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

In order to investigate whether an altered "in vivo" platelet serotonin release contributes to the low platelet serotonin content observed in essential hypertensive patients, we have measured plasma concentrations of beta-thromboglobulin and platelet factor 4, urinary beta-thromboglobulin concentrations and platelet serotonin and platelet factor 4 contents in 11 untreated essential hypertensive patients (WHO Stage I) and in 12 age-matched normotensive controls. Beta-thromboglobulin and platelet factor 4 are specific platelet proteins localized in the alpha-granules which are released during in vivo platelet activation. Plasma and urinary concentrations of these alpha granule proteins determined by radioimmunoassay were found to be similar in hypertensive and normotensive subjects. The low platelet serotonin content determined by high pressure liquid chromatography from platelet rich plasma in hypertensive patients (0.282 +/- 0.008 vs 0.348 +/- 0.019 nmol/10(8) platelets, p less than 0.01) was not associated with a decrease in platelet 4 content (1.36 +/- 0.07 vs 1.36 +/- 0.10 microgram/10(8) platelets). This study shows that platelet alpha-granule content is unaltered in uncomplicated essential hypertension and suggests that the low platelet serotonin content in hypertensives is mainly due to the inhibition of platelet serotonin uptake.
Arch Mal Coeur Vaiss 1987 Jun
PMID:[In vivo platelet activation in mild arterial hypertension]. 295 30

Forearm venous tone (FVT), carotido-femoral pulse wave velocity (PWV), and left ventricular end diastolic diameter (LVD), left ventricular posterior wall thickness (LVPWT), myocardiac mass (MM), measured by echography were evaluated on 25 subjects with sustained essential hypertension and 30 normotensive subjects with same age and same sex. For the overall population, FVT is positively correlated with LVD (r = 0.45, p less than 0.001), with LVPWT (r = 0.37, p less than 0.01) and with MM (r = 0.55, p less than 0.001). PWV is not correlated with LVD but is positively correlated with LVPWT (r = 0.48, p less than 0.001) and with MM (r = 0.40, p less than 0.01). Stroke volume is positively correlated with FVT (r = 0.42, p less than 0.01), but not with PWV. This study shows that in a population of normals and sustained essential hypertensive subjects: i) indexes of venous compliance are correlated with myocardial thickness, myocardiac mass, left ventricular diameter and stroke volume, while ii) indexes of arterial compliance are only correlated with myocardial thickness. Thus, the modifications of arterial and venous compliance observed in sustained essential hypertension influence cardiac structure and function.
Arch Mal Coeur Vaiss 1987 Jun
PMID:[Index of arterial and venous compliance and echocardiographic parameters in essential permanent arterial hypertension]. 295 33

We have measured the basal circulating level of atrial natriuretic factor (ANF) in hypertensive patients. Plasma ANF concentrations in 101 patients with mild untreated, essential hypertension and in 64 normotensive controls were 14.9 +/- 11.1 vs 11.9 +/- 7.7 pg/ml, p = NS respectively. Plasma ANF levels in the patients were correlated with mean arterial pressure (r = 0.35, p less than 0.001) and age (r = 0.38, p less than 0.001). Sixteen patients with uncontrolled hypertension despite treatment, had significantly higher plasma ANF levels (33.5 +/- 27.3 pg/ml, p less than 0.001). Forty other patients with hypertension were subjected to an abdominal aortography and a renal vein catheterism, in order to rule out renovascular hypertension. Of these subjects, 16 were without significant renal artery stenosis, 12 had left renovascular hypertension and 12 others right renovascular hypertension. Plasma ANF levels were maximal in the aorta and there were no differences between the ANF levels in the renal veins, whether the stenosis was on the right or left side. In conclusion, plasma ANF levels were not elevated in 101 untreated patients with mild essential hypertension. Together with the evidence of elevated intra atrial pressure in mild essential hypertension, as found by others, this suggests that ANF secretion might be impaired in this disease.
Arch Mal Coeur Vaiss 1987 Jun
PMID:[Determination of the atrial natriuretic factor in patients with essential and renovascular hypertension]. 295 39

An exaggerated natriuretic response to volume expansion (VE) is observed in many essential hypertensive patients. The plasma levels of atrial natriuretic peptide (ANP) were measured in 11 normal subjects (NT) and 12 patients with mild essential hypertension (EH) during VE (1 800 ml isotonic saline IV over 3 hours). NT and EH groups were similar with respect to age and basal levels of renin, aldosterone and ANP (34.5 +/- 5.5 in NT and 32.5 +/- 6.3 pg/ml in EH, mean +/- sem). In response to VE, ANP increased to the same extent in both groups (a change of + 19.3 +/- 5.2 in NT and 22.2 +/- 7.1 pg/ml in EH) despite the marked difference in observed natriuresis (36 +/- 3.5 in NT and 54.9 +/- 6.3 mmol/3 in EH, p less than 0.02). The change in ANP induced by VE was inversely correlated with the fall in hematocrit and the variation in fractional excretion of sodium in both groups. These results suggest that atrial natriuretic peptide may participate in the control of the renal response to isotonic volume expansion, but they do not support a predominant role of atrial natriuretic peptide in the exaggerated natriuretic responses to volume expansion of patients with essential hypertension.
Arch Mal Coeur Vaiss 1988 Jun
PMID:[Role of atrial natriuretic peptide in the renal response to acute volume expansion in the normal and essential hypertensive patient]. 297 95

