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

A prospective study was performed to determine urinary albumin excretion in a group of 28 patients with systemic sclerosis. At the initial screen one patient had proteinuria and three had microalbuminuria. One year later these abnormalities persisted and in two of of the patients serum creatinine had significantly increased. In addition, a further three patients had developed microalbuminuria. In a control group of 10 patients with primary Raynaud's disease none had microalbuminuria. In a second control group of 16 patients with unrelated skin diseases one patient had microalbuminuria and one proteinuria, but both these patients had a history of hypertension. It is concluded that microalbuminuria is more common in patients with systemic sclerosis than in patients of equivalent age with other dermatological conditions but no vascular disease.
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PMID:Microalbuminuria in systemic sclerosis. 157 87

The kidneys are not only involved in the development of hypertension, but they are also often damaged if the disease is not controlled. Microalbuminuria occurs early and is easily diagnosed. However, microalbuminuria is not detected on routine Albustix testing, which has a sensitivity limit of 300 mg/L. Urinary albumin excretion, therefore, should be routinely determined by radioimmunoassay or other techniques so that appropriate therapies can be instituted to prevent nephropathy.
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PMID:Microalbuminuria: a risk factor for vascular and renal complications of hypertension. 158 Feb 86

Blockade of nitric oxide reduces renal blood flow, but the site or sites at which nitric oxide alters renal vascular resistance are unknown. The effects of N omega-nitro-L-arginine (100 microM), an inhibitor of nitric oxide synthesis, on the pressure-diameter relation of renal arterioles was studied using a rat juxtamedullary microvascular preparation perfused in vitro with a physiological salt solution containing 5% albumin. The basal diameters of the main arcuate and interlobular arteries and the proximal and distal afferent arterioles averaged 438 +/- 26, 64 +/- 4, 30 +/- 1, and 20 +/- 1 microns, respectively, at a perfusion pressure of 80 mm Hg. The diameters of the arcuate and interlobular arteries increased by 14 +/- 2% and 7 +/- 2%, whereas the proximal and distal afferent arterioles decreased by 3 +/- 1% and 7 +/- 2% when perfusion pressure was elevated to 160 mm Hg. Nitro-arginine had no effect on the basal diameters of arcuate and interlobular arteries. Nitro-arginine reduced the diameters of afferent arterioles by 7 +/- 2% at all perfusion pressures studied. Nitro-arginine increased active vascular tone in the interlobular artery and afferent arterioles and enhanced autoregulation of glomerular capillary pressure. L-Arginine (1 mM), the precursor to nitric oxide production, reversed the effects of nitro-arginine. These findings suggest that nitric oxide modulates vascular tone of the interlobular artery and afferent arterioles of deep nephrons and influences the ability of the preglomerular vasculature to autoregulate glomerular capillary pressure.
Hypertension 1992 Jun
PMID:Nitric oxide modulates vascular tone in preglomerular arterioles. 159 79

A total of 26 non-insulin-dependent diabetic patients were enrolled for a clinical study of the effect of buflomedil on microalbuminuria. None of the subjects had hypertension or macroproteinuria. Sixteen cases without previously known urinary albumin excretion rate (AER) were enrolled as experimental group. Buflomedil (Loftyl) was administered orally 600 mg daily in two divided doses in the experimental group while AER was determined 3 times with 3 weeks apart in all of the subjects. Ten cases with known microalbuminuria (greater than 8.55 micrograms/min) were enrolled as control group to check the extent of fluctuation in AER from collection to collection in the absence of urinary tract infection. Six of the experimental group showed AER of microalbuminuric level at the time before buflomedil administration and the remaining 10 patients were normoalbuminuric. The effects of buflomedil were compared between the microalbuminuric and normoalbuminuric subjects in the experimental group. The microalbuminuric group showed a significant decrease of AER from a baseline of 30.4 micrograms/min to 19.8 and 16.8 micrograms/min, respectively, after 3 and 6 weeks of treatment (P less than 0.05, Friedman two-way ANOVA). However, the respective values in the normoalbuminuric group were 5.3, 5.6 and 5.0 micrograms/min (P greater than 0.05, Friedman two-way ANOVA). The AER in the control group remained stationary during the study period (14.0, 12.1 and 11.4, respectively, Friedman two-way ANOVA, P greater than 0.05). These results suggest that buflomedil might be beneficial for the patients with microalbuminuria.
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PMID:The effect of oral buflomedil on microalbuminuria in non-insulin-dependent diabetic patients. 160 Aug 49

