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  1. Ranolazine reduces remodeling of the right ventricle and provoked arrhythmias in rats with pulmonary hypertension.

    Liles, John T; Hoyer, Kirsten; Oliver, Jason; Chi, Liguo; Dhalla, Arvinder K; Belardinelli, Luiz

    2015-06-01

    Pulmonary arterial hypertension (PAH) is a progressive disease that often results in right ventricular (RV) failure and death. During disease progression, structural and electrical remodeling of the right ventricle impairs pump function, creates proarrhythmic substrates, and triggers for arrhythmias. Notably, RV failure and lethal arrhythmias are major contributors to cardiac death in patients with PAH that are not directly addressed by currently available therapies. Ranolazine (RAN) is an antianginal, anti-ischemic drug that has cardioprotective effects in experimental and clinical settings of left-sided heart dysfunction. RAN also has antiarrhythmic effects due to inhibition of the late sodium current in cardiomyocytes. We therefore hypothesized that RAN could reduce the maladaptive structural and electrical remodeling of the right ventricle and could prevent triggered ventricular arrhythmias in the monocrotaline rat model of PAH. Indeed, in both in vivo and ex vivo experimental settings, chronic RAN treatment reduced electrical heterogeneity (right ventricular-left ventricular action potential duration dispersion), shortened heart-rate corrected QT intervals in the right ventricle, and normalized RV dysfunction. Chronic RAN treatment also dose-dependently reduced ventricular hypertrophy, reduced circulating levels of B-type natriuretic peptide, and decreased the expression of fibrotic markers. In addition, the acute administration of RAN prevented isoproterenol-induced ventricular tachycardia/ventricular fibrillation and subsequent cardiovascular death in rats with established PAH. These results support the notion that RAN can improve the electrical and functional properties of the right ventricle, highlighting its potential benefits in the setting of RV impairment. PMID:25770134

  2. Acute hypotension induced by aortic clamp vs. PTH provokes distinct proximal tubule Na+ transporter redistribution patterns

    Leong, Patrick K K; Yang, Li E; Lin, Harrison W;

    2004-01-01

    renal cortical membranes fractionated on sorbitol density gradients. Aortic clamp-induced acute hypotension (from 100 +/- 3 to 78 +/- 2 mmHg) provoked a 62% decrease in urine output and a significant decrease in volume flow from the proximal tubule detected as a 66% decrease in endogenous lithium...... clearance. There was, however, no significant change in glomerular filtration rate (GFR) or subcellular distribution of NHE3 and NaPi2. In contrast, high-dose PTH rapidly (<2 min) decreased arterial blood pressure to 51 +/- 3 mmHg, decreased urine output, and shifted NHE3 and NaPi2 out of the low...

  3. Acute hypertensive crisis in pregnancy.

    Silver, H M

    1989-05-01

    Severe pre-eclampsia is a state of acute afterload increase where compensation may be total by use of the Frank-Starling mechanism and/or increased adrenergic drive, or may be uncompensated in a patient with limited or exhausted preload reserve. As such, we are presented with a diverse group of patients and antihypertensive therapy ideally should be individualized. In reality we are dealing with a complex situation because of the presence of the fetus raising concerns about direct effects on the fetus as well as on uteroplacental blood flow. This limits our choice of agents to those with extensive use in pregnancy except in complicated or resistant cases. For these reasons, hydralazine is the antihypertensive agent of choice for treatment of acute hypertensive emergencies in pregnancy. In the complicated case other agents such as sodium nitroprusside or nitroglycerin may be more appropriate and, in these cases, hemodynamic monitoring should be performed to allow not only greater safety, but also to tailor therapy to the individual hemodynamic profile. PMID:2649760

  4. Acute surgical management in idiopathic intracranial hypertension.

    Zakaria, Zaitun

    2012-01-01

    Idiopathic intracranial hypertension is a headache syndrome with progressive symptoms of raised intracranial pressure. Most commonly, it is a slow process where surveillance and medical management are the main treatment modalities. We describe herein an acute presentation with bilateral sixth nerve palsies, papilloedema and visual deterioration, where acute surgical intervention was a vision-saving operation.

  5. Vasopressor mechanisms in acute aortic coarctation hypertension

    Salgado H.C.

    1997-01-01

    Full Text Available Angiotensin II (ANG II and vasopressin (AVP act together with the mechanical effect of aortic constriction in the onset of acute aortic coarctation hypertension. Blockade of ANG II and AVP V1 receptors demonstrated that ANG II acts on the prompt (5 min rise in pressure whereas AVP is responsible for the maintenance (30-45 min of the arterial pressure elevation during aortic coarctation. Hormone assays carried out on blood collected from conscious rats submitted to aortic constriction supported a role for ANG II in the early stage and a combined role for both ANG II and AVP in the maintenance of proximal hypertension. As expected, a role for catecholamines was ruled out in this model of hypertension, presumably due to the inhibitory effect of the sinoaortic baroreceptors. The lack of afferent feedback from the kidneys for AVP release from the central nervous system in rats with previous renal denervation allowed ANG II to play the major role in the onset of the hypertensive response. Median eminence-lesioned rats exhibited a prompt increase in proximal pressure followed by a progressive decline to lower hypertensive levels, revealing a significant role for the integrity of the neuroaxis in the maintenance of the aortic coarctation hypertension through the release of AVP. In conclusion, the important issue raised by this model of hypertension is the likelihood of a link between some vascular territory - probably renal - below the coarctation triggering the release of AVP, with this vasoconstrictor hormone participating with Ang II and the mechanical effect of aortic constriction in the acute aortic coarctation hypertension

  6. Portal hypertension in acute liver failure.

    3.M. Navasa; Garcia-Pagán, J C; Bosch, J; Riera, J R; R. Bañares; Mas, A.; Bruguera, M; Rodés, J

    1992-01-01

    Twenty five patients with acute liver failure were measured for hepatic venous pressure gradient as an index of portal pressure during the course of a transjugular liver biopsy. Hepatic venous pressure gradient ranged from 4 to 24.5 mm Hg with a mean of 12.8 (5.3) mm Hg (normal values less than 5 mm Hg). All patients but one had increased portal pressure gradient. Portal hypertension correlated with the degree of architectural distortion of the liver, as suggested by a direct correlation betw...

  7. Intra-abdominal hypertension and acute pancreatitis.

    Mifkovic, A; Skultety, J; Sykora, P; Prochotsky, A; Okolicany, R

    2013-01-01

    Intra-abdominal hypertension (IAH) contributes to organ dysfunction and leads to the development of the abdominal compartment syndrome (ACS). IAH and ACS are relatively frequent findings in patiens with severe acute pancreatitis (SAP) and are associated with deterioration in organ functions. The most affected are cardiovascular, respiratory and renal functions. The incidence of IAH in patients with SAP is approximately 60-80%. There is an accumulating evidence in human and animal studies that changes of perfusion, particularly to the microvasculature, are crucial events in the progression of acute pancreatitis (AP). The perfusion of the small and large intestine is impaired due to reduced arterial pressure, increased vascular resistence and diminished portal blood flow. Bacterial translocation has been described in patients with ACS, and this may apply to patients with SAP. Approximately 30-40% of SAP patients develop ACS because of pancreatic (retroperitoneal) inflammation, peripancreatic tissue edema, formation of fluid collections or abdominal distension. Surgical debridement was the preferred treatment to control necrotizing pancreatitis in the past. However, the management of necrotizing pancreatitis has changed over the last decade. The main objective of this article is to describe the association between IAH and AP and to emphasize this situation in clinical praxis as well (Fig. 1, Ref. 38). PMID:23406186

  8. Intra-Peritoneal Administration of Mitochondrial DNA Provokes Acute Lung Injury and Systemic Inflammation via Toll-Like Receptor 9.

    Zhang, Lemeng; Deng, Songyun; Zhao, Shuangping; Ai, Yuhang; Zhang, Lina; Pan, Pinhua; Su, Xiaoli; Tan, Hongyi; Wu, Dongdong

    2016-01-01

    The pathogenesis of sepsis is complex. Mitochondrial dysfunction, which is responsible for energy metabolism, intrinsic apoptotic pathway, oxidative stress, and systemic inflammatory responses, is closely related with severe sepsis induced death. Mitochondria DNA (mtDNA) contain un-methylated cytosine phosphate guanine (CpG) motifs, which exhibit immune stimulatory capacities. The aim of this study was to investigate the role and mechanism of mtDNA release on lipopolysaccharide (LPS) induced acute lung injury (ALI) and systemic inflammation. Following LPS injection, plasma mtDNA copies peak at 8 h. Compared with wild-type (WT) mice, mtDNA in toll like receptor 4 knockout (TLR4 KO) mice were significantly decreased. MtDNA intra-peritoneal administration causes apparent ALI as demonstrated by increased lung injury score, bronchoalveolar lavage fluid (BALF) total protein and wet/dry (W/D) ratio; mtDNA injection also directly provokes systemic inflammation, as demonstrated by increased IL-1β, IL-6, high-mobility group protein B1 (HMGB1) level; while nuclear DNA (nDNA) could not induce apparent ALI and systemic inflammation. However, compared with WT mice, TLR4 KO could not protect from mtDNA induced ALI and systemic inflammation. Specific TLR9 inhibitor, ODN 2088 pretreatment can significantly attenuate mtDNA induced ALI and systemic inflammation, as demonstrated by improved lung injury score, decreased lung wet/dry ratio, BALF total protein concentration, and decreased systemic level of IL-1β, IL-6 and HMGB1. MtDNA administration activates the expression of p-P38 mitogen-activated protein kinases (MAPK) in lung tissue and specific TLR9 inhibitor pretreatment can attenuate this activation. Thus, LPS-induced mtDNA release occurs in a TLR4-dependent manner, and mtDNA causes acute lung injury and systemic inflammation in a TLR9-dependent and TLR4-independent manner. PMID:27589725

  9. Pathophysiology of pulmonary hypertension in acute lung injury

    Price, Laura C.; Mcauley, Danny F.; Marino, Philip S; Finney, Simon J; Griffiths, Mark J.; Wort, Stephen John

    2012-01-01

    Acute lung injury (ALI) and acute respiratory distress syndrome are characterized by protein rich alveolar edema, reduced lung compliance, and acute severe hypoxemia. A degree of pulmonary hypertension (PH) is also characteristic, higher levels of which are associated with increased morbidity and mortality. The increase in right ventricular (RV) afterload causes RV dysfunction and failure in some patients, with associated adverse effects on oxygen delivery. Although the introduction of lung p...

  10. The Impact of Hypertension on Patients with Acute Coronary Syndromes

    Claudio Picariello

    2011-01-01

    Full Text Available Arterial chronic hypertension (HTN is a well-known cardiovascular risk factor for development of atherosclerosis. In order to explain the relation between HTN and acute coronary syndromes the following factors should be considered: (1 risk factors are shared by the diseases, such as genetic risk, insulin resistance, sympathetic hyperactivity, and vasoactive substances (i.e., angiotensin II; (2 hypertension is associated with the development of atherosclerosis (which in turn contributes to progression of myocardial infarction. From all the registries and the data available up to now, hypertensive patients with ACS are more likely to be older, female, of nonwhite ethnicity, and having a higher prevalence of comorbidities. Data on the prognostic role of a preexisting hypertensive state in ACS patients are so far contrasting. The aim of the present paper is to focus on hypertensive patients with ACS, in order to better elucidate whether these patients are at higher risk and deserve a tailored approach for management and followup.

  11. Nifedipine in acute hypertensive emergencies in pregnancy.

    Seabe, S J; Moodley, J; Becker, P

    1989-09-16

    The effect of nifedipine (Adalat; Bayer-Miles)--a calcium channel blocker, which has a well-established place in nonobstetric hypertension--was compared with dihydralazine in 33 primigravidas with severe hypertension of pregnancy. Patients with a diastolic blood pressure greater than 110 mmHg before drug administration were randomly assigned to treatment with either nifedipine or dihydralazine. Both drugs were found to be equally efficacious. Nifedipine, however, showed an earlier onset of action in lowering systolic blood pressure and had the advantage of oral administration. PMID:2781421

  12. Pulmonary hypertension due to acute respiratory distress syndrome

    S.A. Ñamendys-Silva

    2014-10-01

    Full Text Available Our aims were to describe the prevalence of pulmonary hypertension in patients with acute respiratory distress syndrome (ARDS, to characterize their hemodynamic cardiopulmonary profiles, and to correlate these parameters with outcome. All consecutive patients over 16 years of age who were in the intensive care unit with a diagnosis of ARDS and an in situ pulmonary artery catheter for hemodynamic monitoring were studied. Pulmonary hypertension was diagnosed when the mean pulmonary artery pressure was >25 mmHg at rest with a pulmonary artery occlusion pressure or left atrial pressure <15 mmHg. During the study period, 30 of 402 critically ill patients (7.46% who were admitted to the ICU fulfilled the criteria for ARDS. Of the 30 patients with ARDS, 14 met the criteria for pulmonary hypertension, a prevalence of 46.6% (95% CI; 28-66%. The most common cause of ARDS was pneumonia (56.3%. The overall mortality was 36.6% and was similar in patients with and without pulmonary hypertension. Differences in patients' hemodynamic profiles were influenced by the presence of pulmonary hypertension. The levels of positive end-expiratory pressure and peak pressure were higher in patients with pulmonary hypertension, and the PaCO2 was higher in those who died. The level of airway pressure seemed to influence the onset of pulmonary hypertension. Survival was determined by the severity of organ failure at admission to the intensive care unit.

  13. Acute exacerbations and pulmonary hypertension in advanced idiopathic pulmonary fibrosis.

    Judge, Eoin P

    2012-07-01

    The aim of this study was to evaluate the risk factors for and outcomes of acute exacerbations in patients with advanced idiopathic pulmonary fibrosis (IPF), and to examine the relationship between disease severity and neovascularisation in explanted IPF lung tissue. 55 IPF patients assessed for lung transplantation were divided into acute (n=27) and non-acute exacerbation (n=28) groups. Haemodynamic data was collected at baseline, at the time of acute exacerbation and at lung transplantation. Histological analysis and CD31 immunostaining to quantify microvessel density (MVD) was performed on the explanted lung tissue of 13 transplanted patients. Acute exacerbations were associated with increased mortality (p=0.0015). Pulmonary hypertension (PH) at baseline and acute exacerbations were associated with poor survival (p<0.01). PH at baseline was associated with a significant risk of acute exacerbations (HR 2.217, p=0.041). Neovascularisation (MVD) was significantly increased in areas of cellular fibrosis and significantly decreased in areas of honeycombing. There was a significant inverse correlation between mean pulmonary artery pressure and MVD in areas of honeycombing. Acute exacerbations were associated with significantly increased mortality in patients with advanced IPF. PH was associated with the subsequent development of an acute exacerbation and with poor survival. Neovascularisation was significantly decreased in areas of honeycombing, and was significantly inversely correlated with mean pulmonary arterial pressure in areas of honeycombing.

  14. Amyotrophic Lateral Sclerosis with an Acute Hypertensive Crises

    Lee, Ha Lim; Lee, Ju Kang

    2012-01-01

    Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder involving the systemic motor neurons, but autonomic nervous function is relatively well preserved. A few studies related to autonomic dysfunction have been reported, but autonomic dysfunction is rare in ALS. Moreover, dysautonomia symptoms are not prominent in patients with ALS. We present a 55-year-old male patient with ALS, who had acute severe hypertension and tachycardia crises, as well as sudden falls in his ...

  15. [Intraabdominal hypertension in patients with acute conditions of abdominal cavity].

    Riabkov, M G; Izmaĭlov, S G; Lukoianychev, E E; Sabauri, R V; Orlinskaia, N Iu

    2013-01-01

    Treatment results of 301 patients with intraabdominal hypertension were analyzed. Indications for abdominal decompression were substantiated and defined. Algorythm, the novel surgical technique and instrumentarium for different decompressive surgery by peritonitis, acute intestinal obstruction and pancreonecrosis. The use of the algorithm allowed to decrease the postoperative complication rate. Thus, the laparotomic wound inflammation and necrosis was 24% less, eventration frequency was 4 times less and the acute respiratory failure was 43% less. The lethality rate fall from 20.9% to 11.5%. PMID:23612338

  16. Studies on provoked asthma

    A group of adult patients with perennial bronchial asthma has been studied as to lung perfusion and alveolar ventilation (81m-Kr) at rest and after provocation of an acute attack. Asthma was provoked by exercise and by histamine inhalation. After provocation the peak expiratory flow values were reduced to less than 80% of the base line values. Perfusion was often deranged. Regional ventilation changed rapidly after provocation and not always in the same fashion after exercise and histamine. During attacks lung volume increased. The expansion decreased (in parallel with increased peak expiratory flow) after inhalator of a #betta#-2 agonist (terbutaline). 81m-Kr offers unique opportunities for studying acute regional changes in alveolar ventilation. (Author)

  17. A Study of Histology and Enzymatic Histochemistry on Rabbit's Retina in Acute Ocular Hypertension

    1994-01-01

    The changes of activities of enzymes relating to energy metabolism in rabbit's retina in acute ocular hypertension were observed. The activities of succinate dehydrogenase and adenosine triphosphatase were found to be reduced, while the activities of the lactatic dehydrognease and glucose-6-phosphatase increased. The results revealed the metabolic disturbance of energy in retina after acute ocular hypertension might be the underlying factors relating to the defects of the functions and structures of the...

  18. Relationship of cerebral microbleeds with hematoma growth in elderly patients with acute hypertensive intracerebral hemorrhage

    Shou-feng LIU; Yu-wang LI; Xin WANG; XU Xiao-lin

    2015-01-01

    Objective To investigate whether cerebral microbleeds (CMBs) can predict hematoma growth in elderly patients with acute hypertensive intracerebral hemorrhage.  Methods The clinical records of 98 elderly patients with acute hypertensive intracerebral hemorrhage who underwent initial CT within 6 h and repeated CT and susceptibility-weighted imaging (SWI) within 24 h of onset were analyzed. Based on the performance of SWI, patients were divided into microbleeds group and non-microbleeds gr...

  19. Influence factors of salt-sensitive hypertension and responses of blood pressure and urinary sodium and potassium excretion to acute oral saline loading among essential hypertensive patients

    刘叶舟

    2014-01-01

    Objective To explore the influence factors of saltsensitive hypertension and to observe changes of blood pressures and urinary sodium and potassium excretion in response to acute oral saline loading among essential hypertensive patients in China.Methods Essential hypertensive patients from Beijing Jinzhan second community were included in this study.Salt-sensitivity was determined via the improved Sullivan’s acute oral saline loading

  20. Angiotensin II clamp prevents the second step in renal apical NHE3 internalization during acute hypertension

    Leong, Patrick K K; Yang, Li E; McDonough, Alicia A;

    2002-01-01

    Acute hypertension inhibits proximal tubule (PT) sodium reabsorption. The resultant increase in NaCl delivery to the macula densa suppresses renin release. We tested whether the sustained pressure-induced inhibition of PT sodium reabsorption requires a renin-mediated decrease in ANG II levels...... hypertension, including diuresis and redistribution of PT NHE3 into intracellular membranes, require a responsive renin-angiotensin system and that the responses may be induced by the sustained increase in NaCl delivery to the macula densa during acute hypertension....

  1. Downstream shift in sodium pump activity along the nephron during acute hypertension

    Magyar, C E; Zhang, Y; Holstein-Rathlou, N H;

    2001-01-01

    medullary Na,K-ATPase activity from 20 +/- 3.5 to 27 +/- 6.4 micromol Pi/mg protein per h while decreasing renal cortex activity from 10.9 +/- 0.9 to 6.5 +/- 0.7. Hypertension and benzolamide also doubled medullary alkaline phosphatase activity. As chronic hypertension develops in the young spontaneously......Acute hypertension rapidly inhibits proximal tubule (PT) Na,K-ATPase activity and sodium reabsorption 30 to 40%, increasing sodium and volume delivery to the thick ascending loop of Henle (TALH) and macula densa, providing the error signal for tubuloglomerular feedback. The hypothesis was tested in...... rats that an acute increase in sodium and volume delivery to the TALH would acutely increase outer medulla Na,K-ATPase activity. Flow to the TALH was increased by either (1) elevating BP (102 to 160 mmHg) for 5 min by constricting arteries (hypertension) or (2) inhibiting PT sodium and volume...

  2. Acute and chronic antihypertensive effects of Cinnamomum zeylanicum stem bark methanol extract in L-NAME-induced hypertensive rats

    Nyadjeu Paulin

    2013-01-01

    Full Text Available Abstract Background Previous study showed that the aqueous extract of the stem bark of Cinnamomum zeylanicum possesses antihypertensive and vasodilatory properties. The present work investigates the acute and chronic antihypertensive effects of the methanol extract of Cinnamomum zeylanicum stem bark (MECZ in L-NAME-induced hypertensive rats. Methods The acute antihypertensive effects of MECZ (5, 10 and 20 mg/kg administered intravenously were evaluated in rats in which acute arterial hypertension has been induced by intravenous administration of L-NAME (20 mg/kg. For chronic antihypertensive effects, animals were treated with L-NAME (40 mg/kg/day plus the vehicle or L-NAME (40 mg/kg/day in combination with captopril (20 mg/kg/day or MECZ (300 mg/kg/day and compared with control group receiving only distilled water. All drugs were administered per os and at the end of the experiment that lasted for four consecutive weeks, blood pressure was measured by invasive method and blood samples were collected for the determination of the lipid profile. The heart and aorta were collected, weighed and used for both histological analysis and determination of NO tissue content. Results Acute intravenous administration of C. zeylanicum extract (5, 10 and 20 mg/kg to L-NAME-induced hypertensive rats provoked a long-lasting decrease in blood pressure. Mean arterial blood pressure decreased by 12.5%, 26.6% and 30.6% at the doses of 5, 10 and 20 mg/kg, respectively. In chronic administration, MECZ and captopril significantly prevented the increase in blood pressure and organs’ weights, as well as tissue histological damages and were able to reverse the depletion in NO tissue’s concentration. The MECZ also significantly lower the plasma level of triglycerides (38.1%, total cholesterol (32.1% and LDL-cholesterol (75.3% while increasing that of HDL-cholesterol (58.4% with a significant low atherogenic index (1.4 versus 5.3 for L-NAME group. Conclusion MECZ

  3. Gastric mucosal resistance to acute injury in experimental portal hypertension

    Calatayud, Sara; Ramírez, M Carmen; Sanz, M Jesús; Moreno, Lucrecia; Hernández, Carlos; Bosch, Jaume; Piqué, Jose M; Esplugues, Juan V.

