Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The blood pressure response to surgery or percutaneous transluminal angioplasty (PTA) was determined an average of 3 years after treatment. In atherosclerotic disease, 85% of patients benefited. Furthermore, the extremely low overall cure rate of 6% (4/67) suggests that renal artery stenosis due to atherosclerosis is rarely a sole cause of hypertension, but more likely is an atherosclerotic complication of essential hypertension that develops in patients who are cigarette smokers. In fibrodysplastic disease both treatments were likely to improve the blood pressure. However, surgery resulted in a 41% rate of loss of the operated kidney. The response to PTA or surgery is strongly influenced by the etiology of the lesion being treated.
Nephron 1986
PMID:Renal vascular hypertension. Surgery vs. dilation. 294 21

Weight reduction was compared with metoprolol (200 mg daily) in a randomized placebo-controlled trial of first-line treatment of mild hypertension (diastolic blood pressure 90-109 mm Hg) in 56 overweight patients aged under 55 years. After 21 weeks of follow-up the weight-reduction group had lost an average of 7.4 kg. The fall in their systolic pressure of 13 mm Hg was significantly greater than that in the placebo group (7 mm Hg) but not different from that in the metoprolol group (10 mm Hg). Their fall in diastolic pressure (10 mm Hg) was greater than that in both the metoprolol (6 mm Hg) and placebo (3 mm Hg) groups. At the end of the follow-up period, 50% of patients in the weight-reduction group had a diastolic pressure of less than 90 mm Hg. In the weight-reduction group, left ventricular mass decreased by 18% in comparison with placebo; in the metoprolol group left ventricular mass was unchanged. In the weight-reduction group there was a decrease both in total cholesterol and in the ratio of total to HDL-cholesterol; in the metoprolol group there was a decrease in high density lipoprotein(HDL)-cholesterol and an increase in the ratio of total to HDL-cholesterol. In this study, weight reduction produced significant falls in both blood pressure and left ventricular mass but not the adverse effects on plasma lipids commonly associated with antihypertensive drug therapy.
Nephron 1987
PMID:Treatment of high blood pressure in overweight patients. 296 5

To determine the prevalence of left ventricular hypertrophy (LVH; left ventricular wall thickness greater than or equal to 1-2 cm in diastole) among end-stage renal disease (ESRD) patients and the most important risk factors that independently relate to LVH, 189 non-diabetic ESRD patients without dilated cardiomyopathy in two centres had echocardiography and full clinical review. 104 of 189 (55%) patients had LVH consisting of 52 of 83 (65%) patients on haemodialysis, 18 of 20 (90%) peritoneal dialysis patients and 34 of 86 (40%) transplanted patients. Using multiple logistic regression, the most important factors which independently related to LVH, in all patients studied, were dialysis as current ESRD treatment (p less than 0.001), followed by age (p = 0.008), hypertension as defined by number of blood pressure medications (p = 0.007), followed by high serum alkaline phosphatase which probably reflects hyperparathyroidism (p = 0.03). In a subset of patients with severe LVH (left ventricular wall thickness greater than or equal to 1.4 cm), a high serum alkaline phosphatase level was the best predictor of LVH (p less than 0.001), followed by high diastolic blood pressure (p = 0.004) and age (p = 0.02). In dialysis patients, the most important variable were age (p = 0.009) and high serum alkaline phosphatase (p = 0.03). In the transplant group, patients with LVH were taking significantly more antihypertensive medications than those without LVH (p = 0.002). This variable was the only predictor of LVH in the transplant group.(ABSTRACT TRUNCATED AT 250 WORDS)
Nephron 1988
PMID:Left ventricular hypertrophy in end-stage renal disease. 296 65

