Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: 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)

After addition of exogenous human renin, the in vitro rate of angiotensin I generation is faster in plasma of patients with chronic renal insufficiency and, to a lesser extent, in plasma of patients with essential hypertension than in plasma from normotensive control subjects. The increased reactivity of renin in hypertensive and uremic plasma is not related to differences of endogenous renin activity, angiotensinase activity, renin substrate concentration, or substrate reactivity. Addition of normal, hypertensive, and uremic plasma to a human renin-sheep renin substrate system inhibited the rate of angiotensin generation, although significantly less inhibition was observed with uremic plasma. The reactivity of renin increased in normal plasma but not in uremic plasma after treatment with 95% acetone. After acetone extraction renin reactivity in normal and plasma inhibited the rate of angiotensin generation in a renin-renin substrate system. Less inhibition occurred with the acetone extract from a pool of uremic plasma. These results provide evidence for the existence of a naturally occurring acetone soluble renin inhibiting factor in normal and uremic plasma. The increased reactivity of renin in uremic plasma may be related to a deficiency of this factor.
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PMID:Evidence for the existence of an acetone soluble renin inhibiting factor in normal human plasma. 113 76

Secondary hypertension represents about 5-10% of all forms of hypertension, renal and renovascular being the commonest forms. Renal artery stenosis is the principal cause of renovascular hypertension due to atheromatous disease or fibromuscular dysplasia. Rapid sequence intravenous pyelogram, isotope renogram, captopril test and digital subtraction angiography or conventional arteriography, are the diagnostic procedures in the diagnosis of renal artery atenosis. Hypertension is also very common in parenchymal renal disease, mainly in chronic renal insufficiency. In this condition, the mechanism is more related to volume dependent factors than in renovascular hypertension which is mainly renin dependent. In the treatment of renal or renovascular hypertension the same type of drugs have been generally used as in essential hypertension although with some specific indications like the use of angiotensin-converting enzyme inhibitors in unilateral renal artery stenosis or furosemide in case of renal insufficiency. Revascularization by angioplasty or surgical bypass, may be indicated in renovascular hypertension.
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PMID:[Hypertension from the nephrologist's point of view]. 183 18

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

Seventy patients, aged 1-20 years, were seen at Jordan University Hospital with high blood pressure (BP) over a 3-year period. BP values ranged from 140 to 230 mmHg for systolic pressure and from 90 to 130 mmHg for diastolic pressure. Essential hypertension was seen in only 6 patients (8.6%); secondary hypertension (n = 64 or 91.4%) was due to renal parenchymal diseases (RPD) in 46 patients (65.7%), reno-vascular lesions in 8 (11.4%), renal transplantation in 5 (7.2%), teenage pregnancy in 4 (5.7%), and phaeochromocytoma in 1 patient (1.4%). The aetiologies of RPD were as follows: end-stage renal disease requiring dialysis in 14 patients, acute glomerulonephritis in 14, idiopathic nephrotic syndrome in 10, chronic renal insufficiency in 5, and polycystic kidney in 3 patients. Surgical cure of hypertension was achieved in 5 of the children with reno-vascular lesions and in the patient with phaeochromocytoma.
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PMID:Hypertension in Jordanian children: a retrospective analysis of 70 cases. 224 23

