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

The diagnostic value of electrocardiographic P wave analysis in the frontal plane was assessed with respect to previously reported abnormalities: right atrial hypertrophy-dilatation; an enlarged, crenalleted summit without criteria of right atrial hypertrophy. Two observers studied the ECG recordings of 20 hypertensive patients with pheochromocytomas: 10 men and 10 women, aged 45.5 +/- 16 years, and in 30 patients with essential hypertension, 15 men and 15 women, aged 48.9 +/- 9 years (NS). The duration of hypertension was 2.6 +/- 2 years versus 4.7 +/- 4 years (p = 0.02). Right atrial hypertrophy-dilatation was observed in 5 patients in the pheochromocytoma group and in none of the essential hypertensive patients: an isolated abnormality of the summit of the P wave was observed in 5 other cases of pheochromocytoma and by 1 observer in 1 of the essential hypertension. These abnormalities disappeared after ablation of the tumour. These changes were not recorded in 3 patients who had predominant noradrenaline hypersecretion; nevertheless, comparison of the urinary adrenaline, noradrenaline, normeta- and metanephrine levels were inconclusive. No relationship was established between these concentrations, global urinary catecholamines and meta block, the duration of hypertension, the frequency and level of hypertensive crises, or the presence of "ischaemic" ST-T wave changes. P wave changes are thought to be related to high plasma catecholamine levels irrespective of the clinical impact; the sensitivity of these changes is modest (10/20) but the specificity is better within a group of hypertensive patients. An experienced observer can orient the diagnostic investigations to the search for a pheochromocytoma or to a secondary recurrence of the tumour from the surface ECG. The role of marker of a very high noradrenaline or adrenaline secretion cannot be confirmed from a series limited in separated plasma concentration measurements.
Arch Mal Coeur Vaiss 1992 Jan
PMID:[Value of the study of electrocardiographic P wave in pheochromocytoma]. 153 1

In order to assess the relationships between increased cellular sodium-proton (Na+/H+) exchange and cardiovascular abnormalities in essential hypertension (EH), 21 young subjects as part of an ongoing longitudinal study were tested for the platelets Na+/H+ exchange using the amiloride sensitive sodium dependent component of platelet volume change under cytoplasmic acidification induced by a sodium propionate medium; cell volumes were determined by electronic cell sizing (Livne et al., Lancet 1987; i: 533-6). 24 normal subjects with normotension and without familial history of hypertension were taken as controls. Data of ambulatory blood pressure recording (ABPR) defined 2 groups according to the presence of normotension (group I, n = 10), or of hypertension (group II, n = 11): established (n = 2) or borderline (n = 9) hypertension. Hypertensive subjects (group II) had increased values of Na+/H+ exchange (k coefficient, mean (SEM): 0.287 (0.07) vs 0.228 (0.05) in control group (p less than 0.01). Na+/H+ rates were significantly related to ABPR data (r = 0.46, p less than 0.02 with diastolic charge during ABPR), but not to left ventricular mass index in g/m2 by echocardiography. Increased rates of platelets Na+/H+ exchange which were related to diastolic blood pressure levels by ABPR, and perhaps to the level of peripheric vascular resistances, may play a significant role in the development of EH in the early stages.
Arch Mal Coeur Vaiss 1991 Aug
PMID:[Results of the evaluation of platelet sodium-proton exchange in the young hypertensive subject]. 165 45

The main objective is to determine when concentric left ventricular hypertrophy (LVH) increased ventricular ectopic activity in essential hypertension. Twenty-four hours Holter monitoring was recorded in 56 patients with essential hypertension: 20 without LVH and 36 with concentric LVH determined by echocardiography (left ventricular mass greater than 215 g). According the degree of septal thickness (ST), patients were classed in 4 groups: (formula; see text) This study allows to conclude that mean and severe concentric LVH (ST greater than or equal to 12) detected by echo are associated with a greater PVC and a higher Lown's class ventricular ectopy. The degree of ST was strong correlated with the Lown's classification (r = 0.6, p less than .0001).
Arch Mal Coeur Vaiss 1990 Jul
PMID:[Concentric left ventricular hypertrophy in patients with hypertension. When should ventricular hyperexcitability be searched for?]. 170 85