Vascular permeability disorders have been described in experimental models, as well as in human hypertension. We recently described the fact that vascular permeability to albumin is heterogeneous in the normal rat. In the present study, we examine the contents of Evans blue dye (EB) bound to albumin in selected organs of unanesthetized Wistar Kyoto (WKY) and in spontaneously hypertensive rats (SHR) at various stages of development of hypertension. EB was injected in the caudal vein of paired 4, 8, 12, and 16-wk-old WKY and SHR. Rats were killed 10 min after EB injection and extraction of the marker was measured in selected tissues. In additional 4 and 16-wk-old animals, bradykinin B1 and B2 receptor antagonists (BKA) were also injected with EB. Renal contents of EB bound to albumin were higher in the SHR than in the WKY: 196 +/- 9, 202 +/- 10, 182 +/- 7, and 196 +/- 9, compared with 158 +/- 8, 155 +/- 7, 138 +/- 7, and 118 +/- 6 micrograms/g dry tissue, in the 4, 8, 12, and 16-wk-old rats, respectively. In the 4-wk-old SHR and WKY, blood pressure values were normal and comparable, yet the alteration in EB permeability was already present in the SHR. Both BKA failed to alter the renal EB extravasation in the WKY, but the B2-BKA restored the renal permeability to control levels in the SHR. We conclude that a selective defect in the renal vascular permeability to EB developed in the SHR. Since this finding precedes hypertension and is corrected by a selective B2-BKA, it is suggested that bradykinin is involved at an early stage of the disease in the SHR.
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PMID:Renal permeability alteration precedes hypertension and involves bradykinin in the spontaneously hypertensive rat. 160 8

The objective of this study was to examine the relationship between blood pressure, albumin excretion, and renal function in patients with type I diabetes mellitus. The study design was as follows: nonselected consecutive patients with type I diabetes mellitus were divided into three groups by level of albumin excretion rate (AER): less than 20 micrograms/min, 20 to 200 micrograms/min, and greater than 200 micrograms/min. The setting for the study was an outpatient diabetic clinic in a tertiary referral center. There were 166 patients studied: 53% men, 47% women, 86% white, 17% treated for hypertension. Seventy-six percent had an AER less than 20 micrograms/min, 18% had an AER of 20 to 200 micrograms/min, and 6% had an AER of greater than 200 micrograms/min. Glycosylated hemoglobin did not differ between groups. AER was increased with age and disease duration (P less than 0.005 by analysis of variance) after 10 yr of disease. Serum creatinine (P less than 0.005) and systolic (P less than 0.005) and diastolic (P less than 0.01) blood pressures were also increased with AER. Serum creatinine and blood pressure were found to be increased in parallel after 10 yr of disease, but both remained within the normal range overall. A comparison of individual blood pressures in patients not taking antihypertensive drugs (N = 138) with age-related blood pressures of nondiabetic subjects revealed increased systolic and diastolic blood pressures at all ages. Group comparison demonstrated a significant link between increased AER and serum creatinine (declining renal function) and increased blood pressure after a latent period of 10 yr. Blood pressure appears to be increased from the earliest age in diabetes compared with healthy populations.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The role of disease duration and hypertension in albumin excretion of type I diabetes mellitus. 161 Sep 79

We report the case of an elderly black woman with a 20-year history of insulin-independent diabetes mellitus (IDDM), chronic renal failure, hypertension, proliferative retinopathy, and classical histologic features of diabetic glomerulosclerosis on renal biopsy. Repeat determinations of urinary albumin excretion rates failed to disclose significant microalbuminuria. This presentation should remind the clinician that a small minority of patients with IDDM of long duration may have severe diabetic glomerulosclerosis and renal insufficiency without detectable microalbuminuria.
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PMID:Diabetic glomerulosclerosis and chronic renal failure with absent-to-minimal microalbuminuria. 162 84

