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)

Our understanding of the physiology and biochemistry of acid-base and fluid-electrolyte regulations has greatly expanded in recent years. Key physiologic principles have emerged that now permit rational diagnosis and therapy of clinical disorders of serum electrolyte concentration. This paper describes diagnostic strategies based upon these principles. The etiology of the myriad factors in hyponatremia is best derived by first measuring serum tonicity and then assessing extracellular fluid volume. The hyper-, iso- and hypotonic hyponatremia are defined, and the hypotonic group is subclassified into hypo-, iso- and hyper volemic forms. The hypernatremias are best categorized by their state of volume expansion. Classification into the hypo-, hyper- and isovolemic hypernatremias simplifies their diagnosis. Metabolic acidoses are classified in terms of the anion gap. Clinical and chemical aspects of increased and normal anion gap acidoses are described. Metabolic alkaloses require a source of new bicarbonate and its retention by the kidney. The means by which new alkali is synthesized and urinary loss prevented serve to effectively classify the alkaloses. Hypokalemic syndromes are defined in terms of associated changes in body potassium. The potassium-depleted states are further subclassified by whether normotension or hypertension is associated. Hyperkalemia is produced by redistribution of cellular and extracellular potassium or by increased body potassium. Defects in the renin-angiotensin-aldosterone-distal renal tubule effector arm usually underlie hyperkalemic states, which are than classified in terms of this regulatory hormonal cascade. Classifications for disordered serum concentrations of calcium, magnesium, phosphorus and uric acid are presented. Hormonal, metabolic and renal regulatory factors form the basis for an organized approach to these disorders.
 ...
PMID:Diagnostic strategies in disorders of fluid, electrolyte and acid-base homeostasis. 703 39

Although most forms of glomerulonephritis in man are thought to have an immunopathogenesis, certain clinical and experimental observations support the role of other non-immunologic mechanisms in the progression of these diseases. 1. Intra-renal vascular disease thought to be secondary to hypertension, may be responsible for ischemic glomerular sclerosis. 2. Hypertension may damage the diseased glomerulus directly, as has been demonstrated in experimental glomerulonephritis, in the remnant kidney, and in experimental diabetes mellitus. 3. Alterations in glomerular structure and function in the remnant kidney suggest that adaptations to nephron loss may contribute to further renal damage. 4. Glomerular sclerosis occurs under circumstances where immunologic mechanisms are highly unlikely, such as aging, reflex nephropathy, chronic aminonucleoside administration, and protein loading. 5. Preservation of renal function can be achieved by phosphorus restriction in the remnant kidney and in nephrotoxic serum nephritis.
 ...
PMID:Mechanisms of progression in glomerulonephritis. 703 41

The relationships between systolic and diastolic blood pressure, and select demographic, dietary, life-style, and anthropometric variables were examined for a specialized sample of 10,419 adults, 18 years and over, from the National Health and Nutrition Examination Survey (NHANES) I conducted in 1971-1974. The bivariate relationships of blood pressure to each of the measurements above were examined using zero-order correlation coefficients, and Step-wise linear regression. Age and body mass index (BMI) played a major role in accounting for most of the variance in blood pressure. These two indices alone accounted for 94.5% and 89.0% of the variance in systolic and diastolic blood pressure. In contrast, only 5.5% and 11.0% of the changes in systolic and diastolic blood pressure were explained by all other variables combined. Diet explained less than 1% of the total variance observed for blood pressure for whites, and less than 5% for nonwhites. Select dietary variables such as sodium/potassium ratio, calories from fat, and % saturated fat were not significantly (p less than 0.001) correlated to blood pressure. On the other hand, food calcium, sodium/calcium ratio, food vitamin C, and calcium/phosphorus ratio were significantly correlated to both systolic and diastolic blood pressure.
Hypertension
PMID:Demographic, dietary, life style, and anthropometric correlates of blood pressure. 710 43

