increased Na+ leak. Moreover, plasma norepinephrine was elevated in most of the patients presenting a decreased co-transport. Our results suggest that adolescents with labile essential hypertension and elevated plasma norepinephrine present with a decreased co-transport whereas adolescents with stable essential hypertension and normal or subnormal plasma norepinephrine present with an increased countertransport.
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PMID:Erythrocyte cation fluxes in essential hypertension of children and adolescents. 399 72


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