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

Plasma prolactin concentrations and prolactinaemic response to sulpiride, a prolactin releaser with pituitary dopamine receptor blocking activity, were examined in 16 subjects with mild essential hypertension and in 20 patients with long-sustained essential hypertension. When compared with 16 normotensive controls only the former showed raised plasma renin activity (P < 0.001) and higher plasma prolactin levels either after two-hour ambulation (P < 0.05) or at supine rest (P < 0.05). The average of maximal sulpiride-induced prolactin values was 157 +/- 53 ng/ml (mean +/- SD) in the mild hypertensive, significantly different from 60.2 +/- 21.4 ng/ml (mean +/- SD) as resulted in the controls (P < 0.001). In contrast, patients with sustained hypertension had a mean level of 60.2 +/- 21.4 ng/ml (mean +/- SD), indifferent from the one of the normal volunteers. It is suggested that the excessive prolactinaemic response to sulpiride detected in patients with mild hypertension reflects a reduced hypothalamic dopaminergic activity and that such an alteration may assume some pathogenetic relevance in the natural history of essential hypertension. Further, in the mild hypertensive a positive prolactin-renin correlation was found (r = + 0.76; P < 0.01), so suggesting that in these patients a peripheral sympathetic overactivity is associated to an impaired central dopamine control. The individuation of such cases may be important since they could benefit by dopamine agonists as L-dopa and bromocriptine.
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PMID:[Excessive prolactinemic response to sulpiride in patients with mild essential hypertension. Index of diminished hypothalamic dopaminergic activity]. 699 83

Serum prolactin was measured in 76 patients with essential hypertension: 47.4% had elevated serum prolactin, and those with organ damage had presented higher prolactin than those with Phase I (WHO) hypertension. The effect of prolonged treatment (3 years) with guanfacine, an alpha-adrenoceptor stimulant drug, on blood pressure levels, heart rate, and prolactin was evaluated in 15 patients with moderate essential hypertension (WHO: Phase II) and hyperprolactinemia. Treatment produced a marked reduction in blood pressure levels and heart rate. Guanfacine decreased serum prolactin significantly (p less than 0.001), and the inhibition persisted during the 3-year follow-up. The daily dosage of guanfacine did not have to be changed during the 3 years of treatment. Side effects of guanfacine were only observed during the first 3-4 months of therapy. The hypotensive effect of guanfacine was increased by the administration of a diuretic, a vasodilator, or a beta-adrenergic blocking drug. The results indicate that guanfacine administered alone or in combination is an effective drug for treatment of patients with essential hypertension. The inhibitory effect of guanfacine on prolactin suggests that hypothalamic or extrahypothalamic adrenergic pathways may participate in the regulation of prolactin secretion.
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PMID:Blood pressure and prolactin: effects of guanfacine. Three-year follow-up study. 702 19

Plasma prolactin concentration was measured on days 1, 3, 6 and 21 of the puerperium in women who had been normotensive or hypertensive during pregnancy. Elevated plasma prolactin concentration due to breast feeding or reduced plasma prolactin concentration due to treatment with bromocriptine was found not to be related to blood pressure changes in the puerperium in women with essential hypertension, pregnancy induced hypertension or in normotensive patients.
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PMID:Plasma prolactin and puerperal blood pressure. 742 14

1. The vascular and hormonal effects of L- and D-arginine were compared in healthy subjects and in patients with insulin-dependent diabetes mellitus or untreated essential hypertension. 2. Infusion of L- or D-arginine (40 mumol/l) in the forearm vascular bed, sufficient to increase the local concentration approximately 20-fold, had no effect on blood flow or the vasodilator response to acetylcholine (30 and 100 nmol/min) in patients with insulin-dependent diabetes (n = 7) or essential hypertension (n = 7), or in age- and sex-matched control subjects (n = 7 in both groups). 3. Systemic infusion of 10 g of L-arginine (n = 5) or D-arginine (n = 3) increased plasma concentration of arginine approximately 20-fold without altering supine or erect haemodynamics. Increases in plasma insulin, prolactin and glucagon were seen with both enantiomers. The stereopurity of arginine was confirmed in a cell-culture assay system. 4. We conclude that, in healthy subjects and patients with essential hypertension or insulin-dependent diabetes, synthesis of nitric oxide within the vasculature is not limited by substrate availability. At high concentrations of arginine, non-stereospecific effects, including alterations in hormone concentration, occur. It remains to be determined whether these non-stereospecific hormonal changes might contribute to certain haemodynamic effects of arginine.
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PMID:Vascular and hormonal responses to arginine: provision of substrate for nitric oxide or non-specific effect? 755 60

