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

Foremost in the differential diagnosis of hypertension is the identification of surgically correctable lesions. Increased plasma renin activity in a hypertensive patient suggests the presence of a renovascular or renal etiology. We have recently seen two adolescent patients whose hyperreninemia was cuased by a pheochromocytoma. Secondary hyperaldosteronism was an associated finding.
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PMID:Hyperreninemia and secondary hyperaldosteronism in pheochromocytomas. 76 9

A correlation between the tumour and hypertension was investigated in 129 patients with renal cancer. Forty-one patients (31.8%) suffered from hypertension. Primary increased renin secretion was detected in 6 of these patients (14.6%). The renin activity quotient measured in the renal veins between the renal tumour and the contralateral kidney was between 4 and 7. Secondary hyperaldosteronism was detected in only 2 of the patients with a significantly different renin activity in the renal veins. The renin level detected in the tumour itself of these 6 patients was significantly higher than the level detected in the parenchyma of the same kidney. Renin was demonstrated immunohistochemically in the tumours of these patients. The blood pressure returned to normal after nephrectomy in 5 patients and a marked fall in blood pressure was observed in the 6th patient. Cell cultures of 3 tumours revealed autonomous renin production. Renin-secreting renal carcinomas represent a rare form of renal hypertension, which is why the possibility of renal cancer should also be considered when investigating a case of hypertension.
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PMID:[Carcinoma of the kidney with production of renin. A special form of hypertension]. 155 74

A case of a 6 year old girl with angiographically and bioptically verified systemic polyarteritis nodosa is reported. Secondary hyperaldosteronism due to involvement of small and medium-sized renal arteries caused severe hypertension and left ventricular hypertrophy, and together with abdominal complaints, loss of weight, livedo reticularis and elevated titers of streptococcal antibodies formed the clinical pattern of the disease. It may be assumed, that there is a correlation between the recurrent streptococcal infections and the development of systemic polyarteritis nodosa by hypersensitivity or disordered immunologic reactivity. Therapy and short time follow up is reported. For treatment of hypertension an angiotensin converting encyme inhibitor was used, which immediately slowed down the maximal stimulated plasmarenin-angiotensin system.
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PMID:[Panarteritis nodosa with secondary hyperaldosteronism involving renal arterioles]. 167 49

Among the forms of endocrine hypertension, attention has recently been turned, apart from pheochromocytoma, to hypertensions caused by overproduction of mineralocorticoids. In this category are included, in addition to the classic Conn syndrome, aldosteronism associated with bilateral adrenal hypertrophy, dexamethasone-suppressible aldosteronism, and overproduction of mineralocorticoids (other than aldosterone) in the case of defects in the steroidogenesis enzyme system. In these cases, mineralocorticoid overproduction is accompanied by a low level of renin, by hypokalemic alkalosis. Secondary hyperaldosteronism, due to the stimulation of aldosterone secretion by increased activity of the renin-angiotension system, occurs during the malignant phase and in cases of renovascular hypertension. Estrogens, in cyclically secreted physiological quantities, have rather a protective effect on the origination of hypertension. At high dosages (as in contraceptives), estrogens can induce or aggravate hypertension in susceptible women by their effect on the activity of the renin-angiotensin-aldosterone system, notably by increasing the renin substrate. In the case of essential hypertension, deviations were found in the functioning of catecholamine storage granules in the sympathetic nerve endings. The renin-angiotensin-aldosterone system functions as an accelerating factor only in the advanced phase of essential hypertension, and the possibility of its participation in development of malignancy cannot be eliminated. A special group is comprised of essential hypertension with renin suppression, which is associated with a relatively high level of urinary excretion of dopamine as compared with noradrenalin. In renovascular hypertension, the renin-angiotensin-aldosterone system most often functions as an etiopathogenetic factor at the onset of the disease. In advanced stages, increased blood pressure levels must be considered to be attributable to other factors. Blood pressure regulati on and idiopathogenesis in hypertension cases are complex processes induced by the interaction of several different hemodynamic, nervous, and humoral factors. The study of humoral factors contributes to etiopathogenetic understanding and to the differential diagnosis of the various kinds of hypertension.
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PMID:[New data on hormone-dependent hypertension and their significance for the practice]. 434 13

During the last 15 years 8 patients were diagnosed with renin secreting juxtaglomerular cell tumors among 30,000 hypertensive patients. Clinical characteristics included severe hypertension poorly medically controlled in young patients (mean age 22.3 years) and severe hypokalemia (mean 2.83 mmol./l.). Secondary hyperaldosteronism was present in all cases with a constant elevation of renin activity. Renal vein sampling was only positive in 64% of cases. Selective renal arteriography demonstrated an avascular area in 43% of the patients. Computerized tomography showed the tumor in all cases. Mean tumor size was 24 mm. (range 10 to 50). Conservative surgery was feasible in all patients. Perioperative ultrasonography was used for 3 intraparenchymal tumors. Hypertension and hypokalemia resolved within 1 week after surgery. At a mean followup of 98 months (range 24 to 204) no tumor recurrence was documented.
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PMID:Renin secreting tumors: diagnosis, conservative surgical approach and long-term results. 775 16

Recognition of secondary arterial hypertension is one of the main purposes of diagnosis in patients with arterial hypertension. Secondary hyperaldosteronism is one of the most frequent endocrinological causes of arterial hypertension. Because of the increased risk of cardiovascular diseases in these patients, the early diagnosis and proper treatment of primary hyperaldosteronism play a crucial role. The aim of the study was presentation of a patient with secondary arterial hypertension. During the diagnosis of the hypertension cause, a renal tumor was found and then primary hyperaldosteronism due to aldosterone producing adrenal adenoma. The presented case proves the necessity of a thorough diagnosis of etiology of arterial hypertension, as it exists a possibility of coexistence of two independent causes, what can delay the diagnosis and make it more complicated.
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PMID:[Clear cell carcinoma of the kidney and Conn's syndrome in a patient with arterial hypertension--a case report]. 2202 74