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

The smoking and drinking habits of 58 patients with accelerated hypertension were compared with those of a control group of 58 patients with benign hypertension, each individually matched for age, sex and date of presentation. Thirty-eight (66 percent) of the patients with accelerated hypertension were regular smokers compared to 26 (45 percent) of the control group. This excess of smokers was significant, but the average number of cigarettes smoked by smokers in the two groups was similar. The number of patients known to consume alcohol was the same in the two groups; and there were no significant differences in amount of alcohol drunk. Smoking and alcohol habits were not related. Thirty-six patients (62 percent) with accelerated hypertension had serum creatinine levels greater than 0.12 mmol/l compared with nine (16 percent) of the control group. Seventeen (29 percent) patients with accelerated hypertension were known to have died compared with five (9 percent) of the control group. This survey confirms that, as shown by recent studies in Britain, smoking is more common in patients presenting with accelerated than with benign hypertension. It appears that hypertensive patients who smoke regularly are more likely to develop the accelerated phase than those who do not.
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PMID:Cigarettes and accelerated hypertension. 693 29

Renal hemodynamics, plasma renin activity (PRA), plasma aldosterone (PA) and sodium excretion were studied in essential hypertension. PAH clearance (CPAH) and glomerular filtration rate (GFR) were normal or increased in early hypertension and depressed at later stages, especially in malignant cases. The PAH extraction ratio was depressed only in patients with low CPAH values. CPAH did not correlate inversely with blood pressure in benign hypertension. Later reexamination of untreated patients revealed a decrease in CPAH, but no further increase in blood pressure. Antihypertensive treatment prevented the decrease in CPAH. Patients with essential hypertension showed no abnormality in basal sodium excretion, plasma aldosterone, plasma renin activity and the sodium:aldosterone relationship. Basal sodium clearance did not correlate with GFR and the fractional sodium excretion was not pressure-dependent. When clearance determinations and measurements of PA and PRA were performed simultaneously under standardized conditions, PA and PRA were correlated inversely with CPAH and GFR. There was no relationship between PA or PRA and the blood pressure. Unless a defective release of renal prostaglandins and/or kinins could be shown to be responsible for the increase in systemic blood pressure, there is no evidence for a primary renal disturbance in essential hypertension.
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PMID:Relationships between sodium clearance, plasma renin activity, plasma aldosterone, renal hemodynamics and blood pressure in essential hypertension. 700 Apr 63

To examine the sequential renal hemodynamic changes in experimental renovascular hypertension, the uninephrectomized dog was studied immediately after renal artery constriction, throughout chronic benign hypertension, and during malignant hypertension. Intrarenal resistance fell immediately after renal artery constriction, but rose above control within hours. Intrarenal infusion of teprotide resulted in vasodilatation during the first 3 days but failed to do so during the chronic phase of benign hypertension. During the transition from benign to malignant hypertension, angiotensin II-dependent renal vasoconstriction developed associated with natriuresis, plasma volume contraction and a vicious cycle of hyperreninemia and severe vascular damage.
Hypertension
PMID:Sequential renal hemodynamics in experimental benign and malignant hypertension. 702 15

We examined the effect of long-term blood pressure control on renal function in 41 patients with refractory hypertension by using minoxidil, sympathetic suppressants, and diuretics continuously for 6 months to 7 1/2 years. In 15 of 32 patients with benign hypertension, the serum creatinine concentration increased by more than 1 mg/dL, with nine of 15 requiring hemodialysis. Analysis of 1/serum creatinine versus time plots indicated that use of minoxidil delayed the onset of end-stage renal failure in some patients for up to 6 years. In the remaining 17 patients with benign hypertension, renal function remained stable with no decreases greater than 2 mg/dL. Four of nine patients presenting with malignant hypertension had marked and sustained improvement in renal function, although three initially required hemodialysis. The mean serum creatinine concentration in these four patients fell from 9.7 to 2.9 mg/dL. Thus, impressive renal functional improvement may occur with minoxidil use in some patients with malignant hypertension.
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PMID:Renal function during long-term treatment of hypertension with minoxidil: comparison of benign and malignant hypertension. 721 74

