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

In addition to the classical transmitters noradrenaline and acetylcholine, other transmitters have been identified in perivascular nerves, including 5-hydroxytryptamine, ATP and a number of peptides. This paper discusses pre- and postjunctional neuromodulation of vascular transmission, and cotransmission involving noradrenaline, ATP and neuropeptide Y in sympathetic nerves, acetylcholine and vasoactive intestinal polypeptide in parasympathetic nerves, and substance P, calcitonin gene-related peptide and ATP in 'sensory-motor' nerves. Vasomotor nerves derived from intrinsic neurones, for example in the heart and gut, are also discussed. Subpopulations of endothelial cells store and release a variety of substances, including acetylcholine, substance P, ATP, 5-hydroxytryptamine, vasopressin and angiotensin II, that act on receptors on endothelial cells and lead to the production of endothelium-derived relaxing factor (identified as nitric oxide) which, in turn, produces vasodilation in response to changes in flow and hypoxia. Endothelium-derived contracting factors such as endothelin may also be released. There appears to be a resting dynamic balance between endothelium-derived vasodilator tone and sympathetic vasoconstrictor tone, which is altered under different physiological and pathophysiological circumstances. Long-term (trophic) interactions between perivascular nerves and endothelial cells are discussed, as are the changes in vascular control mechanisms that occur with ageing and hypertension and in the nerves that remain following trauma or surgery.
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PMID:Local mechanisms of blood flow control by perivascular nerves and endothelium. 198 71

The role of the hypothalamus (HTH) in the pathogenesis of genetic hypertension was studied in spontaneously hypertensive rats (SHR). It is currently believed that, in this strain, the genetic defect manifests itself mainly in the HTH. We examined this hypothesis by grafting HTH neurons from embryos of SHR or control Wistar Kyoto (WKY) rats into the HTH of adult normotensive WKY rats. Changes in host systolic blood pressure (SBP) were monitored, and alterations in vasoactive intestinal polypeptide (VIP) gene expression of the host brain were studied. In rats grafted with HTH tissue from SHR embryos (G-SHR), the blood pressure rose by 31% as compared with that in the grafted control group. The blood pressure climbed gradually over a period of 6 weeks to its highest level, which was maintained for at least 3 months following grafting. Along with the elevated blood pressure, the heart weight increased by 80% compared to controls. Behavioral changes were also evident in the G-SHR rats, and these were similar to those of the native SHR strain. In situ hybridization histochemistry showed a 40% elevation in VIP transcripts in the suprachiasmatic nucleus of the host G-SHR brain compared to controls. These studies demonstrate that transplantation of embryonic SHR HTH tissue into brains of adult normotensive rats results in the development of hypertensive characteristics in the host. It thus appears that the HTH is a prime candidate for the source of changes leading to spontaneous hypertension in mammals.
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PMID:Hypertension induced by hypothalamic transplantation from genetically hypertensive to normotensive rats. 199 8

A placebo may be a pharmacologically active or an inert substance, a procedure, or a patient-doctor interview. Placebos work best in symptoms or disease which vary over time and between patients. The placebo works best in behaviour disorders, somatic autonomic disorders like pain, and neurohumoral disorders like hypertension. However, placebo action is incompletely defined in its molecular pharmacology. The endogenous brain systems of opioid, antiopioid, and gamma-aminobutyric acid polypeptide transmitters and neuronal receptors account in part for placebo analgesia. Non-painful stress may be mediated through other neurohumoral systems. A separate neural system might control these subsystems. Confidence based on the doctor's empathy commonly evokes the placebo effect. How the symbolic input of thought or emotion is translated into neuronal events is unknown. Double-masked 'controlled' clinical trials use placebo to reduce bias; overuse of placebo here may harm some patients. Oral placebos for routine use include thiamine at low dose. Potent drugs like glucocorticoids cannot be justified as placebo in mild disease or non-disease. Both patient and doctor are usually unaware of the placebo effect during interviews. Doctors may increase placebo efficacy by improving interpersonal skills.
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PMID:Magic or medicine? Clinical pharmacological basis of placebo medication. 202 61

