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

Fibrinogen, fibrinogen-related antigen (FR-antigen), and components of the fibrinolytic enzyme system were measured in patients with essential hypertension, renal disease with and without hypertension, and normal subjects. Essential hypertension was associated with a decrease in plasminogen activator and an increase in FR-antigen. In renal disease these changes were accompanied by increases in plasminogen activation inhibitor, alpha(2)-macroglobulin, alpha(1)-antitrypsin, and fibrinogen.
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PMID:The fibrinolytic enzyme system in hypertension. 471 59

An increased number of skin capillaries has been found in human skin subjected to sustained venous hypertension. To investigate this observation, venous hypertension was produced in the hind limb of Greyhounds by fashioning an arteriovenous (AV) fistula between the femoral vessels. This caused an increase in the number of capillaries in the skin of the lower leg. The capillary permeability of normal legs and legs subjected to chronic venous hypertension was then studied by observing the movement of radioactive molecules from the plasma to the fluid within Guyton capsules. Fibrinogen, a large molecule, leaked out of the capillaries significantly faster in the limbs with a high venous pressure and an enlarged capillary bed. It is suggested that the increase in the size and permeability of the dermal skin capillaries secondary to prolonged venous hypertension is the cause of lipodermatosclerosis and venous ulceration.
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PMID:The effect of sustained venous hypertension on the skin capillaries of the canine hind limb. 705

71 patients with an ischaemic stroke were investigated clinically, by psychological tests (WAIS) and Computertomography. On the basis of the investigation the patients were separated into two groups. 40 patients showed early dementia; 31 were without mental impairment. The frequency of strokes, the history of neurological symptoms and the neurological symptoms at admission were distributed evenly. The dominant hemisphere was significantly more often diseased in the demented group; bilateral signs were also significantly more often seen in the demented group. From the investigated risk factors (Hypertension, Cardiac disease, Diabetes, Viscosity, Fibrinogen). Only hypertension was significantly more often present in demented than non demented patients. The CT confirmed the clinical findings, especially the importance of the bilateral distribution of infarcts as well as a higher distribution of infarction in the thalamus in the demented patient group.
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PMID:A clinical approach to vascular (multiinfarct) dementia. 715 15

Routine investigations designed to detect excessive intravascular coagulation in patients with gestational hypertension and pre-eclampsia have been analysed in 936 cases. Reticulocyte counts did not differ significantly from those in normal controls and abnormal red cell morphology was detected in only two patients. Fibrinogen degradation products and thrombocytopenia were found in about 10% of all hypertensive women and macrothrombocytosis in 32%. Neither reticulocyte counts nor the scanning of stained blood films for evidence of microangiopathic haemolysis have a place in the routine investigation of pre-eclampsia and it is doubtful whether any of the other screening tests can influence the management of patients with uncomplicated gestational hypertension. In fully developed pre-eclampsia, macrothrombocytosis is found in about 50% of patients, fibrinogen degradation products and thrombocytopenia in about 15%. All three parameters reflect the degree of clinical severity of the disease.
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PMID:Intravascular coagulation in gestational hypertension and pre-eclampsia: the value of haematological screening tests. 716 20

The platelet count in 550 patients with gestational hypertension was significantly lower and the mean platelet volume significantly higher than in normal pregnant women. Both the platelet count and volume became increasingly abnormal when hypertension was accompanied by oedema, proteinuria or both, and women with severe pre-eclampsia or eclampsia had the lowest platelet counts and the highest mean platelet volume. The proportion of patients with thrombocytopenia and/or macrothrombocytosis also varied with the severity of the clinical presentation. Fibrinogen degradation products were found mainly in fully developed pre-eclampsia. These findings confirm the concept of a rapid platelet turnover caused by low-grade disseminated intravascular coagulation in gestational hypertension. The platelet pattern in essential hypertension is similar to that seen in normal pregnancy.
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PMID:Thrombocytopenia and macrothrombocytosis in gestational hypertension. 729 1

Epidemiological studies have revealed that elevated fibrinogen concentrations are associated with an increased risk of myocardial infarction, stroke, intermittent claudication, and cardiovascular mortality. The manner in which fibrinogen operates in atherogenesis has not yet been elucidated, but genetic control of fibrinogen levels is partially responsible. Fibrinogen frequently acts in concert with hyperlipidemia, diabetes, hypertension, physical inactivity, and age, variables that are influenced by insulin action. Because the offspring of hypertensive men tend to be hyperinsulinemic and insulin resistant from a young age, we hypothesized that their increased fibrinogen levels might reflect decreased insulin action and thus play a role in the metabolic syndrome. We chose 48 adult offspring (mean age, 38.4 years) of 30 fathers who had been treated for hypertension, and the former were matched by age, body mass index, sex, and smoking habits with 37 control subjects. Elevations in fibrinogen concentration (3.63 +/- 0.93 versus 2.87 +/- 0.54 g/L, P < .001) paralleled increases in blood glucose and insulin levels, estimates of insulin resistance, and blood pressure. In the offspring, in contrast to the control group, correlations between fibrinogen and metabolic-syndrome variables (ie, insulin, glucose, and waist and hip circumferences) were found. In stepwise multiple regression analyses, age and smoking habits were entered as variables in both study groups, but postload insulin and high-density lipoprotein cholesterol were entered as variables in the offspring group only. We propose that familial predisposition influences the relationship between insulin concentration and fibrinogen, an effect that may contribute to the clinical importance of the metabolic syndrome.
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PMID:Increased fibrinogen levels in the offspring of hypertensive men. Relation with hyperinsulinemia and the metabolic syndrome. 748 47

