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Query: UMLS:C0085580 (
essential hypertension
)
14,686
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Measurement of the blood volume in cases of
essential hypertension
has shown a negative correlation with increase in blood pressure. We have been able to distinguish a group of moderate hypertensives who are hypervolemic, and whose systemic effect is more marked than in the moderate hypovolemic type. Such cases respond poorly to single drug therapy with beta blockers, but well to diuretics. The authors propose a general treatment scheme for
essential hypertension
: single therapy (beta blockers or diuretics) in mild cases of hypertension; single therapy by diuretics in the moderate types with the increased volume; single therapy by beta blockers in the moderate types with low volume, multiple treatment with the drugs together in cases of severe hypertension.
Arch
Mal
Coeur Vaiss 1978 Aug
PMID:[Importance of measuring blood volume by an isotope method in essential hypertension]. 3 Apr 25
Not every case of angina pectoris occurring in a hypertensive patient is indicative of coronary atherosclerosis. Nine patients with
essential hypertension
of moderate degree had attacks of angina of sufficient severity to require investigation by arteriography. In these patients, the coronary arteriogram was normal but ventriculography showed hypertrophy of the walls of the left ventricle of restrictive or obstructive type. These appearances were confirmed by echocardiography which also showed hypertrophy of the septum and, in certain cases, confirmed the involvement of the ventricle, while by contrast the electrocardiogram and radiological appearances of the heart were essentially normal. The beta-blockers may have an important part to play in such conditions, and echocardiography is suggested as part of the routine investigation in cases of hypertension.
Arch
Mal
Coeur Vaiss 1978 Jul
PMID:[Angina pectoris in a hypertensive patient with left ventricle hypertrophy: echo-angiographic comparisons]. 10 Nov 81
The regulation of cardiovascular function by the pressor centres of the hypothalamus located in the ventro-medical nucleus of the hypothalamus is discussed, together with the baro-receptor control, the part played by the release of catecholamines, and the limitations of this control. The depressor part of the hypothalamus, located in the paraventricular nucleus, is characterised by its haemodynamic and pharmacological properties. This study throws light on new areas of possible treatment of angina pectoris and so-called
essential hypertension
, which are more appropriate to the clinical findings.
Arch
Mal
Coeur Vaiss 1977 Oct
PMID:[New data concerning hypothalamic cardiovascular regulation and its importance]. 41 10
Analysis of a further series of 125 consecutive unselected adults who were admitted to hospital with hypertension has advanced the study of arterial abnormalities and parenchymal hypoplasia, as demonstrated by selective renal arteriography, further in the direction of the parenchyma. An index of arterioparenchymal thinning is described. The authors list the features and incidence of polar arteries arising from the aorta (46%), polar arteries of non-aortic origin (31%), stenosing dysplasia (26%) and other arterial malformations, as well as biapical hypoplasia (67%), monofocal hypoplasia (37%), and the main types of renal dysgenesis (30%) which they found. The incidence of these abnormalities confirms the previous study of polar arteries arising from the aorta, and gives much more extensive information on the topic of parenchymal hypoplasia in so-called
essential hypertension
in the adult.
Arch
Mal
Coeur Vaiss 1975 Nov
PMID:[Kidney parenchymatous hypoplasia and arterial dysplasia in adult arterial hypertension. Data of selective renal arteriography]. 81 82
The usefulness of salt restriction in
essential hypertension
is still now disputed. This study was designed to test the influence of a diet with and without salt restriction in 19 untreated essential hypertensives (12 with and 7 without family history of hypertension) and free of cardiovascular and renal complications. Each patient was examined after a placebo period, after 1 month of salt restriction, and after 1 month of salt supplementation. Weight, blood pressure, 24 hours urinary sodium excretion and red blood cell ionic fluxes were measured. In patients with hypertensive heredity, the blood pressure did not change. The intracellular sodium concentration, the cotransport and the countertransport remained stable. The ouabain sensitive sodium pump slightly increased during salt restriction and remained stable after salt supplementation. In patients without such hypertensive heredity (who were older and heavier), sodium restriction period was characterized by significant decrease in blood pressure, weight, intracellular sodium concentration and increase in sodium pump activity. When salt was increased, all the parameters remained stable. A more balanced diet with sodium restriction decreases the blood pressure in relation to age, weight and the blood pressure level. Hypertensive heredity does not seem to be a parameter of salt sensitivity. The blood pressure decrease is also related to the quantitative importance of sodium restriction. The ouabain sensitive pump activity changes during diet especially in relation to weight loss and decreasing salt intake.
