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

The mechanism of action of prazosin hydrochloride, a new antihypertensive agent was studied in 14 patients with essential hypertension. Mean supine blood pressure for the group fell from 148/102 +/- 3/2 (SE) mm Hg at baseline to 139/91 +/- 5/4 after eight weeks of therapy (P less than 0.05). No significant postural hypotension was noted in the patients who responded to therapy. Glomerular filtration rate (endogenous creatinine or inulin clearance) and effective renal plasma flow (PAH clearance) remained unchanged during therapy as did supine and stimulated peripheral plasma renin activity. Cardiac output did not change significantly although plasma volume increased in ten out of 12 patients in whom it was measured (P less than 0.025). Among the patients whose mean blood pressure fell 10 mm Hg or more, peripheral vascular resistance fell significantly (P less than 0.025), and the change in plasma volume was not statistically significant. Among the patients whose mean blood pressure changed less than 10 mm Hg with therapy, there was no significant change in peripheral vascular resistance and plasma volume increased significantly (P less than 0.025). Prazosin hydrochloride appears to be an effective antihypertensive agent which acts by peripheral vasodilatation. It may cause fluid retention. The drug does not appear to affect renal function or renin secretion.
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PMID:Physiologic evaluation of a new antihypertensive agent: prazosin HCl. 83 88

To characterize the long-term effects of calcium antagonists on renal function in hypertension felodipine was used to treat 14 patients with severe uncontrolled hypertension associated with renal functional impairment: six patients had renal parenchymal hypertension, six had essential hypertension and two had renovascular hypertension. Mean blood pressure was 197 +/- 2/115 +/- 3 mm Hg despite treatment with three or more antihypertensive drugs. Mean glomerular filtration rate (GFR) was 39 +/- 6 ml/min (Cr-EDTA clearance) before initiation of felodipine treatment. All patients experienced a blood pressure reduction after starting felodipine treatment, which persisted during long-term therapy in combination with previous medication except former vasodilating drugs. Blood pressure after 12 and 24 months was 152 +/- 7/89 +/- 2 and 157 +/- 5/90 +/- 2 mm Hg, respectively. Patients with moderately impaired GFR and absence of progressive renal disease (N = 8) manifested an increase in GFR after 6 and 12 months on felodipine (59 +/- 10 to 63 +/- 7 and 70 +/- 6 ml/min, respectively, P less than 0.05). Renal plasma flow (PAH clearance) exhibited only a slight increase (315 +/- 68 to 340 +/- 63 and 314 +/- 69 ml/min) with a consequent increase in filtration fraction (18 +/- 1 to 21 +/- 1 and 20 +/- 1%, NS). At follow-up after six to eight years patients with initial GFR greater than or equal to 50 ml/min had a maintained renal function. In five patients a progressive deterioration of renal function had been documented.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Long-term effects of felodipine in patients with reduced renal function. 161 60

Felodipine, a dihydropyridine calcium antagonist, was used to treat eight patients with severe uncontrolled hypertension: five had essential hypertension, two had renovascular disease, and one chronic pyelonephritis. Mean blood pressure (BP) was 221 +/- 14/120 +/- 4 mm Hg despite treatment with three or more antihypertensive drugs. All patients experienced an immediate and pronounced lowering of BP after adding felodipine, which persisted during long-term treatment in combination with previous medication except for vasodilating drugs. In all cases, an increase in glomerular filtration rate (51Cr-EDTA clearance) after 6 and 12 months of felodipine treatment was seen (59 +/- 10 to 63 +/- 7 and 70 +/- 6 ml/min, respectively, p less than 0.05). Renal plasma flow (PAH clearance) exhibited only a slight increase (315 +/- 68 to 340 +/- 63 and 314 +/- 69 ml/min), giving a nonsignificant rise in filtration fraction (18 +/- 1 to 21 +/- 1 and 20 +/- 1%, respectively). It is concluded that felodipine decreases BP dramatically in patients with previously refractory hypertension and that the drug causes an improved renal function in these patients.
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PMID:Long-term effects of felodipine on blood pressure and renal hemodynamics in severe hypertension. 169 10

