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 interrelationships among age, cardiovascular pressor reactivity to intravenously infused norepinephrine (NE) or angiotensin II, and endogenous plasma NE or renin (PRA) levels were evaluated i 31 normal subjects and 37 patients with essential hypertension. In normal subjects both angiotensin II pressor dose and PRA decreased progressively with aging. Angiotensin pressor dose correlated positively with PRA (r = 0.41, P < 0.025) and inversely with age (r = -0.46, P < 0.02). NE pressor dose and basal plasma NE were also positively correlated (r = 0.53, P < 0.005), but the two factors remained largely unchanged with aging. Findings in essential hypertension differed in certain aspects. Angiotensin II pressor dose did not correlate with either basal PRA or age; and pressor doses of NE and angiotensin II tended to be lower in some patients than in normal subjects. These findings indicate that aging is accompanied by a physiologic increase in cardiovascular reactivity to angiotensin II, probably due to a concomitant decrease in circulating renin. The dissociation between angiotensin pressor dose and PRA in essential hypertension suggests an interference from an other factor.
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PMID:Age-rated profile of cardiovascular reactivity to norepinephrine and angiotensin II in normal and hypertensive man. 745 3

The authors aim was to evaluate if the changes in the components of the plasma kinin system on PRA, determined during 3-weeks period of treatment with captopril in daily doses of 150 mg, depend on the stage of arterial hypertension. Investigations were carried out in 40 patients with primary hypertension; 6 patients were in I, 20 in II and 14 in III WHO stage. The control group consisted of 18 healthy persons. All the parameters were examined 3 times: before therapy, after 24 h and after 3 weeks of therapy. It was proved that captopril as monotherapy, was effective in every stage of hypertension, however the normalisation of blood pressure was observed only in I and II WHO stage. The normalisation of the prekallikrein levels appeared after 3 weeks of treatment in all periods of hypertension, while the normalisation of the kininogen levels occurred only in patients of I and II WHO stage. Since changes of kininogen level in plasma occurred along with changes in blood pressure, therefore the estimation of kininogen seems to be better criterium of effectiveness of captorpil than the determination of prekallikrein. The changes of PRA were similar in all stages of hypertension, but they were significant only in the group of patients of II WHO stage and only after 24 h. Presented studies indicate that renin-angiotensin-aldosterone system as well as kinin system, participate in the mechanism of antihypertensive effect of captopril in every stage of hypertension.
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PMID:[Changes of components in the kinin system and plasma renin activity during different stages of hypertension in patients treated with captopril]. 786 89

The mechanism by which excessive NaCl intake raises blood pressure has not been fully clarified. The present study was undertaken in 87 Japanese inpatients with essential hypertension to investigate the interrelation among effects of age, sex and the renin-angiotensin system on NaCl sensitivity. After ingesting a regular NaCl diet (170 mmol/day) for one week, subjects were placed sequentially on a week of low NaCl diet (50 mmol/day) and a week of high NaCl diet (340 mmol/day). NaCl sensitivity defined as the difference in mean blood pressure between the low and high NaCl diets did not differ between genders. NaCl sensitivity was positively correlated with age and the change in PRA. The fall in PRA after NaCl loading was significantly smaller in women than in men. By multiple regression analysis, age and the change in PRA independently contributed to the change in mean blood pressure. Furthermore, the interaction between sex and the change in PRA was selected as a statistically significant variable. In conclusion, NaCl sensitivity of blood pressure is independently associated with age and the inadequate suppression of the renin-angiotensin system. Because the contribution of the change in PRA to NaCl sensitivity was greater in women than in men, the mechanism of blood pressure elevation after NaCl loading may differ between genders.
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PMID:Effects of age and sex on sodium chloride sensitivity: association with plasma renin activity. 788 1