Measurements of blood lipids and hormones (plasma renin, aldosterone, vasopressin, prolactin, atrial natriuretic peptide, beta-endorphin, thyrotropin, thyroid hormones) in two groups of patients suffering from obesity (group 1: 64 patients with arterial hypertension and group 2: 26 patients with normal arterial pressure) have brought the authors to a conclusion that arterial hypertension in young obese patients is an early manifestation of essential hypertension. Hormonal dysfunction in obese patients is conducive to early development of essential hypertension in cases when there is a hereditary predisposition to it.
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PMID:[Hormonal aspects of the pathogenesis of arterial hypertension in young obese patients]. 810 42

Although aldosterone (Aldo.) secretion is regulated by various humoral factors, evidence has accumulated to support an involvement of dopaminergic system in its regulation. The pathophysiological significance of the dopaminergic system in primary aldosteronism (PA) however remains unknown. In the present study, we examined the effects of metoclopramide (MCP) on Aldo. secretion in normal subjects (n = 11) and patients with essential hypertension (EH, n = 8), aldosterone-producing adenoma (APA, n = 10), and idiopathic hyperaldosteronism (IHA, n = 6). Plasma Aldo., prolactin (PRL), renin, cortisol, serum sodium, and serum potassium levels were determined before and 30 min after i.v. bolus injection of 10 mg MCP at 9 a.m. Plasma Aldo. showed a significant increase after MCP in normal subjects, EH, and APA, but not in IHA. The incremental response of plasma Aldo. was largest in APA and smallest in IHA. The percentage increase in plasma Aldo. from the basal level was significantly attenuated in IHA, while no significant difference was seen among other groups. Although plasma PRL showed a significant increase in response to MCP, no difference of the change was seen among the groups. There was no significant change in plasma cortisol, renin, serum sodium, and serum potassium levels in response to MCP. In addition, the response of Aldo. to MCP was normalized in APA after unilateral adrenalectomy, while that of PRL did not change. These results indicate that the adrenal dopaminergic activity is enhanced in APA and attenuated in IHA and suggest an involvement of the dopaminergic system in the pathogenesis of IHA.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Dopaminergic regulation of aldosterone secretion: its pathophysiologic significance in subsets of primary aldosteronism. 852 76

Na+/H+ exchange (NHE) was measured as maximal initial velocity of pH-dependent H+ efflux from red cells into an alkaline medium containing Na+ in patients with insulin-dependent or noninsulin-dependent diabetes, with and without hypertension and in normoglycemic, essential hypertensives and normal controls (50 subjects in each subgroup). Maximal velocities of NHE were found in microalbuminuric patients in all subgroups, and NHE correlated with the rate of micro-albuminuria (r = 0.61, p = 0.02). Daily insulin requirements were greater in those with elevated NHE (84 +/- 8 vs 42 +/- 4 U/day). There was no correlation between NHE and levels of plasma glucose, HbA1 and plasma aldosterone and lipid profile and PRA. NHE was correlated with plasma prolactin (r = 0.51, p = 0.02) and PTH r = 0.24, p = 0.05). In uremic patients, NHE was inversely correlated with creatinine clearance (r = -0.48, p = 0.03). Since calphostin C, a selective inhibitor of protein kinase C, lowered increased NHE in vitro, the protein kinase C-dependent pathway of the exchanger regulation was concluded to be responsible for NHE activation in diabetes mellitus and essential hypertension.
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PMID:[Red cell Na+/H+ exchange and role of protein kinase C in its stimulation in diabetes mellitus, essential hypertension and nephropathy]. 922 70

