Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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

The effects of orally administered glandular kallikrein on urinary kallikrein, aldosterone and prostaglandin E (PGE) excretion, plasma renin activity (PRA), immunoreactive 6-keto PGF1 alpha and thromboxane B2 concentrations and platelet aggregation were studied in 12 patients with essential hypertension (EH). After a 2-week control period, each patient was given orally 450 KU/day of hog glandular kallikrein for 8 weeks. Urinary kallikrein, aldosterone and PGE excretion, and plasma 6-keto PGF1 alpha and thromboxane B2 concentrations were measured by radioimmunoassay. Platelet aggregation was measured by the addition of ADP, collagen or ristocetin with an aggregometer. Urinary kallikrein excretion and plasma 6-keto PGF1 alpha concentration were significantly decreased in patients with EH. There were no significant differences in PRA, urinary aldosterone excretion and plasma thromboxane B2 concentrations between control subjects and patients with EH. There was a significant decrease in blood pressure in patients with EH coinciding with significant increases of urinary kallikrein and PGE excretion and plasma immunoreactive 6-keto PGF1 alpha concentration after administration of glandular kallikrein. There was also a significant inhibition of platelet aggregation induced by collagen in these patients. Thus, a suppression of the kallikrein-kinin-prostaglandin system in patients with EH was found, and a decrease in blood pressure with an increment of urinary kallikrein, PGE excretion, plasma immunoreactive 6-keto PGF1 alpha and inhibition of platelet aggregation in vivo by the administration of glandular kallikrein.
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PMID:Effects of orally administered glandular kallikrein on urinary kallikrein and prostaglandin excretion, plasma immunoreactive prostanoids and platelet aggregation in essential hypertension. 388 84

Urinary kallikrein excretion (UKal), determined by the esterase method, was measured in 10 normotensive volunteers, 10 patients with essential hypertension and in 7 patients with primary aldosteronism before and after operative removal of the adenoma. UKal values were low in 5 of the patients with essential hypertension. Preoperative UKal values in the patients with aldosteronism did not differ significantly from those of the normal subjects, but decreased in all after operation in parallel with changes in urinary excretion of tetrahydroaldosterone and plasma aldosterone concentration. The study supports the assumption of an association between the renal kallikrein-kinin system and the mineralocorticoid state in man.
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PMID:Urinary excretion of kallikrein before and after operation for aldosterone-producing adenoma. 389 26

The interaction of inhibition of prostaglandin (PG) synthesis by indomethacin (75 mg/day) with the antihypertensive effect of atenolol (50 mg b.i.d.) was studied in 11 untreated otherwise healthy men 35 to 45 years old with essential hypertension. Atenolol for 3 weeks decreased supine blood pressure (BP) from 157/109 mm Hg during placebo to 148/97 mm Hg. Indomethacin alone for 1 week slightly increased BP and antagonized the antihypertensive action of atenolol. Atenolol reduced plasma renin activity (PRA) to 40% but did not modify either the urinary excretion of vasodilatory PGs (PGE2 and prostacyclin measured as 6-keto-PGF1 alpha) or plasma kininogen and urine kallikrein. Indomethacin suppressed PRA to 27% and PG excretion to approximately 70% but did not markedly change plasma kininogen and urine kallikrein excretion. The decreased excretion of 6-keto-PGF1 alpha, the metabolite of the main vasodilatory prostanoid prostacyclin, correlated with the increased BP measured in standing subjects. The effects of indomethacin were practically the same when given with atenolol as when given alone. We conclude that the slight increase in BP by indomethacin in essential hypertension is associated with the reduced production of vasodilatory PGs but not with alterations in activities of the renin-angiotensin or kallikrein-kinin systems.
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PMID:Inhibition of prostaglandin synthesis by indomethacin interacts with the antihypertensive effect of atenolol. 389 59

Capoten (captopril) treatment was conducted in 39 patients with essential hypertension of stage IIA-IIB and in 4 patients with idiopathic hyperplasia of the adrenals. In 35 patients the hypotensive effect was evaluated following a single administration of captopril in a dose of 12.5, 25 and 50 mg. Twelve patients were treated with this drug alone while in 23 patients it was combined with saluretics. Captopril monotherapy elicited a good and moderate hypotensive effect in 70% of patients with a high and stable hypertension. Both mono- and combined therapy was associated with a decrease in adrenaline and noradrenaline excretion and an increase in uterine kallikrein excretion. The examination of the regional circulation revealed a significant reduction in the resistance and tonus of the arterioles and an enhancement of the blood flow in the forearm as well as an increase in venous tensility. When captopril was combined with diuretics these changes were less marked.
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PMID:[Use of captopril (capoten) in arterial hypertension]. 390 May 22