Arch
Mal
Coeur Vaiss 1992 Aug
PMID:[Effect of dietary sodium in hypertension not treated with drugs]. 133 57
Several authors have discussed an alteration of adrenergic receptivity in arterial hypertension. De Champlain (Hypertension 1990; 8: S77-S85) suggested that postsynaptic alpha 1-adrenergic functions became dominant while beta-adrenergic functions are attenuated in arterial hypertension. However, the status of presynaptic alpha 2-adrenoceptors remains unknown. The present study investigates presynaptic alpha 2-adrenoceptors in hypertension through the measurement of plasma levels of noradrenaline after administration of yohimbine, an alpha 2-adrenoceptor antagonist, in
essential hypertension
. Yohimbine (0.2 mg/kg per os) induced a 73% increase of plasma levels of noradrenaline in hypertensive patients (n = 12) and a 178% one in normotensive subjects (n = 6, p < 0.05). A similar significant difference was found in experimental neurogenic hypertension observed in awake dogs 3 weeks after sinoaortic denervation: the increase in plasma concentrations of noradrenaline after yohimbine (0.5 mg/kg i.v.) was +279% in hypertensive versus +642% in normotensive dogs (p < 0.05). The results show that the magnitude of the yohimbine-induced sympathetic activation is lower in hypertensives than in normotensives. They suggest the existence of a presynaptic alpha 2-adrenoceptor desensitization in arterial hypertension. The abnormality of this presynaptic inhibitory mechanism can increase the sympathetic tone and help to develop and maintain arterial hypertension.
Arch
Mal
Coeur Vaiss 1992 Aug
PMID:[Is there any desensitization of presynaptic alpha 2-adrenergic receptors in hypertension? Experimental and clinical studies]. 136 44
Previous studies have shown that
essential hypertension
is frequently associated with insulin resistance and hyperinsulinism. Because insulin may exert a direct positive inotropic as well as chronotropic effect and controlled the initiation of peptide chains in the heart, we tested the hypothesis that insulin may be a determinant of myocardial hypertrophy and contractility. The relation between glucose metabolism (assessed by the oral glucose tolerance test) and left ventricular (LV) mass and function (assessed by echocardiography) was explored in 47 never-treated lean essential hypertensive patients (EH) of short duration and 19 normotensive subjects (NT). A greater number of EH versus NT (23 vs 5%) had an abnormal glucose tolerance. The fasting insulin-to-glucose ratio was significantly higher in EH as compared to NT. Fasting as well as integrated serum insulin to glucose values ratio were positively correlated with heart rate (r = 0.35, p < 0.05, r = 0.38, p < 0.05) and the LV end-systolic stress to volume ratio (r = 0.48, p < 0.001, r = 0.54, p < 0.001) but not with LV mass (r = 0.02, r = 0.02) in EH. When EH were divided into those with normal (n = 36) and supernormal (n = 11) LV contractility based on the relationship between LV fractional shortening and LV end-systolic stress, integrated insulin level and fasting insulin to glucose ratio were markedly higher in patients with supernormal LV contractility, whereas arterial pressure, heart rate, urinary sodium excretion, and plasma renin activity were similar in the two groups. We concluded that hyperinsulinemia and LV hypercontractility are associated in patients with hypertension of short duration. If chronic hyperinsulinemia is to be causally related to hypertension, one would have to postulate that the effects (inotropism and chronotropism) of insulin on the heart can be dissociated from the resistance to the glucose-lowering action of insulin.
