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Query: UMLS:C0085580 (essential hypertension)
 14,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From at least 1928 until about 1940 essential hypertension was reported to be a rare disease among the population in Kenya and Uganda. Currently, it is 1 of the common causes of heart failure and a major cause of cerebrovascular disease in many hospitals in these 2 nations. Field data in these countries suggest that blood pressure rises during adult life, and essential hypertension occurs in salt-sensitive individuals, when sodium chloride daily intake is excessive. If the intake of potassium chloride is less than that of sodium chloride, and the intake of dietary fiber decreases much, as happens when diets are westernized, these may act as subsidiary risk factors. The East African diets are becoming more and more westernized. The 1st major dietary change involves the addition of much salt to low-salt unprocessed foods. With progressive westernization of diets the foods processed by manufacturers replace homegrown staples. These processed foods contain considerably more sodium, rather less potassium, and much less dietary fiber. While this multiple dietary change takes place, blood pressure levels, previously low and not rising with age, begin to rise during adult life. Essential hypertension, once rare, becomes common in sodium sensitive persons. Diets comparable in many respects to the 1930 Kikuyu diet are suggested to reverse essential hypertension. The therapeutic diet should be of low sodium chloride and should contain much unrefined high fiber high starch foods.
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PMID:From normotension to hypertension in Kenyans and Ugandans 1928-1978. 738 2

Endocrine hypertension is the most common cause of secondary hypertension affecting ~3 % of the population, with primary hyperaldosteronism and pheochromocytoma being the principal conditions. Both diseases share an increased cardiovascular risk in comparison with essential hypertension patients (at the same blood pressure level). This augmented cardiovascular risk as well as the availability of specific treatment emphasize the importance of timely and correct diagnosis. Primary hyperaldosteronism, representing one tenth of hypertensive patients, is an under-diagnosed disease partly because of difficult diagnostic steps and absence of standard criteria. Recently, the description of somatic mutations in KCNJ5 gene in Conn adenomas had precipitated a resurgence of research activity to understand the pathophysiology of this common disease. Research had confirmed the role of these mutations in aldosterone hypersecretion; however, its role in adenoma formation is still to be elucidated. Elsewhere, much remains to be done in order to understand the pathogenesis of bilateral idiopathic hyperaldosteronism, the other common subtype of primary hyperaldosteronism. In pheochromocytoma, the revolution of genetics has led to major advances in the characterization of this rare disease. It is now clear that up to 50 % of patients with pheochromocytoma have a genetic abnormality and that different pheochromocytomas segregate into two clusters with distinct genotypes, signal transduction pathways and expression of biomarkers (phenotype). This continuing progress has huge effects on patient's management and follow-up. In this article we will shed light on the recent developments in both diseases with emphasis on their role in patient care.
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PMID:[Update on endocrine hypertension]. 2308 79

Pheochromocytoma during pregnancy is extremely rare. Its clinical manifestation includes hypertension with various clinical presentations, possibly resembling those of pregnancy-induced hypertension. The real challenge for clinicians is differentiating pheochromocytoma from other causes of hypertension (preeclampsia, gestational hypertension, and pre-existing or essential hypertension), from other cause of pulmonary edema (preeclampsia, peripartum cardiomyopathy, stress or Takotsubo cardiomyopathy, pre-existing cardiac disease [mitral stenosis], and high doses betamimetics), and from other causes of cardiovascular collapse (pulmonary embolism, and amniotic fluid embolism). Although, several cases of pheochromocytoma during pregnancy have been published, fetal and maternal mortalities due to undiagnosed cases are still reported. We report a case of a patient whose delivery by cesarean section was complicated by severe hemodynamic instability resulting in a cardiac arrest. Later on, pheochromocytoma was suspected based on computed tomography (CT) scan findings. Diagnosis was confirmed with special biochemical investigations that showed markedly elevated catecholamines in urine and metanephrines in serum, and later by histopathology of the excised left adrenal mass. This case illustrates the difficulty of diagnosing pheochromocytoma in pregnancy and raises the awareness to when this rare disease should be suspected.
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PMID:Cardiorespiratory crisis at the end of pregnancy: a case of pheochromocytoma. 2418 Jan 71