A role for endothelin in malignant phase hypertension has been suggested on the basis of reported increases of circulating plasma immunoreactive endothelins in animal models. Recently, a hypertensive rat model that exhibits a genetically determined tendency for developing spontaneous onset malignant hypertension has been described. Expression of the three genes endothelin-1, endothelin-2, and endothelin-3 was quantified in the kidney by specific RNase protection assays in rats with established malignant hypertension, in rats with benign hypertension with and without a genetic susceptibility to malignant hypertension, and in normotensive Sprague-Dawley rats. Endothelin-1 mRNA levels were significantly elevated in the group with malignant hypertension compared with the other three groups. For determination of whether endothelin-1-mediated effects were crucial in the transition from benign to malignant phase hypertension, an oral nonspecific combined endothelin-A and endothelin-B receptor antagonist (bosentan) was given to hypertensive rats susceptible to malignant hypertension. No hypotensive effects were observed, and no significant difference in the incidence of malignant hypertension was observed between treated and control groups. In conclusion, although increased endothelin-1 mRNA expression was found in kidney tissue from rats developing malignant hypertension, blockade of endothelin-1-mediated effects did not prevent the transition from benign phase hypertension. Hence, increased renal endothelin-1 expression in this model of malignant hypertension does not appear to have a causative role and may simply reflect cellular damage and ischemia.
Hypertension 1995 Dec
PMID:Endothelin in the kidney in malignant phase hypertension. 749 Jan 50

Hypertension and the kidney are closely linked in several ways. The kidney normally responds rapidly to changes in blood pressure by alteration of renal haemodynamics and sodium excretion. These functions of the kidney are reset in established hypertension. However, several subtle abnormalities of renal function are demonstrable in normotensive offspring of hypertensive parents, suggesting that the kidney may play a central role in the pathogenesis of essential hypertension--a possibility supported by a number of cross-transplantation studies in different animal models of hypertension. Hypertension itself commonly causes severe renal failure when the malignant phase develops, but the question of whether benign hypertension causes renal impairment remains controversial. Firm data that this is so are in general lacking, although in black subjects hypertensive nephropathy appears to be up to 18-fold more frequent than in whites, and is reported as a common cause of end-stage renal failure. The reasons for this racial difference in susceptibility to hypertensive renal injury remain unknown. Secondary hypertension also commonly develops in patients with underlying renal disease, and the co-existence of hypertension with renal impairment greatly worsens the rate of the deterioration of renal function. Effective treatment of hypertension in renal disease, particularly with converting enzyme inhibitors, is capable of slowing the rate of loss of function, both in animal models and in human disease, though in the latter case this benefit has so far been demonstrated unequivocally only in patients with diabetic nephropathy.
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PMID:Hypertension and the kidney. 820 61

The levels of plasma arginine-vasopressin (AVP) in 80 patients with essential hypertension were measured, and its impact on the disease and its clinical significance were studied. The results showed that: (1) The levels of plasma AVP in patients with essential hypertension were significantly higher than that in normotensive subjects (P < 0.001). It dropped to normal level after antihypertensive drugs. (2) The concentrations of plasma AVP in both hypertensive subjects and normotensive subjects were not correlated with age and sex (P < 0.05). (3) The concentration of plasma AVP in patients with essential hypertension was the highest in stage III, the lowest in stage I, and middle in stage II. (4) The levels of plasma AVP in patients with malignant hypertension were significantly higher than that in patients with benign hypertension (P < 0.05). A positive correlation was found between the levels of plasma AVP and blood pressure (r = 0.3398, P < 0.01). (5) The concentrations of plasma AVP in hypertensive subjects with ventricular hypertrophy were higher than that in hypertensive subjects with out ventricular hypertrophy (P < 0.05). (6) The concentrations of plasma AVP in hypertensive subjects with heart failure were significantly higher than that in hypertensive subjects with out heart failure (P < 0.001). The results suggest that AVP has a role in the pathogenesis of hypertension, hypertension complicated with ventricular hypertrophy and hypertension complicated with heart failure. The levels of plasma AVP may be viewed as an index of the patient's condition in hypertensive subjects.
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PMID:[The changes in plasma arginine-vasopressin in patients with essential hypertension and the correlation with patient's condition]. 824 27