Arch
Mal
Coeur Vaiss 1992 Aug
PMID:[Left systolic ventricular function and metabolic disorders in untreated hypertensive patients]. 148 35
The sympathetic nervous system seems to be a non hemodynamic factor involved in the development of hypertension and in left ventricular hypertrophy determinism. The aim of this study was to estimate the myocardial norepinephrine content in essential hypertensive patients, using a reliable radio-iodinated marker of norepinephrine: the 123I-meta-iodobenzylguanidine (123I-meta-iodobenzylguanidine). Eight male and female hypertensive patients with left ventricular hypertrophy and average age of 52 +/- 9 years underwent a resting, ambulatory and effort blood pressure measure. Echocardiographic parameters allowed measure of left ventricular mass index (according to Devereux, and we considered left ventricular hypertrophy as left ventricular mass index greater than 120g/m2. Plasma norepinephrine is measured at rest. Cardiac and mediastinal radioactivity is detected 4 h after a 4mCi i.v. injection of 123I-meta-iodobenzylguanidine and meta-iodobenzylguanidine myocardial uptake is definite as the cardiac/mediastinal ratio (N:1.78 +/- 0.19). Meta-iodobenzylguanidine-myocardial uptake average value of hypertensive patients was 1.89 +/- 0.19 (1.63 to 2.25) without statistical difference to control subjects. We found a significative correlation between meta-iodobenzylguanidine myocardial uptake and effort systolic blood pressure variation in one hand, and with heart rate increase with effort in the other hand. There is no correlation between meta-iodobenzylguanidine-myocardial uptake and left ventricular mass index or ambulatory blood pressure. In hypertensive patients with left ventricular hypertrophy, meta-iodobenzylguanidine myocardial uptake is normal or high, in agreement with experimental data in SHRs, model of human
essential hypertension
. Therefore myocardial scintigraphy with 123I-meta-iodobenzylguanidine can appreciate cardiac norepinephrine content in humans.
Arch
Mal
Coeur Vaiss 1992 Aug
PMID:[Evaluation of norepinephrine content in the myocardium in hypertensive patients with left ventricular hypertrophy]. 148 41
An increase in glomerular filtration rate and in tubular Na+ reabsorption from the parenteral administration of insulin-like growth factor I (IGF-I) have been reported in human subjects. To evaluate whether glomerular hyperfiltration and Na+ hyper-reabsorption present in some essential hypertensives are associated to an excess of IGF-I, the plasma levels of this factor and several parameters of renal function were studied in 30 non-treated essential hypertensives and in 30 normotensive controls. IGF-I levels were higher in hypertensive as compared to controls. With the 95% (upper) limit of the normotensive population as a cut-off point, a subgroup of six hypertensives had an abnormally high IGF-I level. Mean blood pressure was slightly lower in these six patients (112 +/- 7 mmHg) than in the remaining patients (120 +/- 2 mmHg). As compared to normotensives and hypertensives with normal IGF-I levels, patients with increased IGF-I levels were characterized by lower (P < 0.01) fractional Na+ excretion and higher (P < 0.05) creatinine clearance. The analysis of the relation of plasma renin activity and the concurrent daily rate of Na+ excretion showed that patients with increased IGF-I were low-renin hypertensives and patients with normal IGF-I were normal-renin hypertensives. These results indicate that an association exists between exaggerated circulating levels of IGF-I and abnormalities of renal function present in some patients with
essential hypertension
. It is suggested that IGF-I can play a role in low-renin
essential hypertension
.
Arch
Mal
Coeur Vaiss 1992 Aug
PMID:Abnormalities of renal function in essential hypertension with increased circulating levels of insulin-like growth factor I. 148 57
The dosage of urinary catecholamines and their metabolites is a main element of diagnosis in the research of a pheochromocytoma in patients with high blood pressure. The literature reports high values of these compounds in patients treated with labetalol (an alpha/beta-blocker). An analytical interference has been evoked to explain these misleading results, which have not been observed with other beta-blockers. The goal of this work was to look for this eventual analytical interference in the dosage of urinary metanephrine by reversed phase liquid chromatography coupled with electrochemical detection, in patients with high blood pressure. Eighteen hypertensive patients, 52 +/- 14 years old, were included in the study. In 8 patients, a dosage of metanephrine, normetanephrine and creatinine on a 24 hours urine sample was performed before (D1) and 24 hours after (D3) the prescription of labetalol (200 mg twice a day). In the other group, labetalol was not prescribed but dosage was made in the same conditions. Urinary excretion of these compounds (metanephrine+normetanephrine) divided by urinary creatinine was not modified in the treated group (0.16 +/- 0.08 vs 0.14 +/- 0.04), nor in the reference group (0.17 +/- 0.08 vs 0.17 +/- 0.08). This study shows that administration of labetalol in patients with
essential hypertension
does not interfere with urinary metanephrine and normetanephrine determination after 48 hours of treatment. This implies that research for a pheochromocytoma is possible in patients with hypertension and receiving labetalol, by using reversed phase liquid chromatography coupled with an electrochemical detector for the dosage of urinary metanephrine and normetanephrine.
Arch
Mal
Coeur Vaiss 1992 Aug
PMID:[Absence of labetalol interference on urine metanephrine determination in hypertensive patients]. 148 64
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