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)

We measured indices of the renin-aldosterone system and body-fluid spaces in 11 adolescents who had received a renal transplant after removal of their own diseased kidneys. None had hypervolemia but 6 had hypertension. Renal angiography revealed greater than 50% luminal occlusion by allograft renal-artery stenosis (RAS) in only the 3 patients who had severe hypertension refractory to conventional medical therapy. Excessive peripheral plasma renin activity (PRA) distinguished these patients from those who had less severe stenosis or normal angiogram, and diuretic stimulation heightened the PRA differences. We conclude that significant allograft RAS does not necessarily act like a typical single-kidney Goldblatt model until after volume depletion. Our findings indicate that peripheral PRA values can be used to assess the degree of graft ischemia clinically. This permits early identification of patients who have severe RAS that probably will be difficult to control medically, and, therefore, should be followed closely with a view of reconstructive vascular surgery before further deterioration of renal function.
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PMID:Allograft renal-artery stenosis: increased peripheral plasma renin activity as an early indicator of uncontrollable hypertension. 36 8

Ten patients with hypertensive pregnancy were studied in hospital for 3 weeks. Plasma renin activity (PRA), the daily urinary excretion of aldosterone (dU-Aldo) and electrolytes were studied before and during dihydralazine therapy (25 mg 3 times daily). In one week the supine blood pressure decreased (p less than 0.05) without any discernible tachycardia. PRA increased in 3 days of the treatment by 50% (p less than 0.05) and this mean level was maintained. In dU-Aldo no change was found, however, during the study; and the excretions of sodium and potassium remained unchanged as well. In patients without diuretic therapy the basal PRA level before dihydralazine therapy was lower than in normal pregnancy. Also, in patients with preceding diuretic therapy the basal level of PRA was lower than during diuretics in gravidas without hypertension. Judging from the animal experiments, the rise in PRA might be seen as favorable for uteroplacental circulation in pregnancy hypertension.
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PMID:The renin-aldosterone system in dihydralazine therapy during hypertensive pregnancy. 36 99

With advancing age blood pressure rises in most populations with the exception of some isolated tribes. In western countries 30 to 40% of the people above the age of 60 years have casual blood pressure levels greater than or equal to 160/95 mm Hg. Advancing age per se produces a number of physiological changes related to blood pressure, such as a decrease in cardiac output, an increase in peripheral vascular resistance and a decrease in plasma renin-angiotensin-aldosterone levels. The mechanism causing the elevation in pressure with age are unknown though increased rigidity of the great vessels contributes to the rise in systolic pressure. There is a decline in the sensitivity of the baroreceptor reflex, but the contribution of this to the elevation of pressure has not be elucidated. Elderly patients with uncomplicated essential hypertension have a low cardiac output and high peripheral vascular resistance. The rise in blood pressure is associated with an increased cardiovascular morbidity and mortality even in the elderly hypertensives. The available data on the efficacy of hypotensive treatment in the elderly is scanty. There are no data proving that hypotensive therapy prolongs life. Controlled studies on the prevention of organ damage especially cerebrovascular accidents are inconclusive, showing either a significant decrease or no effect. Isolated reports illustrate, however, that drastic blood pressure reduction can provoke serious side effects, thus decreasing the quality of life. Hypotensive treatment is indicated in elderly hypertensive patients with hypertensive retinopathy grade III or IV, congestive heart failure or cerebral haemorrhage, in elderly patients with a markedly elevated diastolic blood pressure (greater than or equal to 120 mm Hg) and a trial of hypotensive therapy should be offered in milder forms of hypertension when it is accompanied by certain specific symptoms such as angina, headache and dyspnoe. The management of elderly hypertensive patients is more difficult than in the young. General measures are often not well accepted. The dose adjustment of the hypotensive agent is more critical and volume depletion or orthostatic hypotension are more likely to occur.
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PMID:Aging and the cardiovascular system. 37 49