    2001-01-01

    The gastric mucosa of portal hypertensive rats exhibits important microvascular changes and a nitric oxide (NO)-dependent hyperemia. This study analyses whether portal hypertensive mucosa exhibits changes in its ability to withstand aggression.Portal hypertension was induced by partial portal vein ligation (PPVL) or common bile duct ligation (CBDL) and gastric damage was induced by oral administration of ethanol or aspirin. Experiments were performed in conscious or anaesthetized rats and som...

  4. "Hiperesplenismo" em hipertensão porta por esquistossomose mansônica "Hiperesplenism" in portal hypertension provoked by Manson's schistosomiasis

    Andy Petroianu

    2004-01-01

    Full Text Available INTRODUÇÃO: Durante anos, as alterações hematológicas que ocorrem na esquistossomose mansônica hepatoesplênica vêm sendo definidas como hiperesplenismo. Inicialmente, acreditava-se que apenas a remoção do baço normalizava os valores hematológicos, entretanto, em cirurgias para o tratamento da hipertensão porta nas quais o baço era preservado, observou-se normalização dos valores hematimétricos. Cabe correlacionar o quadro clínico e laboratorial para definir a real existência de hiperesplenismo. MÉTODO: Foram estudados 51 doentes portadores de hipertensão porta por esquistossomose mansônica distribuídos em cinco grupos: Grupo 1- pacientes não operados e em controle clínico, Grupo 2- pacientes submetidos a anastomose esplenorrenal distal, Grupo 3 - pacientes com esplenectomia subtotal e anastomose esplenorrenal proximal, Grupo 4 - pacientes com esplenectomia total e anastomose esplenorrenal proximal e Grupo 5 - pacientes com esplenectomia total e desconexão porta-varizes. Sinais clínicos de hiperesplenismo foram pesquisados em todos os doentes. Os valores hematológicos e as contagens das imunoglobulinas do pré e do pós-operatório foram comparados pelos testes de Friedman e t para amostras emparelhadas. Os grupos foram comparados pelo teste de Kruskal-Wallis, com significância pFor many years, the hematologic changes occurring in hepatosplenic Manson's schistosomiasis have been defined as hypersplenism. Initially, the belief was that removal of the spleen would normalize the hematologic values. However, hematimetric normalization was observed in surgeries for the treatment of portal hypertension in which the spleen was preserved. In view of these findings, it is necessary to verify the clinical and laboratory profile of these patients in order to define the real presence of hypersplenism. This study was conducted on 51 patients with Manson's schistosomatic portal hypertension divided into five groups: Group 1, non

  5. Protection of the blood-brain barrier by hypercapnia during acute hypertension

    The purpose of this study was to examine effects of hypercapnia on susceptibility of the blood-brain barrier to disruption during acute hypertension. Two methods were used to test the hypothesis that cerebral vasodilation during hypercapnia increases disruption of the blood-brain barrier. First, permeability of the blood-brain barrier was measured in anesthetized cats with 125I-labeled serum albumin. Severe hypertension markedly increased permeability of the blood-brain barrier during normocapnia, but not during hypercapnia. The protective effect of hypercapnia was not dependent on sympathetic nerves. Second, in anesthetized rats, permeability of the barrier was quantitated by clearance of fluorescent dextran. Disruption of the blood-brain barrier during hypertension was decreased by hypercapnia. Because disruption of the blood-brain barrier occurred primarily in pial venules, the authors also measured pial venular diameter and pressure. Acute hypertension increased pial venular pressure and diameter in normocapnic rats. Hypercapnia alone increased pial venular pressure and pial venular diameter, and acute hypertension during hypercapnia further increased venular pressure. The magnitude of increase in pial venular pressure during acute hypertension was significantly less in hypercapnic than in normocapnic rats. They conclude that hypercapnia protects the blood-brain barrier. Possible mechanisms of this effect include attenuation of the incremental increase in pial venular pressure by hypercapnia or a direct effect on the blood-brain barrier not related to venous pressure

  6. Hypertension, high-dose corticosteroids, and renal infiltration in children with acute lymphoblastic leukemia

    Andry Juliansen

    2014-11-01

    Full Text Available Background Hypertension is a rarely recognized complication of acute lymphoblastic leukemia (ALL. The incidence of hypertension in ALL patients in Indonesia remains unknown, but the most common risk factors are corticosteroid use during induction-phase chemotherapy and renal leukemic infiltration. Objective To determine the incidence of hypertension in children with ALL, and to assess for associations of high-dose corticosteroids, renal infiltration, and hyperleukocytosis to hypertension. Methods This was a cross-sectional study involving 100 children aged 2-18 years. Subjects were newly diagnosed ALL patients and those underwent induction-phase chemotherapy in the Pediatric Ward or Outpatient Clinic at Cipto Mangunkusumo or Dharmais Hospitals. Results Hypertension occurred in 6 (10% of 60 newly diagnosed ALL patients and 8 (20% of 40 patients who had received high-dose corticosteroids, but the difference was not statistically significant (OR=2.25; 95%CI 0.72 to 7.07; P=0.239. Hypertension was reported in 8 of 29 subjects who received dexamethasone, but in none of the subjects who received prednisone. However, the difference in these subgroups was also not statistically significant. Renal enlargement was found in 1 of 14 hypertensive patients, but it was not associated with hypertension (OR=0.80; 95%CI 0.52 to 1.24; P=0.417. Hyperleukocytosis was also not associated with hypertension (OR= 0.79; 95% CI 0.20 to 3.11; P=1.000. Conclusion The incidence of hypertension in ALL patients was 14%. Hypertension is not associated with renal infiltration or hyperleukocytosis. Furthermore, hypertension is not associated with corticosteroid dose, though is found only in subjects who receive dexamethasone. [Paediatr Indones. 2014;54:372-6.].

  7. Provoking Intellectual Need

    Lim, Kien H.

    2009-01-01

    This article illustrates how activities or tasks can be designed that are based on the Necessity Principle. Two sections illustrate how tasks can be formulated to provoke the need to use two mathematical ideas--prime factorization and least common multiple. In each section, the author presents two examples to illustrate how some mathematical tasks…

  8. Sildenafil versus nitric oxide for acute vasodilator testing in pulmonary arterial hypertension

    Milger, Katrin; Felix, Janine F.; Voswinckel, Robert; Sommer, Natascha; Franco, Oscar H; Grimminger, Friedrich; Reichenberger, Frank; Seeger, Werner; Ghofrani, Hossein A; Gall, Henning

    2015-01-01

    Vasoreactivity testing with inhaled NO is recommended for pulmonary arterial hypertension (PAH) because of its therapeutic and prognostic value. Sildenafil has acute pulmonary vasodilating properties, but its diagnostic and prognostic impact in PAH is unknown. Our objective was to compare acute vasodilating responses to sildenafil and those to NO during right heart catheterization and also their prognostic values in patients with PAH. Ninety-nine patients with idiopathic PAH and 99 with assoc...

  9. Management of provoked seizure

    Misra Usha

    2011-01-01

    Full Text Available A provoked seizure may be due to structural damage (resulting from traumatic brain injury, brain tumor, stroke, tuberculosis, or neurocysticercosis or due to metabolic abnormalities (such as alcohol withdrawal and renal or hepatic failure. This article is a part of the Guidelines for Epilepsy in India. This article reviews the problem of provoked seizure and its management and also provides recommendations based on currently available information. Seizure provoked by metabolic disturbances requires correction of the triggering factors. Benzodiazepines are recommended for treatment of seizure due to alcohol withdrawal; gabapentin for seizure seen in porphyria; and antiepileptic drugs (AED, that are not inducer of hepatic enzymes, in the seizures seen in hepatic dysfunction. In severe traumatic brain injury, with or without seizure, phenytoin (PHT may be given for 7 days. In ischemic or hemorrhagic stroke one may individualize the AED therapy. In cerebral venous sinus thrombosis (CVST, AED may be prescribed if there is seizure or computed tomographic (CT abnormalities or focal weakness; the treatment, in these cases, has to be continued for 1 year. Prophylactic AED is not recommended in cases of brain tumor and neurosurgical procedures and if patient is on an AED it can be stopped after 1 week.

  10. Reversible effects of acute hypertension on proximal tubule sodium transporters

    Zhang, Y; Magyar, C E; Norian, J M;

    1998-01-01

    blood pressure (BP) of 50 mmHg for 5 min, 2) restoration of normotension after the first protocol, or 3) sham operation. Systolic hypertension increased urine output and endogenous lithium clearance three- to fivefold within 5 min, but these returned to basal levels only 15 min after BP was restored...... BP may be mediated by rapid reversible regulation of sodium pump activity and relocation of apical sodium transporters....

  11. Hypertension

    ... or adrenal-gland disorders. Conditions that can cause secondary hypertension may include: Cushing syndrome Primary aldosteronism Pheochromocytoma Hyperthyroidism Hyperparathyroidism Hypothyroidism Narrowing of the arteries that carry ...

  12. Long-term prognosis after acute myocardial infarction in patients with a history of arterial hypertension. TRACE study group

    Gustafsson, F; Køber, L; Torp-Pedersen, C;

    1998-01-01

    AIMS: The objective of the study was to investigate the influence of a history of arterial hypertension on long-term prognosis after an acute myocardial infarction in a representative population, and secondly to assess the impact on prognosis of left ventricular systolic function in hypertensives...... patients had a history of arterial hypertension. During the time of observation 763 (50.6%) hypertensives and 2253 (43.7%) normotensives died, corresponding to a risk ratio for death in hypertensives of 1.23 (1.13-1.33, P < 0.0001). In a multivariate analysis considering 12 other major risk factors after....... CONCLUSION: A history of arterial hypertension is a moderate risk factor for mortality after an acute myocardial infarction in patients aged 65 years or less. This excess risk is present at all levels of left ventricular systolic function....

  13. Serum uric acid level in hypertensive patients with acute myocardial infarction

    To estimate serum uric acid level in hypertensive patients with acute myocardial infarction and hypertensive patients without myocardial infarction. Study Design Cross-sectional study. Setting Department of Medicine, Mayo Hospital, Lahore. Duration of study with dates Study was carried over a period of six months from 01-01-2007 to 30-06-2007. Subjects and methods Eighty hypertensive patients were included in the study out of which 40 patients with acute myocardial infarction were put in MI group and 40 patients without any history of myocardial infarction were labeled as non-MI group. Results Mean age of the patients in MI group and non-MI was found to be 50.0+-12.4 and 51.8+-10.1 years, respectively. Results of Serum uric acid level in MI group were 6.9+-1.0 mg/dl (0.407 +- 0.059 mmol/L ) and in non-MI group were 5.8+-1.5 mg/dl (0.342 +- 0.088 mmol/L) (p<0.001). (where 1 mmol/L = 16.78 mg/dl or 1 mg/dl = 0.059 mmol/L). Conclusion The present study proved that raised serum uric acid level can cause hypertension and further rise can lead to MI. (author)

  14. The influence of hypertension on in-hospital outcome in patients with acute myocardial infarction

    Davor Miličić; Bojan Jelaković; Zrinka Ivanuša; Mario Ivanuša

    2009-01-01

    Aim To examine the differences in the frequency of risk factors,clinical presentations on admission and in-hospital outcome in hypertensiveand normotensive patients treated for acute myocardialinfarction (AMI).Methods In hypertensive and normotensive patients with AMI weretrospectively analyzed risk factors (age, gender, smoking habits,diabetes, blood lipids, history of angina pectoris, previous myocardialinfarction, previous stroke and family history of atherothromboticdisease), admission Ki...

  15. Hormonal and metabolic changes during acute myocardial infarction in normotensive vs hypertensive rats.

    Wexler, B. C.; McMurtry, J. P.

    1983-01-01

    Male and female, normotensive, Sprague-Dawley (S-D) rats, and spontaneously hypertensive rats (SHR) were subjected to acute and massive myocardial infarction with isoproterenol. Some of the animals were pre-treated (7 days) with the prolactin-lowering drug, bromocryptine. SHR survived in greater numbers than S-D but developed massive congestive heart failure of late onset. The adrenal glands and hearts became greatly hypertrophied in parallel with severely involuted thymus glands. ECG tracing...

  16. Hypertension

    Farrugia, Emanuel

    2004-01-01

    Hypertension is a rapidly moving clinical field with frequent developments in new pharmacologic agents and management strategies. Perhaps more importantly, there have been substantial improvements in our understanding of how best to use the drugs available to us. In this article, I will review some of the more important advances in our understanding of hypertension over the past two years, specifically by reviewing six important trials, one survey and two sets of guidelines, all published bet...

  17. Importance of a history of hypertension for the prognosis after acute myocardial infarction--for the Bucindolol Evaluation in Acute myocardial infarction Trial (BEAT) study group

    Ali, Irma; Akman, Dilek; Bruun, Niels Eske;

    2004-01-01

    BACKGROUND: Arterial hypertension is a major risk factor for cardiovascular events. The prognosis for hypertensive patients after acute myocardial infarction (MI) is uncertain because of the sparse and somewhat contradictionary data. HYPOTHESIS: Our study aimed to investigate the importance of...... hypertension to prognosis after an MI in patients receiving contemporary medical therapy. METHODS: We performed a retrospective study using a large register from the Bucindolol Evaluation in Acute myocardial infarction Trial (BEAT). The register comprised 3,326 patients admitted between June 1998 and August.......9-1.2, p = 0.6). Adjustment for further covariates did not change the result. CONCLUSION: Our study showed that after an acute MI the survival rate of patients with and without a history of hypertension was identical when they received contemporary medical therapy....

  18. Pulmonary Artery Denervation Reduces Pulmonary Artery Pressure and Induces Histological Changes in an Acute Porcine Model of Pulmonary Hypertension

    Rothman, A.M.K.; Arnold, N D; Chang, W.; Watson, O.; Swift, A J; Condliffe, R; Elliot, C A; Kiely, D. G.; Suvarna, S K; Gunn, J.; Lawrie, A.

    2015-01-01

    Background— Pulmonary arterial hypertension is a devastating disease with high morbidity and mortality and limited treatment options. Recent studies have shown that pulmonary artery denervation improves pulmonary hemodynamics in an experimental model and in an early clinical trial. We aimed to evaluate the nerve distribution around the pulmonary artery, to determine the effect of radiofrequency pulmonary artery denervation on acute pulmonary hypertension induced by vasoconstriction, and to de...

  19. Risk Stratification and Effects of the First 24-Hour Pharmacotherapy in Predominantly Hypertensive Patients with Acute Myocardial Infarction

    Peleška, Jan; Grünfeldová, H.; Monhart, Z.; Faltus, Václav; Tomečková, Marie; Ryšavá, D.; Velimský, T.; Ballek, L.; Hubač, J.; Charalampidi, K.

    2009-01-01

    Roč. 27, Suppl. 4 (2009), S421-S422. ISSN 0263-6352. [European Meeting on Hypertension /19./. 12.06.2009-16.06.2009, Milan] R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : pilot registry of acute myocardial infarction * hypertension and other cardiovascular risk factors * first 24-hour pharmacotherapy of myocardial infarction Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  20. Acute hemodynamic effects of nebulized iloprost via the I-neb Adaptive Aerosol Delivery system in pulmonary hypertension

    Richter, Manuel J.; Ghofrani, Hossein A.; Voswinckel, Robert; Seeger, Werner; Schulz, Richard; Reichenberger, Frank; Gall, Henning

    2015-01-01

    Inhaled iloprost has proven to be an effective therapy in patients with pulmonary hypertension (PH). However, the acute hemodynamic effect of nebulized iloprost delivered via the I-neb Adaptive Aerosol Delivery (AAD) system remains unclear and needs to be assessed. In this study, 126 patients with PH were classified according to current guidelines (59, 34, 29, and 4 patients in groups 1/1′, 3, 4, and 5, respectively; 20 patients had idiopathic pulmonary arterial hypertension [iPAH]), were ran...

  1. Correlations between the Memory-Related Behavior and the Level of Oxidative Stress Biomarkers in the Mice Brain, Provoked by an Acute Administration of CB Receptor Ligands

    Kruk-Slomka, Marta; Boguszewska-Czubara, Anna; Slomka, Tomasz; Budzynska, Barbara; Biala, Grazyna

    2016-01-01

    The endocannabinoid system, through cannabinoid (CB) receptors, is involved in memory-related responses, as well as in processes that may affect cognition, like oxidative stress processes. The purpose of the experiments was to investigate the impact of CB1 and CB2 receptor ligands on the long-term memory stages in male Swiss mice, using the passive avoidance (PA) test, as well as the influence of these compounds on the level of oxidative stress biomarkers in the mice brain. A single injection of a selective CB1 receptor antagonist, AM 251, improved long-term memory acquisition and consolidation in the PA test in mice, while a mixed CB1/CB2 receptor agonist WIN 55,212-2 impaired both stages of cognition. Additionally, JWH 133, a selective CB2 receptor agonist, and AM 630, a competitive CB2 receptor antagonist, significantly improved memory. Additionally, an acute administration of the highest used doses of JWH 133, WIN 55,212-2, and AM 630, but not AM 251, increased total antioxidant capacity (TAC) in the brain. In turn, the processes of lipids peroxidation, expressed as the concentration of malondialdehyde (MDA), were more advanced in case of AM 251. Thus, some changes in the PA performance may be connected with the level of oxidative stress in the brain. PMID:26839719

  2. Correlations between the Memory-Related Behavior and the Level of Oxidative Stress Biomarkers in the Mice Brain, Provoked by an Acute Administration of CB Receptor Ligands

    Marta Kruk-Slomka

    2016-01-01

    Full Text Available The endocannabinoid system, through cannabinoid (CB receptors, is involved in memory-related responses, as well as in processes that may affect cognition, like oxidative stress processes. The purpose of the experiments was to investigate the impact of CB1 and CB2 receptor ligands on the long-term memory stages in male Swiss mice, using the passive avoidance (PA test, as well as the influence of these compounds on the level of oxidative stress biomarkers in the mice brain. A single injection of a selective CB1 receptor antagonist, AM 251, improved long-term memory acquisition and consolidation in the PA test in mice, while a mixed CB1/CB2 receptor agonist WIN 55,212-2 impaired both stages of cognition. Additionally, JWH 133, a selective CB2 receptor agonist, and AM 630, a competitive CB2 receptor antagonist, significantly improved memory. Additionally, an acute administration of the highest used doses of JWH 133, WIN 55,212-2, and AM 630, but not AM 251, increased total antioxidant capacity (TAC in the brain. In turn, the processes of lipids peroxidation, expressed as the concentration of malondialdehyde (MDA, were more advanced in case of AM 251. Thus, some changes in the PA performance may be connected with the level of oxidative stress in the brain.

  3. The cytochrome P-450 inhibitor cobalt chloride prevents inhibition of renal Na,K-ATPase and redistribution of apical NHE-3 during acute hypertension

    Zhang, Y B; Magyar, C E; Holstein-Rathlou, N H; McDonough, A A

    1998-01-01

    cobalt chloride (CoCl2). Four groups of rats (n = 4 to 5) were studied: (1) sham-operated; (2) 50 mg of CoCl2/kg subcutaneously for 2 d; (3) acute hypertension by constricting arteries for 5 min; and (4) acute hypertension after CoCl2 treatment as in group 3. Renal cortex was analyzed after sorbitol...

  4. Acute responses of blood pressure, heart rate and rating of perceived exertion in hypertensive patients

    César Giovanni García Cardona

    2007-06-01

    Full Text Available Objective: To assess and compare acute responsesin arterial blood pressure (BP, heartrate (HR and rating of perceived exertion scale(PES during a variable-resistance weight-liftingcircuit (WC versus submaximal aerobicexercise in cycloergometer (AE in individualswith hypertension scaled I and II.Methods: 21 subjects with controlled hypertensionscaled I and II (8 males and 13 females,15 actives and 6 sedentary, age 56±5.9 yearswere evaluated. All the participants receivedtraining about warm-up, use of PES, and respiratoryand weight lifting machines techniquesin exercise. All underwent a single session ofWC in six stations at 50% 1RM and a singlesession of AE at 70%-80% FCmax, in intervalsof one week. BP, HR and PES was measured inboth exercises.Results: To compare responses in both typesof exercise, at Test was used. It found a lowerresponse of HR (p<0.001, systolic BP (p<0.005and PES (p<0.005 during WC. Greater diastolicBP response was found in WC, although it wasnot significative (p=0.139. Sedentary subjectsshowed greater increases. Responses of variableswere similar between stations in WC.Conclusion: This study evidenced a similarbehavior of acute cardiovascular responses and PESduring WC versus AE in hypertensive subjects. Itshowed a lower pressure response during WC insubjects with previous aerobic training.

