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

To assess the potential of antihypertensive drugs for interference with somatic growth and sexual development in hypertensive children, the effect of clonidine therapy on various endocrine, cardiovascular, and neuromuscular functions has been examined in five male adolescents with idiopathic hypertension. In studies done before and at the end of 4 weeks of twice-daily clonidine therapy, in an average daily dose of 0.31 mg, no significant effects were noted in the secretory patterns of growth hormone, luteinizing hormone, follicle-stimulating hormone, prolactin, cortisol, aldosterone, or testosterone, measured in blood obtained every 20 minutes for 24 hours. In blood obtained while the patients were supine and then erect, plasma renin activity and norepinephrine levels were significantly lowered after clonidine therapy. Cardiovascular responses to dynamic exercise were little altered beyond a 17% decrease in maximal oxygen consumption. The performance of fine motor skills was minimally altered. These data provide preliminary evidence that clonidine, an antihypertensive drug that affects the adrenergic nervous system, may not interfere with normal growth and maturation in adolescent males.
Hypertension
PMID:Effects of clonidine on 24-hour hormonal secretory patterns, cardiovascular hemodynamics, and central nervous function in hypertensive adolescents. 676 72

Over a 5-year period 14 patients with acromegaly and gigantism were seen at the endocrine clinic of King Edward VIII Hospital: 9 were Blacks and 5 Indians; 8 of the patients were women. The mean age of the patients was 46 years. Surprisingly, only 2 patients complained of acral overgrowth. Symptomatology was varied and not characteristic of the condition. On examination all patients had unequivocal signs of soft-tissue and bony overgrowth, 64% had visual abnormalities and 50% hypertension. Radiologically, 88% showed an enlarged pituitary fossa. On biochemical investigation, the fasting levels of growth hormone (GH) were increased in 12 patients and during oral glucose tolerance tests, the GH levels in these 12 patients were not suppressed. One patient in whom the fasting GH level was not increased had progressed to the stage of panhypopituitarism, in the remaining patient challenge with thyrotrophin-releasing hormone (TRH) led to increased GH levels and L-dopa challenge resulted in a paradoxical decrease in GH levels. Seven patients with increased GH levels who were challenged with L-dopa showed the typical decrease in GH levels found in this condition; in 5 of these patients, challenged with TRH, GH levels increased. The findings emphasize that despite the ease of clinical diagnosis, appropriate biochemical investigations are necessary to confirm the exact status of the disease, which is rare in the population studied.
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PMID:The clinical presentation and biochemical diagnosis of acromegaly and gigantism. 680 79

Thirty eight acromegalic patients (A) and a control group (C) of subjects without heart disease, were studied with echocardiography. Acromegalies were divided in two groups, A1 and A2, who had increase or normal serum growth hormone (GH) levels respectively after treatment (pituitary adenectomy and/or bromocriptine), at the time of the study. In acromegalic patients (A) mean left ventricular (LV) dimensions were normal while LV wall and septal thickness, LV mass and left atrial (LA) dimension were increased compared to control subjects. LVH was present in 79% of acromegalic patients. Asymmetric septal hypertrophy (ASH) was found in 10,5% of our patients. In group A1, IVS, LVPW, LVMM/m2 were significantly increased as compared to group A2. Fractional shortening (FS), ejection fraction (EF), mean velocity of circumferential fibre shortening (Vcf), frequency-normalized Vcf (Vcfn), posterior left ventricular wall velocity (PWV), and normalized PWV (PWVn) were normal in both groups. In patients with active acromegaly (Al) IVS and LVMM/m2 correlated well with the total duration of the disease (r=0.550 p less than 0.01 for IVS; r=0.624 p less than 0.01 for LVMM/m2) and with the duration of acromegaly before treatment (r=0.568, p less than 0.01 for IVS; r=0.500 p less than 0.01 for LVMM/m2). Furthermore a positive correlation was found between IVS and GH levels (r=0,550 p less than 0.01). Concomitant coronary artery disease and or hypertension did not seem to play any role in causing the above mentioned echocardiographic changes. Echocardiography is useful in assessing the cardiac involvement in patients with acromegaly.
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PMID:[Acromegalic cardiomyopathy: an echocardiographic study]. 688 53

