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

11 patients with primary aldosteronism have been encountered over 11 years and submitted to surgery in a provincial teaching hospital serving a population of 3 million. Contrary to classical teaching, the hypertension has usually been very severe. Precise identification of the site of the lesion preoperatively has been possible by the measurement of adrenal-vein aldosterone levels, and results of surgery have been excellent. The iodocholesterol adrenal scan also correctly identified the site of the adenoma in 5 out of 7 patients in which it was used. Adrenal venography was of little value except in siting catheters.
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PMID:Severe hypertension in primary aldosteronism and good response to surgery. 8 65

In forty patients suspected clinically of having an endocrine cause for hypertension, an adrenal cortical adenoma was confirmed histologically in five. Hyperaldosteronism with enlarged or normal adrenals was demonstrated in three patients. The diagnosis in a further eight patients with an abnormal hormone pattern and/or an abnormal venogram has not yet been confirmed. Adrenal glands show considerable variation in their size, shape and localisation on venography.
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PMID:[Supra-renal venography in patients with suspected endocrine hypertension (author's transl)]. 13 Oct 84

Adrenal and vascular responsiveness to graded doses of angiotensin II (A II) were recorded for seven normal subjects and 12 patients with essential hypertension while in balance on an intake of 200 mEq sodium/100 mEq potassium. Patients with essential hypertension had been previously studied and known to have normal responses of plasma renin activity to sodium restriction and upright posture. A II was administered for 30 minutes at rates of 0.1, 0.3, 1, and 3 ng/kg per minute and plasma aldosterone responses were assessed 20 and 30 minutes later; blood pressure was monitored at intervals of 1 minute during infusion of A II at each rate. A significant increment in plasma aldosterone occurred at an infusion rate of 0.3 ng/kg per minute in patients with hypertension. This change was not seen until the infusion rate reached 1.0 ng/kg per minute in the normotensive control subjects. Even at an A II infusion rate of 1 ng/kg per minute, the increment in plasma aldosterone levels in normotensive subjects (4.2 +/- 0.6 ng/dl) was significantly less (P less than 0.001) than that in patients with essential hypertension (19 +/- 3 ng/dl). In both groups, a significant rise in mean arterial blood pressure occurred at an A II dose of 0.3 ng/kg per minute, but the pressor response of the hypertensive group was significantly greater at the highest infusion rate (3 ng/kg per minute) (P less than 0.05). Thus, enhanced adrenal and pressor responsiveness to infused A II was observed in the hypertensive subjects, suggesting a change in A II receptor affinity.
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PMID:Enhanced aldosterone response to angiotensin II in human hypertension. 17 61

The changes in the content of pyridine nucleotide coenzymes (NAD+ and NADH) in several models of experimentally induced hypertension, differing in mechanism (genetic spontaneous hypertension, renal one kidney Goldblatt hypertension, Adrenal-regeneration hypertension after INGLE-HIGGINS and Skelton, and NaC1 hypertension) were studied. An obvious difference between the changes in NAD+ and NADH in the various models of hypertension, was established: Thus in NaC1 hypertension a high level of the coenzymes in the kidneys and in the vessel wall was found, while the liver coenzyme content was in normal ranges. In ARH the coenzyme level was elevated not only in the kidneys and in the vessel wall, but in the liver as well. Treatment with hypotensive antilipolytic prostaglandin E1 decreased the coenzymes in ARH to normal values. Renal hypertension was characterized by a low content of oxidized NAD, an increased NADH, and a decreased NAD+/NADH ratio in the kidneys and the liver, while in the vessel wall the coenzyme level was moderately increased. The coenzyme changes in the kidneys of SHR were similar to those in renal hypertensive rats. However coenzyme level in the vessel wall of SHR was lower than in all the other forms of hypertension.
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PMID:Coenzyme alterations in rats with experimental hypertension. 18 74

Plasma renin activity (PRA) was measured in 14 control subjects and 27 patients with essential hypertension (EH) (low renin group: 9, normal renin group: 11, and high renin group: 7) before and after the following stimulation tests. Test procedures: 1) Circadian rhythm (0600, 1600 and 2400h). 2) Adrenal stimulation test (ACTH: 12.5 I.U.). 3) Adrenal suppression test (Dexamethasone: 1.0 mg). 4) Metopirone test (1.5 g). 5) Angiotensin II infusion test (8 ng/kg/min). 6) Saline infusion test (1000 ml/hr). Patients with low PRA showed significantly lower levels of PRA than those of other two groups in circadian rhythm, after 2 hours of ACTH infusion and after angiotensin II infusion. Furthermore, these patients showed significantly higher responses of PRA than other two groups after furosemide test under dexamethasone and after metopirone test. In case of saline infusion test, patients with low and normal PRA did not show significantly decreased levels of PRA after the infusion, though all patients with high PRA and all control subjects showed significantly decreased levels of PRA. From the present studies, it might be concluded that patients with low PRA has an unknown mineralocorticoid excess which is ACTH dependent and 11 hydroxylated and some of hypertensive patients have an abnormality in their renin-angiotensin-aldosterone volume feed back loop as a factor for hypertension.
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PMID:Pathogenesis of essential hypertension with low renin: responses of plasma renin activity to various stimulation tests in essential hypertension. 21 18

