Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085580 (essential hypertension)
 14,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prevalence of arterial hypertension was evaluated in a retrospective study of 158 patients with acromegaly, and results were compared to control populations, namely, the Munich Blood Pressure Study (MBPS) and the Framingham Study. The prevalence of hypertension (defined according to WHO criteria) was significantly increased in female patients but not in men; hypertensive acromegalics were older and tended to have higher body weight compared to normotensive patients. Hypertension was not related to serum concentrations of growth hormone. After successful treatment of acromegaly, growth hormone levels and systolic and diastolic blood pressure fell only in female hypertensive acromegalics; this did not occur in normotensives. The rise in plasma renin activity in response to upright posture was diminished in 57.9% of acromegalic patients. The prevalence of low-renin hypertension in our group of patients was 31.6%, which is similar to figures reported for unselected non-acromegalic subjects with essential hypertension. Orthostatic renin activity was weakly and inversely related (r = -0.3) to blood pressure. No relationship between plasma aldosterone concentration and blood pressure could be detected; however, in acromegalic women, aldosterone rose higher after ambulation than in men. In conclusion, hypertension is a common problem in acromegaly and at least in part related to similar risk factors in control populations. The association with abnormalities of the renin-angiotensin-aldosterone system is difficult to interpret and does not offer an explanation for the slight increase in the prevalence of hypertension.
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PMID:Acromegaly and hypertension: prevalence and relationship to the renin-angiotensin-aldosterone system. 219 80

Measurement of exchangeable sodium by isotope dilution is a relatively simple, reliable method for the determination of body sodium contents, which can be used in the clinical practice without significant health hazard to the patient. When computed to body surface area, the values for exchangeable sodium can be compared in patients of different body build. Exchangeable sodium may be variably increased in different clinical conditions associated with hypertension, thus increased sodium contents of the body is of major importance in the pathogenesis of hypertension caused by all forms of mineralocorticoid excess, and in the majority of patients with chronic renal insufficiency. In several endocrine disorders, e. g., acromegaly, hypothyroidism, increased sodium space does not play any significant part in the pathogenesis of hypertension. In diabetes mellitus, exchangeable sodium may be increased already prior to the development of hypertension, however it is still a matter of debate whether this abnormality is involved in the pathogenesis of hypertension in these patients. It seems now beyond any doubt that body sodium is normal in patients with essential hypertension, including those with the low renin form of the disease; nevertheless, some data indicate that blood pressure may be volume dependent in elderly patients with essential hypertension.
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PMID:[The role of exchangeable sodium content of the body in cases of hypertension of various etiology]. 219 11

As previously shown, in essential hypertension postprandial plasma insulin concentrations are elevated. In order to determine a relationship of high blood pressure and plasma insulin levels in acromegaly and in obesity 59 subjects with normal glucose tolerance were studied. They were divided into three groups: (I) patients with acromegaly: 7 normotensives and 8 hypertensives, (II) 12 obese normotensives and 12 obese hypertensives and (III) 10 non-obese hypertensives, and 10 healthy subjects. Blood glucose and plasma insulin concentrations were measured in a fasting state and after an oral glucose load of 75 g. The fasting insulin concentrations in all the acromegalics and in all the obese patients were higher than those in healthy subjects. The insulin response to the glucose load was significantly enhanced in all the three groups of hypertensive patients compared with those of matched normotensive controls. The results indicate that insulin may play a role in the regulation of blood pressure in essential hypertension, and in such hyperinsulinaemic disorders as acromegaly and obesity.
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PMID:High blood pressure and hyperinsulinaemia in acromegaly and in obesity. 266 41