Several authors have suggested that estimating the levels of microalbuminuria will help in early screening for pre-eclampsia. The purpose of this work has been to look for the absence of microalbuminuria in normal pregnancies and to work out its predictive value for the risk of toxaemia of pregnancy when it does appear. The study was carried out on 257 women of whom 43 were controls and 214 women who were pregnant and had neither diabetes nor hypertension and had no kidney infections. The samples of urine were gathered in a 12 hour period of night and those that gave a positive reaction for albumin were rejected. RIA techniques were used to work out the levels of albuminuria and these were confirmed by immunoassay. We have compared microalbuminuria, the relationship between urine albumin and creatinine and the clearance of albumin in relationship to albuminuria (as defined by the relationship of albumin and creatinine clearance). We have calculated the sensitivity and the specificity and the prognostic value both positive and negative for these four parameters. Our results show that in a normal pregnancy there should not be any microalbuminuria, and on the other hand that if microalbuminuria does appear according to the four parameters studied, they are all equally sensitive for predicting pre-eclampsia. The relative clearance of albumin from the urine seems to be the most interesting parameter as far as we are concerned, and it could lead to early screening for toxaemia.
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PMID:[Microalbuminuria and pregnancy. Is microalbuminuria predictive of pregnancy toxemia?]. 162 20

The increase of urinary albumin excretion has a predictive value for cardiovascular disease in insulin-dependent and non insulin-dependent diabetics. To study the relationship between urinary albumin excretion and serum lipids, 380 non insulin-dependent diabetics, 40 to 75 yr old, with urinary albumin excretion from 0 to 200 mg/l, and normal serum creatinine (less than 150 mumol/l), were surveyed. Urinary albumin excretion, was related positively to age (r2 = 0.014; p = 0.02), to systolic blood pressure (r2 = 0.073, p = 0.0001) and diastolic blood pressure (r2 = 0.052, p = 0.0001); a negative correlation existed with HDL-cholesterol (r2 = 0.043, p = 0.0001) and Apoprotein A1 (r2 = 0.044, p = 0.0001). A stepwise regression analysis was performed and resulted in three independently contributing variables related to urinary albumin excretion: First systolic blood pressure (F = 36), second Apoprotein A1 (F 24), third hemoglobin A1C (F = 6). The presence of hypertension or insulin therapy did not modify these findings. In conclusion, serum lipid seems an important determinant of urinary albumin excretion in non insulin-dependent diabetics.
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PMID:Serum lipids and urinary albumin excretion in non insulin-dependent diabetics. 162 84

Myocardial perfusion and left ventricular (LV) diastolic filling were studied in 67 patients with mild to moderate hypertension and left ventricular hypertrophy (LVH). The control group consisted of 28 subjects with no cardiac pathology. LV mass assessed by M-mode echocardiography was obtained in all patients. LV diastolic filling was estimated by pulsed Doppler echocardiography before and after intravenous administration of verapamil (0.145 mg/kg) and contrast ventricular angiography during intracoronary administration of verapamil (1 to 1.5 mg). Myocardial perfusion was estimated by technetium-99m scintigraphy with albumin microspheres and thallium-199 scintigraphy in combination with intravenous dipyridamole. Coronary artery disease was excluded in 42 patients by coronary angiography. Pulsed Doppler echocardiography demonstrated an inverse correlation between the LV mass index and the ratio of peak early to peak atrial velocity (r = -65, P less than .001). Twelve of 20 patients experienced transient "normalization" of LV diastolic filling during intravenous administration of verapamil. In addition, 6 of 22 patients with LVH had an increase in end-diastolic volume owing to enhanced segment relaxation of the injected artery during intracoronary administration of verapamil. Myocardial perfusion defects assessed by scintigraphy with albumin microspheres were observed in 8 of 13 patients but in no controls. According to 199T scintigraphy data, myocardial perfusion defects were more common in patients with LVH (P less than .05). Thus, essential hypertension combined with LVH appears to result in severe cardiac dysfunction, which is probably associated with changes in small vessel walls.
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PMID:Evaluation of cardiac performance in hypertension. 163 39


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