  5. Hypertensive disorders of pregnancy and the recent increase in obstetric acute renal failure in Canada: population based retrospective cohort study

    Mehrabadi, Azar; Liu, Shiliang; Bartholomew, Sharon; Hutcheon, Jennifer A; Magee, Laura A.; Kramer, Michael S; Liston, Robert M; Joseph, K. S.

    2014-01-01

    Objective To examine whether changes in postpartum haemorrhage, hypertensive disorders of pregnancy, or other risk factors explain the increase in obstetric acute renal failure in Canada. Design Retrospective cohort study. Setting Canada (excluding the province of Quebec). Participants All hospital deliveries from 2003 to 2010 (n=2 193 425). Main outcome measures Obstetric acute renal failure identified by ICD-10 diagnostic codes. Methods Information on all hospital deliveries in Canada (excl...

  6. The effects of acute intermittent hypoxia on cardiovascular parameters in normotensive and chronic hypobaric hypoxia-induced hypertensive rabbits.

    Yaman, Muhittin O; Guner, Ibrahim; Uzun, Hafize; Sahin, Gulderen; Yelmen, Nermin

    2014-01-01

    The effects of both chronic hypoxia and acute intermittent hypoxia (AIH) on cardiovascular system are unclear. We designed this study to develop a rabbit model of hypertension by exposure to chronic hypobaric hypoxia (CHH) and to investigate the effects of AIH on hypertensive rabbits. Present study was performed in 13 albino rabbits that divided into CHH and control groups. To develop hypertension, the rabbits were placed in a hypobaric chamber (390 mmHg; 22 hours/day, 30 days). Afterwards, AIH protocol was applied (8% FIO2 (Fraction of Inspired Oxygen) 1 min + 5 min normoxia, 20 cycles, 2 hours) to rabbits anesthetized with urethane and alpha-chloralose. Mean arterial pressure (MAP), heart rate (HR) and hematocrit values have been determined. Also asymmetric dimethylarginine (ADMA), endothelial nitric oxide synthase (eNOS), endothelin-1 and norepinephrine values have been analyzed in blood. We developed a model of hypertension in rabbits via exposure to severe CHH and we believe that ADMA is an important parameter in the development and permanence of CHH-induced hypertension. The main finding of this sudy was the depressor effect of AIH on blood pressure and heart rate in CHH- induced hypertension model. Finally, we believe that AIH protocol may be applicable for prevention and treatment of hypertension if properly developed. PMID:24448370

  7. Posterior reversible encephalopathy syndrome in an AIDS patient with acute renal failure and hypertension

    Olivia Bargiacchi

    2013-03-01

    Full Text Available Introduction: The posterior reversible encephalopathy syndrome (PRES is a neurological entity characterized by magnetic resonance imaging (MRI evidence of bilateral subcortical edema in the occipital regions of the brain. Case report: We report the case of a female patient with AIDS, pulmonary aspergillosis, CMV infection, and acute renal failure due to Clostridium difficile diarrhea. Her clinical course was complicated by seizures and hypertension. MRI findings were consistent with PRES. The patient was treated with anticonvulsants and antihypertensive agents with clinical improvement. Discussion and conclusions: Few cases of PRES in HIV-infected patients have been described, and it is not clear whether HIV infection is a predisposing factor for this syndrome. The article reviews the literature on PRES in HIV and discusses the role of HIV-associated endothelial damage in the pathogenesis of this syndrome.

  8. INTRA-ABDOMINAL HYPERTENSION AS A RISK FACTOR FOR ACUTE KIDNEY INJURY IN CRITICALLY ILL PATIENTS

    Sreelatha

    2016-05-01

    Full Text Available BACKGROUND AND AIMS Increased intra-abdominal pressure (IAP, also referred to as intra-abdominal hypertension (IAH, affects organ function in critically ill patients. The prevalence of IAH is between 32% - 65% in intensive care units. Normal IAP is ≈ 5–7 mmHg. According to WSACS definition, IAH = IAP ≥12 mmHg and is divided into 4 grades. They are Grade I (12-15 mmHg, Grade II (16-20 mmHg, Grade III (21-25 mmHg, Grade IV (>25 mmHg. Transvesical measurement of IAP currently is the most popular technique. Several systems with or without the need for electronic equipment are available that allow IAP measurement. The aim is to study the incidence of IAH in critically ill patients, to assess the risk factors for development of IAH, to study the role of IAH as a risk factor for Acute Kidney Injury (AKI, to assess the role of IAH as a risk factor for increased (Intensive Care Unit ICU mortality. SUBJECTS AND METHODS This is a prospective observational study. Study period was six months. The study included 52 patients admitted to Medical ICU in Government Medical College, Kozhikode, Kerala. RESULTS AND CONCLUSION There was a very high incidence of intra-abdominal hypertension in critically ill patients. IAH was significantly associated with risk factors like sepsis, mechanical ventilation, pancreatitis, capillary leak, ascites, cumulative fluid balance and cirrhosis. IAH is an independent risk factor for development of acute kidney injury. IAH is an independent predictor of mortality in critically ill patients.

  9. Acute exposure to lead increases myocardial contractility independent of hypertension development

    We studied the effects of the acute administration of small doses of lead over time on hemodynamic parameters in anesthetized rats to determine if myocardial contractility changes are dependent or not on the development of hypertension. Male Wistar rats received 320 µg/kg lead acetate iv once, and their hemodynamic parameters were measured for 2 h. Cardiac contractility was evaluated in vitro using left ventricular papillary muscles as were Na+,K+-ATPase and myosin Ca2+-ATPase activities. Lead increased left- (control: 112 ± 3.7 vs lead: 129 ± 3.2 mmHg) and right-ventricular systolic pressures (control: 28 ± 1.2 vs lead: 34 ± 1.2 mmHg) significantly without modifying heart rate. Papillary muscles were exposed to 8 µM lead acetate and evaluated 60 min later. Isometric contractions increased (control: 0.546 ± 0.07 vs lead: 0.608 ± 0.06 g/mg) and time to peak tension decreased (control: 268 ± 13 vs lead: 227 ± 5.58 ms), but relaxation time was unchanged. Post-pause potentiation was similar between groups (n = 6 per group), suggesting no change in sarcoplasmic reticulum activity, evaluated indirectly by this protocol. After 1-h exposure to lead acetate, the papillary muscles became hyperactive in response to a β-adrenergic agonist (10 µM isoproterenol). In addition, post-rest contractions decreased, suggesting a reduction in sarcolemmal calcium influx. The heart samples treated with 8 µM lead acetate presented increased Na+,K+-ATPase (approximately 140%, P < 0.05 for control vs lead) and myosin ATPase (approximately 30%, P < 0.05 for control vs lead) activity. Our results indicated that acute exposure to low lead concentrations produces direct positive inotropic and lusitropic effects on myocardial contractility and increases the right and left ventricular systolic pressure, thus potentially contributing to the early development of hypertension

  10. The cell-type specific uptake of polymer-coated or micelle-embedded QDs and SPIOs does not provoke an acute pro-inflammatory response in the liver

    Markus Heine

    2014-09-01

    Full Text Available Semiconductor quantum dots (QD and superparamagnetic iron oxide nanocrystals (SPIO have exceptional physical properties that are well suited for biomedical applications in vitro and in vivo. For future applications, the direct injection of nanocrystals for imaging and therapy represents an important entry route into the human body. Therefore, it is crucial to investigate biological responses of the body to nanocrystals to avoid harmful side effects. In recent years, we established a system to embed nanocrystals with a hydrophobic oleic acid shell either by lipid micelles or by the amphiphilic polymer poly(maleic anhydride-alt-1-octadecene (PMAOD. The goal of the current study is to investigate the uptake processes as well as pro-inflammatory responses in the liver after the injection of these encapsulated nanocrystals. By immunofluorescence and electron microscopy studies using wild type mice, we show that 30 min after injection polymer-coated nanocrystals are primarily taken up by liver sinusoidal endothelial cells. In contrast, by using wild type, Ldlr-/- as well as Apoe-/- mice we show that nanocrystals embedded within lipid micelles are internalized by Kupffer cells and, in a process that is dependent on the LDL receptor and apolipoprotein E, by hepatocytes. Gene expression analysis of pro-inflammatory markers such as tumor necrosis factor alpha (TNFα or chemokine (C-X-C motif ligand 10 (Cxcl10 indicated that 48 h after injection internalized nanocrystals did not provoke pro-inflammatory pathways. In conclusion, internalized nanocrystals at least in mouse liver cells, namely endothelial cells, Kupffer cells and hepatocytes are at least not acutely associated with potential adverse side effects, underlining their potential for biomedical applications.

  11. Acute hypertensive encephalopathy with widespread small-vessel disease at MRI in a diabetic patient: pathogenetic hypotheses

    Cotton, F. [Centre Hospitalier Lyon Sud, Department of Radiology, Pierre Benite (France); Universite Claude-Bernard Lyon-I, CREATIS, UMR CNRS (France); Universite Claude-Bernard Lyon-I, Laboratoire d' Anatomie, Laennec (France); Kamoun, S.; Rety-Jacob, F.; Tran-Minh, V.A. [Centre Hospitalier Lyon Sud, Department of Radiology, Pierre Benite (France); Nighoghossian, N. [Hopital Neurologique et Neurochirurgical, Department of Neurology, Bron (France); Universite Claude-Bernard Lyon-I, CREATIS, UMR CNRS (France); Hermier, M. [Hopital Neurologique et Neurochirurgical, Department of Neuroradiology and MRI, Bron (France); Universite Claude-Bernard Lyon-I, CREATIS, UMR CNRS (France)

    2005-08-01

    We report unusual magnetic resonance imaging (MRI) findings in a diabetic patient with neglected hypertension and hyperglycemia, presenting with seizures and coma. Outcome was fatal despite intensive care. The MRI findings included bilateral insular and temporo-occipital grey and white matter involvement, and numerous, scattered, lacunar-like lesions involving the peripheral and deep white matter, basal ganglia grey matter, and brainstem. Lesions had a low apparent diffusion coefficient, and some enhanced following contrast injection. Hypertensive encephalopathy with widespread and severe acute small-vessel disease was considered. Pathophysiology is discussed. (orig.)

  12. Acute hypertensive encephalopathy with widespread small-vessel disease at MRI in a diabetic patient: pathogenetic hypotheses

    We report unusual magnetic resonance imaging (MRI) findings in a diabetic patient with neglected hypertension and hyperglycemia, presenting with seizures and coma. Outcome was fatal despite intensive care. The MRI findings included bilateral insular and temporo-occipital grey and white matter involvement, and numerous, scattered, lacunar-like lesions involving the peripheral and deep white matter, basal ganglia grey matter, and brainstem. Lesions had a low apparent diffusion coefficient, and some enhanced following contrast injection. Hypertensive encephalopathy with widespread and severe acute small-vessel disease was considered. Pathophysiology is discussed. (orig.)

  13. Relationship between intracranial hypertension and cerebral blood flow after craniotomy in cases with traumatic acute subdural hematoma

    The purpose of this study is to investigate relationship between the duration of initial intracranial hypertension and postoperative cerebral blood flow (CBF) changes in cases with traumatic acute subdural hematoma (ASDH). Intracerebral pressure (ICP) was monitored using ICP catheter in 17 cases with unilateral traumatic ASDH. ICP monitoring was started before craniotomy, and was continued for 7 days. CBF was quantitatively measured at 7 days after craniotomy with 123I-infetamine (IMP) single photon emission computed tomography (SPECT). Clinical outcome was evaluated using Glasgow Outcome Scale (GOS) at the time of discharge. Patients were divided into 2 groups by the duration of intracranial hypertension: patients who presented with intracranial hypertension (>25 mmHg) and received surgical decompression within 6 hours after deterioration (group A, n=9), and patients who presented with intracranial hypertension and received surgical decompression more than 6 hours after deterioration (group B, n=6). In group A, 7 of 9 patients demonstrated ipsilateral hemispheric hyperperfusion, and the clinical outcome was relatively favorable: Good Recovery (GR) 4 cases, Moderately Disabled (MD) 4 cases, and Severely Disabled (SD) 1 case. In group B, 5 of 6 patients demonstrated ipsilateral hemispheric hypoperfusion, and the clinical outcome was unfavorable: SD 4 cases, and Dead 2 cases. These results suggest that the duration of intracranial hypertension affects on postoperative CBF changes. Duration of intracranial hypertension may also affect on clinical outcome directly, or secondary by altering postoperative CBF changes in patients with traumatic ASDH. (author)

  14. The acute effects of outdoor temperature on blood pressure in a panel of elderly hypertensive patients

    Chen, Renjie; Lu, Jianxiong; Yu, Qun; Peng, Li; Yang, Dandan; Wang, Cuicui; Kan, Haidong

    2015-12-01

    Higher level of blood pressure (BP) in winter than in summer has been observed, but the association between temperature and BP and its potential modifiers with adjustment of individual confounders and time trends was rarely explored. We aimed to investigate the association between outdoor temperature and BP and its potential modification factors in a longitudinal panel study in Shanghai, China. From January 2011 to December 2012, we scheduled 54 follow-ups for BP measurements per subject via home visit every other week for 50 elderly hypertensive patients. We applied linear mixed-effect models to analyze the association between temperature and BP after controlling for individual characteristics, antihypertensive medication, comorbidities, and time trends. We evaluated the potential effect modifiers by stratification analyses. For a 1 °C decrease in the average temperature on concurrent day and previous day, systolic BP increased by 0.19 mmHg (95 % confidence interval = 0.06, 0.31) and diastolic BP increased by 0.12 mmHg (95 % confidence interval = 0.03, 0.21). The effect of temperature on BP was stronger among those with older age, female sex, low socioeconomic status, and obese physique. The effect was weak and even null for those taking the angiotensin receptor blockers, angiotensin-converting enzyme inhibitor, or its combination with calcium antagonists. Further, the effect was almost restricted within those having chronic comorbidities. Our results demonstrated that an acute decrease in outdoor temperature was significantly associated with a rise in BP among elderly hypertensive patients, in Shanghai, China. Individual characteristics, antihypertensive medications, and comorbidities may modify this effect.

  15. Sarcoidosis-associated pulmonary hypertension: acute vasoresponsiveness to inhaled nitric oxide and the relation to long-term effect of sildenafil

    Milman, Nils; Svendsen, Claus Bo; Iversen, Martin; Videbæk, Regitze; Carlsen, Jørn

    2009-01-01

    Abstract Background: Severe pulmonary sarcoidosis is often complicated by pulmonary hypertension (PH) caused by different pathophysiological mechanisms. Objectives: To assess the acute vasoresponsiveness in patients with sarcoidosis and PH and the relation to the therapeutic effect of sildenafil...

  16. Regional myocardial extraction of a radioiodinated branched chain fatty acid during right ventricular pressure overload due to acute pulmonary hypertension

    To determine whether branched chain fatty acid extraction is reduced during right ventricular (RV) dysfunction due to acute pulmonary artery hypertension, studies were done in 6 anesthetized dogs. Regional branched chain fatty acid extraction was measured by comparing the myocardial uptake of I-125 labeled 15-[p-(iodophenyl)]-3-methylpentadecanoic acid (I-PDA) to myocardial blood flow. Acute pulmonary hypertension was induced by incremental intravenous injection of 100 micron diameter glass beads into six pentobarbital anesthetized, mechanically ventilated dogs. Myocardial blood flow was measured by radiolabeled microspheres both under baseline conditions and during pulmonary hypertension. Mean RV pressure rose from 12 +- 2 (mean +- SEM) to 30 +-3mmHg resulting in a 225 +- 16% increase in RV stroke work. RV ejection fraction, as assessed by gated blood pool scans fell from 39 +- 2 to 18 +- 2%. Left ventricular (LV) pressures, stroke work and ejection fraction were unchanged. Myocardial blood flow increased 132 + 59% in the RV free wall and 67 +- 22% in the RV septum. LV blood flow was unchanged. Despite increased RV work and myocardial blood flow, no differences were noted in the branched chain fatty acid extraction ratios among LV or RV free walls or septum. The authors conclude that early RV dysfunction associated with pulmonary artery hypertension is not due to inadequate myocardial blood flow or branched chain fatty acid extraction

  17. Acute and chronic effects of surgical thromboendarterectomy on exercise capacity and ventilatory efficiency in patients with chronic thromboembolic pulmonary hypertension

    Iwase, T.; Nagaya, N; Ando, M.; Satoh, T.; Sakamaki, F; Kyotani, S; Takaki, H; Goto, Y.; Ohkita, Y; Uematsu, M.; Nakanishi, N; Miyatake, K

    2001-01-01

    OBJECTIVE—To assess acute and chronic effects of surgical thromboendarterectomy on exercise capacity and ventilatory efficiency in patients with chronic thromboembolic pulmonary hypertension (CTEPH).
DESIGN—Cardiopulmonary exercise testing was performed in 20 patients with CTEPH before thromboendarterectomy (baseline), one month after (early phase), and four months after (late phase). Peak oxygen uptake (peak V̇O2) and the ventilatory response to carbon dioxide production (V̇E-V̇CO2 slope) we...

  18. Hypertension of Both the Pulmonary and Systemic Circulations and the Vasodilator Properties of L-Arginine (Acute Drug Testing)

    Kupnovytska, I. H.; Dron, L. A.

    2015-01-01

    The article highlights the problems of the correction of endothelial dysfunction and peripheral hemodynamics of both the pulmonary and systemic circulations in patients with arterial hypertension (AH) stage II and co-existent chronic obstructive pulmonary disease (COPD) by acute intravenous L-arginine infusion. Materials and methods. 20 patients with AH stage II and co-existent COPD in remission phase without respiratory failure with the average age of 48±3.9 years (males to females = 1:1) su...

  19. Use of amelotex to treat patients with acute musculoskeletal pain in the back and grade 1 essential hypertension

    E V Podchufarova; N N Yakhno

    2011-01-01

    Among nonsteroidal anti-inflammatory drugs, meloxicam has a slight effect on blood pressure (BP). Objective: to study the efficacy and safety of amelotex in acute musculoskeletal pain in the lumbosacral region and essential hypertension (EH). Subjects and methods. An open-label comparative trial of the safety and efficacy of amelotex (meloxicam injectable dosage form) in an intramuscular dose of 15 mg/day and diclofenac sodium in an intramuscular dose of 75 mg/day was conducted in 120 patient...

  20. Correlation of serum neutrophil gelatinase-associated lipocalin with acute kidney injury in hypertensive disorders of pregnancy

    Patel ML

    2013-10-01

    Full Text Available ML Patel,1 Rekha Sachan,2 Radheyshyam Gangwar,3 Pushpalata Sachan,4 SM Natu51Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India; 2Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, Uttar Pradesh, India; 3Department of Critical Care, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India; 4Department of Physiology, King George's Medical University, Lucknow, Uttar Pradesh, India; 5Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, IndiaAbstract: Hypertensive disorders of pregnancy (HDP remain one of the largest single causes of maternal and fetal morbidity and mortality, accounting for 16.1% of maternal deaths in developed countries. The aim of the study was to evaluate acute kidney injury (AKI in hypertensive disorders of pregnancy and to examine the correlation of serum neutrophil gelatinase-associated lipocalin (NGAL with acute kidney injury. This prospective case control study was carried out over a period of 1 year. After written, informed consent and ethical clearance, 149 cases of hypertensive disorders of pregnancy were screened, and seven were lost to follow-up. Acute kidney injury was detected in 88 cases and acute renal failure in 30 cases of HDP. Thirty-one healthy pregnant nonhypertensive women were enrolled as controls. Quantitative measurement of serum NGAL levels was done by enzyme linked immunosorbent assay technique using a sandwich enzyme-linked immunosorbent assay kit. As per the Kidney Diseases Improving Global Outcomes International guidelines acute kidney injury network (AKIN, 50 cases (42.37% of AKI stage I, 38 (32.2% cases of AKI stage II, and 30 (25.42% cases of renal failure were detected. Serum NGAL had a positive association with increasing proteinuria. It also had a positive correlation with systolic blood pressure (r~0.36, diastolic blood pressure (r~0.37, and serum creatinine (r~0

  1. The Acute Effect of Resistance Exercise with Blood Flow Restriction with Hemodynamic Variables on Hypertensive Subjects

    Araújo Joamira P.

    2014-12-01

    Full Text Available The purpose of this study was to analyze systolic blood pressure (SBP, diastolic blood pressure (DBP and the heart rate (HR before, during and after training at moderate intensity (MI, 50%-1RM and at low intensity with blood flow restriction (LIBFR. In a randomized controlled trial study, 14 subjects (average age 45±9,9 years performed one of the exercise protocols during two separate visits to the laboratory. SBP, DBP and HR measurements were collected prior to the start of the set and 15, 30, 45 and 60 minutes after knee extension exercises. Repeated measures of analysis of variance (ANOVA were used to identify significant variables (2 x 5; group x time. The results demonstrated a significant reduction in SBP in the LIBFR group. These results provide evidence that strength training performed acutely alters hemodynamic variables. However, training with blood flow restriction is more efficient in reducing blood pressure in hypertensive individuals than training with moderate intensity.