The treatment of hypertension in arteritic patients must take account of several parameters: respective severity of hypertension and of arteriopathy, possibility of other sites of atherosclerosis and supposed cause of hypertension. The association of essential hypertension and of an arteriopathy does not sum up all possibilities. Hypertension may be purely systolic, due to decreased compliance. A stenosis of the renal arteries is also worth evoking in the context of an already symptomatic atherosclerotic disease. For the confirmation of the latter hypothesis, Doppler associated to echography may be an alternative to the intravenous or intra-arterial opacification of the renal arteries. In case of moderate hypertension (diastolic pressure ranging from 90 to 104 mmHg), non-medicamentous treatments should be preferred: low-sodium diet, suppression of tobacco and other risk factors, weight loss. Beta-blockers, whatever their class, reduce the walking distance in case of intermittent claudication. Though not formally contraindicated, especially when their use is justified by an associated coronary insufficiency, they are not advised in hypertensive arteritic patients. On the other hand, captopril allows both reducing blood pressure and preserving the walking distance. However, a prerequisite to the possible use of agents inhibiting the conversion enzyme is the preliminary search for a stenosis of the renal arteries. In fact, when these medications are carelessly used in case of bilateral stenosis or of stenosis on a functionally single kidney, they entail a risk of renal failure or of thrombosis of the stenosed renal artery. Calcium inhibiting agents are also anti-hypertensive substances of choice in hypertensive arteritic subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
J Mal Vasc 1991
PMID:[Treatment of hypertension in arteritic patients]. 179 78

The aim of the present study was to determine when a search for ventricular arrhythmias, by ambulatory electrocardiographic monitoring, is necessary in hypertensive patients. An electrocardiogram, an echocardiogram and a 24 hour Holter monitoring were recorded in 88 patients with essential hypertension. According to the results of electrocardiogram patients were subdivided into 4 groups: normal electrocardiogram, isolated left auricular hypertrophy (LAH), isolated left ventricular hypertrophy (LVH) and major ST-T wave changes. According to the degree of septal thickness (ST), patients were classed in 4 groups. [table; see text] For hypertensive patients with normal electrocardiogram, Holter monitoring is not necessary; in fact practically no complex arrhythmias is found in this group. On the contrary, for hypertensive subjects with ST-T waves changes, this investigation seems very interesting, nearly 75% of them present high-grade ventricular arrhythmias. For the patients with electrocardiographic isolated LAH or LVH, the realisation of an echocardiography permits to separate the subjects with mild LVH (ST less than 12 mm) where Holter monitoring is not necessary (81% Lown O-I) and the patients with mean or severe LVH (ST greater than or equal to 12 mm) where this investigation seems very interesting, nearly 65% of them present high-grade ventricular arrhythmias.
Arch Mal Coeur Vaiss 1991 Aug
PMID:[In which type of hypertension should ventricular hyperexcitability be suspected?]. 183 54

The frequent association of sleep apnea syndrome and essential hypertension led to think of sleep apnea as an etiology of hypertension, especially as a good correlation has been found between the severity of both diseases. Moreover, treating the apnea syndrome results in a decrease of blood pressure. The aim of our study is to depict the outlines of a severe hypertensive individual with sleep apnea by comparing 9 men primarily referred to the hypertension clinic with refractory hypertension and finally found to have sleep apnea (study group) to 23 men whose diagnosis of sleep apnea was made in the pulmonary unit (controls). Fifteen of these were hypertensives. Mean age of the study group was 47 +/- 7 years vs 60 +/- 11. Controls were less overweighted: BMI = 33 +/- 6 kg/m3 vs 39 +/- 5. Mean blood pressure was 171 +/- 16/107 +/- 4 mmHg in the study group vs 157 +/- 19/92 +/- 12 mmHg in controls. Prevalence of glucose metabolism disorders was significantly greater in the study group: 6 patients with maturity onset diabetes and 3 with proven glucose intolerance, vs respectively 4 and 6 controls. Triglycerides were elevated in both groups whereas mean cholesterol was slightly above normal values. Six patients of the study group could have an echocardiogram which showed left ventricular hypertrophy (mean left ventricular mass index = 206 +/- 31 g/m2 after the Penn convention).(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1991 Aug
PMID:[Should arterial hypertension in sleep apnea syndrome be stressed?]. 183 55

The effects of 6 months treatment with Sotalol on the blood pressure, left ventricular mass and function, were studied in patients with essential hypertension and left ventricular hypertrophy. Thirty-three patients (18 men and 15 women aged 53 +/- 11 years) were included initially and 26 were reviewed after 6 months of treatment. The left ventricular mass and function were evaluated by Doppler echocardiography and all recordings were interpreted "blind" at the end of the study by two operators. Treatment led to a significant reduction of the blood pressure (152 +/- 12/94 +/- 11 versus 166 +/- 18/100 +/- 9 mmHg) and of the heart rate (60 +/- 10 versus 76 +/- 12 beats per minute). The left ventricular mass index decreased by 8% (p less than 0.001) due to reduction in wall thickness. Resting left ventricular systolic function was unchanged. Left ventricular filling patterns improved with an increase in the E/A ratio which was reduced at the beginning of the trial.
Arch Mal Coeur Vaiss 1991 Dec
PMID:[Effect of sotalol on left ventricular mass and function in the hypertensive patient]. 183 17