One hundred and fifty-five acromegalics, 76 males (mean age 44 +/- 1.3 years) and 79 females (45 +/- 1.4 years) were studied. The frequency of clinical features were: acral enlargement 100 per cent, hyperhidrosis 65 per cent, headache 55 per cent, paraesthesiae 49 per cent, cardiac problems 34 per cent, hypertension 32 per cent, diabetes mellitus (clinical and chemical) 27 per cent, and visual field defects 6 per cent. Signs and symptoms, and particularly headache, did not show any relation with the size or shape of pituitary tumours, nor with growth hormone (GH) values, age, sex or weight. Mean of GH values at 60, 90 and 120 minutes during a GTT averaged 135 mIU/l, range 8-1833. Diabetes mellitus was more frequent and severe in patients with higher GH values, occurring in 32 per cent of patients with mean GH values greater than or equal to 50 mIU/l and only in 16 per cent of the rest (p less than 0.05). GH values correlated positively with size of tumours. Forty-nine per cent of patients presented with entirely intrasellar tumours, 27 per cent with suprasellar extensions and 23 per cent with partially empty sellae. The mean GH (238 mIU/l) of patients with suprasellar extensions was significantly higher (p less than 0.004) than those of the others. Younger acromegalics showed a tendency to larger tumours. Early treatment of acromegaly, particularly in young patients and those presenting with high GH values, is recommended.
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PMID:The acromegaly syndrome. Relation between clinical features, growth hormone values and radiological characteristics of the pituitary tumours. 711 79

1. In an attempt to test the hypothesis of a derangement in central catecholaminergic function in hypertensive patients, the serum growth hormone and prolactin responses to the alpha-adrenergic agonist clonidine (0.15 mg infused intravenously) and to L-dopa administration (500 mg orally) were evaluated in 15 hypertensive and 15 normotensive subjects matched for sex, age and body weight. 2. Whereas L-dopa elicited a growth hormone response of similar magnitude in both groups, clonidine infusion induced a significant increase in serum growth hormone in normotensive, but not in hypertensive, subjects. 3. Prolactin levels were equally suppressed by L-dopa and did not change after clonidine in either group. 4. The present study adds neuroendocrine evidence to the concept of a derangement in central alpha-adrenergic function in human hypertension.
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PMID:Growth hormone secretion in hypertensive patients: evidence for a derangement in central adrenergic function. 735 32

11 acromegalics were treated with bromocriptine for 2--18 months. Their hormonal response was assessed by an acute suppression test with bromocriptine (AST), an oral glucose tolerance test (GTT), and by measuring growth hormone (GH) concentrations during a day of hospital life. The GTTs and the 24-hour profiles were performed before and after bromocriptine. During the AST all patients showed a decrease of GH concentrations ranging from 33 to 86% of the basal. Following bromocriptine, the mean GH concentration was lowered in 7 out of 11 patients during the GTT, and in 8 out of 11 during the profile, but it was within the normal range in 4 patients only during the GTT, and in 1 during the profile. Bromocriptine normalises radioimmunoassayble GH levels in a percentage of patients (12%) which is less than those following conventional treatment of acromegaly, surgery (80%) and pituitary irradiation (70%). Clinically, however, bromocriptine was more effective than judged by the changes of GH levels. Subjective and objective symptoms of acromegaly, such as articular pain, excessive sweating, hypertension, amenorrhoea, urinary hydroxyproline excretion and heel pad thickness decreased in our patients after bromocriptine. A specific action of bromocriptine on the degradation rate of 'little' GH may result in a selective reduction of the bioactive monomeric component of GH and may explain the discrepancy between the clinical and the biochemical response to bromocriptine. This discrepancy might also be explained by a specific action of bromocriptine on the somatomedin levels.
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PMID:Reappraisal of bromocriptine treatment for acromegaly. 739 Apr 5