  2. Acute Superoxide Radical Scavenging Reduces Blood Pressure but Does Not Influence Kidney Function in Hypertensive Rats with Postischemic Kidney Injury

    Zoran Miloradović

    2014-01-01

    Full Text Available Acute kidney injury (AKI is associated with significant morbidity and mortality in hypertensive surroundings. We investigated superoxide radical molecules influence on systemic haemodynamic and kidney function in spontaneously hypertensive rats (SHR with induced postischemic AKI. Experiment was performed in anesthetized adult male SHR. The right kidney was removed, and left renal artery was subjected to ischemia by clamping for 40 minutes. The treated group received synthetic superoxide dismutase mimetic TEMPOL in the femoral vein 5 minutes before, during, and 175 minutes after the period of reperfusion, while the control AKI group received the vehicle via the same route. All parameters were measured 24 h after renal reperfusion. TEMPOL treatment significantly decreased mean arterial pressure and total peripheral resistance P<0.05 compared to AKI control. It also increased cardiac output and catalase activity P<0.05. Lipid peroxidation and renal vascular resistance were decreased in TEMPOL P<0.05. Plasma creatinine and kidney morphological parameters were unchanged among TEMPOL treated and control groups. Our study shows that superoxide radicals participate in haemodynamic control, but acute superoxide scavenging is ineffective in glomerular and tubular improvement, probably due to hypertension-induced strong endothelial dysfunction which neutralizes beneficial effects of O2− scavenging.

  3. Acute aerobic exercise reduces 24-h ambulatory blood pressure levels in long-term-treated hypertensive patients

    Emmanuel G. Ciolac

    2008-01-01

    Full Text Available BACKGROUND: Even with anti-hypertensive therapy, it is difficult to maintain optimal systemic blood pressure values in hypertensive patients. Exercise may reduce blood pressure in untreated hypertensive, but its effect when combined with long-term anti-hypertensive therapy remains unclear. Our purpose was to evaluate the acute effects of a single session of aerobic exercise on the blood pressure of long-term-treated hypertensive patients. METHODS: Fifty treated hypertensive patients (18/32 male/female; 46.5±8.2 years; Body mass index: 27.8±4.7 kg/m² were monitored for 24 h with respect to ambulatory (A blood pressure after an aerobic exercise session (post-exercise and a control period (control in random order. Aerobic exercise consisted of 40 minutes on a cycle-ergometer, with the mean exercise intensity at 60% of the patient's reserve heart rate. RESULTS: Post-exercise ambulatory blood pressure was reduced for 24 h systolic (126±8.6 vs. 123.1±8.7 mmHg, p=0.004 and diastolic blood pressure (81.9±8 vs. 79.8±8.5 mmHg, p=0.004, daytime diastolic blood pressure (85.5±8.5 vs. 83.9±8.8 mmHg, p=0.04, and nighttime S (116.8±9.9 vs. 112.5±9.2 mmHg, p<0.001 and diastolic blood pressure (73.5±8.8 vs. 70.1±8.4 mmHg, p<0.001. Post-exercise daytime systolic blood pressure also tended to be reduced (129.8±9.3 vs. 127.8±9.4 mmHg, p=0.06. These post-exercise decreases in ambulatory blood pressure increased the percentage of patients displaying normal 24h systolic blood pressure (58% vs. 76%, p=0.007, daytime systolic blood pressure (68% vs. 82%, p=0.02, and nighttime diastolic blood pressure (56% vs. 72%, p=0.02. Nighttime systolic blood pressure also tended to increase (58% vs. 80%, p=0.058. CONCLUSION: A single bout of aerobic exercise reduced 24h ambulatory blood pressure levels in long-term-treated hypertensive patients and increased the percentage of patients reaching normal ambulatory blood pressure values. These effects suggest that

  4. SUCCESSFUL MEDICATION THERAPY OF ACUTE RIGHT VENTRICLE INSUFFICIENCY IN RECIPIENT WITH SIGNIFICANT PULMONARY HYPERTENSION AFTER HEART TRANSPLANTATION

    A. M. Chernyavskiy

    2014-12-01

    Full Text Available Acute right ventricular failure in the early period after orthotopic heart transplantation is a severe complication and can often lead to a fatal outcome. This is especially important in patients with high pulmonary arteries resistance. Drug therapy has shown effectiveness only for the treatment of primary pulmonary hypertension. Patient K., 23 years old with signifi cant pulmonary hypertension (mean pulmonary artery pressure of 60 mm Hg, PVR – 6 Wood units underwent orthotopic heart transplantation. Acute right ventricular failure occurred at early postoperative period which required multicomponent inotropic support. In order to reduce resistance of the pulmonary circulation the patient received sildenafi l (daily dose 50 mg in combination with inhaled Ventavis (5 mcg a dose every 3 hours and receipt of Tracleer (bosentan (at a dose of 125 mg per day. Complex drug therapy resulted in reduction of right ventricular failure, normalization of biochemical parameters. Invasive pulmonary artery pressure decreased to 30 mm Hg and pulmonary vascular resistance was 1.1 Wood units at the moment of discharge. We also revealed right ventricle end-diastolic volume reduction from 70 ml to 62 ml and ejection fraction of the right ventricle (RV EF increased from 47,7% to 62% in 2 months. Our clinical observation demonstrates the high effi ciency of acute right heart failure complex therapy including inotropic agents in combination with drugs that reduce the pulmonary vascular resistance.

  5. Acute renal failure and arterial hypertension due to sub capsular hematoma: is percutaneous drainage a feasible treatment?

    Kobel, Marie Cæcilie; Nielsen, Tommy Kjærgaard; Graumann, Ole

    Percutaneous drainage proved to be successful in managing a renal subcapsular haematoma that was causing acute renal failure and hypertension in a 74-year-old woman. The patient presented with oliguria, nausea and malaise 2 days after a ureteronephroscopic procedure with biopsies of a suspected...... did not respond to antihypertensive treatment, Page kidney was suspected. A pigtail catheter was placed in the haematoma and, shortly after drainage, the diuresis resumed and plasma creatinine together with blood pressure decreased. This condition had previously been managed by open surgery, but...... recent case reports have described successful management by laparoscopy-assisted and radiology-assisted drainage, as described in this case report....

  6. Gas exchange and pulmonary hypertension following acute pulmonary thromboembolism: has the emperor got some new clothes yet?

    Tsang, John Y C; Hogg, James C

    2014-06-01

    Patients present with a wide range of hypoxemia after acute pulmonary thromboembolism (APTE). Recent studies using fluorescent microspheres demonstrated that the scattering of regional blood flows after APTE, created by the embolic obstruction unique in each patient, significantly worsened regional ventilation/perfusion (V/Q) heterogeneity and explained the variability in gas exchange. Furthermore, earlier investigators suggested the roles of released vasoactive mediators in affecting pulmonary hypertension after APTE, but their quantification remained challenging. The latest study reported that mechanical obstruction by clots accounted for most of the increase in pulmonary vascular resistance, but that endothelin-mediated vasoconstriction also persisted at significant level during the early phase. PMID:25006441

  7. The effect of intra-abdominal hypertension incorporating severe acute pancreatitis in a porcine model.

    Lu Ke

    Full Text Available INTRODUCTION: Abdominal compartment syndrome (ACS and intra abdominal hypertension(IAH are common clinical findings in patients with severe acute pancreatitis(SAP. It is thought that an increased intra abdominal pressure(IAP is associated with poor prognosis in SAP patients. But the detailed effect of IAH/ACS on different organ system is not clear. The aim of this study was to assess the effect of SAP combined with IAH on hemodynamics, systemic oxygenation, and organ damage in a 12 h lasting porcine model. MEASUREMENTS AND METHODS: Following baseline registrations, a total of 30 animals were divided into 5 groups (6 animals in each group: SAP+IAP30 group, SAP+IAP20 group, SAP group, IAP30 group(sham-operated but without SAP and sham-operated group. We used a N(2 pneumoperitoneum to induce different levels of IAH and retrograde intra-ductal infusion of sodium taurocholate to induce SAP. The investigation period was 12 h. Hemodynamic parameters (CO, HR, MAP, CVP, urine output, oxygenation parameters(e.g., S(vO(2, PO(2, PaCO(2, peak inspiratory pressure, as well as serum parameters (e.g., ALT, amylase, lactate, creatinine were recorded. Histological examination of liver, intestine, pancreas, and lung was performed. MAIN RESULTS: Cardiac output significantly decreased in the SAP+IAH animals compared with other groups. Furthermore, AST, creatinine, SUN and lactate showed similar increasing tendency paralleled with profoundly decrease in S(vO(2. The histopathological analyses also revealed higher grade injury of liver, intestine, pancreas and lung in the SAP+IAH groups. However, few differences were found between the two SAP+IAH groups with different levels of IAP. CONCLUSIONS: Our newly developed porcine SAP+IAH model demonstrated that there were remarkable effects on global hemodynamics, oxygenation and organ function in response to sustained IAH of 12 h combined with SAP. Moreover, our model should be helpful to study the mechanisms of IAH

  8. Intra-abdominal hypertension is an independent cause of acute renal failure after orthotopic liver transplantation

    SHU Ming; PENG Chenghong; CHEN Hao; SHEN Boyong; ZHOU Guangwen; SHEN Chuan; LI Hongwei

    2007-01-01

    Abstract An independent association between acute renal failure(ARF)and intra-abdominal hypertension(IAH)after liver transplantation has not been established previously.The aim of this retrospective study was to understand the role of IAH as an independent risk factor for ARF in the early postoperative period.This study involved 62 subjects who underwent liver transplantation.Intra-abdominal pressure (IAP)was measured in the first three days after surgery by using the urinary bladder technique.An IAP of at least 20 mmHg per day was defined as IAH.Clinical parameters between group IAH and group NO-IAH were compared in terms of the incidence of ARF,blood creatinine levels,blood urea nitrogen (BUN)levels,urine volume per hour and glomerular filtration gradient(GFG).Hemodynamic variations were recorded in the first three postoperative days between group ARF and group NO-ARF.The perioperative suspected risk factors of ARF were determined for statistical evaluation using correlation coefficients and logistic regression analysiIn group IAH.45.8%patients developed ARF as against 7.9in group NO-IAH;GFG was significantly lower at 0-72 h after surgery;and blood creatinine levels,BUN levels,urine volume per hour were significantly different at 24-72 h after surgery compared with group NO-IAH.The patients with ARF were not significantly difierent from those without ARF in terms of central venous pressure,pulmonary artely pressure and mean arterial pressure(MAP) in the first three postoperative days despite a significant increase in heart rate at 24-72h after operation.Postoperative IAH,intraoperative MAP and intraoperative blood transfusion volume of more than 15 U were found to be independent risk factors for ARF.IAH impaired renal function and was an independent risk factor for ARF after liver transplantation.Routine measurement should be taken to monitor IAP every eight hours postoperatively.

  9. Acute effects of riociguat in borderline or manifest pulmonary hypertension associated with chronic obstructive pulmonary disease

    Ghofrani, Hossein A.; Staehler, Gerd; Grünig, Ekkehard; Halank, Michael; Mitrovic, Veselin; Unger, Sigrun; Mueck, Wolfgang; Frey, Reiner; Grimminger, Friedrich; Ralph T. Schermuly; Behr, Juergen

    2015-01-01

    Riociguat is the first oral soluble guanylate cyclase stimulator shown to improve pulmonary hemodynamics in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension (PH). This pilot study assessed the impact of a single dose of riociguat on hemodynamics, gas exchange, and lung function in patients with PH associated with chronic obstructive pulmonary disease (COPD). Adults with COPD-associated borderline or manifest PH (pulmonary vascular resistance > 27...

  10. [Hypertensive retinopathy].

    Genevois, Olivier; Paques, Michel

    2010-01-20

    Acute hypertensive retinopathy should be distinguished from retinal arteriolosclerosis. The presence of microvascular abnormalities in the ocular fundus increases the risk of heart and/or brain attack. At the clinical level, the current classification of chronic hypertensive retinopathy is based on the long-term risk of stroke. In research, a great number of studies are focused on the predictive value of retinal vascular diameters related to the general micro- and macrovascular disease. PMID:20222306

  11. The biological effects of higher and lower positive end-expiratory pressure in pulmonary and extrapulmonary acute lung injury with intra-abdominal hypertension

    Santos, Cíntia Lourenco; Moraes, Lillian; Santos, Raquel Souza; dos Santos Samary, Cynthia; Silva, Johnatas Dutra; Morales, Marcelo Marcos; Capelozzi, Vera Lucia; de Abreu, Marcelo Gama; Schanaider, Alberto; Silva, Pedro Leme; Garcia, Cristiane Sousa Nascimento Baez; Pelosi, Paolo; Rocco, Patricia Rieken Macedo

    2014-01-01

    Introduction Mechanical ventilation with high positive end-expiratory pressure (PEEP) has been used in patients with acute respiratory distress syndrome (ARDS) and intra-abdominal hypertension (IAH), but the role of PEEP in minimizing lung injury remains controversial. We hypothesized that in the presence of acute lung injury (ALI) with IAH: 1) higher PEEP levels improve pulmonary morphofunction and minimize lung injury; and 2) the biological effects of higher PEEP are more effective in extra...

  12. Effect of acute hyperglycemia on erythrocyte membrane ion transport in offspring of hypertensive parents

    Suchánková, G.; Vlasáková, Z.; Zicha, Josef; Vokurková, Martina; Dobešová, Zdenka; Pelikánová, T.

    2003-01-01

    Roč. 21, č. 7 (2003), s. 1325-1330. ISSN 0263-6352 R&D Projects: GA ČR GA305/00/1638; GA MZd NB6682 Institutional research plan: CEZ:AV0Z5011922 Keywords : ion transport * hypertension * insulin resistance Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 3.572, year: 2003

  13. Is cardiac tolerance to acute ischemia in spontaneously hypertensive rats age- and sex- dependent?

    Szárszoi, O.; Bešík, J.; Chvojková, Zuzana; Kuneš, Jaroslav; Ošťádalová, Ivana; Kolář, František; Pirk, J.; Ošťádal, Bohuslav

    Elsevier. Roč. 42, č. 6 (2007), S195-S195. ISSN 0022-2828. [World Congress of the ISHR /19./. 22.06.2007-26.06.2007, Bologna] R&D Projects: GA MŠk(CZ) 1M0510 Institutional research plan: CEZ:AV0Z50110509 Keywords : gender * spontaneously hypertensive rats * ischemia/reperfusion injury Subject RIV: ED - Physiology

  14. Awareness of arterial hypertension, hyperlipidaemia and diabetes among patients admitted with acute coronary syndrome

    Monhart, Z.; Reissigová, Jindra; Widimský, J.; Janský, P.; Zvárová, Jana; Grünfeldová, H.; Vojáček, J.

    2012-01-01

    Roč. 33, Suppl 1 (2012), s. 1077. ISSN 0195-668X. [ESC 2012. Congress of the European Society of Cardiology. 25.08.2012-29.08.2012, München] Institutional support: RVO:67985807 Keywords : hypertension * hyperlipidaemia * diabetes mellitus * cardiovascular diseases Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  15. Effects of meldonium on cognitive and clinico-functional status of elderly patients with acute myocardial infarction and arterial hypertension

    Dotsenko N.J.

    2013-03-01

    Full Text Available 40 elderly patients with a diagnosis of acute myocardial infarction developed on the background of arterial hypertension were examined. The patients were divided into two groups: the main – 20 patients (18 men, 2 women, age 70.0 ± 1.8 years, and the control group – 20 patients (19 men, 1 woman, age 69.5 ± 1.6 years, who received the standard treatment of acute myocardial infarction and hypertension. "Standard therapy" included acetylsalicylic acid and clopidogrel, statins, beta-blockers and ACE inhi¬bitors, if necessary, drugs to control hypertension, according to the recom¬mendations of the Ukrainian Society of Cardiologists. In addition, the first group of patients undergoing standard therapy of AMI and hypertension was administered Vazonat® for 15 days intravenously at a dose of 1000 mg per day. Effect of Vazonat® (meldonium therapy on the clinical and functional status, exercise capacity, and cognitive status in patients with acute myocardial infarction and hypertension against the background of dyscirculatory encephalopathy was studied explored. Psycho-emotional state of patients was studied by Beck's depression scale. Cognitive status was assessed by neuropsychological tests (Schulte tables, Luria’s test for memorizing of 10 words and Luria’s pictograms. In was shown dynamics a positive effects of Vazonat® therapy on the improvement of cardio¬hemo¬dynamics (noted reduction in LVED with 55.20 ± 1.7 mm to 51.28 ± 1.5 mm (p > 0.1, an increasing transmitral flow Ve/Va from 0.98 ± 0.03 to 1.10 ± 0.04 (p < 0.05, an increasing exercise tolerance (at 6MWT distance increased by 12.8% in the main group (from 289.6 ± 12.2 m to 326.0 ± 13.5 m, an increasing the speed of active attention – time of sensorimotor reactions decreased from 68.55 ± 6.2 sec to 54.35 ± 3.52 sec (p < 0.05, increasing productivity of short-term memory, increasing the number of words in the Luria test from 5.90 ± 0.42 to 7.25 ± 0.38 (p < 0

  16. Acute effect of amiodarone on cardiovascular reflexes of normotensive and renal hypertensive rats

    Oliveira P.F.

    2005-01-01

    Full Text Available The aim of the present study was to evaluate the effect of amiodarone on mean arterial pressure (MAP, heart rate (HR, baroreflex, Bezold-Jarisch, and peripheral chemoreflex in normotensive and chronic one-kidney, one-clip (1K1C hypertensive rats (N = 9 to 11 rats in each group. Amiodarone (50 mg/kg, iv elicited hypotension and bradycardia in normotensive (-10 ± 1 mmHg, -57 ± 6 bpm and hypertensive rats (-37 ± 7 mmHg, -39 ± 19 bpm. The baroreflex index (deltaHR/deltaMAP was significantly attenuated by amiodarone in both normotensive (-0.61 ± 0.12 vs -1.47 ± 0.14 bpm/mmHg for reflex bradycardia and -1.15 ± 0.19 vs -2.63 ± 0.26 bpm/mmHg for reflex tachycardia and hypertensive rats (-0.26 ± 0.05 vs -0.72 ± 0.16 bpm/mmHg for reflex bradycardia and -0.92 ± 0.19 vs -1.51 ± 0.19 bpm/mmHg for reflex tachycardia. The slope of linear regression from deltapulse interval/deltaMAP was attenuated for both reflex bradycardia and tachycardia in normotensive rats (-0.47 ± 0.13 vs -0.94 ± 0.19 ms/mmHg and -0.80 ± 0.13 vs -1.11 ± 0.13 ms/mmHg, but only for reflex bradycardia in hypertensive rats (-0.15 ± 0.02 vs -0.23 ± 0.3 ms/mmHg. In addition, the MAP and HR responses to the Bezold-Jarisch reflex were 20-30% smaller in amiodarone-treated normotensive or hypertensive rats. The bradycardic response to peripheral chemoreflex activation with intravenous potassium cyanide was also attenuated by amiodarone in both normotensive (-30 ± 6 vs -49 ± 8 bpm and hypertensive rats (-34 ± 13 vs -42 ± 10 bpm. On the basis of the well-known electrophysiological effects of amiodarone, the sinus node might be the responsible for the attenuation of the cardiovascular reflexes found in the present study.

  17. Hypertension and Life-Threatening Bleeding in Children with Relapsed Acute Myeloblastic Leukemia Treated with FLT3 Inhibitors.

    Yılmaz Karapınar, Deniz; Karadaş, Nihal; Önder Siviş, Zühal; Balkan, Can; Kavaklı, Kaan; Aydınok, Yeşim

    2015-09-01

    Experiences with new multikinase inhibitors are limited, especially in children. In this report we summarize our experience with 2 patients with relapsed acute myeloblastic leukemia (AML), one with FMS-like tyrosine kinase-3-internal tandem duplication mutation and the other with a single base mutation (D835Y). Both patients received sorafenib, one for 19 days and the other for 42 days, with clofarabine-including chemotherapy. One additionally received sunitinib for a total of 20 days. Both patients developed severe pancytopenia, hypertension, life-threatening bleedings from the gastrointestinal system, and, finally, intrapulmonary hemorrhage. Although both reached severe aplasia of the bone marrow without blastic infiltration, death occurred with neutropenic sepsis. PMID:25912283

  18. Hypertension and Life-Threatening Bleeding in Children with Relapsed Acute Myeloblastic Leukemia Treated with FLT3 Inhibitors

    Deniz Yılmaz Karapınar

    2015-09-01

    Full Text Available Experiences with new multikinase inhibitors are limited, especially in children. In this report we summarize our experience with 2 patients with relapsed acute myeloblastic leukemia (AML, one with FMS-like tyrosine kinase-3-internal tandem duplication mutation and the other with a single base mutation (D835Y. Both patients received sorafenib, one for 19 days and the other for 42 days, with clofarabine-including chemotherapy. One additionally received sunitinib for a total of 20 days. Both patients developed severe pancytopenia, hypertension, life-threatening bleedings from the gastrointestinal system, and, finally, intrapulmonary hemorrhage. Although both reached severe aplasia of the bone marrow without blastic infiltration, death occurred with neutropenic sepsis.

  19. Analysis of Doppler flow spectra of the superior vena cava in a canine model of acute thromboembolic pulmonary hypertension.

    Sun, Dan Dan; Chen, Hong Mao; Duan, Yun You; Yuan, Li Jun; Shang, Fu Jun; Liang, Ning Nan; Cao, Wei

    2011-10-01

    We aimed to establish a canine model of acute thromboembolic pulmonary hypertension (ATEPH) and to explore the feasibility of diagnosing pulmonary hypertension (PH) through the Doppler flow spectra of the superior vena cava (SVC). A canine model of ATEPH was developed by infusing thrombus into the right femoral vein. The pulmonary arterial pressure was simultaneously measured via a right heart catheter with the guidance of ultrasound. The maximum systolic peak flow velocity (SPV), ventricular reverse peak flow velocity (VRPV), diastolic peak flow velocity (DPV), and atrial reverse peak flow velocity (ARPV) of the SVC were measured by transthoracic echocardiography. ATEPH was successfully established in 24 dogs (88.9%) with the pulmonary arterial systolic pressure (PASP) greater than 30 mmHg. ARPV increased significantly with the increase of PASP, and was positively correlated with PASP (PSPV larger than 0.8 could be better adopted to identify all the subjects with PH in this study. The Doppler flow spectra of the SVC could be employed to assess the severity of ATEPH.  PMID:21916968

  20. Participation of kinins in the inhibitory action of captopril on acute hypertension induced by L-NAME in anesthetized rats

    Soares de Moura R.

