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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Changes in brain neuropeptide content in spontaneously hypertensive rats may be primarily related to the development of hypertension or may be secondary consequences of it. We have measured brain concentrations of beta-endorphin, Leu-enkephalin, arginine vasopressin (AVP) and oxytocin (OXT) in stroke-prone spontaneously hypertensive rats (SHRSP) and in age-matched normotensive Wistar Kyoto (WKY) controls, as well as in SHRSP with normalized blood pressure by chronic treatment with clonidine. Opioid peptide contents were measured in 12-, 18- and 24-week-old rats. beta-Endorphin was measured in the neuro-intermediate and anterior lobes of the pituitary, the hypothalamus, mid-brain and brain stem; Leu-enkephalin in the neuro-intermediate lobe of the pituitary, hypothalamus, mid-brain, brain stem, as well as in the spinal cord and adrenal glands. AVP and OXT were measured in the neuro-intermediate lobe of the pituitary, hypothalamus, brain stem and spinal cord. beta-Endorphin in the neuro-intermediate lobe of the pituitary was significantly higher in 12- and 18-week-old SHRSP. Adrenal gland Leu-enkephalin was lower in SHRSP as compared with the WKY. OXT and AVP contents were markedly reduced in all brain regions of SHRSP except the neuro-intermediate lobe of the pituitary, where no significant changes were found. In no case did long-term antihypertensive treatment with clonidine reverse the altered peptide content in the SHRSP. We conclude that alterations in brain neuropeptide content in SHRSP are not secondary to hypertension. The blood pressure lowering activity of clonidine appears not to depend on major alterations of peptide concentrations. A genetic defect in the synthesis of adrenal enkephalins and hypothalamic OXT and AVP seems likely from these studies.
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PMID:Altered neuropeptide concentrations in spontaneously hypertensive rats: cause or consequence? 315 51

Primary aldosteronism (PA) is the most common cause of mineralocorticoid hypertension. Different studies, using the plasma aldosterone concentration to plasma renin activity ratio (PAC/PRA) for the screening of patients with hypertension, have shown a marked increase in the detection rate of PA. Idiopathic bilateral adrenal hyperplasia (IHA) and aldosterone-producing adrenal adenoma (APA), are the leading causes of primary aldosteronism. Glucocorticoid-remediable aldosteronism (GRA), also called familial hyperaldosteronism type I, familial hyperaldosteronism type II and carcinomas are rare causes of PA. Patients with hypertension and hypokalemia, those with a family history of hypertension and stroke at an early age, or patients with medication-resistant hypertension should be screened for PA using the PAC/PRA ratio. If a high ratio is found, a sodium loading test or a captopril test is warranted to confirm the diagnosis. Adrenal gland imaging is important in subtype differentiation (APA vs IHA). Adrenal venous sampling should be used when other tests prove inconclusive. Genetic testing has facilitated detection of GRA. Surgery is considered the treatment of choice for patients with APA, while bilateral hyperplasia subtypes are treated medically. Normalization of aldosterone levels or aldosterone receptor blockade are necessary to prevent the morbidity and mortality associated with hypertension, hypokalemia, and cardiovascular damage.
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PMID:Detecting and treating primary aldosteronism: primary aldosteronism. 1742 5

Primary aldosteronism (PA) is the most common cause of mineralocorticoid hypertension. Different studies using the plasma aldosterone concentration (PAC)-plasma renin activity ratio (ARR ratio) for the screening of patients with hypertension, have shown a marked increase in the detection rate of PA. PA is commonly caused by an adrenal adenoma (APA) or idiopathic bilateral adrenal hyperplasia of the adrenal zona glomerulosa (IHA) and, in rare cases, by the inherited condition of glucocorticoid-remediable aldosteronism (GRA). The early diagnosis of PA is important, not only because the forms caused by adrenal adenoma are surgically curable, but also because correlation between the duration of PA and the development of cardiovascular complications has been reported. Patients with resistant and/or severe hypertension, patients with hypokalemia, those with a family history of hypertension and stroke at an early age, or patients with an adrenal incidentaloma should be screened for PA using the ARR ratio. Suspicion of PA owing to a pathological ratio requires confirmatory testing, including fludrocortisone suppression test, saline infusion and captopril challenge. Adrenal gland imaging is important in subtype differentiation (APA vs IHA), but adrenal venous sampling is the gold standard and should be used when other tests prove inconclusive. Genetic testing has facilitated detection of GRA.
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PMID:Screening and diagnosis of primary aldosteronism. 3029 Apr 70