The first compounds used to block the renin-angiotensin system were polypeptide antagonists of angiotensin II, administered parenterally. Subsequently, orally active angiotensin converting enzyme inhibitors were developed which were generally well tolerated, and were effective in the treatment of hypertension and congestive heart failure. Today they are well established as therapeutic agents. Nevertheless, the search continues for more specific therapeutic agents such as orally active renin inhibitors and angiotensin II antagonists, and accurate biochemical methods must be available to assess their efficacy. All approaches trigger a considerable compensatory rise in renin secretion which tends to counteract the blocking effect of these compounds. Hence all agents, but particularly the renin inhibitors, must have a good bioavailability and a high affinity in order to overcome the effect of the compensatory renin secretory response. As yet, it is too early to predict whether the potentially more specific renin inhibitors or angiotensin II antagonists will replace the present widely used angiotensin converting enzyme inhibitors.
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PMID:Various approaches to blockade of the renin-angiotensin system: persistent renin response. 209 83

We determined plasma and cardiac immunoreactive atrial natriuretic polypeptide (ir-ANP) levels in rats treated with deoxycorticosterone acetate (DOCA) and sodium chloride for 1, 7, and 28 days. Systolic blood pressure of DOCA-salt rats began to increase from the 7th day and reached 191 +/- 7 mmHg at the 28th day. One day after treatment with DOCA-salt, plasma levels of ir-ANP were increased compared to that of control rats. This was accompanied by decreased cardiac ir-ANP content. However, at the 7th day of DOCA-salt treatment, both plasma and cardiac ir-ANP levels of DOCA-salt rats were not different from those of control animals. At the 28th day, DOCA-salt rats had high plasma ir-ANP levels and no significantly different cardiac ir-ANP content compared to the controls. These data suggest that there are time-related changes in plasma ANP concentration during the development of DOCA-salt hypertension and higher plasma ANP levels might not necessarily be associated with a decreased cardiac ANP content.
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PMID:Phasic plasma atrial natriuretic polypeptide changes in DOCA-salt hypertensive rats. 214 77

Calcitonin gene-related peptide (CGRP) is a 37-amine acid bioactive polypeptide and known to be a powerful vascular relaxant. CGRP was measured in 45 cases with essential hypertension (EH). The results suggested that plasma CGRP level in patients with EH was lower than that in normal subjects (P less than 0.001). It was found that decrease of plasma CGRP was closely related with the severity of hypertension. However, the level of plasma atrial natriuretic factor (ANF) in EH patients was significantly increased as compared with normal subjects (P less than 0.01). A negative correlation between plasma CGRP and ANF (r = -0.3615, P less than 0.02) was found. These data suggested that decrease of plasma CGRP may play an important role in the pathogenesis of hypertension.
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PMID:[Plasma calcitonin gene-related peptide (CGRP) level in patients with essential hypertension]. 215 Jul 97

We report an unusual case of malignant mixed mesodermal tumor of the uterine corpus associated with various symptoms related to overproduction of catecholamine by the tumor cells. Histologically, the tumor was dominated by carcinomatous epithelium with foci of malignant mesenchyma. The type of epithelium was endometrioid with papillary adenocarcinomas containing foci of malignant squamous epithelium. The malignant mesenchyma consisted mainly of a fibrous stroma with many large and bizarre cells and spindle cells mimicking leiomyosarcoma, many of which were pleomorphic and contained large bizarre hyperchromatic nuclei. Foci of atypical adult-type cartilage and neoplastic osteoid formation were noted. In the tumor tissue, membrane-bound neurosecretory-type cytoplasmic granules were demonstrated by electron microscopy and polypeptide hormone synthesis was demonstrated by immunohistochemistry. Furthermore, the patient suffered frequent attacks of sudden hypertension with hypercatecholaminemia.
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PMID:A malignant mixed mesodermal tumor of the uterine corpus with hypercatecholaminemia. 216 44