In patients with essential hypertension, left ventricular hypertrophy (LVH) increases the risk for cardiovascular morbidity and mortality. Thus its reversal represents one of the principal end-points of antihypertensive treatment. We assessed the cardiovascular effects of 1-year antihypertensive treatment with rilmenidine (1 or 2 mg/day orally), a new oxazoline with a potent antihypertensive action that acts selectively through imidazoline-preferring receptors. In 11 hypertensive patients (mean age, 49 +/- 2 years) with LVH, we measured systemic hemodynamics, large artery compliance, cardiac anatomy, and endocrine function. Patients underwent M-mode and 2-dimensional echocardiography as well as Doppler and peripheral pulsed Doppler flowmetry, determination of plasma atrial natriuretic factor (ANF) levels and renin activity (PRA), and of 24-hour urinary electrolyte and creatinine excretion in control conditions (systolic/diastolic blood pressure, 148 +/- 3/102 +/- 1 mm Hg), 4 weeks after blood pressure normalization (131 +/- 2/84 +/- 2 mm Hg; p < 0.01), after 1 year of satisfactory antihypertensive treatment (142 +/- 3/90 +/- 1 mm Hg; p < 0.01) and, finally, 1 month after therapy withdrawal (155 +/- 3/106 +/- 2 mm Hg; difference not significant [NS]). One-year of rilmenidine treatment induced an improvement in brachial artery compliance (from 0.92 +/- 0.06 to 1.16 +/- 0.08 cm4/dyne; p < 0.05), which persisted after withdrawal of treatment (1.17 +/- 0.06 cm4/dyne; p < 0.05). LVH was reversed after 1 year of rilmenidine treatment (from 152 +/- 5 to 131 +/- 4 g/m2 body surface area; p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of one-year treatment with rilmenidine on systemic hypertension-induced left ventricular hypertrophy in hypertensive patients. 799 84

An analysis of the renin-secreting tumors published in the literature suggests the diagnosis of JGC tumor should be evoked systematically in a young patient with severe hypertension and hypokalemia in whom a renovascular lesion has been eliminated by arteriography. A very high PRA usually is observed and blood pressure drops during converting enzyme treatment. Under acute administration of captopril, plasma renin may or may not increase, showing the inconsistency of the secretory autonomy of the tumor. The most useful examination for the localization of the tumor is the CT scan. Excessive renin production may provoke vascular lesions, left ventricular hypertrophy, and impairment of renin function that all disappear after surgical treatment, at the time when blood pressure returns to normal. Primary reninism has great physiologic importance for the hypothesis that favors the essential role of the kidney in determining the level of blood pressure. It can be considered as a unique, purely renin-dependent form of hypertension. This syndrome has no experimental equivalent and is the most caricatural form of other renin-dependent hypertension, such as renovascular disease, and probably some other forms of essential hypertension. The discovery of a renin-secreting tumor therefore constitutes a life-saving diagnosis for the patient, a subject of reflection for the specialist, and a useful tool for studies of the general mechanisms involved in enzyme biosynthesis and tumoral endocrine cell function.
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PMID:Renin-secreting tumors. 807 Apr 21

Plasma concentrations of beta-endorphin (beta-EP), leucine enkephalin (LEK), arginine vasopressin (AVP), neurotensin (NT), renin activity (PRA) and angiotensin II (AT-II) were determined before and after the treatment with clonidine in 117 patients with essential hypertension. Before the treatment, the patient group had lower levels of beta-EP and LEK (P < 0.001), higher levels of AVP, PRA and AT-II (P < 0.05-0.01), as compared with those in control group. After 14 days of the treatment, plasma levels of beta-EP, LEK increased significantly (P < 0.001), and correlated negatively with the decrease of the mean artery pressure (r = -0.369 and r = -0.441, respectively, P < 0.01). PRA and AT-II decreased significantly (P < 0.05, P < 0.01). Decrease of AVP level was also observed, but did not reach the statistical significance. NT did not change both before and after the treatment. These data suggest that beta-EP and LEK may be involved in pathogenesis of hypertension and in hypotensive action of clonidine.
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PMID:[Changes in plasma neuropeptides before and after clonidine in patients with essential hypertension]. 824 25