Glucocorticoid stimulation and suppression tests are essential to the definitive diagnosis of diseases of the hypothalamic-pituitary-adrenal axis, because they document abnormal physiologic control of hormonal secretion. Similarly, diseases of the renin-angiotensin-aldosterone axis are diagnosed by mineralocorticoid stimulation and suppression testing. [Ed. Note: See Moore TJ, Williams GH: Adrenal causes of hypertension, in this issue.] Unlike tests of glucocorticoid function, testing of the renin-angiotension-aldosterone system is more complicated, because knowledge of posture and dietary sodium are necessary to interpret the results. However, measurement of the tropic hormone renin and plasma levels of aldosterone can be accurately made, allowing precise definition of this system. Errors are most commonly encountered when dynamic tests of cortisol output are performed in patients taking medications that may interfere with the assays or with the metabolism of the administered compounds, such as dexamethasone or metyrapone. Abnormal, spurious values may also be obtained in some individuals who do not have adrenocortical hyperfunction if they are very obese or if testing is performed in a setting of clinical stress. Careful attention to these pitfalls will avoid errors and allow the clinician to arrive at the correct diagnosis.
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PMID:Adrenal function testing. 21 24

Adrenal cysts are rare, mostly harmless, processes, either congenital inborn or acquired by regression, bleeding, infection and tumor. In the case of endocrine dysfunction with arterial hypertension and local expansion with perforation into the retroperitoneal, peritoneal and pleural cavity, purulence, bleeding and vasal obstruction complications are serious. In the differential diagnosis carcinoma of the kidney and the adrenal gland should be excluded.
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PMID:[Adrenal gland cysts. Case reports and potential complications--review of the literature (author's transl)]. 32 74

Some hypothesized risk factors in chronic open-angle glaucoma were investigated in a sample of 87 patinets with glaucoma and 87 matched controls. A significant positive association was found with diabetes, a systolic blood pressure/intraocular pressure (BP/IOP) ratio less than 5.75, and the taking of medication for systemic hypertension. No significant association was found with a history of smoking or an elevated systemic blood pressure. Analysis indicates that the systolic BP/IOP index may be useful as a screening test for the detection of glaucoma in samples where the prevalence of glaucoma is high.
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PMID:Relative risk factors in chronic open-angle glaucoma: an epidemiological study. 32 56

In a retrospective study, 92 patients with ocular hypertension, ie, intraocular pressure of 21 mm Hg or higher, and no evidence of glaucomatous visual field defects, were observed for five years. Visual field defects developed in one or both eyes of 33 patients during the five-year follow-up period, while none were detected in the remaining 59. Values for suspected risk factors, determined at the outset of the follow-up period, were subjected to a multivariate analysis with use of linear discriminant analysis and a multiple logistic function. Models of risk providing maximum separation of the two patient groups (visual field loss vs no visual field loss) found that the risk factors having the greatest significance for prediction of visual field loss included vertical estimates of cup/disc ratio, mean IOP during the period of observation, a positive family history of glaucoma, and age. Factors having the lowest predictive values included IOP response to topical dexamethasone, plasma cortisol suppression, and a history of systemic hypertension.
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PMID:Multivariate analysis of the risk of glaucomatous visual field loss. 46 68

Adrenal steroids and compenents of the renin-angiotensin system were measured before and after adrenalectomy in a woman with Cushing's syndrome and hypertension from a functioning adrenocortical adenoma. Aldosterone, deoxycorticosterone and cortisol were produced in excess by the adenoma, and were measured in tumor tissue. High plasma renin substrate concentrations, and normal basal and furosemide-stimulated plasma renin activities and plasma renin concentrations which were present before surgery, decreased after adrenalectomy, and the hypertension diminished. The inappropriately normal levels of renin and potassium in this patient, despite autonomous aldosterone overproduction, suggest an ineffective mineralocorticoid action of aldosterone, possibly from interaction with her other adenoma-produced steroids. The decrease in components of the renin-angiotensin system suggests a partial renin-dependence of her hypertension.
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PMID:Hypertension and aldosterone overproduction without renin suppression in Cushing's syndrome from an adrenal adenoma. 47 1


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