The kallikrein-kininogen-kinin system has been postulated to play a role in the regulation of blood pressure and modulation of renal salt and water transport. The activity of this system has usually been determined by measurements of urinary kallikrein excretion. However, urinary kallikrein rarely correlates with simultaneously measured urinary kinins. To further evaluate the factors influencing urinary kinin excretion, we evaluated the role of urinary kininogen in this system. Urines were analyzed from normal subjects and individuals with untreated essential hypertension and end-stage renal disease. Intact urinary kininogen was significantly correlated with urinary kinins in normal subjects (r = 0.65, P = 0.003) and essential hypertensives (r = 0.52, P = 0.026). In both essential hypertension and end-stage renal disease, urinary kinins were significantly decreased (8.00 +/- 1.93, 0.90 +/- 0.18, P less than 0.05, respectively) compared to controls (23.73 +/- 5.20). In essential hypertensives, the reduction in urinary kinins was paralleled by a reduction in intact kininogen with a normal excretion of kallikrein. In end-stage renal disease, the reduction in kinins was paralleled by a reduction in kallikrein with a normal excretion of intact kininogen. This data suggests that kininogen may be an important determinant of urinary kinin excretion in various disease states.
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PMID:The role of urinary kininogen in the regulation of kinin generation. 391 Sep 18

Urinary kallikrein excretion was evaluated in 85 normal subjects and in 149 uncomplicated and recently diagnosed essential hypertensive patients. Moreover, the possible interrelationships between urinary kallikrein excretion and age, sex, electrolyte excretion, and plasma renin activity were examined. In patients with essential hypertension, urinary kallikrein excretion was similar to that of normal subjects. In these patients the enzyme was weakly and positively related to urinary potassium and plasma renin activity; no correlation was found with blood pressure, urinary sodium, age, or sex. In normal subjects and in patients with essential hypertension, the variables studied account for only 25% and 17%, respectively, of the variability of urinary kallikrein excretion. We conclude that the relatively short duration of hypertension in our patients may explain the unaltered values of urinary kallikrein excretion with respect to controls.
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PMID:Urinary kallikrein activity is not altered in human essential hypertension. 391 22

The hemodynamic, hormonal, and renal responses to alterations in dietary potassium were studied in normotensive and hypertensive subjects. In a short-term study, nine normotensive and nine hypertensive young men received a normal diet and low potassium, high potassium, and high potassium/low sodium diets for 1 week, each. The long-term effect of potassium supplementation (normal diet plus 96 mmol KC1/d for 8 weeks) was evaluated in 17 patients with essential hypertension. Blood pressure did not change significantly during short-term alterations of potassium intake but decreased during long-term supplementation (from 152.2 +/- 3.5/99.6 +/- 1.9 mm Hg to 137.4 +/- 2.9/89.1 +/- 1.4 mm Hg). High dietary potassium induced a significant but transient natriuresis. Plasma potassium concentration was increased during long- but not during short-term high potassium intake. In contrast to plasma renin activity (PRA) and aldosterone, urinary kallikrein was consistently stimulated during long-term potassium supplementation. The plasma concentrations of adrenaline and noradrenaline were significantly higher in hypertensive than in normotensive subjects and were not markedly altered by the dietary changes. It is concluded that long- but not short-term potassium supplementation lowers blood pressure in patients with essential hypertension. The antihypertensive effect may be mediated by potassium-induced natriuresis, by a stimulation of Na-K-ATPase secondary to increased plasma potassium levels, and/or by a modulation of the renin-angiotensin-aldosterone, kallikrein-kinin, and sympathetic nervous systems.
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PMID:Hemodynamic, renal, and hormonal responses to changes in dietary potassium in normotensive and hypertensive man: long-term antihypertensive effect of potassium supplementation in essential hypertension. 392 52

In twenty-five outpatients with essential hypertension, the relevance of renal kallikrein excretion for inter-individual differences in the blood pressure response to changes in dietary sodium intake was investigated. The patients were studied during 2 weeks of high (300 mmol) and 2 weeks of low (50-100 mmol) sodium intake. In addition there were two control periods of normal sodium intake, one lasting 4 weeks at the beginning and one lasting 2 weeks at the end of the study. Blood pressure, body weight and 24 h urinary sodium and kallikrein excretion were measured at the end of all periods. At the end of the first control period, 1 mg furosemide per kg body weight was administered intravenously, and the urinary excretion of kallikrein and sodium were measured 30 and 120 min later. The difference in mean arterial pressure (delta MAP) between high and low sodium intake ranged from + 18 to -8 mmHg. The eight patients with a delta MAP greater than 10 mmHg were regarded as salt-sensitive. They were older and had a higher initial blood pressure than salt-insensitive patients. For all patients, urinary kallikrein excretion at the end of the low sodium period (123(SEM 20.3) micrograms 24 h-1) was significantly higher than at the end of the first control period (96(SEM 16.3) micrograms 24 h-1, P less than 0.01) and at the end of the high sodium period (96(SEM 23.7) micrograms 24(-1), P less than 0.01). When compared with salt-insensitive patients, salt-sensitives had lower levels of urinary kallikrein excretion and a blunted kallikrein response to dietary sodium restriction and furosemide.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Is the renal kallikrein system relevant to sodium sensitivity in patients with essential hypertension. 392 10