    1997-01-01

    Full Text Available The aim of the present study was to investigate the role of bradykinin in the inhibitory action of captopril in hypertension induced by L-NAME in anesthetized rats. Male Wistar rats (260-320 g were anesthetized with chloralose and arterial blood pressure was recorded with a polygraph pressure transducer. The hypertensive effect of L-NAME was studied in rats pretreated with saline, captopril or HOE 140 plus captopril. The effect of captopril was also studied during the sustained pressor effect of L-NAME. The acute pressor effect of L-NAME (10 mg/kg, iv was significantly reduced by iv pretreatment with 2 mg/kg captopril (D increase of 49 ± 4.9 mmHg reduced to 20 ± 5.4 mmHg, P = 0.01. The pressor effect of L-NAME (D increase of 38 ± 4.8 mmHg observed in rats pretreated with captopril and HOE 140 (0.1 mg/kg, iv was not significantly different from that induced by L-NAME in rats pretreated with saline (P = 0.09. During the sustained pressor effect induced by L-NAME (D increase of 49 ± 4.9 mmHg captopril induced a significant (P<0.05 reduction in arterial blood pressure (D decrease of 22 ± 3.0 mmHg. The present results demonstrate that the acute pressor effect of L-NAME is reduced by captopril and this inhibitory effect may be partly dependent on the potentiation of the vasodilator actions of bradykinin

  1. Intracranial Hypertension as an Acute Complication of Aseptic Meningoencephalitis with Leptomeningeal Contrast Enhancement on FLAIR MRI

    Wolf, Marc E.; Eisele, Philipp; Schweizer, Yvonne; Alonso, Angelika; Gass, Achim; Hennerici, Michael G.; Szabo, Kristina

    2016-01-01

    We report a case of a 19-year-old woman who developed intracranial hypertension as an unusual clinical complication of severe aseptic meningoencephalitis probably due to a diminished cerebrospinal fluid reabsorption capacity or leptomeningeal transudation as a consequence of blood-brain barrier dysfunction. These severe inflammatory changes were accompanied by prominent leptomeningeal contrast enhancement best visualized on fluid-attenuated inversion recovery magnetic resonance imaging. In su...

  2. Acute deterioration of idiopathic portal hypertension requiring living donor liver transplantation: a case report.

    Inokuma, Takamitsu; Eguchi, Susumu; Tomonaga, Tetsuo; Miyazaki, Kensuke; Hamasaki, Koji; Tokai, Hirotaka; Hidaka, Masaaki; Yamanouchi, Kosho; Takatsuki, Mitsuhisa; Okudaira, Sadayuki; Tajima, Yoshitsugu; Kanematsu, Takashi

    2009-01-01

    Case reports of severe idiopathic portal hypertension (IPH) requiring liver transplantation are very rare. We report the case of a 65-year-old woman who was diagnosed as having IPH. At the age of 60 years, her initial symptom was hematemesis, due to ruptured esophageal varices. Computed tomography of the abdomen showed splenomegaly and a small amount of ascites, without liver cirrhosis. She was diagnosed as having IPH and followed-up as an outpatient. Five years later, she developed symptoms ...

  3. Acute effect of tetrandrine pulmonary targeting microspheres on hypoxic pulmonary hypertension in rats

    程德云; 陈文彬; 莫晓能

    2002-01-01

    Objective To assess the effect of tetrandrine (Tet) pulmonary targeting microspheres on hypoxic pulmonary hypertension and evaluate its selective action on pulmonary circulation. Methods Twenty rats were exposed to hypoxic conditions for 3 weeks. Ten rats were used as normoxic controls. We administered Tet pulmonary targeting microspheres to 10 hypoxic rats and Tet aqueous solution to 10 hypoxic rats and the 10 control rats. Mean pulmonary arterial pressure (mPAP) was measured by a right cardiac catheterization, and mean systemic blood pressure (mSBP) was measured by left femoral catheterization. Results Rats exposed to hypoxia developed pulmonary hypertension. The decrease in mPAP in rats treated with Tet pulmonary targeting microspheres was significantly greater than that in rats receiving Tet aqueous solution (P<0.05), and the effects were longer with Tet pulmonary targeting microspheres. Moreover, Tet pulmonary targeting microspheres, unlike Tet aqueous solution, did not decrease mSBP. Conclusion Tet pulmonary targeting microspheres were more effective than Tet aqueous solution in treating hypoxic pulmonary hypertension and acted selectively on the pulmonary circulation.

  4. Hypertensive crisis.

    Rubenstein, E B; Escalante, C

    1989-07-01

    Hypertensive crisis is an acute emergency requiring aggressive management. Its incidence has decreased in recent years but still is prevalent in the medical community. From review of past and present treatment regimens, the following recommendations can be considered. (1) In the treatment of malignant hypertension with associated CHF, sodium nitroprusside is still an excellent agent. It has a rapid onset of action and blood pressure can be easily titrated. Nitroglycerin is also another agent that can be used in this situation. (2) In the treatment of malignant hypertension with associated aortic dissection, trimethophan camsylate is the preferred agent. An alternative choice is the combination of nitroprusside and labetalol. (3) In the treatment of malignant hypertension with associated myocardial ischemia, an excellent choice is nitroglycerin. Labetalol also should be considered in this situation. (4) In the treatment of hypertension during pregnancy, hydralazine is still a good choice. Labetalol has also been shown to be efficacious. (5) In the treatment of malignant hypertension with associated cerebral ischemia, the following drugs should be considered: nitroprusside, nitroglycerin, and labetalol. The most important attribute of these agents is that they are nonsedating and rapid in onset. (6) In the treatment of postoperative hypertension the choices best suited are labetalol, enalapril, nitroprusside, and nitroglycerin. These agents are rapid in onset and all can be administered intravenously. PMID:2670090

  5. INTRA-ABDOMINAL HYPERTENSION AS A RISK FACTOR FOR ACUTE KIDNEY INJURY IN CRITICALLY ILL PATIENTS

    Sreelatha; Noushad Thekke; Jayakumar Edathadathe

    2016-01-01

    BACKGROUND AND AIMS Increased intra-abdominal pressure (IAP), also referred to as intra-abdominal hypertension (IAH), affects organ function in critically ill patients. The prevalence of IAH is between 32% - 65% in intensive care units. Normal IAP is ≈ 5–7 mmHg. According to WSACS definition, IAH = IAP ≥12 mmHg and is divided into 4 grades. They are Grade I (12-15 mmHg), Grade II (16-20 mmHg), Grade III (21-25 mmHg), Grade IV (>25 mmHg). Transvesical measurement of IAP curren...

  6. Intracranial Hypertension as an Acute Complication of Aseptic Meningoencephalitis with Leptomeningeal Contrast Enhancement on FLAIR MRI

    Marc E. Wolf

    2016-01-01

    Full Text Available We report a case of a 19-year-old woman who developed intracranial hypertension as an unusual clinical complication of severe aseptic meningoencephalitis probably due to a diminished cerebrospinal fluid reabsorption capacity or leptomeningeal transudation as a consequence of blood-brain barrier dysfunction. These severe inflammatory changes were accompanied by prominent leptomeningeal contrast enhancement best visualized on fluid-attenuated inversion recovery magnetic resonance imaging. In such a prolonged course, a continuous lumbar drainage might be a temporary option to provide rapid symptom relief to the patient.

  7. Combined radiologic and surgical treatment for portal hypertension and acute variceal hemorrhage

    This paper evaluates the use of percutaneous arterial embolization and angiographic variceal sclerosis performed during minilaparotomy to treat portal hypertension and variceal bleeding. One hundred twenty-five patients with variceal bleeding that could not be controlled by sclerotherapy were treated with angiographic mid-splenic artery and left gastric artery embolization and variceal sclerosis induced by absolute alcohol delivered through a surgically introduced catheter during minilaparotomy. The procedure was technically successful in all 135 patients. Bleeding was controlled in 122 (90%). Thirteen patients died of continued variceal bleeding, five of disseminated intravascular coagulation, and 28 hepatic failure

  8. Hypertensive emergencies.

    Murphy, C

    1995-11-01

    Hypertensive emergencies are uncommon and physiologically diverse. Consequently, it is difficult for most physicians to develop a familiarity with all the different hypertensive crises and with all drugs available for treating them (Table 4). Clinicians should not agonize over which is the perfect therapeutic agent for a particular emergency, but instead, they should focus on scrupulous monitoring and familiarize themselves with a few agents that will serve in most situations. Generally, these agents will be sodium nitroprusside and nitroglycerin. Vigilant neurologic monitoring is mandatory in all hypertensive emergencies. The early symptoms and signs of cerebral hypoperfusion can be vague and subtle, but if recognized, serious complications of therapy can be avoided. Remember, the patient may still be hypertensive. Avoid acute (during the first hour) reductions in MAP of more than 20% whenever possible; subsequent reductions should be gradual. In patients known to have markedly elevated ICP and who need acute reductions in their BP, serious consideration should be given to direct monitoring of the ICP so that CPP can be maintained within safe limits. In general, oral agents should not be used for the treatment of hypertensive emergencies. Intravenous Labetalol and intravenous nicardipine are not suitable for general use in hypertensive emergencies. In special situations (e.g., perioperative hypertension and subarachnoid hemorrhage), however, they may be employed. Their role may expand with further study. Trimethaphan may be superior to nitroprusside for hypertension complicated by elevated ICP or cerebral dysfunction. Realistically, most physicians will continue to use nitroprusside. Intense neurologic monitoring is more important than the specific agent used. Nitroglycerin is the agent of choice for acute ischemic heart disease complicated by severe hypertension; if it fails, use nitroprusside. For aortic dissection, the combination of nitroprusside and IV

  9. Acute Effects of Vardenafil on Pulmonary Artery Responsiveness in Pulmonary Hypertension

    Edibe Karasu-Minareci

    2012-01-01

    Full Text Available Phosphodiesterase type-5 (PDE-5 inhibitors are novel and important options for the treatment of pulmonary arterial hypertension (PAH. Therefore, we aimed to examine effects of vardenafil, a PDE-5 inhibitor, on the pulmonary arteries isolated from rats with monocrotaline- (MCT- induced pulmonary hypertension. MCT (60 mg/kg or its vehicle was administered by a single intraperitoneal injection to 6-week-old male Sprague Dawley rats. Rats were sacrificed 21 days after MCT injection, and the main pulmonary arteries were isolated and then mounted in 20 mL organ baths. Concentration-response curves for vardenafil (10−10–10−5 M were constructed in phenylephrine- (Phe- precontracted rings. PAH caused marked rightward shift in the curves to vardenafil whereas maximal responses were not affected. Inhibition of NO synthase (L-NAME, 10−4 M or guanylyl cyclase (ODQ, 10−5 M caused similar attenuation in responses evoked by vardenafil. Moreover, contraction responses induced by CaCl2 (3×10−5–3×10−2 M were significantly reduced in concentration-dependent manner by vardenafil. In conclusion, vardenafil induced pulmonary vasodilatation via inhibition of extracellular calcium entry in addition to NO-cGMP pathway activation. These results provide evidence that impaired arterial relaxation in PAH can be prevented by vardenafil. Thus, vardenafil represents a valuable therapeutic approach in PAH besides other PDE-5 inhibitors.

  10. Influence of a history of arterial hypertension and pretreatment blood pressure on the effect of angiotensin converting enzyme inhibition after acute myocardial infarction. Trandolapril Cardiac Evaluation Study

    Gustafsson, F; Køber, L; Torp-Pedersen, C;

    1998-01-01

    inhibition after AMI complicated by left ventricular dysfunction may be of particular importance in patients with a history of arterial hypertension or a relatively high pretreatment blood pressure. However, further investigations are necessary to establish the clinical impact of these results.......OBJECTIVE: To evaluate the influence of a history of arterial hypertension and the level of pretreatment blood pressure on the efficacy of the angiotensin converting enzyme (ACE) inhibitor trandolapril on mortality and morbidity in patients with acute myocardial infarction (AMI) and left...... broad spectrum of potential confounders. Also, benefit from ACE inhibition increased with increasing blood pressure at the time of randomization. Significant interactions between benefit from ACE inhibition and hypertension history, and systolic and diastolic blood pressure were found. CONCLUSION: ACE...

  11. Acute hemodynamic effects of nebulized iloprost via the I-neb Adaptive Aerosol Delivery system in pulmonary hypertension

    Richter, Manuel J.; Ghofrani, Hossein A.; Voswinckel, Robert; Seeger, Werner; Schulz, Richard; Reichenberger, Frank

    2015-01-01

    Abstract Inhaled iloprost has proven to be an effective therapy in patients with pulmonary hypertension (PH). However, the acute hemodynamic effect of nebulized iloprost delivered via the I-neb Adaptive Aerosol Delivery (AAD) system remains unclear and needs to be assessed. In this study, 126 patients with PH were classified according to current guidelines (59, 34, 29, and 4 patients in groups 1/1′, 3, 4, and 5, respectively; 20 patients had idiopathic pulmonary arterial hypertension [iPAH]), were randomly assigned to inhale iloprost 2.5 g (n = 67) or 5.0 g (n = 59) via the I-neb AAD system, and were assessed by right heart catheterization. In seven patients with iPAH, iloprost plasma levels were measured. The two iloprost doses caused decreases from baseline in pulmonary vascular resistance (PVR; 2.5 g: –14.7%; 5.0 g: –15.6%) and mean pulmonary arterial pressure (mPAP; 2.5 g: –11.0%; 5.0 g: –10.1%) while cardiac index (CI) increased (2.5 g: +6.5%; 5.0 g: +6.4%). The subset with iPAH also showed decreases from baseline in PVR and mPAP and an increase in CI. Peak iloprost plasma levels showed no significant difference after inhalation of 2.5 g or 5.0 g iloprost (95.5 pg/mL vs. 73.0 pg/mL; P = 0.06). In summary, nebulized iloprost delivered via the I-neb AAD system reduced mPAP and PVR and increased CI from baseline in a heterogeneous group of patients with PH and in the subset with iPAH. In patients with iPAH, inhalation of 2.5 g or 5.0 g iloprost resulted in broadly similar peak iloprost plasma levels. PMID:25992279

  12. Therapeutic effects of intravenous urapidil in elderly patients with hypertension and acute decompensated heart failure: A pilot clinical trial

    YANG, WEI; ZHOU, YU-JIE; FU, YAN; QIN, JIAN; TAN, SHU; CHEN, XIAO-MIN; GUO, JIN-CHENG; WANG, DE-ZHAO; ZHAN, HONG; GUAN, WEI; XU, YA-WEI; HE, JING-YU; LI, JING; HUA, QI

    2016-01-01

    Urapidil has been proposed to be an effective vasodilator for the treatment of acute decompensated heart failure (ADHF); however, its effect on cardiac function, as compared with that of nitroglycerin, in elderly patients with hypertension and ADHF has yet to be determined. In the present study, a multicenter, open-label clinical trial was performed, in which 120 elderly patients with hypertension and ADHF were randomly assigned to the treatment (50–400 µg/min intravenous urapidil) or control group (5–40 µg/min intravenous nitroglycerin). The dosages of the medications were adjusted according to the blood pressure of the patients. The systolic and diastolic blood pressure, heart rate and serum level of N-terminal pro B-type natriuretic peptide (NT-proBNP) were evaluated at hospital admission and at days 1, 2, 3 and 7 after treatment. In addition, the left ventricular function was assessed by measuring the left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume at hospital admission and at days 2 and 7 after treatment. The results indicated that intravenous administration of urapidil and nitroglycerin were effective in lowering the blood pressure and heart rate within 7 days, with no significant differences observed between the two groups (P>0.05). By contrast, greater reduction in the serum NT-proBNP level (2,410.4±546.1 vs. 4,234.1±876.4 pg/ml; P<0.05) and greater improvement in the LVEF (55.3±3.4 vs. 45.2±2.4%; P<0.05) were observed in the urapidil-treated group, as compared with the nitroglycerin-treated group. No adverse events were reported during the treatment period in the two groups. The clinical outcomes at 6 months following discharge were evaluated and were not found to be significantly different between the two groups. In conclusion, the present results of the present study suggested that urapidil was as effective as nitroglycerin in controlling blood pressure and heart rate and was more effective in improving

  13. Managing acute severe hypertension during coronary angiography: Lessons from a challenging case.

    Zabulon, Audrey; Ozier-Lafontaine, Nathalie; Jocelyn, Inamo

    2016-06-01

    We report the clinical case of a 52-year-old man referred to our catheterization laboratory for an acute coronary syndrome. The coronary angiogram course was soon disrupted by a life-threatening blood pressure chaos lasting for hours. An abdominal paraganglioma was eventually diagnosed, requiring surgery. This case outlines the potential diagnosis and therapeutic missteps in managing such patients and suggests strategies for quick improvement. PMID:26729064

  14. Cardiorespiratory effects of recruitment maneuvers and positive end expiratory pressure in an experimental context of acute lung injury and pulmonary hypertension

    Doras, Camille; Le Guen, Morgan; Peták, Ferenc; Habre, Walid

    2015-01-01

    Background Recruitment maneuvers (RM) and positive end expiratory pressure (PEEP) are the cornerstone of the open lung strategy during ventilation, particularly during acute lung injury (ALI). However, these interventions may impact the pulmonary circulation and induce hemodynamic and respiratory effects, which in turn may be critical in case of pulmonary hypertension (PHT). We aimed to establish how ALI and PHT influence the cardiorespiratory effects of RM and PEEP. Methods Rabbits control o...

  15. Hypertension and experimental stroke therapies

    O'Collins, Victoria E; Donnan, Geoffrey A; Macleod, Malcolm R; Howells, David W.

    2013-01-01

    Hypertension is an established target for long-term stroke prevention but procedures for management of hypertension in acute stroke are less certain. Here, we analyze basic science data to examine the impact of hypertension on candidate stroke therapies and of anti-hypertensive treatments on stroke outcome. Methods: Data were pooled from 3,288 acute ischemic stroke experiments (47,899 animals) testing the effect of therapies on infarct size (published 1978–2010). Data were combined using meta...

  16. Ocular Hypertension

    ... Español Eye Health / Eye Health A-Z Ocular Hypertension Sections What Is Ocular Hypertension? Ocular Hypertension Causes ... Hypertension Diagnosis Ocular Hypertension Treatment What Is Ocular Hypertension? Written by: Kierstan Boyd Reviewed by: J Kevin ...

  17. Pleiotropic preconditioning-like cardioprotective effects of hypolipidemic drugs in acute ischemia-reperfusion in normal and hypertensive rats.

    Ravingerová, Táňa; Ledvényiová-Farkašová, Veronika; Ferko, Miroslav; Barteková, Monika; Bernátová, Iveta; Pecháňová, Ol'ga; Adameová, Adriana; Kolář, František; Lazou, Antigone

    2015-07-01

    Although pleiotropy, which is defined as multiple effects derived from a single gene, was recognized many years ago, and considerable progress has since been achieved in this field, it is not very clear how much this feature of a drug is clinically relevant. During the last decade, beneficial pleiotropic effects from hypolipidemic drugs (as in, effects that are different from the primary ones) have been associated with reduction of cardiovascular risk. As with statins, the agonists of peroxisome proliferator-activated receptors (PPARs), niacin and fibrates, have been suggested to exhibit pleiotropic activity that could significantly modify the outcome of a cardiovascular ailment. This review examines findings demonstrating the impacts of treatment with hypolipidemic drugs on cardiac response to ischemia in a setting of acute ischemia-reperfusion, in relation to PPAR activation. Specifically, it addresses the issue of susceptibility to ischemia, with particular regard to the preconditioning-like cardioprotection conferred by hypolipidemic drugs, as well as the potential molecular mechanisms behind this cardioprotection. Finally, the involvement of PPAR activation in the mechanisms of non-metabolic cardioprotective effects from hypolipidemic drugs, and their effects on normal and pathologically altered myocardium (in the hearts of hypertensive rats) is also discussed. PMID:25965412

  18. TRAIL treatment provokes mutations in surviving cells

    Lovric, M M; Hawkins, C J

    2010-01-01

    Chemotherapy and radiotherapy commonly damage DNA and trigger p53-dependent apoptosis through intrinsic apoptotic pathways. Two unfortunate consequences of this mechanism are resistance due to blockade of p53 or intrinsic apoptosis pathways, and mutagenesis of non-malignant surviving cells which can impair cellular function or provoke second malignancies. Death ligand-based drugs, such as tumor necrosis factor-related apoptosis inducing ligand (TRAIL), stimulate extrinsic apoptotic signaling,...