In this study, the measurement of blood pressure values, glomerular filtration rate (GFR, inulin clearance), renal plasma flow (RPF, PAH clearance), the filtration fraction (GFR/RPF), natiuresis and proximal sodium resorption (measured by lithium clearance), was performed at rest and during a computerised psychological stress test (Stroop word color conflict test) in 12 normotensive and 10 hypertensive subjects. The stress induced in the normotensives induced a significant increase of the filtration fraction and proximal tubule sodium resorption. The hypertensive kidney, submitted to a basal vasoconstriction greater than that of the normotensive kidney, does not react to stress. In the hypertensives, proximal sodium resorption occurs but is not significantly greater than at rest. In the long-term, the increased sodium resorption during stress could contribute to the development and the persistence of essential hypertension.
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PMID:[Renal function during stress in hypertensive patients]. 195 68

The antihypertensive effects of the hydralazine-related compound cadralazine (2-(3-[6-(2-hydroxypropyl)ethylamino]pyridazinyl)ethyl carbazate, ISF 2469), were investigated in 16 patients with primary hypertension concurrently treated with beta-blockers and diuretics. The protocol included a double-blind placebo controlled haemodynamic evaluation after the first tablet and two 4-week double-blind placebo controlled cross-over periods followed by an open evaluation during 2 months. Cadralazine induced a moderate, prolonged fall in blood pressure that was associated with vasodilatation and slight increases in cardiac output (dye-dilution) and heart rate. Renal plasma flow (PAH) and glomerular filtration rate (51Cr-EDTA) were not significantly influenced, but the filtration fraction was reduced. Plasma concentrations of noradrenaline and adrenaline rose, whereas plasma renin activity was unchanged. The haemodynamic parameters were not correlated with the plasma concentrations of cadralazine. During chronic cadralazine treatment the supine blood pressure was significantly lower than during the double-blind placebo phase (160/93 vs 174/102 mmHg). The compound was generally well tolerated but the body weight increased slightly (1.1 kg), probably because of fluid retention. Several patients who had previously experienced side effects with hydralazine, including one with hydralazine-syndrome, tolerated cadralazine well. This suggests that cadralazine does not cross-react with hydralazine.
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PMID:Acute systemic and renal haemodynamic effects and long-term antihypertensive action of cadralazine in patients pretreated with beta-blockers and diuretics. 288 88

Split renal function tests were studied in 41 patients with unilateral stenosis of the main renal artery in comparison with 36 subjects with essential hypertension. The two populations were matched for sex, age (39 +/- 10 vs 37 +/- 11 years (+/- 1 standard deviation) and systemic arterial pressure (193/114 +/- 29/15 vs 205/110 +/- 30/17 mmHg). The PAH clearance (CPAH) was decreased in essential hypertensives. The decrease was similar in the right (160.3 +/- 56.9 ml/min/m2) and left kidneys (158.7 +/- 45 ml/min/m2). The inulin clearance (Cin) was similar in both kidneys (35.2 +/- 12.5 vs 33.6 +/- 11.6 ml/min/m2). In addition, in essential hypertensive, CPAH was negatively correlated with blood pressure (p less than 0.01). In patients with renal artery stenosis, CPAH of the "stenotic" kidney was reduced (91.5 +/- 47.8 ml/min/m2) as well as Cin (22.9 +/- 9.3 ml/min/m2). In contrast, a significant increase in CPAH (194.1 +/- 63.8 ml/min/m2) and Cin (47.6 +/- 12.6 ml/min/m2) was observed in the contralateral kidney. Kidney function (CPAH and Cin) was not correlated with blood pressure in the "stenotic" kidney. CPAH and Cin of the non stenotic kidney were positively and significantly correlated with systemic arterial pressure (p less than 0.01). Cin was positively correlated with CPAH (p less than 0.001) in all kidneys in renovascular or in sustained essential hypertensives. However, in the contralateral kidney of renovascular hypertensives, a significant upward resetting of the correlation was observed. The Cin/CPAH was increased in the stenotic kidney (25.7 +/- 7.6%), as well as in the contralateral kidney (25.6 +/- 6.2%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Comparison of renal hemodynamics in 2 types of arterial hypertension, essential and renovascular, in man. Physiopathological implications]. 339 58