Essential hypertension has long been assumed to be a multifactorial disease. However, recent evidence suggests that it is a syndrome rather than a disease with a common symptom--an elevated blood pressure. One large segment of the hypertensive population--approximately 60%--has in common an increased blood pressure sensitivity to salt intake. Further analysis of this subgroup suggests that it is also heterogeneous, consisting of at least six major entities: renal parenchymal disease, bilateral renal artery stenosis, primary aldosteronism, acromegaly, low renin essential hypertension, and the most recently described entity--nonmodulating essential hypertension. This subset's name is derived from the fact that sodium intake does not modify (modulate) renovascular and adrenal responses to angiotensin II, as occurs in normotensives and modulating hypertensive patients. The following abnormalities have been reported in these patients: (1) a failure of renal blood flow to increase with salt loading; (2) a reduced ability to excrete a salt load; (3) reduced renin suppression both by salt and angiotensin II; and (4) a hypertensive response to salt load. These patients also have a strong family history for hypertension and an increase in erythrocyte sodium countertransport. With a better understanding of the mechanisms underlying the elevated blood pressure in a specific patient, a more rational approach to therapy is possible. For example, in the salt-sensitive hypertensive patient a diuretic would be the presumed treatment of choice. While this is correct for some salt-sensitive hypertensives, in nonmodulators diuretics may be relative ineffective while converting enzyme inhibitors may be more effective because they specifically correct the underlying pathophysiologic derangement.
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PMID:Sodium-sensitive essential hypertension: emerging insights into an old entity. 269 48

Circulating inhibitors of the Na+ pump have been proposed as participating in sodium excretion, extracellular and vascular volume regulation and as hypertensiogenic agents. The presence of digitalis-like compounds in human plasma has been investigated by measuring its ability to compete with tritiated ouabain for binding to the digitalis site of red blood cells. Their activities in plasma from either hypertensive or volume expanded patients were compared. High levels were found in plasma from 37 p. cent of the untreated patients with essential hypertension, 64 p. cent of patients with end-stage renal failure and 71 p cent of acromegalic patients in the hypersecreting phase. The patients of these two last classes have been selected as being normotensives and without family history of hypertension. An increased activity of the inhibitor should more likely be linked to the positive Na+ balance and the volemic expansion which characterise these last two diseases than to high blood pressure. The observations that the activity of the inhibitor is correlated with the plasma volume in acromegalic patients, it returns to normal values after hemodialysis in renal insufficiency or successful therapy of acromegaly and the decrease in its activity is proportional to the weight lost during dialysis in uremic patients, agree with this proposal.
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PMID:[Circulating inhibitor of sodium active transport in essential hypertension and volemic expansion]. 300 21

There is increasing evidence for endogenous, circulating compounds that interact with the digitalis receptor of [Na,K]ATPase and with antidigoxin antisera. Circulating levels of these digitalis-like compounds increase in response to fluid or salt loading and appear to play a role in diseases characterized by fluid and salt retention, e.g. renal failure, liver disease, acromegaly, experimental and human hypertension, and preeclampsia. Because of assay nonspecificity, many diverse substances are being measured. Of the few compounds currently identified as having "digitalis-like" activity, none appears to be the natural ligand of the digitalis receptor and none appears linked with hypertension. Nevertheless, research still suggests that digitalis-like factors may have a central role in essential hypertension and related disorders.
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PMID:Endogenous digitalis-like natriuretic factors. 303 37

The endogenous digoxin-like substance seems to play an important role in the aetiology and pathogenesis of essential and secondary hypertension. Immunoreactive digoxin-like substance was determined in 52 subjects: 17 healthy ones, 15 patients with essential hypertension, 10 cases of chronic renal failure and 10 patients with acromegaly. The substance was not found in healthy subjects, in acromegaly and essential hypertension. In chronic renal failure detectable concentrations of the substance were observed but they showed no correlation with the creatinine level and other clinical data.
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PMID:[Endogenous digoxin-like substance level in essential arterial hypertension, renal failure and acromegaly]. 327 65