  19. Non-obstructive low attenuation coronary plaque predicts three-year acute coronary syndrome events in patients with hypertension. Multidetector computed tomographic study

    Arterial hypertension is an established risk factor for acute coronary syndrome (ACS). Multidetector computed tomography (MDCT) is an accurate and less invasive technique for assessment of the degree of coronary artery luminal narrowing and characterization of coronary atherosclerosis. We therefore aimed to investigate the predictive power of MDCT for future ACS events and compared with traditional parameters in patients with hypertension. One hundred and thirty-four patients (93 men, mean age 70±11 years) with hypertension underwent MDCT for evaluation of coronary artery disease. MDCT analysis focused on the presence of plaques, the degree of stenosis, and the plaque characteristics. Traditional parameters included Framingham risk score, carotid intima-media thickness, and left ventricular mass index. During a mean follow-up of 39±10 months, ACS events occurred in 10 patients, including myocardial infarction (n=3) and unstable angina (n=7). Multivariate analysis identified total number of low attenuation plaques as an independent predictor of ACS events (p<0.001). We demonstrated that non-obstructive low attenuation coronary plaques on MDCT predicted more accurately future ACS events in patients with hypertension than traditional parameters. (author)

  20. Trigeminovascular fibers increase blood flow in cortical gray matter by axon reflex-like mechanisms during acute severe hypertension or seizures

    Sakas, D.E.; Moskowitz, M.A.; Kano, M.; Ogilvy, C.S. (Harvard Medical School, Boston, MA (USA)); Wei, E.P.; Kontos, H.A. (Medical College of Virginia, Richmond (USA))

    1989-02-01

    Cerebral blood flow was measured and compared in 10 symmetrical brain regions following unilateral trigeminal ganglionectomy, sham operation, or trigeminal root section (rhizotomy) in cats. Multiple determinations were obtained in anesthetized and paralyzed animals using radiolabeled microspheres during (i) normocapnia-normotension, (ii) hypercapnia, (iii) angiotensin-induced acute severe hypertension, or (iv) bicuculline-induced seizures. Flow was symmetrical in all brain regions at rest and during increases induced by hypercapnia in the three groups. During severe hypertension or seizures, marked elevations developed bilaterally. In ganglionectomized animals, increases due to hypertension or seizures were attenuated by 28-32% on the denervated side within cortical gray matter regions corresponding to the anterior, middle, and posterior cerebral arteries. Flow was symmetrical within all brain regions in sham-operated animals and in the rhizotomy group, despite comparable increases in regional cerebral blood flow induced by angiotensin. Hence, the trigeminal nerve mediates blood flow adaptations during severe hypertension and seizures. Furthermore, since trigeminal cell bodies and peripheral axons are destroyed or degenerate following ganglionectomy but not following rhizotomy, local axon reflex-like mechanisms mediate these increases in cerebral blood flow.

  1. A case of progressive hypertension preceding gemcitabine-associated thrombotic microangiopathy complicated by acute kidney injury and stroke.

    Phelan, Paul J

    2009-01-01

    Gemcitabine-associated thrombotic microangiopathy is being increasingly recognized as a serious complication of treatment. We report a normotensive patient who developed progressive hypertension after commencing gemcitabine therapy. She also developed subtle changes in her platelet count and serum creatinine months before her emergent presentation. Clinicians should be aware of new onset or worsening hypertension and \\'mild\\' biochemical changes in gemcitabine-treated patients.

  2. Monitoring the changes in plasm C-reactive protein,fibrinogen and blood white cell in patients with primary hypertension combined with acute cerebral infarction

    Yuanfei Deng; Juan Hang; Yane Chen

    2006-01-01

    BACKGROUND: Inflammatow reaction and the increased level of its accompanying active protein play an important role in the occurrence and development of cerebral infarction. C-reactive protein, fibrinogen and white blood cell, as the monitoring index of inflammatory reaction, are very important in the occurrence and development of acute cerebral infarction.OBJECTIVE: To make a comparison between patients with primary hypertension accompanied with acute cerebral infarction and with simple primary hypertension by observing the changes in plasma C-reactive protein and fibrinogen levels as well as white blood cell and differential counts and analyzing their significances.DESIGN : Controlled observation.SETTTNG: Ward Building for VIP, Shenzhen Hospital, Peking University.PARTICIPANTS: Totally 133 patients with primary hypertension were selected from Ward Building for VIP,Shenzhen Hospital, Peking University during September 2003 to September 2005. The diagnostic criteda were based on the hypertension diagnosis criteria formulated by the 7th World Health Organization-lnternational Society of Hypertension Guidelines (WHO-ISH) in 1998. The informed consents were obtained from all the participants. The involved patients were assigned into two groups: primary hypertension group, in which, there were 65 patients with primary hypertension ( degree 2), including 42 males and 23 females,with mean age of (61 ±14)years and mean blood pressure of (162.7±6.8)/(94.2±8.4) mm Hg(1 mm Hg =0.133 kPa), and primary hypertension combined with cerebral infarction group, in which, there were 68 patients with primary hypertension combined with cerebral infarction ( meeting the diagnostic criteria formulated in the 4th National Cerebrovascular Diseases Meeting in 1995 and diagnosed by skull CT or MRI to exclude the patients with lacunar infarction), including 42 males and 26 females, with mean age of (56±15)years and mean blood pressure of (176.4±9.2)/(96.3±9.7) mm Hg.METHODS: Plasm C

  3. Hypertensive Encephalopathy

    Mostafa SHARIFIAN

    2012-09-01

    Full Text Available How to cite this article: Sharifian M. Hypertensive Encephalopathy. Iran J Child Neurol 2012; 6(3:1-7.Hypertension is called the silent killer and vital organs such as the brain, eyes,kidneys and the heart are the targets. Seizure, central nervous system (CNShemorrhage, and cerebrovascular accident (CVA, blindness and heart attacksare the end points.The prevalence of hypertension in children is much less than adults, but evidencereveals that the source of hypertension in adulthood goes back to childhood. In70-80% of cases hypertension is due to renal diseases. In children, hypertensiveencephalopathy (HE may be the first manifestation of renal diseases. Seizure isone of the most common manifestations of HE.In this article, definitions, etiology, pathophysiology and finally the acute andchronic managements of HE will be discussed.ReferencesSawicka K, Szczyrek M, Jastrzębska I, Prasal M, ZwolakA, Jadwiga D. Hypertension – The silent killer. J Pre-Clin Clin Res 2011;5(2:43-6.Croix B, Feig DI. Childhood hypertension is not a silent disease. Pediatr Nephrol 2006 Apr;21(4:527-32.Wong TY, Mitchell P. Hypertensive retinopathy. N Engl J Med 2004 Nov;351(22:2310-7.Krzesinski JM, Cohen EP.Hypertension and the kidney.Acta Clin Belg 2007 Jan-Feb;62(1:5-14.Report of the Second Task Force on Blood Pressure Control in Children – 1987. Task Force on Blood Pressure Control in Children. National Heart, Lung, and Blood Institute, Bethesda, Maryland. Pediatrics 1987Jan;79(1:1-25.Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Pediatrics 1996 Oct;98(4 Pt1:649-58.Ataei N, Aghamohammadi A, Yousefi E, Hosseini M, Nourijelyani K, Tayebi M, et al. Blood pressure nomograms for school children in Iran. Pediatr Nephrol 2004 Feb;19

  4. [Hypokalemic periodic paralysis provoked by "Ambene"].

    Wessel, K; Schumm, F; Peiffer, J; Schlote, W

    1985-12-01

    The case of a 42-year-old man is reported, who on four occasions developed a hypokalaemic periodic paralysis after an intramuscular injection of "Ambene". The detailed examination of this patient shows, that it is the primary, autosomal dominant inherited form of hypokalaemic periodic paralysis, and not the secondary form, which is caused by a renal or gastrointestinal loss of potassium. Clinical and electrophysiological, as well as histopathological and electron microscopic findings are presented, showing the typical vacuolar myopathy with submicroscopic tubular structures. In the literature there is evidence for an increased sensitivity of the muscle membrane to insulin with an increased potassium-shift inside the cell in hypokalaemic periodic paralysis. "Ambene" is a combination, which contains amongst other substances dexamethasone and the local anaesthetic drug lidocain. In the present case the paresis was possibly caused by a combined effect of dexamethasone with a consequent hyperglycaemia and lidocain with a change in the excitability of the muscle membrane. The pathophysiological mechanism of hypokalaemic periodic paralysis is discussed in terms of the release by the combination of these two drugs. It has not previously been reported that "Ambene" can provoke a hypokalaemic periodic paralysis. This is a severe side effect because of the resulting cardiac and respiratory problems. PMID:2936967

  5. 17β-Estradiol mediates superior adaptation of right ventricular function to acute strenuous exercise in female rats with severe pulmonary hypertension.

    Lahm, Tim; Frump, Andrea L; Albrecht, Marjorie E; Fisher, Amanda J; Cook, Todd G; Jones, Thomas J; Yakubov, Bakhtiyor; Whitson, Jordan; Fuchs, Robyn K; Liu, Aiping; Chesler, Naomi C; Brown, M Beth

    2016-08-01

    17β-Estradiol (E2) exerts protective effects on right ventricular (RV) function in pulmonary arterial hypertension (PAH). Since acute exercise-induced increases in afterload may lead to RV dysfunction in PAH, we sought to determine whether E2 allows for superior RV adaptation after an acute exercise challenge. We studied echocardiographic, hemodynamic, structural, and biochemical markers of RV function in male and female rats with sugen/hypoxia (SuHx)-induced pulmonary hypertension, as well as in ovariectomized (OVX) SuHx females, with or without concomitant E2 repletion (75 μg·kg(-1)·day(-1)) immediately after 45 min of treadmill running at 75% of individually determined maximal aerobic capacity (75% aerobic capacity reserve). Compared with males, intact female rats exhibited higher stroke volume and cardiac indexes, a strong trend for better RV compliance, and less pronounced increases in indexed total pulmonary resistance. OVX abrogated favorable RV adaptations, whereas E2 repletion after OVX markedly improved RV function. E2's effects on pulmonary vascular remodeling were complex and less robust than its RV effects. Postexercise hemodynamics in females with endogenous or exogenous E2 were similar to hemodynamics in nonexercised controls, whereas OVX rats exhibited more severely altered postexercise hemodynamics. E2 mediated inhibitory effects on RV fibrosis and attenuated increases in RV collagen I/III ratio. Proapoptotic signaling, endothelial nitric oxide synthase phosphorylation, and autophagic flux markers were affected by E2 depletion and/or repletion. Markers of impaired autophagic flux correlated with endpoints of RV structure and function. Endogenous and exogenous E2 exerts protective effects on RV function measured immediately after an acute exercise challenge. Harnessing E2's mechanisms may lead to novel RV-directed therapies. PMID:27288487

  6. Detection of acute myocardial infarction in spontaneously hypertensive rats by sup(99m)Tc-Pyrrolidino methyl tetracycline

    The myocardial infarct induced by isoproterenol in spontaneously hypertensive rats accumulates higher activities of 99sup(m)Tc-PM tetracycline compared with the cardiac infarct in normotensive rats caused by the same method. The isoproterenol model of the myocardial necrosis was induced in intact rats without opening the thorax and is a convenient method for experimental radioisotope studies. (orig.)

  7. Hypertensive emergencies of pregnancy.

    Alexander, James M; Wilson, Karen L

    2013-03-01

    Hypertension is commonly encountered in pregnancy and has both maternal and fetal effects. Acute hypertensive crisis most commonly occurs in severe preeclampsia and is associated with maternal stroke, cardiopulmonary decompensation, fetal decompensation due to decreased uterine perfusion, abruption, and stillbirth. Immediate stabilization of the mother including the use of intervenous antihypertensives is required and often delivery is indicated. With appropriate management, maternal and fetal outcomes can be excellent. PMID:23466139

  8. Portal Hypertension

    ... Continues to Fall Additional Content Medical News Portal Hypertension By Steven K. Herrine, MD NOTE: This is ... Hepatic Encephalopathy Jaundice in Adults Liver Failure Portal Hypertension Portal hypertension is abnormally high blood pressure in ...

  9. [Secondary hypertension].

    Yoshida, Yuichi; Shibata, Hirotaka

    2015-11-01

    Hypertension is a common disease and a crucial predisposing factor of cardiovascular diseases. Approximately 10% of hypertensive patients are secondary hypertension, a pathogenetic factor of which can be identified. Secondary hypertension consists of endocrine, renal, and other diseases. Primary aldosteronism, Cushing's syndrome, pheochromocytoma, hyperthyroidism, and hypothyroidism result in endocrine hypertension. Renal parenchymal hypertension and renovascular hypertension result in renal hypertension. Other diseases such as obstructive sleep apnea syndrome are also very prevalent in secondary hypertension. It is very crucial to find and treat secondary hypertension at earlier stages since most secondary hypertension is curable or can be dramatically improved by specific treatment. One should keep in mind that screening of secondary hypertension should be done at least once in a daily clinical practice. PMID:26619670

  10. Systemic hypertension.

    Elliott, William J

    2007-04-01

    Hypertension is a growing public health problem worldwide. Only 37% of American hypertensives currently have their blood pressures controlled. Hypertension is traditionally diagnosed in the medical office, but both home and ambulatory blood pressure monitoring can help. Lifestyle modifications are recommended for everyone who has higher than "normal" blood pressure (hypertension in pregnancy, in childhood, in the elderly, and in both extremes of blood pressure (pre-hypertension or hypertensive emergencies). PMID:17398315

  11. Acute hemodynamic effects of single-dose sildenafil when added to established bosentan therapy in patients with pulmonary arterial hypertension: results of the COMPASS-1 study.

    Gruenig, Ekkehard; Michelakis, Evangelos; Vachiéry, Jean-Luc; Vizza, Carmine Dario; Meyer, F Joachim; Doelberg, Martin; Bach, Doris; Dingemanse, Jasper; Galiè, Nazzareno

    2009-11-01

    This study investigated the acute pharmacodynamic effects of sildenafil in patients with pulmonary arterial hypertension (PAH) and concomitant bosentan treatment, in view of a mutual pharmacokinetic interaction between the 2 drugs. This prospective, open-label, noncomparative, multicenter, phase II study enrolled 45 patients (>or=18 years) with stable PAH (idiopathic, familial, or related to corrected congenital systemic-to-pulmonary shunts, drugs, or toxins) and on bosentan treatment for at least 3 months. Patients underwent right heart catheterization to evaluate the acute hemodynamic effects of (a) inhaled nitric oxide (iNO) and (b) a single oral dose of sildenafil (25 mg). Mean pulmonary vascular resistance (PVR) decreased from baseline following iNO (-15%; 95% confidence limits: -21%, -8%; P = .0001). A statistically significant decrease from baseline in mean PVR was also observed 60 minutes following sildenafil administration (-15%; 95% confidence limits: -21%, -10%; P < .0001). The reduction in PVR following sildenafil was comparable to that resulting from iNO. There were no unexpected safety findings. The pharmacodynamic effect suggests that addition of sildenafil to bosentan treatment can elicit additional hemodynamic benefits. These data represent a rationale for long-term combination studies with the 2 compounds. PMID:19755415

  12. Horizontal dimensions of ionosphere agitation provoked by underground nuclear explosions

    The horizontal dimensions of ionosphere agitation provoked by underground nuclear explosions have been experimentally determined for 13 explosions conducted at the Balapan test site of the Semipalatinsk test site. (author)

  13. Rapid redistribution and inhibition of renal sodium transporters during acute pressure natriuresis

    Zhang, Y; Mircheff, A K; Hensley, C B;

    1996-01-01

    and basolateral Na+ pumps to internal membranes. Arterial pressure was increased 50 mmHg by constricting various arteries. We also tested whether transporter internalization occurred when PT Na+ reabsorption was inhibited with the carbonic anhydrase inhibitor benzolamide. Five minutes after initiating...... either natriuretic stimuli, cortex was removed, and membranes were fractionated by density gradient centrifugation. Urine output and endogenous lithium clearance increased threefold in response to either stimuli. Acute hypertension provoked a redistribution of apical Na+/H+ exchanger NHE3, alkaline...... arterial pressure is mediated by both endocytic removal of apical Na+/H+ exchangers and basolateral Na+ pumps as well as decreased total Na+ pump activity....

  14. Impact of Comorbidities on Acute Injury and Recovery in Preclinical Stroke Research: Focus on Hypertension and Diabetes.

    Ergul, Adviye; Hafez, Sherif; Fouda, Abdelrahman; Fagan, Susan C

    2016-08-01

    Human ischemic stroke is very complex, and no single preclinical model can comprise all the variables known to contribute to stroke injury and recovery. Hypertension, diabetes, and hyperlipidemia are leading comorbidities in stroke patients. The use of predominantly young adult and healthy animals in experimental stroke research has created a barrier for translation of findings to patients. As such, more and more disease models are being incorporated into the research design. This review highlights the major strengths and weaknesses of the most commonly used animal models of these conditions in preclinical stroke research. The goal is to provide guidance in choosing, reporting, and executing appropriate disease models that will be subjected to different models of stroke injury. PMID:27026092

  15. Loss of Notch3 Signaling in Vascular Smooth Muscle Cells Promotes Severe Heart Failure Upon Hypertension.

    Ragot, Hélène; Monfort, Astrid; Baudet, Mathilde; Azibani, Fériel; Fazal, Loubina; Merval, Régine; Polidano, Evelyne; Cohen-Solal, Alain; Delcayre, Claude; Vodovar, Nicolas; Chatziantoniou, Christos; Samuel, Jane-Lise

    2016-08-01

    Hypertension, which is a risk factor of heart failure, provokes adaptive changes at the vasculature and cardiac levels. Notch3 signaling plays an important role in resistance arteries by controlling the maturation of vascular smooth muscle cells. Notch3 deletion is protective in pulmonary hypertension while deleterious in arterial hypertension. Although this latter phenotype was attributed to renal and cardiac alterations, the underlying mechanisms remained unknown. To investigate the role of Notch3 signaling in the cardiac adaptation to hypertension, we used mice with either constitutive Notch3 or smooth muscle cell-specific conditional RBPJκ knockout. At baseline, both genotypes exhibited a cardiac arteriolar rarefaction associated with oxidative stress. In response to angiotensin II-induced hypertension, the heart of Notch3 knockout and SM-RBPJκ knockout mice did not adapt to pressure overload and developed heart failure, which could lead to an early and fatal acute decompensation of heart failure. This cardiac maladaptation was characterized by an absence of media hypertrophy of the media arteries, the transition of smooth muscle cells toward a synthetic phenotype, and an alteration of angiogenic pathways. A subset of mice exhibited an early fatal acute decompensated heart failure, in which the same alterations were observed, although in a more rapid timeframe. Altogether, these observations indicate that Notch3 plays a major role in coronary adaptation to pressure overload. These data also show that the hypertrophy of coronary arterial media on pressure overload is mandatory to initially maintain a normal cardiac function and is regulated by the Notch3/RBPJκ pathway. PMID:27296994

  16. Lithium clearance and renal tubular sodium handling during acute and long-term nifedipine treatment in essential hypertension

    Bruun, N E; Ibsen, H; Skøtt, P; Toftdahl, D; Giese, J; Holstein-Rathlou, N H

    1988-01-01

    1. In two separate studies the lithium clearance method was used to evaluate the influence of acute and long-term nifedipine treatment on renal tubular sodium reabsorption. 2. In the acute study, after a 4 week placebo period two doses of 20 mg of nifedipine decreased supine blood pressure from 155....../101 (20.6/13.5) +/- 11/4 (1.5/0.5) to 139/88 (18.5/11.7) +/- 16/9 (2.1/1.2) mmHg (kPa) (means +/- SD; P less than 0.01). Lithium clearance, glomerular filtration rate and sodium clearance did not change. Therefore the calculated values of absolute proximal and absolute distal sodium reabsorption rates...... reabsorption did not change. Sodium clearance, fractional sodium excretion, potassium clearance, plasma volume and extracellular fluid volume were also unchanged. 4. In conclusion, we found no changes of renal tubular sodium reabsorption during acute nifedipine treatment, whereas long-term nifedipine treatment...

  17. Acute Response of Right Ventricular Function to Iloprost Inhalations in Patients with Pulmonary Arterial Hypertension: Preliminary Evaluation 
with Cardiac Magnetic Resonance Imaging

    Qingqing LU

    2015-03-01

    Full Text Available Background and objective Pulmonary arterial hypertension (PAH is a progressive disorder characterized by abnormally elevated blood pressure of the pulmonary circulation. Without treatment, PAH progresses rapidly to right ventricular (RV failure and even death. Cardiac magnetic resonance imaging (CMRI has been an accurate and reproducible tool to assessment of RV morphology and function, which are important factors in the prognosis of patients with PAH. The aim of this study is to investigate acute RV response to inhalation of aerosolized iloprost in patients with PAH using CMRI. Method From March 2012 to March 2014, 48 patients with PAH underwent CMRI before and immediately after inhalation of iloprost with a single dose of 20 μg over 15 min-20 min. RV function parameters derived from CMRI images were analyzed before and after iloprost inhalation, including end-diastolic volume (EDV, end-diastolic area (EDA, end-systolic volume (ESV, end-systolic area (ESA, stroke volume (SV, ejection fraction (EF and cardiac output (CO. Percentage of RV area change was also calculated [%RVAC=(EDA-ESA/EDA×100%]. Wilcoxon's Sign Rank Test or Paired Samples t-Test was used to compare the differences of RV function parameters before and after inhalation. Results After iloprost inhalation, all patients showed significant decrease in RV EDV and RV ESV (P=0.007, P<0.001 respectively. Whereas, there were significant increase in RV SV (P=0.014, RV EF (P=0.009 and %RVAC (P=0.006. RV CO had no significant difference before and after inhalation (P=0.851. Conclusions Inhalation of iloprost can immediately improve RV function in patients with PAH, and noninvasive evaluation of the acute response with CMRI is feasibility.

