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

Wider application of the aldosterone/plasma renin activity ratio among hypertensives has facilitated the detection of primary aldosteronism at earlier stages of evolution (with most patients normokalemic), and found prevalence rates far greater than those previously reported. Reliable detection of patients with PAL requires that 1) the diagnosis is considered in all hypertensives; 2) blood samples are collected under standardized conditions of diet, posture, and time of day; 3) medications known to alter the ratio are avoided or their effects taken into account; 4) aldosterone and plasma renin activity are measured using consistently accurate assay techniques; and 5) reliable methods (such as fludrocortisone suppression testing) are used to confirm primary aldosteronism. Adrenal venous sampling is the only dependable way to differentiate aldosterone-producing adenoma from bilateral adrenal hyperplasia. As has occurred in familial hyperaldosteronism type I, the elucidation of genetic mutations causing other forms of primary aldosteronism should further facilitate detection of this potentially curable or specifically treatable variety of hypertension.
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PMID:Primary aldosteronism: rare bird or common cause of secondary hypertension? 1135 74

1. Evidence from recent experimental and clinical studies suggests that excessive circulating levels of aldosterone can bring about adverse cardiovascular sequelae independent of the effects on blood pressure. Examples of these sequelae are the development of myocardial and vascular fibrosis in uninephrectomized, salt-loaded rats infused with mineralocorticoids and, in humans, an association of aldosterone with left ventricular hypertrophy, impaired diastolic and systolic function, salt and water retention causing aggravation of congestion in patients with established congestive cardiac failure (CCF), reduced vascular compliance and an increased risk of arrhythmias (resulting from intracardiac fibrosis, hypokalaemia, hypomagnesaemia, reduced baroreceptor sensitivity and potentiation of catecholamine effects). 2. These sequelae of aldosterone excess may contribute to the pathogenesis and worsen the prognosis of CCF and hypertension. 3. The heart and blood vessels may be capable of extra-adrenal aldosterone biosynthesis, raising the possibility that aldosterone may have paracrine or autocrine (and not just endocrine) effects on cardiovascular tissues. 4. The high prevalence of CCF, which is associated with secondary aldosteronism, and primary aldosteronism (PAL; recently recognized to be a much more common cause of hypertension than was previously thought) argue for an important role for aldosterone excess as a cause of cardiovascular injury. 5. The recognition of non-blood pressure-dependent adverse sequelae of aldosterone excess raises the question as to whether normotensive individuals with PAL, who have been detected as a result of genetic or biochemical screening among families with inherited forms of PAL, are at excess risk of cardiovascular events. 6. Provided that patients are carefully investigated in order to permit the appropriate selection of specific surgical (laparoscopic adrenalectomy for PAL that lateralizes on adrenal venous sampling) or medical (treatment with aldosterone antagonist medications) management and safety considerations for the use of aldosterone antagonists are kept in mind, the appreciation of a widening role for aldosterone in cardiovascular disease should provide a substantially better outlook for many patients with CCF and hypertension.
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PMID:New perspectives on the role of aldosterone excess in cardiovascular disease. 1155 16

Pindolol is a non-selective beta-adrenergic antagonist (beta-blocker) for the treatment of cardiovascular diseases such as hypertension and angina pectoris. It has one chiral center, and, therefore, two optical isomers. It was essential to develop an enantioselective assay to measure each enantiomer in human plasma. However, separation of enantiomers using chiral chromatography usually requires relatively long retention times. This can pose a problem for rapid turnaround of a large number of samples (i.e., clinical studies). In the present study, a simple and sensitive chiral liquid chromatography/electrospray ionization tandem mass spectrometry (LC/ESI-MS/MS) method was developed and validated for the determination of S-(-)- and R-(+)-pindolol in human plasma. To increase throughput, staggered sample injection was employed using a CTC Trio Valve system on a CTC HTS PAL autosampler. The method exhibited good intra- and inter-day accuracy and precision, and was linear over a dynamic range of 250 pg/mL to 250 ng/mL for each pindolol enantiomer. Intra- and inter-day accuracy ranged between 90.0-106% and 91.6-104% for both quality control (QC) samples of S-(-)- and R-(+)-pindolol, respectively. The respective intra- and inter-day precision ranged between 4.24-7.86% and 4.98-10.4%.
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PMID:Enantiomeric separation and quantification of pindolol in human plasma by chiral liquid chromatography/tandem mass spectrometry using staggered injection with a CTC Trio Valve system. 1634 28

The state of the renin-aldosterone system in 100 patients with hypertonic form of chronic glomerulonephritis (CGN) with the preserved renal function was assessed by RIA. The control group comprised 35 patients with CGH without arterial hypertension (AH). The study showed that plasma active renin (PAR) and aldosterone (PAL) levels remained unaltered in normotensive CGN patients with the preserved renal function but tended to increase in patients with AH. PAR levels correlated with the severity of AH. The PAL level was significantly elevated in CGN patients with grade II and III AH. Results of the study suggest an important role of elevated PAR levels in the development of AH in patients with CGN and preserved renal function. Moreover, such patients show a tendency toward a rise in their PAL level.
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PMID:[Renin-aldosterone system in patients with hypertensive form of chronic glomerulonephritis and preserved renal function]. 1982 34

Polycystic ovary syndrome (PCOS) is a common endocrinological disorder in female reproductive age. Insulin resistance (IR) and compensatory hyperinsulinemia seem to be the main pathophysiologies of this syndrome. Therefore, PCOS is at risk for abnormal glucose tolerance, dyslipidemia, central obesity and hypertension. Also, plasminogen activator-inhibitor-1 (PAL-1), hemostatic factor and C-reactive protein (CRP), inflammatory factor have been reported in PCOS women. The metabolic syndrome (MS), a clustering of several metabolic abnormalities, is more prevalent in PCOS. One-third to 46% of PCOS women with MS have been reported. Since these metabolic abnormalities as well as MS are the important risk factors of cardiovascular disease (CVD), PCOS is at risk for CVD.
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PMID:Polycystic ovary syndrome and the metabolic syndrome. 2121 22