The thesis that primary disturbances of divalent ion metabolism contribute to the development and maintenance of hypertension is addressed. Representative interactions of calcium, magnesium, and phosphorus with normal cardiovascular physiology are presented. Established and postulated abnormalities of divalent ion metabolism associated with human and experimental hypertension are reviewed. The influence of calcium balance on blood pressure development in the young spontaneously hypertensive rat is demonstrated by the results of a diet intervention study. Twelve male SHRs were randomized at 4 weeks of age to one of three diets that differed only in the calcium content (0.25%, 0.5%, and 4.0% by weight). The SHRs' blood pressures stratified inversely (p less than 0.001) based upon the calcium content. The low calcium animals experienced a more rapid and greater rise in blood pressure between 4 and 20 weeks of age (p less than 0.01). Blood pressures of the supplemented SHRs (4%) peaked at a lower value (174 vs 192 mm Hg, p less than 0.01). After maturity, the 4% SHRs experienced an attenuation (p less than 0.01) of their hypertension (154 +/- 7 mm Hg, 4% SHR vs 176 +/- 7 mm Hg, 0.5% SHR). It is proposed that membrane-associated bioavailable Ca2+ is reduced in the SHR, and possibly in human, hypertension. Dietary calcium supplementation may reverse this defect, resulting in cell membrane stabilization and vascular smooth muscle relaxation.
Hypertension
PMID:Calcium, magnesium, and phosphorus balance in human and experimental hypertension. 710 50

Forty-nine patients with gout, many with hypertension and/or renal calculi, were given hydrochlorothiazide, furosemide, or ticrynafen. Diuresis and increased clearances of sodium (Na), potassium (K), chloride (Cl), and calcium (Ca) occurred after a single dose of hydrochlorothiazide, 100 mg, or furosemide, 40 mg, orally. There was very slight change in urate and phosphorus clearances. With prolonged use of hydrochloride or furosemide, diuresis and increased electrolyte excretion disappeared. Urate and Ca excretion fell with hydrochlorothiazide. With long-term use of furosemide, urate excretion was suppressed, but Ca excretion was sustained. Ticrynafen produced diuresis and increased clearances of Na, K, and Cl. Calcium excretion was increased after a single dose and minimally decreased after long-term use. Most striking was the severe and rather sustained uricosuria. Though ticrynafen is an effective uricosuric, natriuretic, and antihypertensive agent, its hepatotoxicity and nephrotoxicity mitigate against its clinical use.
 ...
PMID:Effects of diuretics on urate and calcium excretion. 723 11

Toxemia in pregnancy is characterized by a combination of at least two of the following clinical symptoms: hypertension, edema, and proteinuria. In this study the dietary intakes of young pregnant women attending a Maternal and Infant Care Program at Tuskegee Institute were evaluated for selected vitamins and minerals. Women with toxemia were identified, and women without toxemia served as controls. The toxemia group generally consumed lesser amounts of vitamins and minerals than the controls. However, both groups were deficient (less than two-thirds RDA) in calcium, magnesium, vitamin B6, vitamin B12, and thiamin. Milk, meat, and grains supplied an appreciable proportion of each vitamin except vitamin A, which was found primarily in the two vegetable groups. Meat and grains contained the greatest quantities of minerals, but milk provided a relatively good proportion of potassium, calcium, magnesium, and phosphorus. Anemia was not related to the incidence of toxemia. Women exhibiting anemia consumed smaller amounts of vitamins studied than did women without anemia.
 ...
PMID:Intakes of vitamins and minerals by pregnant women with selected clinical symptoms. 725 6

The clinical spectrum of 100 consecutive cases of surgically proved primary hyperparathyroidism treated from 1974 through 1978 was analyzed. Their laboratory test results were compared with 64 cases of other form of hypercalcemia using multivariate discriminant analysis. The clinical spectrum has dramatically shifted during the past three decades from renal calculi and bone disease to the asymptomatic patient discovered by routine serum chemical analysis. Hypertension was twice as common among hyperparathyroid patients as in the general population but failed to improve in 92% after parathyroidectomy. The most useful discriminant laboratory test in descending order of value were the serum chloride, serum calcium, hematocrit, serum phosphorus, and parathormone. Multivariate discriminant analysis of the serum calcium, phosphorus, chloride, and Hct provided a 98% degree of accuracy in separating hyperparathyroidism from other forms of hypercalcemia.
 ...
PMID:Primary hyperparathyroidism. Changing clinical spectrum, prevalence of hypertension, and discriminant analysis of laboratory tests. 731 24