Inhibitors of the angiotensin conversion enzyme (ICE) represent an effective and well tolerated therapeutic class, for the treatment of arterial hypertension. The antihypertensive efficacy or perindopril, an ICE active in one single daily dose, is at least equal to that of reference antihypertensive drugs administered at usual doses. The possibility of occurrence of some side-effects while using ICE, has resulted in a particular attention in evaluating the safety of perindopril. First, the renal function was monitored. During essential hypertension, no significant variation of the creatininemia was observed with long-term administration of the drug (12 months). In elderly hypertensive patients or patients with chronic renal insufficiency, the glomerular filtration is also preserved, except during rare occurrences of decreased creatinine clearance, especially after adjunction of hydrochlorothiazide. A discrete elevation of the kaliemia without clinical significance is observed when perindopril is used as a single drug. Reports of symptomatic hypotension with perindopril are rare (0.2%), even in situations of water and sodium depletion. Among other side-effects of ICE, cough, more recent, was thoroughly investigated. Its frequency was determined during a double blind trial comparing perindopril (1.2%) with captopril (2.4%). It was also evaluated during a long-term study concerning 632 hypertensive patients (391 patients treated in 1 year); its incidence is the 2.9 p. cent and it resulted in discontinuation of the treatment in 8 cases. In this study, 36 patients interrupted the treatment prematurily because of an adverse reaction (5.7%). Finally no harmful drug interaction was reported. The favorable tolerance profile of perindopril is combined with a beneficial effect on the functional and structural modifications of the heart and large vessels related to hypertension.
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PMID:[First intention treatment of arterial hypertension. Effectiveness and safety of perindopril]. 268 25

Endogenous digitalis-like factors have been implicated in the adaptations that accompany renal insufficiency and in the pathogenesis of hypertension. We recently described several fractions of normal human plasma that inhibit NaK-ATPase and exhibit apparent digoxin-like immunoreactivity. To determine if hypertension and/or renal insufficiency affect plasma levels of these factors, we examined four patient groups: normotensive controls; hypertensive subjects with normal renal function; hypertensives with moderate renal insufficiency; and chronic dialysis patients. Plasma levels of digoxin-like immunoreactivity and NaK-ATPase inhibitory activity were significantly increased in hypertensive patients with mild renal failure (7.6 +/- 1.1 ouabain equivalents, mean +/- SEM, N = 21 vs 4.1 +/- 1.1 in normotensive controls, N = 20, P less than 0.05). NaK-ATPase inhibitory activity tended to be higher in patients with primary hypertension and normal renal function (5.5 +/- 0.7 ouabain equivalents, P less than 0.07); in dialysis patients, it was not different from controls. There was no correlation between NaK-ATPase inhibitory activity and blood pressure in any group. There was a significant rise in plasma NaK-ATPase inhibitory activity during dialysis (+ 1.8 +/- 0.7 ouabain equivalents, N = 22, P less than 0.03). As we have found that NaK-ATPase inhibitory activity in the plasma of normal humans can be separated into three distinct fractions, EI1, EI2, and EI3, we analyzed the plasma of 10 dialysis patients further. The increase in NaK-ATPase inhibitory activity could be attributed to fractions EI1 and EI3. These results suggest that plasma NaK-ATPase inhibitors increase with chronic renal insufficiency, but not hypertension alone. Although hemodialysis may acutely raise plasma levels, long-term dialysis returns them to the normal range.
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PMID:Endogenous digitalis-like factors in hypertension and chronic renal insufficiency. 302 36

Spontaneous (not experimentally induced) systemic hypertension was detected in 5 male dogs that were examined because of apparent blindness caused by intraocular hemorrhage and/or retinal detachment. Secondary causes of hypertension, including renal, adrenal, and thyroid disease, were investigated. Four of the dogs had glomerulonephropathy, renal insufficiency, and proteinuria. Four dogs had compensatory cardiac hypertrophy. Hypertension in 4 of 5 dogs was associated with glomerulosclerosis with chronic renal insufficiency, bilateral adrenocortical hyperplasia, adrenocortical adenoma with renal amyloidosis, and immune-mediated glomerulonephritis with chronic renal insufficiency, respectively. The fifth dog was determined to have essential hypertension. The dogs were treated for their primary diseases. Sodium restriction alone was inadequate to reduce blood pressure; 4 of the dogs also required antihypertensive medications.
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PMID:Spontaneous systemic hypertension in dogs: five cases (1981-1983). 317 Mar 25