Dopamine modulates cardiovascular function by actions in the central and peripheral nervous system, by altering the secretion/release of prolactin, pro-opiomelanocortin, vasopressin, aldosterone, and renin, and by directly affecting renal function. Dopamine produced by the renal proximal tubule exerts an autocrine/paracrine action via two classes of dopamine receptors, D1-like (D1 and D5) and D2-like (D2, D3, and D4), that are differentially expressed along the nephron. The autocrine/paracrine function of dopamine, manifested by tubular rather than by haemodynamic mechanisms, becomes most evident during extracellular fluid volume expansion. This renal autocrine/paracrine function is lost in essential hypertension and in some animal models of genetic hypertension. The molecular basis for the dopaminergic dysfunction in hypertension may involve an abnormal post-translational modification of dopamine receptors.
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PMID:D1 dopamine receptor signalling defect in spontaneous hypertension. 1069 8

Simultaneous measurements of serum estradiol, testosterone, cortisol, prolactin, total cholesterol (TC), high density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC) and triglycerides in Thai men and postmenopausal women aged over 50 years were carried out in four groups of subjects: healthy controls, and patients with essential hypertension, non-insulin dependent diabetes mellitus (NIDDM), and coronary heart disease. Hypertriglyceridemia and hypercholesterolemia were found more often in patients with essential hypertension than in patients with other diseases. Low levels of HDLC with high TC/HDLC and LDLC/HDLC ratios occurred more frequently in coronary heart disease patients. Hypertensive men had the highest plasma estradiol levels while men with coronary heart disease had the least testosterone levels compared with men with the other two diseases. Decreased testosterone and/or increased estradiol may have an adverse effect on lipid profiles in elderly men. However, neither the sex hormones, cortisol, nor prolactin, appeared to have any influence on serum lipids and lipoproteins in elderly women. These findings in the Thai population are consistent with those previously reported in other populations.
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PMID:Study of plasma hormones and lipids in healthy elderly Thais compared to patients with chronic diseases: diabetes mellitus, essential hypertension and coronary heart disease. 1080 81

Although the biological effects of adrenomedullin (AM) and PAMP have been reported extensively in animal studies and from in-vitro experiments, relatively little information is available on responses to the hormone administered to man. This review summarizes data from the few studies carried out in man. In healthy volunteers, i.v. infusion of AM reduces arterial pressure, probably at a lower rate of administration than is required to elicit other responses. AM stimulates heart rate, cardiac output, plasma levels of cAMP, prolactin, norepinephrine and renin whilst inhibiting any concomitant response in plasma aldosterone. Little or no increase in urine volume or sodium excretion has been observed. Patients with essential hypertension differ only in showing a greater fall in arterial pressure and in the development of facial flushing and headache. In patients with heart failure or chronic renal failure, i.v. AM has similar effects to those seen in normal subjects but also induces a diuresis and natriuresis, depending on the dose administered. Infusion of AM into the brachial artery results in a dose-related increase in forearm and skin blood flow, more prominent and more dependent on endogenous nitric oxide in healthy volunteers than in patients with cardiac failure. When infused into a dorsal hand vein, AM partially reversed the venoconstrictor action of norepinephrine. Although much more information is required to clarify the role of AM under physiological and pathophysiological circumstances, it is clear that it has prominent hemodynamic and neurohormonal effects, though generally lesser urinary effects when administered short-term in doses sufficient to raise its levels in plasma to those seen in a number of clinical disorders. The only study of PAMP in man showed that its skeletal muscle vasodilator potency, when infused into the brachial artery of healthy volunteers, was less than one hundredth that of AM, and it was without effect on skin blood flow.
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PMID:Bioactivity of adrenomedullin and proadrenomedullin N-terminal 20 peptide in man. 1175 60


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