Pituitary and adrenal glands removed from male and female spontaneously hypertensive (SH) rat donors with high blood pressure were implanted in normotensive, Sprague-Dawley (S-D) recipients which had been hypophysectomized or adrenalectomized. The transplants were accepted readily and after 90 days the animals were necropsied. Maintenance of organs and body weights suggested that the pituitary glands of SH rats have an adequate content of growth hormone but there may be an intrinsic deficiency of gonadotrophic hormones in this strain. The blood pressure of the hypophysectomized and adrenalectomized recipients was well maintained, particularly by the Sh-rat adrenal transplants, but the blood pressure of the recipients did not become abnormally elevated. SH-rat pituitary and adrenal glands caused fatty infiltration of the liver and hyperlipidaemia indicative of a lipotrophic factor in the SH rat strain. The histopathological changes in the transplanted pituitary and adrenal glands, and in intact pituitary and adrenal glands of the recipients, suggested that SH-rat pituitary glands secrete extra quantities of ACTH, that the pituitary-adrenal axis of this strain is extra sensitive to stressful stimuli, and that the spectrum of adrenal steroids secreted by this strain may be different from that of most normotensive strains.
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PMID:Transplantation of pituitary and adrenal glands of spontaneously hypertensive rats into hypophysectomized or adrenalectomized, normotensive Sprague-Dawley rats. 742 92

Secondary polycythemia has been noted in association with various neoplasms. An erythropoiesis stimulating factor (erythropoietin) has been demonstrated in the fluid or tissues obtained from most of these neoplasms and erythropoietin levels were found to be elevated in the serum and returned to normal after resection of these tumors. Recently, the potential of pheochromocytoma to produce a wide variety of hormones and neurotransmitters such as growth hormone, motilin, ACTH, atrial natriuretic factor (ANF) and others has been shown. Although elevated hematocrit has been observed in association with pheochromocytomas, the occurrence of absolute polycythemia in such cases is very rare. In this report, we describe a patient with a long history of hypertension and cardiac dysrhythmia as well as polycythemia which was secondary to pheochromocytoma. The patient's blood pressure normalized and the polycythemia regressed after resection of the tumor. Increased release of erythropoietin is the most favored explanation for this rare association. Pheochromocytoma should be included in the differential diagnosis of secondary polycythemia.
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PMID:Pheochromocytoma associated with polycythemia: case report. 750 17

The introduction of human growth hormone (GH) prepared by recombinant DNA technology has resulted in increased numbers of children and adults receiving treatment. This trend has led to questions concerning the safety of GH, particularly when used for indications other than GH deficiency. This review discusses the effects of GH on fluid, lipid, and carbohydrate metabolism; the risk of intracranial hypertension or pseudotumor cerebri; the effects on the skeletal system; the risk of malignancy; and the effects on the immune system. At present, GH treatment appears to be safe, although long-term follow-up of GH-treated patients is necessary.
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PMID:Complications of growth hormone therapy in children. 758 53

Acromegaly is a clinical syndrome that most typically is the manifestation of adenomatous hyperplasia of growth hormone-secreting cells in the pituitary gland. Although the primary process is benign, many disfiguring and potentially serious complications can develop. Because of the slow evolution of signs and symptoms, acromegaly can be a diagnostic challenge. Furthermore, many common diseases, such as hypertension, diabetes mellitus and hyperlipidemia, occur secondary to acromegaly but may initially be treated as isolated primary processes. Systematic evaluation should be performed if acromegaly is suspected. The diagnosis is based on clinical observation, hormonal assays and selective radiologic imaging. Acromegaly is most often treated surgically, but radiotherapy and drug therapy can be effective alternatives.
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PMID:Diagnosis and treatment of acromegaly. 760 64


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