The purpose of this study was to determine whether there are racial differences in the rates of prevalence and new claims to Medicaid for hypertension treatment in a population of uniformly low economic status--i.e., Georgia Medicaid recipients. Age-specific and age-adjusted prevalence rates of hypertension in 1991 and the first 1991 claim rates by race and gender were calculated. Gender-specific black-to-white risk ratios, using the Mantel-Haenszel pooled point estimate (RMH) and the corresponding test-based 95 percent confidence interval (CI) were also calculated. African-American females were more likely than African-American males, or whites of either sex to have hypertension diagnoses. For newly claimed cases, the gender-specific black-to-white risk ratios were significant in malignant hypertension for both females (RMH = 1.9, 95 percent CI 1.4-2.5) and males (RMH = 2.0, 95 percent CI 1.2-3.7) and in unspecified hypertension for females (RMH = 1.5, 95 percent CI 1.4-1.6), but were less significant in unspecified hypertension for males, and in benign hypertension for both sexes. Using Medicaid data may have caused underestimation of the prevalence and incidence of hypertension among Medicaid recipients; however, significant racial differences in the "occurrence" of hypertension still existed among them. Factors other than the household income status may be responsible for much of the excess risk of hypertension in the black Medicaid population.
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PMID:Is there a difference in hypertensive claim rates among Medicaid recipients? 925 52

Hypertension prevalence rates remain comparatively low in Nigeria, although the associated morbidity and mortality including that due to malignant hypertension (MHT) is considerable. To determine the factors that may be associated with the development of MHT we compared 74 patients with essential MHT (age 48 +/- 9 years, 59 male, blood pressure (BP) 234 +/- 31/140 +/- 17 mm Hg) with 74, age, gender and BP-matched patients with essential benign hypertension (BHT) (49 +/- 8 years, 60 male, 227 +/- 26/136 +/- 15 mm Hg). Body mass index was higher in the BHT [corrected] group by 1.3 (95% Cl: 0.5 to 2.1, P < 0.01). In the subset (25 MHT, 43 BHT) in whom hypertension had been diagnosed before presentation, duration of hypertension was shorter (P < 0.05) in the MHT group. Patients with MHT, were more likely to have been receiving inadequate therapy in the months before (OR 2.7, 95% Cl: 1.4 to 5.4), showed a decreasing proportion with increasing socio-economic class (chi2 = 5.79, P < 0.02) and had been exposed to a greater degree of stress (OR 3.5, 95% Cl: 1.7 to 7. 1). Smoking (OR 1.1, 0.6 to 2.3), alcohol use (OR 0.9, 0.5 to 1.8) and contraceptive pill use (OR 0.9, 0.1 to 8.6) did not impart excess risk. MHT is associated with the underprivileged and measures aimed at raising the general awareness and the socio-economic level of the people are expected to produce a decline in the incidence of MHT. Journal of Human Hypertension (2000) 14, 171-174.
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PMID:Factors influencing the development of malignant hypertension in Nigeria. 1069 28

Hypertension prevalence rates remain comparatively low in Nigeria, although the associated morbidity and mortality including that due to malignant hypertension (MHT) is considerable. To determine the factors that may be associated with the development of MHT we compared 74 patients with essential MHT (age 48 +/- 9 years, 59 male, blood pressure (BP) 234 +/- 31/140 +/- 17 mm Hg) with 74, age, gender and BP-matched patients with essential benign hypertension (BHT) (49 +/- 8 years, 60 male, 227 +/- 26/136 +/- 15 mm Hg). Body mass index was higher in the BHT group by 1.3 (95% Cl: 0.5 to 2.1, P < 0.01). In the subset (25 MHT, 43 BHT) in whom hypertension had been diagnosed before presentation, duration of hypertension was shorter (P < 0.05) in the MHT group. Patients with MHT, were more likely to have been receiving inadequate therapy in the months before (OR 2.7, 95% Cl: 1.4 to 5.4), showed a decreasing proportion with increasing socio-economic class (chi2 = 5.79, P < 0.02) and had been exposed to a greater degree of stress (OR 3.5, 95% Cl: 1.7 to 7. 1). Smoking (OR 1.1, 0.6 to 2.3), alcohol use (OR 0.9, 0.5 to 1.8) and contraceptive pill use (OR 0.9, 0.1 to 8.6) did not impart excess risk. MHT is associated with the underprivileged and measures aimed at raising the general awareness and the socio-economic level of the people are expected to produce a decline in the incidence of MHT. Journal of Human Hypertension (2000) 14, 171-174.
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PMID:Factors influencing the development of malignant hypertension in nigeria 1096 23


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