Atrial natriuretic peptide (ANP) and arginine vasopressin concentrations were measured in 9 patients with pregnancy-induced hypertension. The results were compared to those found in 7 normal pregnant women matched for age, duration of pregnancy, and parity. Plasma ANP levels were significantly higher in the pregnancy-induced hypertension patients than in the control group. Plasma arginine vasopressin concentrations, however, were not significantly different in the two populations. The mechanism of the observed rise in ANP concentrations in the patients with pregnancy-induced hypertension is not known. However, it may be related to a rise in intra-atrial pressures secondary to hypertension, an increase in baroreceptor discharge as a result of hypertension, or, less likely, the ANP may be released from extracardiac sites.
Nephron 1988
PMID:Atrial natriuretic peptide and arginine vasopressin in pregnancy and pregnancy-induced hypertension. 296 20

This prospective, double-blind, multicenter study compared enalapril plus hydrochlorothiazide with standard triple therapy (STT; hydrochlorothiazide, timolol, and hydralazine) with regard to safety, tolerability, antihypertensive efficacy, and effect on renal function in 75 patients with documented renovascular hypertension. Both groups showed a significant mean decrease in systolic and diastolic blood pressure during the double-blind study, with the enalapril group showing a mean 12 mm greater decrease in systolic blood pressure as compared to STT (less than 0.05). Effective treatment of diastolic hypertension was noted in 96% of the enalapril group as compared to 82% on STT (p less than 0.05). STT failure was seen exclusively in patients with bilateral renal artery stenosis of high grade and frequently in association with impaired renal function. cPAH, a measure of effective renal plasma flow, showed a significant increase in the enalapril group, as compared to the STT (p less than 0.05). In contrast, there was a bimodal response of CIn (GFR): 80% of patients in the enalapril group showed no significant change while 20% (10 patients) showed a mean decrease of 28% along with a 12% increase in CPAH (p less than 0.01). No acute renal failure or toxic side effects were noted in the enalapril group. Enalapril plus hydrochlorothiazide is very effective in treating renovascular hypertension and is without significant toxic side effects. The self-limited increase in serum creatinine seen in 20% of renovascular hypertensive patients receiving enalapril and hydrochlorothiazide may identify a subset of patients with unilateral or bilateral high grade renal artery stenosis who should be treated with angioplasty or operative intervention.
Nephron 1986
PMID:A comparison of enalapril plus hydrochlorothiazide with standard triple therapy in renovascular hypertension. 301 2

The potential role of trace metals in the pathogenesis of various disease states, especially of renal and cardiovascular disease, has been recognized increasingly. Moreover, altered membrane transport was recently incriminated to play a role in renal tubular syndromes, such as the Fanconi syndrome, as well as in the pathogenesis of volume dependent hypertension. We therefore investigated the possible in vitro effects of various trace metals on Na-K-ATPase, the biochemical correlate of active cellular transmembrane sodium and sodium-dependent transport. To more closely mimic the in vivo situation, we deliberately chose as enzyme source renal tissue homogenate, which may contain protective agents. Under these experimental conditions, the metals studied inhibited the enzyme quantitatively in the following order: Hg greater than Pb greater than Cd greater than Ur greater than Cu greater than Zn greater than Mn greater than Ba greater than Ni greater than Sr. Enzyme kinetic studies showed that Hg, Pb, and Cd competitively, and Cu noncompetitively, inhibited the enzyme. In general, Mg-ATPase was significantly less sensitive to the trace metals. Accumulation of these metals may present serious health hazards by producing a general defect in cell membrane transport. From the other metals studied, i.e., Mn, Ba, Ni and Sr, some may have toxic effects via other mechanisms, whereas some may exert a protective role against toxicity of other agents including metal ions.
Nephron 1986
PMID:In vitro inhibition of Na-K-ATPase by trace metals: relation to renal and cardiovascular damage. 302 55