Post-transplant hypertension has been observed in 98 renal allograft recipients who had good renal function and whose follow-up was more than 15 months. The role of the original diseased kidneys as well as the role of the renal pressor system was studied with emphasis on late hypertension. Post-transplant hypertension was found to be a multifactorial phenomenon with frequency decreasing as a function of prolonged graft survival. Renal artery stenosis was an infrequent but significant cause of hypertension and was found in 10 of 29 arteriograms performed. Renin studies performed in 34 hypertensive patients and in a control group of 11 recipients showed that elevation of plasma renin activity and of plasma aldosterone level is frequent but difficult to interpret, particularly when a renal artery stenosis is observed. These investigations may be useful in recognizing the role of retained diseased kidneys in sustaining hypertension. Plasma aldosterone was found elevated in nearly all of the patients. The role of corticosteroids and the similarity of post-transplant hypertension, in some cases, with the one kidney model of experimental hypertension are discussed.
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PMID:Late hypertension following renal allotransplantation. 37 92

Of the various hypertensive disorders in which mineralocorticoid hormones are involved mainly those are reviewed in which, apart from aldosterone, hyporeactivity of the adrenergic nervous system may play a permissive role. The simultaneous occurrence and extent of participation of these two factors in essential hypertension are being appreciated increasingly. Their share in the mosaic of hypertension may add to the accumulating knowledge of this disease entity. In exploring the underlying mechanisms of hypertension common regulatory pathways involving aldosterone and the adrenergic nervous system may lead to new aethiopathogenetic insights.
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PMID:An apraisal of the role of aldosterone and the sympathetic nervous system in essential hypertension. 38 Nov 38

We describe the natural recovery from the aggravated hypertension, hypokalemia and suppression of the renin-aldosterone axis after the glycyrrhizin discontinuation in two mild hypertensive women aged 71 and 68 years, who had been administered 273 to 546 mg glycyrrhizin daily for 1.5 and 6 months, respectively, for the treatment of liver disease. About one month after the glycyrrhizin discontinuation, acceleration of hypertension, hypokalemia and suppression of the renin-aldosterone system still continued in both patients. At this stage, sodium restriction resulted in the normalization of blood pressure with weight loss and the subsequent sodium repletion produced a rapid increase in blood pressure to hypertensive levels observed before sodium restriction, with weight gain. Plasma renin activity and plasma aldosterone were low and did not respond to sodium restriction. Inappropriately excessive amounts of potassium were also excreted in the presence of hypokalemia. About one and a half months later, the improvements of aggravated hypertension, hypokalemia and suppressed renin-aldosterone system gradually occurred in both patients. Sodium restriction performed about three months later in case 2 no longer produced the changes in blood pressure and body weight. Plasma renin activity and plasma aldosterone responded subnormally to sodium restriction. These results demonstrate that both patients had a prolongation of the syndrome resembling primary aldosteronism except the low plasma aldosterone level about one month after the glycyrrhizin discontinuation. The possible mechanisms by which this prolongation was caused are discussed.
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PMID:Prolonged pseudoaldosteronism induced by glycyrrhizin. 39 3

To examine the involvement of renin-angiotensin-aldosterone system in the etiology of oral contraceptive induced hypertension, normal women (Group I), normotensive (Group II) and hypertensive (Group III) women taking Ovulen (R) were infused with a competitive angiotensin II (AII) antagonist, [1-sarcosine, 8-isoleucine] angiotensin II. The angiotensin II antagonist was infused at a rate of 600 ng/kg/min for 30 min 1.5 hrs after intravenous injection of 40 mg of furosemide. Blood pressure was monitored and pre-infusion and post-infusion plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were determined. Pre-infusion PRA and PAC showed no significant differences among these three groups. In response to the AII antagonist infusion blood pressure rose in Groups I and II, but blood pressure responses in Group III were variable. Four out of the total 6 subjects had pressor responses and only one subject had a significant blood pressure reduction. In both Groups I and II, PRA decreased and PAC rose after infusion of the antagonist. In Group III, PRA decreased to a lesser degree and PAC showed no consistent change. These data suggest that the renin-angiotensin-aldosterone system in hypertensive women or oral contraceptives is different from that of the normotensive users. However, the pathophysiology of oral contraceptive induced hypertension is not homogenous and angiotensinogenic hypertension is uncommon.
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PMID:Effects of an angiotensin II antagonist; [sarcosine 1, isoleucine 8] angiotensin II, on blood pressure, plasma renin activity and plasma aldosterone concentration in hypertensive and normotensive subjects taking oral contraceptives. 39 5

