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

Erythrocyte membrane Na+,K+-ATPase activity was measured using a bioluminescence technique in 28 hypertensive patients (24 with essential hypertension, 2 with renovascular hypertension and 2 with hypertension secondary to primary hyperaldosteronism) and in 28 normotensive control subjects matched for age and sex. Erythrocyte Na+,K+-ATPase activity was significantly reduced in the patients with essential hypertension (130.9 +/- 11.4 vs. 186.6 +/- 19.5 nmol ATP/mg prot per h; mean values +/- SEM; p less than 0.05) and in the patients with secondary hypertension. A significant negative correlation was found between erythrocyte Na+,K+-ATPase and systolic blood pressure (r = -0.603; p less than 0.01), but not between Na+,K+-ATPase and plasma renin activity or plasma aldosterone levels. These data confirm the findings of a number of previous studies reporting reduced activity of erythrocyte Na+,K+-ATPase possibly related to the presence of a circulatory inhibitor of sodium pump. The method, based on ATP assay by bioluminescence, presents a high degree of specificity as well as simple, rapid execution.
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PMID:Measurement by bioluminescence technique of erythrocyte membrane Na+,K+-ATPase activity in hypertensive patients. 303 52

Differential-diagnosis tests for low-renin hypertension viz essential hypertension and arterial hypertension due to Conn's syndrome (adrenocortical adenoma or hyperplasia) have been assessed. The examined patients showed considerable humoral and metabolic differences, as compared to patients with high and normal plasma renin activity (PRA). For example, patients with essential hypertension and low PRA showed depressed noradrenalin and PGE2 secretion, increased PGF2 alpha secretion, low triglyceride level, and elevated erythrocyte sodium content. Patients with adrenocortical adenoma exhibited increased secretion of adrenalin, dopamine and PGF2 alpha, and a higher erythrocyte sodium level. Enhanced dopamine synthesis in patients with Conn's syndrome may be an adaptive response to a high aldosterone level.
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PMID:[Activity of the sympathetic nervous system and the levels of prostaglandins and intracellular electrolytes in patients with arterial hypertension and low plasma renin activity]. 307 43

During the last 10 years we operated on 69 Conn's adenomas of which 59 were followed up for a mean period of 16 months (range: 3-96 months). Surgery cured the hypertension (blood pressure less than 140/90) in 47 p. 100 of the patients. Improved blood pressure (systolic: mean = 46 mmHg; range 0-135 mmHg and diastolic: mean = 25 mmHg; range 0-66 mmHg) was noted in another 47 p. 100 of patients whereas no blood pressure change was noted in 3 patients. Biological primary aldosteronism was found post-operatively in 2 of these 3 patients and also in one whose hypertension was improved. In this last patient plus the three unimproved by surgery, small tumours (less than 10 mm) were found and co-existnt multifocal hyperplasia was found in the 2 patients who had had an adrenalectomy. Fifty-one patients were treated pre-operatively by spironolactone (SP) alone (3.2 +/- 1.3 mg/kg) for a mean period of 6.8 weeks (range: 3 to 20 weeks). Only 2 of the 24 patients controlled by SP were not cured by surgery and one of them had persistnt primary aldosteronism. Conversely, 3 of the 27 uncontrolled by SP were cured post-operatively, and these exceptions could be due to the weak dose of SP (n = 2) and an observance problem (n = 1). Patients cured by surgery had shorter duration of hypertension (4.3 +/- 3.0 years vs 10.1 +/- 8.1; p less than 0.01) and lower diastolic pressure (111 +/- 14 mmHg vs 121 +/- 12; p less than 0.01) than uncured patients. No significant difference between these two groups was observed with respect to systolic pressure, age, sex, plasma potassium, plasma renin activity and plasma aldosterone levels.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Results of the surgical treatment of Conn's adenomas]. 311 1

Primary aldosteronism-characterized by hypertension, hypokalemia and metabolic alkalosis--is caused by benign adenomata or bilateral adrenal hyperplasia in most cases. Aldosterone producing carcinomata of the adrenal cortex are very rare tumors. As the histological classification is difficult, the diagnosis is often drawn from tumor size, very high levels of plasma aldosterone, severe hypokalemia and malignant behaviour. The prognosis is very poor: Overall median and 5 year survival rate from diagnosis of adrenocortical carcinoma are 14 months and 24%.
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PMID:[Malignant aldosteronoma in the differential diagnosis of Conn syndrome]. 321 80

Primary aldosteronism due to an adrenocortical adenoma is commonly known as surgically correctable hypertension. Forty-three cases of primary aldosteronism were treated operatively at our Department between 1960 and 1985. Forty of them were operatively, found to have aldosteronoma with a mean size of 1.88 cm and weight of 2.67 g. The patients average age was 39.4 years old and the male to female ratio was 1 to 3. Adrenal phlebography, selective adrenal venous sampling, adrenal scintigraphy, CT and echography were used to preoperatively locate the tumor, and their diagnostic value was 83, 78, 76, 87 and 60%, respectively. Unilateral adrenalectomy or unilateral partial adrenalectomy was performed extraperitoneally with lumbar oblique incision in 32 of the 43 operated patients. Since the application of the preoperative diagnosing studies above mentioned, tumor localization has been clearly demonstrated in about 90% of the patients and the unilateral extraperitoneal approach is proved as a safe operative method with minimal blood loss of less than 200 ml and performed within two hours. Unilateral adrenalectomy by the flank approach has now become the operation of choice for the treatment of an aldosterone-producing adrenal adenoma.
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PMID:[Surgical management of primary aldosteronism--progress in localization studies and operative treatment]. 330 70