  18. A Type A and Type D Combined Personality Typology in Essential Hypertension and Acute Coronary Syndrome Patients: Associations with Demographic, Psychological, Clinical, and Lifestyle Indicators.

    Steca, Patrizia; D'Addario, Marco; Magrin, Maria Elena; Miglioretti, Massimo; Monzani, Dario; Pancani, Luca; Sarini, Marcello; Scrignaro, Marta; Vecchio, Luca; Fattirolli, Francesco; Giannattasio, Cristina; Cesana, Francesca; Riccobono, Salvatore Pio; Greco, Andrea

    2016-01-01

    Many studies have focused on Type A and Type D personality types in the context of cardiovascular diseases (CVDs), but nothing is known about how these personality types combine to create new profiles. The present study aimed to develop a typology of Type A and Type D personality in two groups of patients affected by and at risk for coronary disease. The study involved 711 patients: 51.6% with acute coronary syndrome, 48.4% with essential hypertension (mean age = 56.4 years; SD = 9.7 years; 70.7% men). Cluster analysis was applied. External variables, such as socio-demographic, psychological, lifestyle, and clinical parameters, were assessed. Six groups, each with its own unique combined personality profile scores, were identified: Type D, Type A-Negatively Affected, Not Type A-Negatively Affected, Socially Inhibited-Positively Affected, Not Socially Inhibited, and Not Type A-Not Type D. The Type A-Negatively Affected cluster and, to a lesser extent, the Type D cluster, displayed the worst profile: namely higher total cardiovascular risk index, physical inactivity, higher anxiety and depression, and lower self-esteem, optimism, and health status. Identifying combined personality profiles is important in clinical research and practice in cardiovascular diseases. Practical implications are discussed. PMID:27589065

  19. [Hypertensive emergency and urgence].

    Gegenhuber, Alfons; Lenz, Kurt

    2003-12-01

    DEFINITION, PATHOPHYSIOLOGY, THERAPY: The hypertensive crisis is characterized by a massive, acute rise in blood pressure. Patients with underlying hypertensive disease usually have an increase in systolic blood pressure values > 220 mmHg and diastolic values > 120 mmHg. The severity of the condition, however, is not determined by the absolute blood pressure level but by the magnitude of the acute increase in blood pressure. Thus, in the presence of primarily normotensive baseline values (such as those in eclampsia), even a systolic blood pressure > 170 mmHg may lead to a life-threatening condition. The most important causes are non-compliance (reduction or interruption of therapy), inadequate therapy, endocrine disease, renal (vessel) disease, pregnancy and intoxication (drugs). The management of this condition greatly depends on whether the patient has a hypertensive crisis with organ manifestation (hypertensive emergency) or a crisis without organ manifestation (hypertensive urgency). By documenting the medical history, the medical status and by simple diagnostic procedures, the differential diagnosis can be established at the emergency site within a very short period of time. In the absence of organ manifestations (hypertensive urgency) the patient may have non-specific symptoms such as palpitations, headache, malaise and a general feeling of illness in addition to the increase in blood pressure. In a hypertensive urgency the patient's blood pressure should not be reduced within a few minutes but within a period of 24 to 48 hours. Such adjustment can be achieved on an out-patient basis, however, only if the patient can be followed up adequately for early detection of a renewed attack. In the absence of follow-up facilities, the patient's blood pressure should be reduced over a period of 4 to 6 hours, if necessary in an out-patient emergency service. While intravenous medication is given preference when a rapid effect is desired, oral medication may be used for

  20. Renovascular hypertension

    Renal hypertension; Hypertension - renovascular; Renal artery occlusion; Stenosis - renal artery; Renal artery stenosis ... blood pressure to rise. Risk factors for atherosclerosis: High blood pressure Smoking Diabetes High cholesterol Heavy alcohol use Cocaine ...

  1. New Attacks on Animal Researchers Provoke Anger and Worry

    Guterman, Lila

    2008-01-01

    This article reports on firebomb attacks at the homes of two animal researchers which have provoked anger and unease. The firebomb attacks, which set the home of a neuroscientist at the University of California at Santa Cruz aflame and destroyed a car parked in the driveway of another university researcher's home, have left researchers and…

  2. What Provokes Young People to Get into Trouble: Singapore Stories

    Tam, Kai Yung; Heng, Mary Anne; Bullock, Lyndal M.

    2007-01-01

    In this article, the authors address correctional education and juvenile delinquency. The authors examined the case files of 54 juvenile offenders incarcerated in the Kaki Bukit Center Prison School in Singapore to analyze the antecedents that provoked these young offenders to commit the offenses. The juveniles reported that peer influence and…

  3. Resistant Hypertension.

    Doroszko, Adrian; Janus, Agnieszka; Szahidewicz-Krupska, Ewa; Mazur, Grzegorz; Derkacz, Arkadiusz

    2016-01-01

    Resistant hypertension is a severe medical condition which is estimated to appear in 9-18% of hypertensive patients. Due to higher cardiovascular risk, this disorder requires special diagnosis and treatment. The heterogeneous etiology, risk factors and comorbidities of resistant hypertension stand in need of sophisticated evaluation to confirm the diagnosis and select the best therapeutic options, which should consider lifestyle modifications as well as pharmacological and interventional treatment. After having excluded pseudohypertension, inappropriate blood pressure measurement and control as well as the white coat effect, suspicion of resistant hypertension requires an analysis of drugs which the hypertensive patient is treated with. According to one definition - ineffective treatment with 3 or more antihypertensive drugs including diuretics makes it possible to diagnose resistant hypertension. A multidrug therapy including angiotensin - converting enzyme inhibitors, angiotensin II receptor blockers, beta blockers, diuretics, long-acting calcium channel blockers and mineralocorticoid receptor antagonists has been demonstrated to be effective in resistant hypertension treatment. Nevertheless, optional, innovative therapies, e.g. a renal denervation or baroreflex activation, may create a novel pathway of blood pressure lowering procedures. The right diagnosis of this disease needs to eliminate the secondary causes of resistant hypertension e.g. obstructive sleep apnea, atherosclerosis and renal or hormonal disorders. This paper briefly summarizes the identification of the causes of resistant hypertension and therapeutic strategies, which may contribute to the proper diagnosis and an improvement of the long term management of resistant hypertension. PMID:26935512

  4. Historical review: does stress provoke Plasmodium falciparum recrudescence?

    Shanks, G Dennis

    2015-06-01

    Plasmodium falciparum, unlike P. vivax, must maintain infection in the blood/bone marrow over many months/years in order to bridge periods between transmission periods. Asymptomatic parasitemia at very low concentrations is now known to be quite common due to molecular detection methods. Old tropical medicine texts commonly list many stressful events stated to provoke recrudescent falciparum parasitemia such as fatigue, heat/chill, trauma/surgery, famine/war, transit between areas and other febrile illness. The older literature is reviewed to discover the factual basis of such varied reports since they have not been recently confirmed. It seems likely that human stress sometimes induces falciparum recrudescence of an otherwise asymptomatic infection. Reproducing such observations today has been radically altered as malaria chemotherapy has evolved from suppressive quinine to curative artemisinin combinations. Host stress-provoked recrudescence may be part of P. falciparum's survival strategy. PMID:25918217

  5. [Rare forms of hypertension : From pheochromocytoma to vasculitis].

    Haller, H; Limbourg, F; Schmidt, B M; Menne, J

    2015-03-01

    Secondary hypertension affects only 5-10 % of hypertensive patients. Screening is expensive and time-consuming and should be performed only in patients for whom there is a high clinical suspicion of secondary hypertension. Clinical signs of secondary forms of hypertension are new-onset hypertension in patients without other risk factors (i.e., family history, obesity, etc.), sudden increase of blood pressure (BP) in a previously stable patient, increased BP in prepubertal children, resistant hypertension, and severe hypertension or hypertensive emergencies. In adults, renal parenchymal and vascular diseases as well as obstructive sleep apnea are the most common causes of secondary hypertension. Medication-induced hypertension and non-adherence to medication have to be ruled out. Of the endocrine causes associated with hypertension, primary aldosteronism is the most common. Other endocrine causes of hypertension such as thyroid disease (hypo- or hyperthyroidism), hypercortisolism (Cushing's syndrome), hyperparathyroidism, and pheochromocytoma are rare. Monogenetic forms of hypertension are mostly of tubular origin and associated with alterations in mineralocorticoid handling or signaling. Rare causes of hypertension also include inflammatory vascular disease. Acute forms of vasculitis may present as "malignant" hypertension with associated thrombotic microangiopathy and organ damage/failure. It is important to diagnose these rare forms of hypertension in order to prevent acute organ damage in these patients or unnecessary invasive treatment strategies. PMID:25700646

  6. Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies

    Patel NH

    2012-11-01

    Full Text Available Nirali H Patel,1 Sarah K Romero,2 David C Kaelber31Division of Emergency Medicine, Akron Children's Hospital, Akron, OH, USA; 2Division of Emergency Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH, USA; 3Departments of Information Services, Internal Medicine, Pediatrics, and Epidemiology and Biostatistics, The Center for Clinical Informatics Research and Education, The MetroHealth System and School of Medicine, Case Western Reserve University, Cleveland OH, USAAbstract: Hypertension (HTN in the pediatric population is estimated to have a world-wide prevalence of 2%-5%. As with adults, pediatric patients with HTN can present with hypertensive crises include hypertensive urgency and hypertensive emergencies. However, pediatric blood pressure problems have a greater chance of being from secondary causes of HTN, as opposed to primary HTN, than in adults. Thorough evaluation of a child with a hypertensive emergency includes accurate blood pressure readings, complete and focused symptom history, and appropriate past medical, surgical, and family history. Physical exam should include height, weight, four-limb blood pressures, a general overall examination and especially detailed cardiovascular and neurological examinations, including fundoscopic examination. Initial work-up should typically include electrocardiography, chest X-ray, serum chemistries, complete blood count, and urinalysis. Initial management of hypertensive emergencies generally includes the use of intravenous or oral antihypertensive medications, as well as appropriate, typically outpatient, follow-up. Emergency department goals for hypertensive crises are to (1 safely lower blood pressure, and (2 treat/minimize acute end organ damage, while (3 identifying underlying etiology. Intravenous antihypertensive medications are the treatment modality of choice for hypertensive emergencies with the goal of reducing systolic blood pressure by 25% of the original value over an 8

  7. Hypertension hos gravide

    Mathiesen, Elisabeth R; Johansen, Marianne; Kamper, Anne Lise;

    2009-01-01

    There are four major hypertensive disorders in pregnancy: chronic hypertension, gestational hypertension, preeclampsia and chronic hypertension with superimposed preeclampsia. The indications and efficacy of antihypertensive treatment of the different hypertensive disorders are assessed. Advantages...

  8. [Hypertension during pregnancy

    Mathiesen, E.R.; Johansen, M.; Kamper, A.L.;

    2009-01-01

    There are four major hypertensive disorders in pregnancy: chronic hypertension, gestational hypertension, preeclampsia and chronic hypertension with superimposed preeclampsia. The indications and efficacy of antihypertensive treatment of the different hypertensive disorders are assessed. Advantages...

  9. Chronic in vivo or acute in vitro resveratrol attenuates endothelium-dependent cyclooxygenase-mediated contractile signaling in hypertensive rat carotid artery.

    Denniss, Steven G; Ford, Rebecca J; Smith, Christopher S; Jeffery, Andrew J; Rush, James W E

    2016-05-15

    Exaggerated cyclooxygenase (COX) and thromboxane-prostanoid (TP) receptor-mediated endothelium-dependent contraction can contribute to endothelial dysfunction. This study examined the effect of resveratrol (RSV) on endothelium-dependent contraction and cell signaling in the common carotid artery (CCA) from spontaneously hypertensive rats (SHR) and Wistar Kyoto rats (WKY). Acetylcholine (Ach)-stimulated endothelium-dependent nitric oxide synthase (NOS)-mediated relaxation in precontracted SHR CCA was impaired (maximum 73 ± 6% vs. 87 ± 5% in WKY) (P water) with a ∼0.075 mg·kg(-1)·day(-1) RSV dose affected neither endothelium-dependent relaxation nor endothelium-dependent contraction and associated prostaglandin (PG) production evaluated in non-precontracted NOS-blocked CCA. In contrast, a chronic ∼7.5 mg·kg(-1)·day(-1) RSV dose improved endothelium-dependent relaxation (94 ± 6%) and attenuated endothelium-dependent contraction (58 ± 4% vs. 73 ± 5% in No-RSV) and PG production (183 ± 43 vs. 519 ± 93 pg/ml) in SHR CCA, while U46619-stimulated TP receptor-mediated contraction was unaffected. In separate acute in vitro experiments, 20-μM RSV preincubation attenuated endothelium-dependent contraction (6 ± 4% vs. 62 ± 2% in No Drug) and PG production (121 ± 15 vs. 491 ± 93 pg/ml) and attenuated U46619-stimulated contraction (134 ± 5% vs. 171 ± 4%) in non-precontracted NOS-blocked SHR CCA. Compound C, a known AMP-activated protein kinase (AMPK) inhibitor, did not prevent the RSV attenuating effect on Ach- and U46619-stimulated contraction but did prevent the RSV attenuating effect on PG production (414 ± 58 pg/ml). These data demonstrate that RSV can attenuate endothelium-dependent contraction both by suppressing arterial wall PG production, which may be partially mediated by AMPK, and by TP receptor hyporesponsiveness, which does not appear to be mediated by AMPK. PMID:26917696

  10. Positive end expiratory pressure titrated by transpulmonary pressure improved oxygenation and respiratory mechanics in acute respiratory distress syndrome patients with intra-abdominal hypertension

    YANG Yi; LI Yang; LIU Song-qiao; LIU Ling; HUANG Ying-zi; GUO Feng-mei; QIU Hai-bo

    2013-01-01

    Background Intra-abdominal hypertension (IAH) is common in acute respiratory distress syndrome (ARDS) patients and when resulting in decrease of chest wall compliance will weaken the effect of positive end expiratory pressure (PEEP).We investigated the effect of PEEP titrated by transpulmonary pressure (Ptp) on oxygenation and respiratory mechanics in ARDS patients with IAH compared with PEEP titrated by ARDSnet protocol.Methods ARDS patients admitted to the intensive care unit (ICU) of the Zhongda Hospital were enrolled.Patients were ventilated with volume control mode with tidal volume of 6 ml/kg under two different PEEP levels titrated by Ptp method and ARDSnet protocol.Respiratory mechanics,gas exchange and haemodynamics were measured after 30 minutes of ventilation in each round.IAH was defined as intra-abdominal pressure of 12 mmHg or more.Results Seven ARDS patients with IAH and 8 ARDS patients without IAH were enrolled.PEEP titrated by Ptp were significant higher than PEEP titrated by ARDSnet protocol in both ARDS patients with IAH ((17.3±2.6) cmH2O vs.(6.3±1.6)cmH2O and without IAH ((9.5±2.1) cmH2O vs.(7.8±1.9) cmH2O).Arterial pressure of O2/fraction of inspired oxygen (PaO2/FiO2)was much higher under PEEP titrated by Ptp when compared with PEEP titrated by ARDSnet protocol in ARDS patients with IAH ((27.2±4.0) cmHg vs.(20.9± 5.0) cmHg.But no significant difference of PaO2/FiO2 between the two methods was found in ARDS patients without IAH.In ARDS patients with IAH,static compliance of lung and respiratory system were higher under PEEP titrated by Ptp than by ARDSnet protocol.In ARDS patients with IAH,central venous pressure (CVP) was higher during PEEP titrated by Ptp than byARDSnet protocol.Conclusion Positive end expiratory pressure titrated by transpulmonary pressure was higher than PEEP titrated by ARDSnet protocol and improved oxygenation and respiratory mechanics in ARDS patients with IAH.

  11. Management of hypertension emergencies.

    Elliott, William J

    2003-12-01

    Although they have become less common, hypertensive emergencies occur with an incidence of approximately 1 to 2/100,000 people per year. Our knowledge about this problem, its pathophysiology, risk factors, and appropriate treatment options has expanded during the past decade. A hypertensive emergency can be declared when an elevated blood pressure is associated with acute target-organ damage. Rapid evaluation and treatment (typically with an intravenously administered agent) should be instituted, usually in an intensive care unit setting, and the patient should be observed carefully during acute blood-pressure lowering. When properly treated, the prognosis for these patients is not nearly as dismal as it was more than 60 years ago, and the initial level of function of target organs (brain, heart, kidneys) is more indicative of an emergency than the actual level of blood pressure. Therapeutic options include the time-tested sodium nitroprusside (which has toxic metabolic products and is contraindicated in pregnancy, tobacco amblyopia, and Leber's optic atrophy); fenoldopam mesylate; and nicardipine. When properly treated, "malignant hypertension" need be considered malignant no longer. PMID:14594569

  12. Hypertension screening

    Foulke, J. M.

    1975-01-01

    An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.

  13. Pulmonary hypertension

    Anton Vonk Noordegraaf; Joanne A. Groeneveldt; Harm Jan Bogaard

    2016-01-01

    In 2015, more than 800 papers were published in the field of pulmonary hypertension. A Clinical Year in Review article cannot possibly incorporate all this work and needs to be selective. The recently published European guidelines for the diagnosis and treatment of pulmonary hypertension contain an inclusive summary of all published clinical studies conducted until very recently. Here, we provide an overview of papers published after the finalisation of the guideline. In addition, we summaris...

  14. Endokrin hypertension

    Poulsen, Per Løgstrup; Ibsen, Hans

    2009-01-01

    Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma-aldosterone-to-renin ......Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma...

  15. Hepatic angiography: Portal hypertension

    Portal hypertension is usually a manifestation of underlying hepatic parenchymal disease, although it may be secondary to portal or hepatic venous thrombosis and rarely to hyperdynamic portal states. Portal hypertension may present as encephalopathy, ascites, jaundice, hepatic failure, or catastrophic upper gastrointestinal hemorrhage. Radiologic investigation should include indirect or direct measurements of portal pressure, assessment of portal venous perfusion, visualization of collaterals, and demonstration of arterial and venous anatomy for potential shunt procedure. Following survival of initial variceal bleeding, the most effective procedure to prevent recurrent hemorrhage is a shunt to decompress the varices. The decision whether to intervene medically or surgically during the acute hemorrhagic episode as well as the type of shunt used to prevent future hemorrhage is the subject of continuing controversy

  16. Perioperative hypertension

    G. Pinna

    2013-05-01

    Full Text Available BACKGROUND Perioperative hypertension is a situation whose management is suggested by the clinical judgement much more than clinical evidences. JNC 7 guidelines give a classification of blood pressure (BP, without any mention specifically dedicated to patients undergoing surgery. The ACC/AHA guidelines recommend deferring surgery if diastolic BP is above 110 mmHg and systolic BP is above 180 mmHg. AIM OF THE STUDY In this review we considered pathogenetic, clinical and therapeutic factors related to perioperative management of hypertensive patients. DISCUSSION In actual trend of the preoperative evaluation, alone hypertension is considered as a minor risk factor. BP values ≤ 180/110 mmHg do not influence the outcomes in patients who underwent noncardiac surgery. Therefore, in these conditions it’s not necessary to delay surgery. Hypertensive picks are possible during the operation, mostly because of the intubation, but, much more dangerous, falls of pressure are possible. The intraoperative arterial pressure should be maintained within 20% of the best estimated preoperative arterial pressure, especially in patients with markedly elevated preoperative pressures. After surgery the arterial BP can increase for stress factors, pain, hypoxia and hypercapnia, hypothermia and infusional liquids overload. For all these reasons a careful monitoring is mandatory. Anti-hypertensive medication should be continued during the postoperative period in patients with known and treated hypertension, as unplanned withdrawal of treatment can result in rebounded hypertension. The decision to give anti-hypertensive drugs must be made for each patient, taking into account their normal BP and their postoperative BP. With regard to the optimal treatment of the patient with poorly or uncontrolled hypertension in the perioperative evaluation, recent guidelines suggest that the best treatment may consider cardioselective β-blockers therapy, but also clonidin by

  17. Managing hypertension in the newborn infants

    Azar Nickavar

    2014-01-01

    Full Text Available Hypertension in newborn infants, particularly those requiring intensive care, is becoming increasingly recognized, with prevalence of 0.2-3%. Recent studies have established normative tables for blood pressure (BP in both term and pre-term infants based on the gestational age, postnatal age, gender, weight and height, identifying the neonates at increased risk for early-onset cardiovascular disease. Common causes of neonatal hypertension include thromboembolic complications secondary to umbilical artery catheterization, congenital renal structural malformation, renovascular disease, aortic coarctation, as well as acute kidney injury and certain medications. A careful diagnostic evaluation should lead to identification of the underlying cause of hypertension in most infants. Treatment options should be tailored to the severity; and underlying cause of hypertension, including intravenous and/or oral therapy. This review summarizes recent work in these areas, focusing on optimal BP measurement, definition, evaluation and management of hypertension as well as advances in drug therapy of neonatal hypertension.

  18. Pharmacologic treatment of hypertensive disorders during pregnancy.

    Yankowitz, Jerome

    2004-01-01

    Pregnancy complicated by hypertension is a common problem faced by clinicians. It can lead to substantial maternal and/or fetal/neonatal morbidity and mortality. There are a variety of medications that can be used during pregnancy either for treatment of significant chronic hypertension or in cases of acute severe hypertension. Most antihypertensive drugs have been shown to be safe for use in pregnancy. A variety of medications are available to treat more severe hypertension, although the use of pharmacologic therapy to treat mild chronic hypertension during pregnancy has not been supported in the literature. The data are more limited concerning drugs that would be used in the event of hypertensive emergencies or in an intensive care setting; however, in such a situation, maternal health and life become paramount and, despite lack of good studies, appropriate treatment should be rendered. PMID:15478474

  19. Types of Pulmonary Hypertension

    ... from the NHLBI on Twitter. Types of Pulmonary Hypertension The World Health Organization divides pulmonary hypertension (PH) ... are called pulmonary hypertension.) Group 1 Pulmonary Arterial Hypertension Group 1 PAH includes: PAH that has no ...