We substituted minoxidil for dihydralazine in the treatment of 10 patients with refractory hypertension. Supine diastolic blood pressure decreased from 114 +/- 15 mmHg ou dihydralazine to 90 +/- 10 mmHg after one week on minoxidil (mean +/- ISD, p less than 0.01), the concomitant therapy being unchanged (sodium depletion and betablockade in all patients, methyl dopa or clonidine in seven). Simultaneously themean plasma volume increased by 395 ml (p less than 0.02) with no correlation to the decrease in blood pressure, and with no change in plasma renin activity and plasma aldosterone. Further expansion of plasma volume was prevented by furosemide, individual dosage requirement ranging from 40 to 500 mg/day, irrespective of the renal function. fter three to six months of ambulatory treatment a satisfactory blood pressure control was maintained. Hirsuties appeared in all our patients, but no subjective side effects was reported.
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PMID:[Effects of minoxidil on blood pressure and plasma volume in refractory hypertension (author's transl)]. 39 2

1. The response of arterial blood pressure, plasma renin activity and plasma aldosterone concentration to inhibition of angiotensin I converting enzyme (kininase II) with captopril has been studied in patients with severe, treatment-resistant, malignant hypertension. 2. Nine patients with a past history of severe hypertension, supine diastolic blood pressure greater than 120 mmHg before conventional antihypertensive therapy and resistant to conventional antihypertensive therapy were studied. 3. Captopril administration resulted in a marked decrease in arterial blood pressure and plasma aldosterone concentration and an increase in plasma renin activity. 4. Although arterial blood pressure remained significantly below the values observed during the control period, pressure did tend to increase again after 3 days. Addition of hydrochlorothiazide kept arterial pressure significantly below pretreatment control values.
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PMID:Response of arterial blood pressure, plasma renin activity and plasma aldosterone concentration to long-term administration of captopril in patients with severe, treatment-resistant malignant hypertension. 39 84

The response of plasma renin activity (PRA) and plasma aldosterone (PA) to change in sodium intake was evaluated in pregnant women during the third trimester. After 7 days on a 10 mEq sodium diet, PRA rose from 20.6 +/- 6.2 to 59.6 +/- 11.6 ng/ml/hr and PA from 47 +/- 11 to 127 +/- 27 ng% in pregnant women compared to PRA from 5 +/- 1.2 to 18.9 +/- 5.2 ng/ml/hr and PA from 7.7 +/- 1 to 42 +/- 3 ng% in nonpregnant controls. Pregnant women conserved sodium normally with urinary sodium excretion and weight loss similar to nonpregnant women. After 6 days on a 300 mEq sodium intake, PRA and PA in pregnant women were significantly higher, 10.2 +/- 1.4 ng/ml/hr and 22 +/- 3 ng%, respectively, compared to 1.5 +/- 0.3 ng/ml/hr and 7.3 +/- 1 ng% in controls. On both low- and high sodium intake there was a positive correlation between PRA and PA in pregnant women. Plasma prostaglandin E (PGE) was 0.45 +/- 0.06 ng/ml in pregnant women compared to 0.1 +/- 0.01 ng/ml in control women (p less than 0.01) and urinary PGE excretion was 2780 +/- 357 ng/24 hr in 28 pregnant women compared to 1191 +/- 142 ng/24 hrs (p less than 0.01) in 14 nonpregnant controls. These findings indicate that although renin and aldosterone secretion respond to change in sodium intake in pregnancy, the cause of the increased renin secretion of pregnancy may be secondary to the increase that occurs in prostaglandin synthesis.
Hypertension
PMID:Factors controlling plasma renin and aldosterone during pregnancy. 39 42


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