Ischaemic heart disease and stroke are the major causes of death in the Western world. Established risk factors such as smoking, hypertension and hypercholesterolaemia explain only some of these events. Most myocardial infarctions and cardiac deaths are precipitated by acute occluding coronary thrombi, and it has been known for some time that thrombosis participates in atherogenesis. For these reasons, haemostatic variables have been included in studies of cardiovascular risk. The plasma fibrinogen level is associated with both the severity and the extent of coronary, cerebral and peripheral atherosclerosis. In prospective studies, fibrinogen was found to be an independent predictor of myocardial infarction in both sexes and of stroke in men. The plasma fibrinogen level thus provides information on risk over and above that supplied by established risk factors. Fibrinogen may play a part in atherothrombosis via several mechanisms: (1) by promoting atherosclerosis, (2) as an essential component of platelet aggregation, (3) because the amount of fibrin deposited and the size of the clot are directly related to the plasma fibrinogen level and (4) because fibrinogen increases plasma viscosity. Nevertheless, it is not yet possible to determine whether high fibrinogen levels are a cause or a consequence of cardiovascular disease because no drugs that selectively lower plasma fibrinogen levels are available. In addition, further standardization of measurements is needed before routinely including plasma fibrinogen in cardiovascular risk scores.
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PMID:Fibrinogen and cardiovascular risk. 758 94

As evidence accumulates to implicate fibrinogen as a risk factor for cardiovascular disease (CVD) it becomes important to characterize the levels and correlates of fibrinogen in diverse populations. Knowledge of the correlates of fibrinogen may help researchers to disentangle the independent contribution of elevated fibrinogen concentrations to CVD. Characterization of the normal range and possible determinants of fibrinogen concentrations, likewise, may aid CVD risk assessment and intervention research. Fibrinogen concentrations vary widely among populations and increase with age. Levels are consistently higher in women than men and rise after menopause. Smoking is the most important lifestyle correlate of fibrinogen. People with diabetes and hypertension have elevated fibrinogen levels, as do sedentary and obese individuals. Alcohol intake and oestrogen replacement therapy are associated with lower fibrinogen levels. Most other CVD risk factors are correlated positively with fibrinogen. Fibrinogen is clearly a marker of CVD risk. Yet, the strikingly non-specific pattern of higher fibrinogen with every CVD risk factor suggests that proving an independent causal role of fibrinogen will remain elusive in the absence of trials selectively lowering fibrinogen with the aim of reducing CVD.
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PMID:Epidemiology of fibrinogen. 779 26

Microalbuminuria (urinary albumin excretion between 20 and 200 micrograms/min) and endothelial dysfunction coexist in patients with essential hypertension. To evaluate whether the two phenomena are related and the determinants of that association, we recruited 10 untreated males with essential hypertension and microalbuminuria without diabetes to be compared with an equal number of matched patients with essential hypertension excreting albumin in normal amounts and 10 normal controls. The status of endothelial function was inferred from circulating von Willebrand Factor antigen (vWF), a glycoprotein secreted in greater amounts when the vascular endothelium is damaged. vWF concentrations were higher in hypertensive patients with microalbuminuria than in hypertensive patients without and controls. Individual vWF and urine albumin-excretion values were correlated (r = 0.55, p < 0.002). Blood pressure correlated with both urinary albumin excretion and vWF. Left ventricular mass index and minimal forearm vascular resistances were comparable in patients with hypertension and higher than in controls; total and low-density lipoprotein cholesterol, triglycerides, lipoprotein-a, Factor VII, and plasminogen activator inhibitor-1 did not differ. Fibrinogen was higher and creatinine clearance lower in microalbuminurics. Albuminuria in essential hypertension may reflect systemic dysfunction of the vascular endothelium, a structure intimately involved in permeability, haemostasis, fibrinolysis, and blood pressure control. This abnormality may have important physiopathological implications and expose these patients to increased cardiovascular risk.
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PMID:Microalbuminuria and endothelial dysfunction in essential hypertension. 798 Jul 88

Two families with hereditary renal amyloidosis were found to have a novel mutation in the fibrinogen A alpha chain gene. This form of amyloidosis is an autosomal dominant condition characterized by proteinuria, hypertension, and subsequent azotemia. DNAs of patients with amyloidosis were screened for a polymorphism in fibrinogen A alpha chain gene by single-strand conformation polymorphism analysis, and affected individuals from two kindreds were found to have a mutation. Both of these kindreds are American of Irish descent presenting with non-neuropathic, nephropathic amyloidosis in the fifth to the seventh decade of life. DNA sequencing showed a point mutation in the fibrinogen A alpha chain gene that is responsible for substitution of valine for glutamic acid at position 526. By restriction fragment length polymorphism analysis, 7 affected individuals and 14 asymptomatic individuals in these two kindreds were positive for the fibrinogen A alpha chain Val 526 gene. Fibrinogen was isolated from plasma of a heterozygous gene carrier and shown to contain approximately 50% variant fibrinogen. Discovery of this new mutation confirms the association between fibrinogen A alpha chain variant and hereditary renal amyloidosis and establishes a new biochemical subtype of amyloidosis.
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PMID:Hereditary renal amyloidosis with a novel variant fibrinogen. 811 8


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