Plasma renin activity (PRA), plasma aldosterone concentration (PAC), and urinary aldosterone (UA) were compared in 311 hospitalized patients with arterial hypertension and in 54 healthy subjects. Patients with fixed benign essential hypertension (EH) had PRA, both recumbent and upright, the same as the controls; in advanced EH, increased PRA was accompanied by higher blood pressure (BP) as well. Nevertheless no direct correlation was found between the individual values of mean BP and PRA. The group of EH with suppressed PRA (35.9%) had a higher men age and included a higher percentage of women. Suppressed PRA was proved also in 20.9% of patients with renal hypertension and in 34.4% of patients with hypertension in chronic renal insufficiency. The PAC was moderately higher in benign EH than in the controls, and so was the urinary excretion of 18-aldosterone glucuronide (UA). Markedly elevated PAC was found in groups with high PRA. In primary aldosteronism, high UA and PAC together with suppressed PRA represent an important diagnostic guideline for differentiation from other types of low-renin hypertensions. The study points out a great variance of PRA, PAC, and UA values in different types of hypertension, and analyses the significance of their changes for the pathogenesis, course, and diagnosis of arterial hypertensions.
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PMID:Renin-angiotensin-aldosterone system in arterial hypertension. 699 18

In 47 patients with hypertension and chronic renal insufficiency (CRI) and 38 patients with essential hypertension (EH), the following parameters were measured under moderate salt restriction: plasma volume (PV), blood volume (BV), extracellular fluid volume (ECFV), ratio of blood volume to insterstitial fluid volume (BV/IV), recumbent plasma renin activity (PRA), increase in PRA upon standing (delta PRAst), creatinine clearance (Ccr), and mean arterial pressure (MAP). Mean PRA, ECFV, and MAP values did not differ significantly between the two groups. In the CRI group, MAP showed a weak positive correlation with ECFV (r = 0.34). Mean PV, BV and BV/IV ratio were significantly higher than in the EH group, whereas delta PRAst was markedly blunted (p less than 0.001) and showed a weak correlation with Ccr (r = 0.33). This suggests that patients with CRI on a moderate Na intake have a decreased tissue compliance which results in a relative elevation of BV. On the other hand, although MAP was not significantly correlated with either BV or IV, a negative correlation (r = -0.31) was found between MAP and BV/IV, indicating that elevation of the blood pressure (BP) tends to depress BV. These oppositely directed effects may explain the failure so far to establish a relationship between BP in renal disease and any haemodynamic parameter or combination of such parameters.
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PMID:Renin and body fluid volumes in chronic renal disease. Relations between arterial pressure, plasma renin activity, blood volume, and extracellular volume in chronic renal disease, as compared with essential hypertension. 702 51

The association of excessive lead burden and essential hypertension has been a subject of much dispute. In particular, the potential detrimental effect of low level environmental exposure on BP has caused considerable concern. We studied the urinary excretion of lead following the infusion of EDTA (1 g of calcium disodium edetate) in 12 healthy controls (group I), 10 subjects with essential hypertension alone (Group II) and in 36 subjects with chronic renal insufficiency. Those subjects with renal insufficiency were further divided into three groups: group III, 12 patients with a history of 7-19 years of essential hypertension who subsequently developed into renal failure; group IV, patients with chronic renal failure alone; and group V, patients with chronic renal failure due to causes other than hypertensive nephropathy and associated with secondary hypertension. In comparison with other groups, subjects with hypertensive nephropathy (group III) had significantly elevated lead body burden. In addition, we found that five of the 12 subjects with hypertensive nephropathy had histories of acute gouty attacks after the development of renal function impairment. In conclusion, our observation of a higher EDTA postinfusional urinary lead excretion among some patients with essential hypertension with renal function impairment indicates that lead may play a crucial role in a subgroup of patients with hypertensive nephropathy.
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PMID:Does lead play a role in the development of renal insufficiency in some patients with essential hypertension? 793 12


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