Vascular remodeling is central to the pathophysiology of hypertension and atherosclerosis. Recent evidence suggests that vasoconstrictive substances, such as angiotensin II (AII), may function as a vascular smooth muscle growth promoting substance. To explore the role of the counterregulatory hormone, atrial natriuretic polypeptide (ANP) in this process, we examined the effect of ANP (alpha-rat ANP [1-28]) on the growth characteristics of cultured rat aortic smooth muscle (RASM) cells. ANP (10(-7) M) significantly suppressed the proliferative effect of 1% and 5% serum as measured by 3H-thymidine incorporation and cell number, confirming ANP as an antimitogenic factor. In quiescent RASM cells, ANP (10(-7), 10(-6) M) significantly suppressed the basal incorporations of 3H-uridine and leucine by 50 and 30%, respectively. ANP (10(-7), 10(-6) M) also suppressed AII-induced RNA and protein syntheses (by 30-40%) with the concomitant reduction of the cell size. Furthermore, ANP also significantly attenuated the increase of 3H-uridine and leucine incorporations caused by transforming growth factor-beta (4 x 10(-11), 4 x 10(-10) M), a potent hypertrophic factor. These results indicate that ANP possesses an antihypertrophic action on vascular smooth muscle cells. Down-regulation of protein kinase C by 24-h treatment with phorbol 12,13-dibutyrate did not inhibit ANP-induced suppression on 3H-uridine incorporation. Based on the observation that ANP was more potent than a ring-deleted analogue of ANP on inhibiting 3H-uridine incorporation, we conclude that the ANP's inhibitory effect is primarily mediated via the activation of a guanylate cyclase-linked ANP receptor(s). Indeed 8-bromo cGMP mimicked the antihypertrophic action of ANP. Accordingly, we speculate that in addition to its vasorelaxant and natriuretic effects, the antihypertrophic action of ANP observed in the present study may serve as an additional compensatory mechanism of ANP in hypertension.
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PMID:Atrial natriuretic polypeptide inhibits hypertrophy of vascular smooth muscle cells. 217 26

1. Vascular endothelium releases different substances (endothelium-derived contractile factors, EDCFs), which mediate vasoconstrictor responses induced by several agents. 2. Clear differences have been reported in endothelium-dependent contractions, which suggest at least three distinct EDCFs, named EDCF1, EDCF2 and EDCF3, respectively. 3. EDCF1 is a cyclooxygenase metabolite(s) of arachidonic acid. EDCF2 is a polypeptide released from cultured endothelial cells. It has been isolated and identified as a 21-amino acid peptide called endothelin, which is described as the most potent vasoconstrictor agent known to date. EDCF3 is an unidentified contractile factor(s), which is neither EDCF1 nor EDCF2. 4. The physiological role of these endothelial contractile factors is not yet clear. However, they have been implicated in the local mechanisms involved in blood flow regulation, as well as in some pathological conditions, such as hypertension or cerebral vasospasm.
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PMID:Endothelium-derived contractile factors. 227 80

The distribution of specific proteins in erythrocyte membranes was studied in patients with essential hypertension (EH) (n = 44), secondary hypertension of renal genesis (n = 42), and healthy persons (n = 44). Densitograms of gel analyzed after electrophoresis of erythrocyte ghosts showed a twofold increase in polypeptide levels in EH patients as compared to those in health persons: the band being 4.5 (Mw = 52-59 kD) and 6 (Mw = 35 kD), respectively. Radioimmunoassay has demonstrated that the amount of monoclonal antibodies bound to fragmented erythrocyte membranes from EH patients is greater by at least 28% than that in healthy persons. Patients with secondary arterial hypertension of renal genesis showed no significant difference in monoclonal antibody binding as compared to the controls.
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PMID:[Changes in the levels of erythrocyte membrane proteins in hypertension]. 233 59


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