Prostaglandins are naturally occurring compounds which are easily separable from other biologically active substances because of its acidic lipid nature. They are divided into 4 series, the A, B, E, and Falpha series, which differ in the structure of the characteristic 5-membered ring. Prostaglandins play a role in the following reproductive functions: 1) conception; 2) luteolysis; 3) menstruation; and 4) parturition. It has also been proposed that Prostaglandin A may be the natriuretic hormone, the circulating hormone which controls sodium reabsorption by the kidney. The experiments of Lee and Ferguson in which prostaglandins inhibited PAH uptake by rabbit renal cortex slices in vitro support this view. Prostaglandins are also implicated 1) in the fluid transfer in the gut; 2) as causative agents of diarrhea that accompanies medullary carcinoma of the thyroid or neural crest tumors; 3) in reducing blood pressure in humans with essential hypertension; 4) in fatty acid metabolism, including lipolysis; and 5) as mediators of the inflammatory response. Further research in prostaglandins will establish the validity of the proposed physiologic or pathologic functions of prostaglandins.
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PMID:Functions of prostaglandins. 458 48

In 8 ambulatory patients with stable essential hypertension (WHO grade I and II) the effects of a new beta-blocker with marked sympathomimetic activity on arterial blood pressure, creatinin clearance and renal plasma flow, as measured by total PAH clearance (constant infusion technique), were studied. In contrast to previous findings no significant reduction in creatinin clearance or renal blood flow was observed during a 3-5 weeks' observation period. The small reduction in calculated renal vascular resistance was not statistically significant. In addition to its postulated peripheral vasodilatory effect, bufuralol appears to interfere less than propranolol with renal hemodynamics and renal excretory function.
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PMID:[Bufuralol: do beta blockers reduce blood circulation in the kidneys?]. 613 56

Following 7 days on a low sodium diet, a regular sodium diet or a high sodium diet each, urine samples were collected from 37 subjects in the final days of each sodium treatment. Urinary kallikrein excretion was determined in 9 patients with primary aldosteronism, 15 normal subjects and 13 patients with essential hypertension. Urinary aldosterone excretion, plasma renin activity (PRA), urinary sodium excretion, urinary potassium excretion and p-aminohippuric acid clearance were also determined on the same days. Levels of urinary kallikrein excretion in patients with primary aldosteronism due to aldosterone-producing adenoma (APA) were greater (p less than 0.05 to p less than 0.001) than those in patients with primary aldosteronism due to idiopathic adrenal hyperplasia (IHA) under any sodium diet. Other examined variables were of limited value in differentiating patients with APA from those with IHA. Urinary kallikrein excretion, urinary excretion of electrolyte, urinary aldosterone excretion, PRA and PAH clearance were similar in normal subjects and patients with essential hypertension. It appears reasonable to conclude from these data that urinary kallikrein does not play an important role in the pathogenesis of essential hypertension, and elevated urinary kallikrein excretion in patients with primary aldosteronism due to APA can be used for biochemical differentiation from those with IHA.
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PMID:Urinary kallikrein excretion in patients with primary aldosteronism: differentiation of adrenal adenoma from idiopathic adrenal hyperplasia. 637 65

The rate of recovery of the renin-angiotensin-aldosterone axis after stopping diuretic administration was examined in 18 male patients with essential hypertension. Upright plasma renin activity (PRA) and plasma aldosterone (PA) were measured during sodium restriction (10 mEq sodium intake), after three days of furosemide administration (40 mg BID po) and for five days following cessation of the diuretic. After diuretic administration, the mean PRA level (8.2 +/- 1.7 ng/ml/hr) was significantly elevated compared to the level on low sodium diet (4.2 +/- 0.5 ng/ml/hr). However, the major finding was that PRA levels continued to increase significantly compared to levels during diuresis on days 1 (11.3 +/- 1.7 ng/ml/hr) and 2 (10.8 +/- 1.5 ng/ml/hr) of the postdiuretic period. Mean PA values paralleled PRA responses in the study. Infusion of normal saline on postdiuretic day 1 failed to suppress PRA to levels seen in subjects not receiving diuretics. The postdiuretic period was accompanied by increased urinary sodium reabsorption and decreased urinary potassium excretion and by significant decreases in creatinine, PAH and free water clearance. The mechanism of this sustained renin response several days after cessation of diuretic therapy may be best explained by a prolonged action of furosemide or by partial ongoing volume depletion with reduced sodium load to the distal nephron. Since all patients demonstrated a marked and consistent PRA response after diuretic withdrawal, this time period represents a potent stimulatory challenge for monitering renin responses.
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PMID:Enhanced renin levels after discontinuation of furosemide: additional effects of loop diuretics on renin release. 674 46


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