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

We wish to determine what cellular and functional alterations are associated with the development of glomeruloscierosis when rats with one kidney are fed an excess of salt or protein. Rats with one kidney are more likely to develop pronteinuria and glomerulosclerosis than control animals. Blood pressure recordings indicate that proteinuria and glomerulosclerosis occur before hypertension is evident. Fluorescent antibody studies disclose that albumin accumulates in the epithelial cells of glomeruli and tubules. Ultrastructural examination shows that vacuolozation of epithelial cells and basement membrane thickening precede the sclerotic collapse of capillary loops. Increased concentrations of sodium or urea that are found in urines of these rats favor the point of view that an elevation of solute load when combined with a reduction of renal mass will on some unknown manner accelerate the deterioration of glomeruli.
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PMID:Protein overload nephropathy in rats with unilateral nephrectomy. A correlative light immunogluorescence and electron microscopical analysis. 4 49

Examination of ischaemic kidneys reveals changes which generally correlate well with the pathophysiology of renal ischaemia. Although there is an association between renal ischaemia, juxtaglomerular granulation and hypertension, notable exceptions are seen from time to time. Improved methods of identification of the contents of juxtaglomerular granules may provide better methods of prediction of those patients likely to benefit from nephrectomy for hypertension associated with renal ischaemia. Further studies of the function of mesangial cells and of the smooth muscle cells of the juxtaglomerular apparatus promises to provide information to explain the collapse of glomerular tufts, and hence of impaired glomerular filtration, following ischaemia.
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PMID:The pathology of renal ischaemia. 26 14

71 patients undergo myocardial revascularisation for Prinzmetal's angina; among them, 50 p. cent are operated upon in emergency according to three ways of anaesthesia: neuroleptanalgesia, analgesic anaesthesia, combined anaesthesia. The authors lay stress on the importance of per- and post-operative complications: electrocardiographic ischemia in 22 p. cent of the cases, severe ventricular excitability perturbations were observed in 21 p. cent, myocardial necrosis in 14 p. cent, cardiovascular collapse in 21 p. cent and hypertensions in 22 p cent. These complications are often associated. In the discussion, the authors underline anesthetic induction as a cause of Prinzmetal's angina in 50 p. cent of the cases. They put the accent on the severity of peroperative crisis followed in 50 p. cent of the cases by serious ventricular excitability perturbations. In 25 p. cent of the cases myocardial necrosis is a complication of the spasm of a coronary artery. In this field, posterior necrosis are more frequent and correspond to the spasm of the right coronary artery. All the patients of this series, except one, develop necrosis in the spastic area (by-passed or not). Per-operative hypertension has no incidence on the occurrence of post-operative complications. Lastly, continuous per-operative infusions of nitroglycerine has been performed in several patients in order to reduce morbidity of this type of surgery.
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PMID:[Prinzmetal's angina during myocardial revascularisation. Cardiovascular complications in 71 patients (author's transl)]. 31 82

Thirteen patients with chronic renal insufficiency who had been transferred from haemodialysis to haemofiltration treatment because of dialysis and drug resistant hypertension (10 with high plasma renin activity) showed normalisation of blood pressure during a treatment period of 8 months, after which only one patient required antihypertensive drug therapy. During the first period blood pressure drop paralleled body weight loss and after 3--4 weeks blood pressure remained normal in spite of an increase in body weight. In the course of the second phase the effect of fluid withdrawal on blood pressure was directly proportional to the blood pressure at the beginning of the procedure. Adaptation of baroreceptor function must be assumed. In contrast to haemodialysis, haemofiltration did not influence the inulin space. Because of the reduced removal of small molecular substances compared with haemodialysis, extracellular osmolarity was kept stable during haemofiltration. Withdrawal of even large amounts of fluid was sustained without collapse reactions or signs of orthostatic dysregulation.
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PMID:Treatment of severe hypertension in chronic renal failure by haemofiltration. 60 Sep 48

Cardiovascular collapse associated with pneumoencephalography (PNE) has been reported but there has been no prospective study of its nature and cause. We have recorded prospectively the e.c.g. of 82 unselected patients, with no cardiovascular or metabolic disease, undergoing PNE under general anaesthesia. The frequency of arrhythmia following air injection was 60%; bradycardia 22%; ventricular ectopic beats 26%; nodal rhythm or sinus tachycardia 11%. Cardiovascular collapse occurred in three patients; two with "torsades de pointes" and one with bigeminy and q.r.s. block. Arrhythmia was more frequent in patients with a pituitary tumour and intracranial hypertension (91%). Eight postoperative control PNE examinations were uneventful. Three of four patients with frontal lobe tumours and four of seven with posterior fossa tumours exhibited arrhythmia.
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PMID:Cardiac arrhythmia induced by pneumoencephalography. 67 72