Recent studies suggest the existence of a relationship between the renin-angiotensin system and erythropoietin (EPO) secretion. It has been studied whether patients with various forms of arterial hypertension (essential, renal, renovascular, in the course of arteritis) differ with respect to EPO secretion and whether EPO serum levels are related to renin response induced by dietary sodium restriction to 10-20 mmol Na/24 h for 3 days and upright body position for 3 h. Patients with different forms of hypertension and normal renal excretory function and healthy subjects did not differ in hematocrit value, markers of iron metabolism, and EPO secretion except for patients with arteritis who had higher ferritin values. In these patients a positive correlation between EPO levels and hematocrit values suggests the existence of an altered regulation of EPO secretion. In essential hypertension a negative correlation found between changes in EPO and PRA levels in response to sodium restriction and upright body position may also reflect an altered regulation of both EPO and renin production.
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PMID:Influence of the renin-angiotensin system stimulation on erythropoietin production in patients with various forms of arterial hypertension. 830 4

The usefulness of the captopril test as a simultaneous screening method for primary aldosteronism (PA) and renovascular hypertension (RVH) was evaluated in 111 patients with essential hypertension, and in 79 patients with secondary hypertension, which included 16 patients with PA and 18 with RVH. Plasma renin activity (PRA, ng/mL/h) and plasma aldosterone concentration (PAC, ng/dL) were determined before and 90 min after administration of 50 mg of captopril in the supine position on a normal NaCl diet. A cutoff point or a discriminant function in the screening was determined by discriminant analysis. A quadratic discriminant function of PRA and PAC after the captopril test identified patients with PA with a false negative rate of 6.3% (1/16), and a false positive rate of 0.6% (1/174) which was significantly lower than that of 3.4% at the basal state (P < .05). In the screening for RVH, the criterion of a postcaptopril PRA of greater than 10.6 ng/mL/h had a false negative rate of 5.6% (1/18) and a false positive rate of 15.1% (26/172). This false positive rate was also significantly lower than that using a criterion for precaptopril PRA of 2.21 ng/mL/h (P < .05). Accordingly, the captopril test was a useful method in the simultaneous screening for PA and RVH, and it may be particularly applicable in specialized hypertension clinics.
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PMID:The usefulness of the captopril test as a simultaneous screening for primary aldosteronism and renovascular hypertension. 830 62

To elucidate the characteristics of end-organ damage in essential hypertension in the elderly, the progression of end-organ damage, with respect to deterioration of renal function and changes in the optic fundi, were compared between young and elderly essential hypertensive patients with the same left ventricular mass index (LVMI). Forty five elderly hypertensive patients (age > or = 65 years) were matched with 40 young patients (age < or = 55 years) for sex and LVMI. All studies were performed under hospitalisation to uniform the background of diet and daily activity. Compared with young hypertensive patients, elderly patients were characterised to have advanced end-organ damage. In young patients, the levels of progression of end-organ damage were significantly correlated with each other, while in elderly patients no relation was observed. In young patients, LVMI was significantly correlated with urinary and plasma noradrenaline, PRA and 24 h blood pressure. In elderly patients, LVMI correlated only with 24 h systolic blood pressure.
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PMID:End-organ damage in essential hypertension in the elderly. 855 84

A defect in the endothelium-dependent vasorelaxation could contribute to the development of arterial hypertension through the facilitation of renal vasoconstriction and sodium retention. In this study, we tested the hypothesis that aging impairs kidney function in essential hypertension through a derangement of nitric oxide-dependent renal mechanisms. To this end, we compared the renal response to an intravenous infusion of the precursor of nitric oxide synthesis, L-arginine, in young and aged essential hypertensives. In young hypertensives, L-arginine induced a significant increase in renal plasma flow, glomerular filtration rate, natriuresis and kaliuresis, without changes in filtration fraction. These effects were not observed in aged hypertensives. Neither PRA nor PA were affected by L-arginine infusion in any group. These results indicate that aging produces a derangement of endothelial function in essential hypertension.
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PMID:Aging abolishes the renal response to L-arginine infusion in essential hypertension. 874 32


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