The metabolism of phosphoinositides, a class of membrane lipids that appears to be intimately involved in the regulation by the membrane of the intracellular Ca2+ level, has been reported to be modified in the erythrocyte of the spontaneously hypertensive rat (SHR and SHR/SP). In order to elucidate the link between the phosphoinositide alteration and hypertension, the metabolism of phosphoinositides was studied in human essential hypertension and in Sabra rats under various patho-physiological conditions. Experiments were performed in vitro on isolated ghost membranes by measuring the radioactivity incorporated into triphosphoinositides (PI-P2) and diphosphoinositides (PI-P) following the incubation of membranes with [gamma 32P]-ATP. 32P-PI-P2, in moderate untreated essential hypertensive controls (n = 31) was higher than in normotensives (n = 30) (1.18 +/- 0.06 vs 0.92 +/- 0.04, 32P nmol/15 min/mg prot, p less than 0.005); 32P-PI-P2 and 32P-PI-P in hypertensive patients treated with beta-blocking agents (n = 20) did not differ from the values observed in untreated hypertensives. In Sabra rats, 32P-PI-P2 values were 0.79 +/- 0.03 and 1.32 +/- 0.08 for SbN and SbH, respectively (8-11 animals per group); difference was significant. 32P-PI-P values varied similarly. Both 32P-PI-P2 and 32P-PI-P did not change significantly when animals were fed a high sodium diet or were injected with DOCA, though such treatments rose the blood pressure. Our data indicate that the modification of phosphoinositide metabolism that we observed both in rat and human hypertension is not a consequence of the blood pressure elevation, but may be considered as an intrinsic membrane defect. Changes in the phosphoinositide metabolism may therefore be associated with the functional and structural alterations concerning the transmembrane Na+ and Ca2+ fluxes which may be of pathogenic importance.
Arch Mal Coeur Vaiss 1985 Oct
PMID:[Phosphoinositide metabolism in essential and experimental hypertension]. 300 20

Circulating inhibitors of the Na+ pump have been proposed as participating in sodium excretion, extracellular and vascular volume regulation and as hypertensiogenic agents. The presence of digitalis-like compounds in human plasma has been investigated by measuring its ability to compete with tritiated ouabain for binding to the digitalis site of red blood cells. Their activities in plasma from either hypertensive or volume expanded patients were compared. High levels were found in plasma from 37 p. cent of the untreated patients with essential hypertension, 64 p. cent of patients with end-stage renal failure and 71 p cent of acromegalic patients in the hypersecreting phase. The patients of these two last classes have been selected as being normotensives and without family history of hypertension. An increased activity of the inhibitor should more likely be linked to the positive Na+ balance and the volemic expansion which characterise these last two diseases than to high blood pressure. The observations that the activity of the inhibitor is correlated with the plasma volume in acromegalic patients, it returns to normal values after hemodialysis in renal insufficiency or successful therapy of acromegaly and the decrease in its activity is proportional to the weight lost during dialysis in uremic patients, agree with this proposal.
Arch Mal Coeur Vaiss 1985 Oct
PMID:[Circulating inhibitor of sodium active transport in essential hypertension and volemic expansion]. 300 21

The objective of this prospective study was to evaluate the effect of nifedipine administered at usual daily doses of 30 to 40 mg on the carotid flow in arterial hypertension. The study included 15 patients (8 men and 7 women), 50 to 79 (mean 59.5) years old suffering from long-standing, fixed essential hypertension becoming instable under central antihypertensive drug therapy. For calculating the carotid blood flow, vascular echotomography combined with Doppler ultrasonography and spectral analysis (Duplex probe) determining the vascular section and flow velocity were used. Arterial pressure using a mercury tonometer, flow velocity, common carotid artery diameter, carotid blood flow, Pourcelot's index, parietal tension and heart rate were measured before treatment and at the 8th day of nifedipine administration. It could be shown that the drug produced a significantly (p less than 0.001) increased carotid blood flow, in spite of a marked (p less than 0.001) decrease in systolic (p less than 0.001) and diastolic (p less than 0.005) blood pressure. The increase in carotid blood flow was directly related to the increase in flow velocity (p less than 0.001) and in the diameter of common carotid artery (p less than 0.01) and was associated with a significant decrease in the Pourcelot's index. Analysis of two groups of patients isolated from the total group according to the elevation of carotid blood flow, showed that the degree of hypotensive effect of nifedipine is negatively correlated with the baroreflex response determined by the variation of parietal tension.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1986 Sep
PMID:[Effects of nifedipine on carotid blood flow and baroreflex response in essential arterial hypertension. Preliminary results]. 309 82