Cardiac hypertrophy in hypertension is related to increased peripheral vascular resistance and reduced aortic compliance. Non-invasive measurement of pulse wave velocities and systolo-diastolic variations of the diameter of the aortic arch show that an increase in the elastic modulus of the aorta is closely related to the increase in cardiac mass. This relationship holds even after correction for mean arterial pressure. Therefore, it has been suggested that, in hypertension, the decreased aortic compliance leads to a disproportionate increase in systolic blood pressure and end systolic wall stress, predisposing to cardiac hypertrophy. The blood pressure, arterial haemodynamics of the forearm (by pulsed Doppler flow measurement) and echocardiographic parameters were studied in 16 patients with permanent essential hypertension, before and 3 months after treatment with perindopril, an ACE inhibitor. In a simple blinded study versus placebo, perindopril was shown to significantly reduce the blood pressure (p less than 0.01) while brachial blood flow increased (p less than 0.01) because of a simultaneous increase in blood flow velocity and arterial diameter. During 5 minutes' occlusion at the wrist, blood flow velocity decreased more in patients taking perindopril than those on placebo (p less than 0.01) whilst the reduction in arterial diameter was equivalent, indicating that the increase in arterial diameter with perindopril could not be explained by flow-dependent dilatation alone but by a direct effect of the drug on the artery. During the treatment phase, brachial arterial compliance increased (p less than 0.01) and pulse wave velocity decreased (p less than 0.01) and there was no change in arterial shear stress defined as the product of mean blood pressure and arterial diameter.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1991 Dec
PMID:[Cardiac hypertrophy and arterial compliance after antihypertensive treatment]. 183 23

In vascular diseases, when the vasomotor reserve is exhausted, microcirculation is strongly dependent on blood fluidity. For patients with vascular disorders, it was therefore decided to evaluate red blood cells (RBC) aggregation and disaggregation (SEFAM erythro-aggregometer) which are important factors determining blood viscosity in low flow areas. Our results show that, in essential hypertension (EH), RBC aggregation is significantly increased (+15%), and disaggregation is decreased (-20%). The highest frequency of troubles was found in EH. This observation led to exclusion of EH subjects in all the other studied pathological groups. When EH is excluded from a group of 70 patients with cerebrovascular disorders (CVD), we did not observe significant changes in RBC aggregation. However, in essential and post-thrombotic venous insufficiency there remains a significant increase in RBC aggregation (+10%) and a decrease in disaggregation (-13%). In diabetes, disaggregation is more disabled than for controls (-16%). In all these pathologies presence of EH magnifies the abnormalities, or makes them appear like in CVD. This study underlines the critical importance of taking the influence of hypertension into consideration when evaluating RBC aggregation in vascular pathology. The increase in RBC aggregability and in the shear resistance of the aggregates, when present in vascular pathology, is likely to add a burden to the circulatory system already hindered by a deficient vasomotor regulation system.
J Mal Vasc 1991
PMID:[Erythrocyte aggregation in vascular disease. Influence++ of hypertension]. 194 Jun 53

The purpose of this study was to estimate the effect of hypertension on the visco-elastic properties of the brachial artery in man. Seventy-five subjects including 23 with normal blood pressure (group N, PN = 95 +/- 7 mmHg, P designates the arterial mean pressure, P = DBP + (SBP-DBP)/3) and 52 with essential hypertension (group H, PH = 122 +/- 12 mmHg) participated to this study. We measured the diameter of the brachial artery (D) by the pulsed Doppler method, the brachial-radial pulse wave velocity (PWV) by the mecanographic method, and calculated the arterial compliance (C) by the Bramwell-Hill formula. A nonlinear model was used to calculate compliance and pression at any given pressure, in particular at PN or PH. We obtained the following results: [table; see text] Passive (pressure-induced) effect was obtained by comparing D(PH) to D(PN) and C(PH) to C(PN). Isobaric effect of hypertension was estimated by comparing D(PH) and C(PN) between the N and H groups. We concluded that hypertension actually induces a decrease in compliance. However, arterial diameter is increased in hypertension. The increase in diameter appears as a compensatory effect, without which the reduction in compliance would be more nocive to the circulatory system.
Arch Mal Coeur Vaiss 1991 Aug
PMID:[Intrinsic (isobaric) effect of essential hypertension on visco-elastic properties of the brachial artery]. 195 49


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