Spontaneous adrenal haemorrhages are rare but non exceptional. They mainly occur in elderly men (mean age: 61 years). The main risk factors are: anticoagulant therapy (prescribed for myocardial infarction, occlusive vascular ou thromboembolic disease), hypertension and chronic respiratory insufficiency, as in the present case. The clinical picture is one of abdominal of lumbar pain with abdominal distension, circulatory collapse, often delayed and sometimes preceeded by an hypertensive bout, quite often fever with leucocytosis. Hyponatraemia and hyperkalaemia, are not constant features. The diagnosis is often not made until laparotomy, and it even can be missed there. In fact, plasma cortisol level or, if unavailable, urinary corticosteroid measurements are the best diagnostic procedures, permitting adequate therapy and giving best chances of survival. They must always be made in a patient with abdominal signs falling into one of the above mentioned etiologic categories.
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PMID:[Spontaneous adrenal hemorrhage. Apropos of a case]. 96 41

The case of a 34-year-old woman who developed uremia secondary to renal thrombotic microangiopathy after taking oral contraceptives for 3 years is reported. The case is unusual in that the clinical manifestations of nephropathy and terminal kidney failure were preceded by an almost 1-year development with benign hypertension. During the final stage (3-4 weeks prior to complete development of uremia), hemolysis was observed only once and malignant hypertension not at all. The question, if and when reversible hypertension due to oral contraceptives becomes persistent renal hypertension, can be answered only after long-term observations with careful documentation (renal biopsy and nephrologic functional diagnosis). This case suggests that benign hypertension does not cause renovascular damage and renal failure. Plasma renin activity was found to be basically elevated and, furthermore, stimulated by e.g., dialysis. However, this single case does not permit any conclusions about a pathogenetic role of renin in creating hypertension by e.g., renal vasoconstriction or despite hypertension - collapse of the capillary network.
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PMID:[Renal thrombotic microangiopathy with benign hypertension and uremia secondary to oral contraceptives (author's transl)]. 97 70

Numerous deviations from normal physiology formerly ascribed to artificial heart pumping actually resulted from experimental artifacts. Recent results indicate that infection, thromboembolism, pulmonary pathology, and renal deterioration could be considered mostly nonspecific artifacts of mechanical heart implantation. Nonetheless, damage to the blood constituents and hepatic congestion seemed to be specific effects of artificial heart pumping. Hemolysis correlated to pumping sac collapse, low cardiac output, and hematocrit value (r = .912, p is less than .001). Hepatic congestion, caused by pulsatile venous hypertension and hypervolemia, was postulated to result from functional atrial volume restriction (small atrium syndrome).
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PMID:Physiology of the artificial heart. 118 49

A 33-year-old female patient, with a 4-year history of hypertension plus a 3-year history of systemic lupus erythematosus, who had been taking high dosages of corticosteroids, has shown repetitive respiratory infections and congestive heart failure for the past 8 months. Angiocardiography confirmed the diagnosis of aortic insufficiency with aneurysmatic dilation of Valsalva's posterior sinus, ascending aorta of normal diameter and normal coronary arteries. Aortic dissection causing aortic insufficiency due to collapse of aortic leaflets was spotted during the surgery and was corrected by a bovine pericardial tube and suspension of aortic valve. The postoperative (PO) period was complicated by left-sided seizures followed by left hemiparesis and respiratory infection. She was discharged on the 25th PO day with mild left hemiparesis and in functional class I (NYHA), using medicines. We emphasize the need to consider the diagnosis of aortic dissection in patients with systemic lupus erythematosus and aortic insufficiency, specially in those who have a history of systemic arterial hypertension and long-term corticosteroid therapy.
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PMID:[Aortic dissection associated with systemic lupus erythematosus]. 134 Nov 57

Vascular disease increases in incidence with age and is the commonest cause of morbidity and mortality among elderly people. Hypertension is associated with hypertrophy of the arterial media. This study was designed to investigate changes in arterial structure that may occur with age independent of blood pressure. Collapsed sections of human mesenteric arteries (external diameter 2-3 mm) were measured using a semi-automatic image analysis system. There was a nonlinear increase in both the wall/lumen area ratio and the relative intimal area with age. There were no significant relationships between blood pressure and either the wall/lumen ratio or the relative intimal area.
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PMID:Age-associated changes in mesenteric arteries. 141 68


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