The antihypertensive effects of exercise have been examined in 2 randomized studies of multiple levels of activity. In 12 normal subjects, 1 month's exercise 3 times weekly lowered blood pressure (BP) and vascular resistance. There was only a slightly greater effect after 7 times/week exercise. In most subjects there was a marked reduction in noradrenaline spillover rate, a measure of sympathetic activity. Exercise also improved glucose utilization and lowered plasma cholesterol. Thirteen previously untreated patients with essential hypertension had an average fall in BP of 11/9 and 16/11 mm Hg after 1 month each of 3/week and 7/week exercise respectively, again associated with fall in vascular resistance and a 20-30% reduction in plasma noradrenaline. BP remained lowered by 3/week exercise for 1 year. In patients who had BP controlled with drug for greater than 1 year, exercise 3 times weekly also prevented the redevelopment of hypertension after long-term drug therapy was ceased. Regular exercise is useful in the initial management of patients with mild hypertension. In more severely hypertensive patients, exercise may also be effective after an initial period of drug therapy.
Nephron 1987
PMID:The place of exercise in the long-term treatment of hypertension. 312 65

Renal artery stenosis was diagnosed in 3 women when hypertension of pregnancy persisted beyond the puerperium; all had poor obstetric histories and 2 had been hypertensive in the first trimester. A fourth case presented as hypertension associated with oral contraceptive use. After corrective procedures 6 further pregnancies were embarked upon, all of them successful and with only minor hypertensive complications in 2. Renal artery stenosis is an important cause of pregnancy hypertension persisting after the puerperium, since its correction greatly improves the prognosis for future pregnancies.
Nephron 1985
PMID:Prognosis for pregnancy after correction of renovascular hypertension. 315 81

A patient with hypertension is shown to have both a renal artery stenosis due to fibromuscular dysplasia and a hypoplastic contralateral kidney, a condition comparable to that of the one-kidney Goldblatt hypertension. Both blood volume and plasma renin activity were increased. Blood pressure was lowered either by an angiotensin II analog or by captopril. Secretion of excess renin was observed only from the stenotic kidney. A 4-week period of captopril treatment was accompanied by an acute, reversible deterioration of renal function. Transluminal angioplasty corrected the abnormalities in renin and in blood volume and has kept blood pressure and renal function normal for over 2 years.
Nephron 1985
PMID:A case of one-kidney hypertension: contrasting effects of angioplasty and treatment with captopril. 315 29

To study the role of sodium and renal prostaglandin E2 in the chronic phase of two-kidney one-clip renovascular hypertension, urinary excretion rates of sodium and prostaglandin E2 were measured in rabbits with hypertension induced by left renal artery constriction during alteration in sodium intake. The arterial blood pressure, the increasing rate of body weight and sodium balance during alteration in sodium intake were directly proportional to the amount of sodium intake in the hypertensive rabbits, but not in the control ones. Plasma renin activity and plasma aldosterone concentration, which had no significant difference between hypertensive and control rabbits, were inversely proportional to the amount of sodium intake in both rabbits. Urinary excretion rates of sodium in the clipped kidneys of the hypertensive rabbits were significantly lower than the control values in all dietary regimens (p less than 0.01). Urinary excretion rates of sodium in the nonclipped kidneys were not significantly higher and in the total kidneys were significantly lower than the corresponding control values during sodium load (p less than 0.01). Urinary excretion rates of prostaglandin E2 were inversely proportional to the amount of sodium intake in both groups. Urinary excretion rates of prostaglandin E2 in the clipped kidneys were significantly lower than the control values in all dietary regimens (p less than 0.001). Urinary excretion rates of prostaglandin E2 in the nonclipped kidneys were significantly higher during sodium restriction (p less than 0.01) but not during sodium load than the control values. Furthermore, urinary excretion rates of prostaglandin E2 in the total kidneys were significantly lower than the control values in all dietary regimens (p less than 0.01). These results suggest that two-kidney one-clip renovascular hypertension in rabbits seems to be partly sodium-dependent in the chronic phase because the nonclipped kidney fails to excrete sodium sufficiently. There may also be disorders of renal prostaglandin E2 metabolism influencing these disorders of sodium in the nonclipped kidneys.
Nephron 1988
PMID:Role of sodium and renal prostaglandin E2 in the maintenance of hypertension in the chronic phase of two-kidney one-clip renovascular hypertension in rabbits. 316 91


<< Previous 1 2 3 4 5 6 7 8 9 10