The effects of glucagon on the adrenergic system have been studied in experimental and clinical conditions. 1. in vitro studies: In the first experiment a continuous flow incubation system was developed in which the secretory response to these drugs was characterized by a serial fluorimetric assay of catecholamines in the effluent medium. Pig adrenal medulla or human pheochromocytoma were studied. There was an initial massive release of catecholamines which declined to basal levels (0.02 micrograms/mg) after 1.5 hours. When 10(-4) glucagon was infused for 10 minutes following 2 hours of preincubation, both adrenaline and nonadrenaline outputs rose abruptly to concentrations of 0.08 micrograms/mg and 0.07 micrograms/mg respectively. In the second experiment the effect of these drugs on the in vitro release of catecholamines from the isolated in vitro chromaffin granules of the pig adrenal medulla were studied. The results were the same as in the previous experiment. 2. clinical studies: The effects of glucagon were studied on the blood pressure and urinary catecholamine levels of healthy control subjects, of patients suffering from essential hypertension, thyroid disease, diabetes mellitus and acromegaly. Glucagon induced a slight but constant increase in blood pressure. By contrast no significant urinary catecholaline elevation was evoked. There was no difference in the effect of intravenous glucagon between normal subjects and patients suffering from the above-mentioned disorders.
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PMID:[A reevaluation of the glucagon provocative test for pheochromocytoma--on the in vitro release of catecholamine from the adrenal medulla or pheochromocytoma tissue, and on the effect of intravenous glucagon on urinary catecholamine excretion and blood pressure (author's transl)]. 740 74

Plasma glucose and serum insulin during OGTT were measured in 33 patients with essential hypertension, 17 patients with simple obesity, 19 patients with acromegaly and 10 normal adults. Compared with control, serum insulin concentration increased in 33 patients with essential hypertension at 3 hour postload (P < 0.05) and in 17 patients with simple obesity at 1 hour postload (P < 0.05) during OGTT, 19 patients with acromegaly also had their insulin concentration increased at 1.3 hour postload (P < 0.05) during OGTT. The correlationships between diastolic blood pressure and integrated area under the curve for serum insulin concentration (r = 0.3838, P < 0.05) were observed in 33 patients with essential hypertension. Serum insulin concentration decreased in 10 patients with essential hypertension at 1 and 2 hour postload during OGTT after antihypertensive treatment with captopril or captopril plus hydrochlorothiazide. The results indicated that the patients with essential hypertension, simple obesity and acromegaly are insulin resistant and hyperinsulinemic after an oral glucose load.
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PMID:[A preliminary study of insulin resistance in essential hypertension, simple obesity and acromegaly]. 820 Mar 5

It was reported recently that the endogenous digitalis-like factor ouabain may mainly originate from the adrenal gland. To ascertain the pathophysiological significance of endogenous ouabain and to examine if it originates in the adrenal gland, we determined plasma immunoreactive ouabain levels in patients with various cardiovascular and endocrine diseases. Plasma immunoreactive ouabain levels were also determined in the adrenal venous blood by adrenal venous sampling. Plasma immunoreactive ouabain levels were significantly increased in patients with essential hypertension, primary aldosteronism, Cushing's syndrome, pheochromocytoma, acromegaly, and chronic renal failure. Plasma immunoreactive ouabain levels were decreased in patients with primary aldosteronism after unilateral adrenalectomy, acromegaly after pituitary adenomectomy, and chronic renal failure after hemodialysis. Plasma immunoreactive ouabain levels in patients after bilateral adrenalectomy were similar to those in healthy subjects. There was no significant step-up of immunoreactive ouabain levels in the adrenal vein from the peripheral vein in three patients, whereas one patient with hypertension and right adrenal tumor but without any known adrenal hormone excess showed higher plasma immunoreactive ouabain levels in the right adrenal vein than those in the peripheral vein. These results suggest an important pathophysiological significance of endogenous ouabain in various cardiovascular and endocrine diseases. It is unlikely that the adrenal gland is a major source of plasma ouabain, although a possible excess production of ouabain by the adrenal tumor remains to be elucidated.
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PMID:Does plasma immunoreactive ouabain originate from the adrenal gland? 828 39


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