The antihypertensive effect of unilateral adrenalectomy was analyzed in 19 patients with arterial hypertension and primary hyperaldosteronism diagnosed by way comparing clinical findings, a degree of hypokalemia, activity of plasma renin and aldosterone concentration and CT data. A follow-up period after operation was 8-14 mos. Clinical and biochemical findings were compared with the results of morphological investigation of the adrenal glands and kidneys. An antihypertensive postoperative effect was observed in 12 patients: good in 6, moderate in 6, the absence of an antihypertensive effect in 7. Different forms of adrenocortical hyperplasia revealed during histomorphological investigation, endocrine nephropathy of various degree and vascular changes of hypertensive genesis in the renal parenchyma were discussed as causes of residual hypertension.
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PMID:[Evaluation of the hypotensive effect of unilateral adrenalectomy in patients with low-renin hyperaldosteronism]. 332 17

Primary hyperaldosteronism (HA1) represent a rare etiology of arterial hypertension (less than 1%). It concerns, most of the time, aldosterone-producing adenomas or bilateral adrenal hyperplasias although intermediate forms have been reported. The diagnosis of HA1 is based on simple examinations, especially systematic measurement of kaliemia in every hypertensive patient with a normal sodium diet before treatment. The elevation of aldosterone blood levels associated with a low plasma renin activity confirms the autonomous nature of the hormonal secretion which is dissociated from the renin-angiotensin system. Study of the ratio aldosterone blood level/ARP and the captopril test are particularly useful in borderline cases. Once the diagnosis of HA1 is made, a topographic analysis may be undertaken; tomodensitometry and adrenal scintigraphy are currently the examinations of choice in the diagnosis of adrenal tumors. Due to biological, morphological and topographic factors, aldosterone-producing adenomas may be identified with a great deal of certainty: surgical excision ensures a cure in a large majority of cases. The treatment of bilateral hyperplasias remains medical.
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PMID:[Diagnosis of primary hyperaldosteronism. Apropos of 3 cases]. 342 22

An outpatient diagnostic procedure measuring the 6-hour integrated plasma concentration of aldosterone and plasma renin activity was used to detect primary aldosteronism in 12 patients with low renin hypertension, including six with mild hypertension and normal urinary excretion and spot plasma levels of aldosterone. The ratio of integrated plasma concentration of aldosterone to plasma renin activity in the 12 patients (mean, 339; range, 116-700; p less than 0.0001) did not overlap with that measured in 105 normotensive controls (mean, 27.8; range, 5-97) or in 87 subjects with essential hypertension (mean, 29.2; range, 4-67). Eight patients had surgically proven adenomas (3 of which measured less than 5 mm) with normalization of blood pressure following adrenalectomy. The four remaining patients had bilateral hyperplasia. The 6-hour integrated plasma concentration of aldosterone to plasma renin activity ratio was found to be a useful new outpatient diagnostic tool for evaluation of primary hyperaldosteronism.
Hypertension 1986 Apr
PMID:Detection of primary aldosteronism by the 6-hour integrated aldosterone/renin ratio. 351 48

Severe hypertension discovered incidentally in a 10 year-old boy was associated with persistent hypokalaemia and metabolic alkalosis. Primary hyperaldosteronism was diagnosed by demonstrating elevated plasma aldosterone levels and increased urinary aldosterone excretion with concomitant depressed plasma renin activity. Adrenal sonography identified a left adrenal adenoma which was removed surgically; normotension and normalization of plasma renin and aldosterone values ensued. This appeared to be the first use in children of sonography to identify adrenal adenoma and it is suggested to be the first step in the differential diagnosis of primary hyperaldosteronism.
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PMID:Severe hypertension in a ten-year-old boy secondary to an aldosterone-producing tumour identified by adrenal sonography. 353 37

The prevalence, reversibility, and mortality of secondary hypertension among 3783 patients with moderately severe nonmalignant hypertension attending the Glasgow (Scotland) Blood Pressure Clinic were assessed. Underlying causes of hypertension were found in 297 patients (7.9%). Eighty-seven patients (2.3%) were considered to have a potentially reversible cause for their hypertension, including the oral contraceptive pill (38 patients), renovascular disease (27 patients), and primary hyperaldosteronism (ten patients), but of these only 33 patients (0.9% of total clinic population) were cured by specific intervention. Two hundred ten patients (5.6%) had irreversible renal parenchymal disease and significantly higher mortality than men and women with other causes of hypertension. Excess deaths in the renal group were attributed to renal failure (International Classification of Diseases [ICD] 580 to 589) and vascular causes (ICD 390 to 458) but not to cancer (ICD 140 to 208; 235 to 239) or other nonvascular disease. These results suggest that investigation of hypertension for an underlying cause will reveal a small number of patients with treatable disorders, of whom only a few will be cured by specific intervention, and a moderate number with irreversible disease who are at high risk of myocardial infarction and stroke.
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PMID:Secondary hypertension in a blood pressure clinic. 360 86


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