The efficacy and tolerability of the new ACE-inhibitor enalapril (MK 421) and the beta 1-selective adrenoceptor blocker atenolol for the treatment of primary hypertension were compared in a double blind parallel study. 12 patients were randomized to each drug. The doses of enalapril were 20 and 40 mg o.d. and of atenolol 50 and 100 mg o.d. for 4 weeks each, whereafter hydrochlorothiazide (HCTZ) 25 or 50 mg o.d. was added if necessary to achieve a supine diastolic blood pressure (BP) less than 90 mm Hg 24 hours after drug intake. Supine BP was reduced from 160 +/- 7/111 +/- 4 mm Hg to 153 +/- 13/101 +/- 9 mm Hg (p less than 0.05/p less than 0.005) with enalapril and from 163 +/- 17/109 +/- 6 mm Hg to 145 +/- 11/95 +/- 7 mm Hg (p less than 0.005/p less than 0.001) with atenolol. The addition of HCTZ caused a profound additive BP reduction to 132 +/- 7/88 +/- 6 mm Hg with enalapril and to 130 +/- 10/88 +/- 7 mm Hg with atenolol. There was no significant difference between the efficacy of enalapril and atenolol alone or combined with HTCZ. The reduction in mean arterial pressure with enalapril tended to correlate with pre-treatment stimulated plasma renin activity and 24 hours urinary kallikrein excretion. Both drugs tended to reduce serum and urinary aldosterone and kallikrein excretion to the same extent. There was one drop-out in each group, one due to impotence on the combination of enalapril and HCTZ and one due to peripheral coldness during atenolol treatment. Other side effects were mild. No toxic adverse effects were registered.
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PMID:Enalapril and atenolol in primary hypertension--a comparative study of blood pressure lowering and hormonal effects. 608 25

We studied the possible interplay between plasma bradykinin (P-BK) and the renin-angiotensin axis in essential hypertension, the effect of catecholamine on P-BK by standing and norepinephrine (NE) infusion, and the possible role of bradykinin in the hypotensive mechanism of angiotensin I converting enzyme inhibitor (captopril) in renin-independent essential hypertension. Plasma bradykinin was measured by sensitive radioimmunoassay in 44 hypertensive patients and compared with that of 24 normotensive subjects. P-BK was not significantly reduced in hypertensive patients, and when subjects were divided by age range, the P-BK was reduced by aging in normotensive subjects but not in hypertensive patients, and the elder (60 approximately 80 yr) age normotensive group showed significantly (p less than 0.05) lower P-BK compared with the elder hypertensive group. 28 essential hypertensive patients (EHT) who were classified as WHO stageI (n=15) and WHO stageII (n=13) were given 80 mg of furosemide orally and kept upright for 4 hours. Plasma renin activity (PRA), P-BK, plasma aldosterone (P-Ald) and serum angiotensin converting enzyme activity (ACEA) were measured before and after furosemide administration. Twelve normotensive subjects served as controls. PRA, P-Ald and ACEA showed a significant increase (p less than 0.05) in all groups in response to furosemide. In normotensives, basal P-BK was 11.1 +/- 1.3 pg/ml which increased to 15.6 +/- 1.8 pg/ml (p less than 0.02) after furosemide. These changes of P-BK were in parallel with PRA, P-Ald and ACEA. In the WHO stageI EHT group, baseline P-BK was 9.7 +/- 1.3 pg/ml which increased to 15.6 +/- 1.8 pg/ml (p less than 0.02) and PRA, P-Ald and ACEA showed a similar increase as in normotensives. In the WHO stageII EHT patients, however, P-BK showed only a slight increase from 9.8 +/- 1.0 pg/ml to 12.0 +/- 1.1 pg/ml after furosemide. These changes were smaller either than normotensives or the WHO stageI EHT group. There was a slight but significant correlation between PRA and P-BK in normotensives and in the WHO stageI EHT. There was no correlation between PRA and P-BK in the WHO stageII EHT. The present results do not support the view that there may be a direct linkage between the kallikrein kinin system and the renin angiotensin axis mediated by kininase II or angiotensin converting enzyme in human peripheral blood.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The effect of alterations of the renin-angiotensin system and the sympathetic nervous system on plasma bradykinin concentration in patients with essential hypertension]. 609 86


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