The relation between hypertension and diabetic nephropathy is complex. Nephropathy is probably involved in the elevated blood pressure found in diabetic patients. In maturity onset diabetes, patients may also have hypertension which is associated with obesity or essential hypertension. It has been suggested that in both types of diabetes, hypertension enhances the development of diabetic nephropathy. Moreover, an aggressive antihypertensive treatment seems able to reduce rate of decline in kidney function in insulin-dependent diabetic patients with patent nephropathy. In this work, creatinine clearance and microalbuminuria in 20 diabetic patients (mostly with maturity-onset-diabetes) with known moderate and effectively treated hypertension were therefore measured and the results were compared with those for 18 normotensive diabetic patients and 22 controls. Duration of diabetes was from one to 26 years (mean: 11 years) and duration of hypertension was from one to 35 years (mean: 10 years). Patients and controls had normal serum creatinine and proteinuria below 0.1 g/l. Microalbuminuria was measured by immunonephelometric assay using specific antiserum (sensitivity = 1.5 mg/l; intra and interassay coefficients: 6.5% and 8% respectively). The highest value was observed in hypertensive diabetic patients with retinopathy (group 1). But hypertensive patients without retinopathy (group 2) and normotensive patients also had significantly increased microalbuminuria. In group 1, microalbuminuria was significantly higher than in group 2. The creatinine clearance was reduced in groups 1 and 2 versus normotensive diabetics, but hypertensive patients were older.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1986 Jun
PMID:[Microalbuminuria in diabetics with moderate hypertension]. 309 93

An Expert System (ES) has been connected to a database management system for the management and follow-up of hypertensive patients. The patient data base, called Artemis, contains approximately 18,000 medical records. About 90% of the initial informations used by the ES is contained in the medical records of the Artemis data base. The knowledge base consists of 870 rules. A first group of rules allows the description of knowledge structures (hierachies, graphs and mutual exclusions). The second group consists of production rules which describe the dynamic reasoning of the expert. The inference engine uses a combination of forward and backward chaining. The ES produce diagnostic hypotheses (possible causes of hypertension) and therapeutic suggestions before and after requiring additional information (patient supplementary interrogation, biological or radiological investigations). The evaluation of the diagnostic performance of the ES was made on 40 confirmed cases of secondary hypertension (SH) and 40 cases of essential hypertension (EH). The initial initial diagnosis, just after the forward chaining step, was correct in 17 cases of SH and 32 cases of EH. The final diagnosis proposed after several steps of forward and backward chaining was correct in 37 cases (92%) of SH and 36 (90%) of EH. Averages of 5 (EH) and 8 (SH) questions were formulated by the ES to reach the final diagnosis. The integration of the ES to the database is expected to facilitate the validation of the knowledge base and to enhance its overall acceptability. Whether or not such an integration will be useful and accepted as a complementary tool by physicians remains however an open question.
Arch Mal Coeur Vaiss 1986 Jun
PMID:[Testing an expert system for hypertension]. 309 96

Recent studies in essential hypertensive patients and rats with genetic hypertension strongly suggested that the development of primary hypertension results from a transient and chronic "cascade" of events; I) excess Na+ intake, II) secretion of natriuretic factors, III) abnormal cell Na+ homeostasis in the vascular wall, due to the presence of inherited and induced abnormalities in different Na+ transport system and IV) increase in cytosolic free Ca2+ content and sympathetic drive. In vitro studies have previously shown that canrenone, an antihypertensive antialdosterone drug, behaves like a partial agonist at the digitalis-receptor site of the Na+, K+-pump. In particular, it has been shown that canrenone counterbalances the increases in internal Na+ and cytosolic free Ca2+ contents induced by ouabain in cultured smooth muscle cells. We thus investigated the effect of canrenone administration in a model of experimental hypertension with increased endogenous "ouabain-like" factors (rats with reduced renal mass under excess Na+ intake: RRM-salt rats). Results presented here confirm that RRM-salt rats exhibit: volume expansion, strongly decreased plasma renin activity, increased endogenous "ouabain-like" factors and (IV) decreased Na+, K+-pump activity and increased Na+ content in erythrocytes. In addition, we found that canrenone is antihypertensive in this model and this is associated with a tendency to normalize volume expansion, plasma levels of endogenous "ouabain-like" factors, Na+, K+-pump activity and Na+ content in erythrocytes. In conclusion, our results suggest that administration of canrenone to RRM-salt rats may induce a lowering of blood pressure by antagonism with endogenous "ouabain-like" factors at the vascular wall.
Arch Mal Coeur Vaiss 1986 Jun
PMID:[Canrenone: an effective antihypertensive in an experimental model of hypertension in which the active transport of sodium is diminished]. 309 4


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