The effects on blood pressure and renal function of long-term treatment with the alpha- and beta-blocker arotinolol at a dose of 20 mg/day were studied in 10 hypertensive patients with chronic renal failure. Patients received low-protein therapy in which the protein and phosphorus intakes were controlled at a certain level. The average duration of arotinolol treatment was 18.4 months. A significant decrease in blood pressure was seen after the second month of treatment, and this effect continued up to the 20th month. The progression rates of renal failure (creatinine clearance/month) before and after treatment were -0.377 +/- 0.344 and -0.164 +/- 0.172 ml/min/month, respectively. No side effects attributable to the drug were observed. These findings indicate that arotinolol has a stable antihypertensive effect and no adverse effects on renal function. Arotinolol appears to be a useful drug in the long-term treatment of hypertension in patients with chronic renal failure.
 ...
PMID:Effects of long-term therapy with arotinolol on blood pressure and renal function in hypertensive patients with chronic renal failure. 768 85

Although altered cellular calcium handling plays a critical role in the pathophysiology of hypertension, little attention has been focused on the impact of calcium regulating hormones on target-organs (e.g. vascular tissue). Therefore the relationship between calcium, phosphorus, parathyroid hormone, 25- and 1,25-(di) hydroxyvitamin D3, blood pressure (BP) and regional circulation was examined in 25 patients (44 +/- 2.5 years) with moderate hypertension (systolic BP 164 +/- 4 mmHg, diastolic BP 105 +/- 2 mmHg). Calf and finger blood flow were measured simultaneously using ECG-triggered plethysmography at rest and after 3 min arterial occlusion (reactive hyperemia). Systolic and diastolic BP were inversely correlated with 25-hydroxyvitamin D3 (r = -0.511 and r = -0.445, p < 0.002). Calf vascular resistance at rest (r = -0.46, p = 0.02) and after 3 min arterial occlusion (r = -0.78, p = 0.0001) was related to 25-hydroxyvitamin D3 concentration. Only calf vascular resistance during reactive hyperemia was significantly related to 1,25-dihydroxyvitamin D3 (r = -0.44, p = 0.03). After correction for blood pressure calf vascular resistance after 3 min arterial occlusion remained significantly and inversely related with 25-hydroxyvitamin D3. There was no relation between finger (skin) circulation and vitamin D3. All other calcium regulating factors were unrelated to the parameters of peripheral circulation. Our results indicate that among the calcium regulating factors, particularly vitamin D3 seems to inversely influence muscle, but not skin vascular tone-independently of blood pressure in mild to moderate hypertension.
 ...
PMID:Relationship between vitamin D3 and the peripheral circulation in moderate arterial primary hypertension. 770 87

The study described was conducted to evaluate a simple enzymatic method for the study of the cholesterol/phospholipids ratio in erythrocyte membrane (C/PL) in a group of normal pregnant, of hypertensive pregnant, in non-pregnant controls and in cord blood. Subjects consisted of 28 normotensive pregnant women (NT), 14 women with pregnancy induced hypertension (PIH), 10 non-pregnant normotensive women (Non-Preg) and 14 samples obtained from umbilical cord (C) at delivery from normotensive pregnant. Red blood cells were isolated from heparinated blood samples. Lipids were extracted from erythrocytes by isopropanol/chloroform, without preparation of cell ghosts. Cholesterol content was evaluated by cholesterol oxidase and phospholipids were estimated as organic phosphorus in the total lipid extract. We found a significant difference of C/PL between the PIH group and the NT group (1.01, SD 0.11 vs. 0.76, SD 0.10, 95% CI 0.74-0.78; p < 0.001) and the Non-Preg group (0.83, SD 0.11, 95% CI 0.80-0.86; p < 0.001). Cord blood C/PL was significantly elevated with respect to NT (1.25, SD 0.13 vs. 0.76, SD 0.10; p < 0.001). The method was proven to be fast, reliable and of value for the study of the pathophysiology of the alteration of the lipid composition, i.e., the increased cholesterol content, of the red cell membrane found in hypertensive pregnant patients.
 ...
PMID:The cholesterol to phospholipids ratio (C/PL) of the erythrocyte membrane in normotensive, hypertensive pregnant and in cord blood as assessed by a simple enzymatic method. 770 66


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