  20. Nitric oxide treatment for fulminant pulmonary hypertension.

    Allman, K G; Young, J D; Stevens, J E; Archer, L N

    1993-01-01

    A 3 year old child with known pulmonary haemosiderosis suffered acute circulatory collapse secondary to raised pulmonary vascular resistance. Nitric oxide inhalation produced a profound improvement in circulatory parameters and gaseous exchange. Nitric oxide may have a therapeutic role in acute pulmonary hypertensive crisis.

  1. Renovascular hypertension

    Hypertension constitutes a major health problem and the challenge is to identify patients having 'surgically' curable renal vascular disease among the majority with so-called essential hypertension. The best of unsatisfactory diagnostic tests are renography and plasma renin activity both before and during angiotensin II blockade. The necessity of better screening tests has increased because of the recent advances in surgical techniques and especially percutaneous transluminal renal angioplasty. The latter has definitely become the method of choice for correction of suspected hemodynamically significant artery stenoses whenever technically feasible. With improved angioplasty techniques the risk of treating renal artery stenosis without hemodynamic and clinical importance (so-called cosmetic repair) has increased. Unfortunately randomized trials including surgery versus angioplasty are not available. It should be kept in mind that only after correction of the stenosis is achieved and the blood pressure has become normal, can the diagnosis of renovascular hypertension be made with certainty. (orig.)

  2. Effects of hypertension on stroke-associated pneumonia after acute cerebral infarction%急性脑梗死患者血压对卒中相关性肺炎的影响

    陈武松

    2014-01-01

    目的:研究急性脑梗死患者的血压与卒中相关性肺炎(SAP)的相关性。方法选取2010-03-2013-03在我院诊治的急性脑梗死患者174例,根据患者的血压状况分为血压正常组(31例)、轻度高血压组(27例)、中度高血压组(63例)和重度高血压组(53例);根据患者有无并发卒中相关性肺炎分为卒中相关性肺炎组(46例)和无卒中相关性肺炎组(128例)。比较各组患者的外周血白细胞计数(WBC)、血清C反应蛋白(CRP)、白蛋白、吞咽障碍发生率、收缩压(SBP)、Glasgow昏迷量表(GCS),记录所有患者既往病史,包括吸烟史、饮酒史、既往脑梗死病史、高血压史、糖尿病史、缺血性心脏病史及充血性心力衰竭病史等。结果血压正常组、轻度组、中度组和重度组患者WBC、CRP、GCS评分、吞咽障碍及SAP发生率比较,差异有统计学意义(P<0.05)。SAP与无SAP组SBP、WBC、CRP水平、吸烟史、GCS评分、意识障碍和吞咽障碍发生率比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析发现CRP、WBC以及高血压状况、吸烟史、GCS评分和吞咽障碍是SAP的危险因素,与血压正常组患者相比较,重度高血压组患者发生SAP的风险明显增高(P<0.05)。结论重度高血压是急性脑梗死患者发生卒中相关性肺炎的独立危险因素,为急性脑梗死患者防治SAP发生提供依据。%Objective To investigate the relationship between the blood pressure (BP) and stroke-associated pneumonia (SAP) in patients with acute cerebral infarction.Methods A total of 174 patients with acute cerebral infarction admitted to our hospital from March 2010 to March 2013 were divided ,according to acute blood pressure values ,into normal BP group (with normal BP ,n=31) ,mild group (with mild hypertension ,n=27) ,moderate group (with moderate hypertension ,n=63) ,se-vere group (with

  3. Portopulmonary hypertension.

    Lv, Yong; Han, Guohong; Fan, Daiming

    2016-07-01

    Portopulmonary hypertension (PoPH) refers to the condition that pulmonary arterial hypertension (PAH) occur in the stetting of portal hypertension. The development of PoPH is thought to be independent of the severity of portal hypertension or the etiology or severity of liver disease. PoPH results from excessive vasoconstriction, vascular remodeling, and proliferative and thrombotic events within the pulmonary circulation that lead to progressive right ventricular failure and ultimately to death. Untreated PoPH is associated with a poor prognosis. As PoPH is frequently asymptomatic or symptoms are generally non-specific, patients should be actively screened for the presence of PoPH. Two-dimensional transthoracic echocardiography is a useful non-invasive screening tool, but a definitive diagnosis requires invasive hemodynamic confirmation by right heart catheterization. Despite a dearth of randomized, prospective data, an ever-expanding clinical experience shows that patients with PoPH benefit from therapy with PAH-specific medications including with endothelin receptor antagonists, phosphodiesterase-5 inhibitors, and/or prostanoids. Due to high perioperative mortality, transplantation should be avoided in those patients who have severe PoPH that is refractory to medical therapy. PMID:27002212

  4. FMLP provokes coronary vasoconstriction and myocardial ischemia in rabbits

    Recent pathological studies of coronary arteries from humans with suspected coronary spasm have revealed an augmented intramural burden of inflammatory cells. To test the hypothesis than inappropriate activation of inflammatory cells participates in the evolution of coronary vasospasm, the present experiment employed a newly developed coronary arteriographic technique for use in pentobarbital-anesthetized rabbits to evaluate the coronary vasomotor actions of the nonselective inflammatory cell stimulant, N-formyl-L-methionyl-L-leucyl-L-phenylalanine (fMLP). In 10 of 10 animals, selective left intracoronary injection of 200 ng fMLP evoked profound left coronary narrowing accompanied in all cases by ST segment deviation and dysrhythmias. Thallium-201 scintigraphy demonstrated hypoperfusion of the left ventricular free wall and septum supplied by the spastic coronary artery. The fMLP-induced epicardial vasoconstriction, ischemic electrocardiogram (ECG) changes, and thallium perfusion defects were reversed by intravenous nitroglycerin. Neither the right coronary artery nor its distribution were influenced by left coronary injection of fMLP. Additional experiments in isolated, salt solution-perfused rabbit hearts demonstrated that fMLP failed to exert direct coronary vasoconstrictor effects. These observations indicate that the nonselective inflammatory cell stimulant, fMLP, provokes arteriographically demonstrable coronary spasm with attendant myocardial hypoperfusion and ischemic ECG changes in anesthetized rabbits. Such a model may be useful in exploring the dynamic role of inflammatory cells in development of coronary spasm

  5. Pain Symptoms in Fibromyalgia Patients with and without Provoked Vulvodynia.

    Ghizzani, Anna; Di Sabatino, Valentina; Suman, Anna Lisa; Biasi, Giovanni; Santarcangelo, Enrica Laura; Carli, Giancarlo

    2014-01-01

    Objective. The aim of the study was to compare the pain symptoms of fibromyalgia patients exhibiting (FMS+PVD) and not exhibiting (FMS) comorbidity with provoked vulvodynia. Study Design. The case control study was performed in 39 patients who had been diagnosed with FMS and accepted to undergo gynaecological examination and in 36 healthy women (C). All patients completed standardized questionnaires for pain intensity, pain area, and psychological functioning. The gynaecological examination included vulvar pain pressure reactivity (Q-tip), pelvic tone assessment (Kegel manoeuver), and a semistructured interview collecting detailed information about pelvic symptoms and sexual function. Results. FMS+PVD patients displayed a higher number of associated symptoms than FMS patients. The vulvar excitability was significantly higher in FMS+PVD than in FMS and in both groups than in Controls. Half of FMS+PVD patients were positive to Kegel manoeuver and displayed higher scores in widespread pain intensity, STAI-Y2, and CESD levels than Kegel negative patients. Conclusions. The study reveals that increased vulvar pain excitability may occur in FMS patients independently of the presence of coital pain. Results suggest that coital pain develops in patients with higher FMS symptoms severity due to the cooperative effects of peripheral and central sensitization mechanisms. PMID:24624294

  6. Pain Symptoms in Fibromyalgia Patients with and without Provoked Vulvodynia

    Anna Ghizzani

    2014-01-01

    Full Text Available Objective. The aim of the study was to compare the pain symptoms of fibromyalgia patients exhibiting (FMS+PVD and not exhibiting (FMS comorbidity with provoked vulvodynia. Study Design. The case control study was performed in 39 patients who had been diagnosed with FMS and accepted to undergo gynaecological examination and in 36 healthy women (C. All patients completed standardized questionnaires for pain intensity, pain area, and psychological functioning. The gynaecological examination included vulvar pain pressure reactivity (Q-tip, pelvic tone assessment (Kegel manoeuver, and a semistructured interview collecting detailed information about pelvic symptoms and sexual function. Results. FMS+PVD patients displayed a higher number of associated symptoms than FMS patients. The vulvar excitability was significantly higher in FMS+PVD than in FMS and in both groups than in Controls. Half of FMS+PVD patients were positive to Kegel manoeuver and displayed higher scores in widespread pain intensity, STAI-Y2, and CESD levels than Kegel negative patients. Conclusions. The study reveals that increased vulvar pain excitability may occur in FMS patients independently of the presence of coital pain. Results suggest that coital pain develops in patients with higher FMS symptoms severity due to the cooperative effects of peripheral and central sensitization mechanisms.

  7. Intracranial Hypertension

    Xenophon Sinopidis

    2012-01-01

    Full Text Available We present the case of a 4-year-old boy who was admitted to hospital with intracranial hypertension, headache, diplopia, papilledema, and a normal brain MRI. Brucella melitensis in the cerebrospinal fluid was confirmed with PCR assay. We believe that neurobrucellosis should be included in the differential diagnosis when headaches persist following brucellosis. In addition, we suggest that when cerebrospinal fluid culture is negative, PCR may prove to be an optimal alternative tool for an immediate and accurate diagnosis.

  8. Pulmonary Hypertension Secondary to COPD

    Adil Shujaat; Abubakr A. Bajwa; Cury, James D.

    2012-01-01

    The development of pulmonary hypertension in COPD adversely affects survival and exercise capacity and is associated with an increased risk of severe acute exacerbations. Unfortunately not all patients with COPD who meet criteria for long term oxygen therapy benefit from it. Even in those who benefit from long term oxygen therapy, such therapy may reverse the elevated pulmonary artery pressure but cannot normalize it. Moreover, the recent discovery of the key roles of endothelial dysfunction ...

  9. Hypertension and Spina Bifida

    SBA National Resource Center: 800-621-3141 Hypertension A disease that often goes undetected. What is hypertension? Hypertension, also called high blood pressure , is a condition in which the arteries of ...

  10. Intracranial Hypertension Research Foundation

    ... Intracranial Hypertension and Pseudotumor Cerebri). The Intracranial Hypertension Research Foundation is the only non-profit organization in the ... view this email address) © 1998 - 2016 Intracranial Hypertension Research Foundation | About Us | Join Us | Donate | Privacy | Site Map | ...

  11. What Causes Pulmonary Hypertension?

    ... from the NHLBI on Twitter. What Causes Pulmonary Hypertension? Pulmonary hypertension (PH) begins with inflammation and changes in the ... different types of PH. Group 1 pulmonary arterial hypertension (PAH) may have no known cause, or the ...

  12. Pulmonary Arterial Hypertension

    Pulmonary Arterial Hypertension What Is Pulmonary Hypertension? To understand pulmonary hypertension (PH) it helps to understand how blood ows throughout your body. While the heart is one organ, it ...

  13. Hormones and Hypertension

    Fact Sheet Hormones and Hypertension What is hypertension? Hypertension, or chronic (long-term) high blood pressure, is a main cause of ... tobacco, alcohol, and certain medications play a part. Hormones made in the kidneys and in blood vessels ...

  14. [Hypertensive emergencies in adults: a practical review].

    Sosner, Philippe; Plouin, Pierre-François; Herpin, Daniel

    2010-10-01

    Hypertensive emergencies must be distinguished from severe blood pressure elevations without acute target organ damage. Clinical examination (chest pain, dyspnoea, neurological disorders, ECG, retinal examination) and laboratory tests (blood and urine tests, cerebral imaging in case of neurological disorders) have to be immediately performed. Immediate referral to an intensive care unit is indicated, and an intravenous antihypertensive therapy has to be implemented. Blood pressure objectives depend on the associated acute pathology (myocardial infarction, pulmonary oedema, aortic dissection, severe pre-eclampsia and eclampsia of pregnancy, hypertensive encephalopathy, retinopathy, subarachnoid hemorrhage, cerebral hemorrhage, ischemic stroke treated or not with thrombolysis). PMID:20547034

  15. How Is Pulmonary Hypertension Treated?

    ... from the NHLBI on Twitter. How Is Pulmonary Hypertension Treated? Pulmonary hypertension (PH) has no cure. However, ... Types of Pulmonary Hypertension." ) Group 1 Pulmonary Arterial Hypertension Group 1 pulmonary arterial hypertension (PAH) includes PH ...

  16. Hypertensive crisis during pregnancy and postpartum period.

    Too, Gloria T; Hill, James B

    2013-08-01

    Hypertension affects 10% of pregnancies, many with underlying chronic hypertension, and approximately 1-2% will undergo a hypertensive crisis at some point during their lives. Hypertensive crisis includes hypertensive urgency and emergency; the American College of Obstetricians and Gynecologists describes a hypertensive emergency in pregnancy as persistent (lasting 15 min or more), acute-onset, severe hypertension, defined as systolic BP greater than 160 mmHg or diastolic BP >110 mmHg in the setting of pre-eclampsia or eclampsia. Pregnancy may be complicated by hypertensive crisis, with lower blood pressure threshold for end-organ damage than non-pregnant patients. Maternal assessment should include a thorough history. Fetal assessment should include heart rate tracing, ultrasound for growth and amniotic assessment, and Doppler evaluation if growth restriction is suspected. Initial management of hypertensive emergency (systolic BP >160 mmHg or diastolic BP >110 mmHg in the setting of pre-eclampsia or eclampsia) generally includes the rapid reduction of blood pressure through the use of intravenous antihypertensive medications, with goal systolic blood pressure between 140 mmHg and 150 mmHg and diastolic pressure between 90 mmHg and 100 mmHg. First-line intravenous drugs include labetalol and hydralazine, but other agents may be used, including esmolol, nicardipine, nifedipine, and, as a last resort, sodium nitroprusside. Among patients with hypertensive urgency, slower blood pressure reduction can be provided with oral agents. The objective of this article is to review the current understanding, diagnosis, and management of hypertensive crisis during pregnancy and the postpartum period. PMID:23916027

  17. Experimental study in establishment of acute intracranial hypertension model and the effect of intracranial hypertension upon pattern of transcranial Doppler%急性局灶性颅内压升高动物模型的建立及颅内压升高对经颅多普勒频谱影响的实验研究

    万景雯; 吴钢; 林建东; 郑依勇

    2009-01-01

    Objective To establish the animal model of acute intracranial hypertension,investigate the changes of transeranial Doppler patterns in raised intraeranial pressure so that the necessary experimental evidence will be provided to clinical experience for monitoring intraeranial pressure (ICP) and cerebral perfusion pressure (CPP) using transeranial Doppler non-invasively. Methods Acute intraeranial hypertension was induced by inflating the balloon inserted into the epidural space. Blood flow velocity of basilar artery was measured with transcranial Doppler and intracranial pressure as well as cerebral perfusion pressure was measured. Results With progressive increase of intracranial pressure five characteristic flow patterns were observed, appearing in the following order: high resistance pattern, systolic flow, retrograde diastolic flow, very small systolic flow and zero flow. Conclusions Analysing patterns of TCD may be helpful for evaluating ICP and CPP qualitatively. The animal model is simple and strict so that it is worthy of being spreadcd.%目的 建立急性局灶性颅内高压动物模型,探讨兔颅内高压状态下经颅多普勒(TCD)频谱动态变化规律,为临床应用TCD无创监测颅内压(ICP)、脑灌注压(CPP)提供实验依据.方法 用硬膜外球囊注水法制作急性局灶性颅内高压动物模型,持续监测兔ICP、CPP及基底动脉TCD.结果 随着颅内压升高,依次出现5种典型的TCD频谱:高阻力血流频谱、收缩峰、舒张期逆向血流、极小的收缩峰、无血流.结论 根据TCD频谱变化能够定性判断颅内压和脑灌注压.本动物模型简便、严密,具有推广价值.

  18. Inhaled Therapies for Pulmonary Hypertension.

    Hill, Nicholas S; Preston, Ioana R; Roberts, Kari E

    2015-06-01

    The inhaled route has a number of attractive features for treatment of pulmonary hypertension, including delivery of drug directly to the target organ, thus enhancing pulmonary specificity and reducing systemic adverse effects. It can also improve ventilation/perfusion matching by dilating vessels supplying ventilated regions, thus improving gas exchange. Furthermore, it can achieve higher local drug concentrations at a lower overall dose, potentially reducing drug cost. Accordingly, a number of inhaled agents have been developed to treat pulmonary hypertension. Most in current use are prostacyclins, including epoprostenol, which has been cleared for intravenous applications but is used off-label in acute care settings as a continuously nebulized medication. Aerosolized iloprost and treprostinil are both prostacyclins that have been cleared by the FDA to treat pulmonary arterial hypertension (PAH). Both require frequent administration (6 and 4 times daily, respectively), and both have a tendency to cause airway symptoms, including cough and wheeze, which can lead to intolerance. These agents cannot be used to substitute for the infused routes of prostacyclin because they do not permit delivery of medication at high doses. Inhaled nitric oxide (INO) is cleared for the treatment of primary pulmonary hypertension in newborns. It is also used off-label to test acute vasoreactivity in PAH during right-heart catheterization and to treat acute right-heart failure in hospitalized patients. In addition, some studies on long-term application of INO either have been recently completed with results pending or are under consideration. In the future, because of its inherent advantages in targeting the lung, the inhaled route is likely to be tested using a variety of small molecules that show promise as PAH therapies. PMID:26070575

  19. Severe hypoxia during incremental exercise to exhaustion provokes negative post-exercise affects.

    Keramidas, Michail E; Stavrou, Nektarios A M; Kounalakis, Stylianos N; Eiken, Ola; Mekjavic, Igor B

    2016-03-15

    The post-exercise emotional response is mainly dependent on the intensity of the exercise performed; moderate exercise causes positive feelings, whereas maximal exercise may prompt negative affects. Acute hypoxia impairs peak O2 uptake (V̇O2peak), resulting in a shift to a lower absolute intensity at the point of exhaustion. Hence, the purpose of the study was to examine whether a severe hypoxic stimulus would influence the post-exercise affective state in healthy lowlanders performing an incremental exercise to exhaustion. Thirty-six male lowlanders performed, in a counter-balanced order and separated by a 48-h interval, two incremental exercise trials to exhaustion to determine their V̇O2peak, while they were breathing either room air (AIR; FiO2: 0.21), or a hypoxic gas mixture (HYPO; FiO2: 0.12). Before and immediately after each trial, subjects were requested to complete two questionnaires, based on how they felt at that particular moment: (i) the Profile of Mood States-Short Form, and (ii) the Activation Deactivation Adjective Check List. During the post-exercise phase, they also completed the Multidimensional Fatigue Inventory. V̇O2peak was significantly lower in the HYPO than the AIR trial (~15%; pmotivation were markedly impaired, whereas tension, confusion, and perception of physical and general fatigue were exaggerated (p≤0.05). Accordingly, present findings suggest that an incremental exercise to exhaustion performed in severe hypoxia provokes negative post-exercise emotions, induces higher levels of perceived fatigue and decreases motivation; the affective responses coincide with the comparatively lower V̇O2peak than that achieved in normoxic conditions. PMID:26802281

  20. [EFFICACY OF STANDARD TWO-YEAR COMPREHENSIVE THERAPY TO ACHIEVE TARGET BLOOD PRESSURE AND REGRESSION DEGREES OF REMODELING OF THE LEFT VENTRICULAR HYPERTROPHY IN PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION WITH COMORBID HYPERTENSION].

    Denesiuk, E V

    2015-01-01

    The study involved 23 men after acute myocardial infarction (AMI) with comorbid arterial hypertension (AH). Mean age of patients was 56.7 years. Recurrent myocardial infarction was determined in 38.4%, cardiac failure I-III functional classes--100% of the cases. All patients underwent clinical examination, electrocardiography and echocardiography, blood lipid profile. Standard comprehensive treatment for two years included an perindopril 5-10 mg/day, beta-blocker bisoprolol--5-10 mg/day, antisclerotic drug atorvastatin--20 mg/day and aspirin--75 mg/day. The patients after treatment was determined by a gradual increase towards the target of AT at 3, 6 and 12 to 24 months. Concentric left ventricular hypertrophy (LVH) before treatment was determined in 47.8%, eccentric--in 52.2% of patients. In the study of degrees of LVH I (initial) the extent to treatment was determined by 4.3%, II (moderate)--26.1%, III (large)--at 69.6%, indicating the development of cardiac remodeling. After the treatment was determined by marked reduction III (large) degree and transfer it in the II (moderate) and I (small) degree of left ventricular hypertrophy due to more or less pronounced changes remodeling left ventricular. The obtained data allow a more detailed and adequately assess the structural and functional outcome variables and determine the regression of myocardial hypertrophy in the background to achieve target blood pressure, which is important in practical cardiology. PMID:27491146

  1. Effects of Electroacupuncture on Adrenalin and Noradrenalin Levels of Acute Hypertension Rats%电针对急性高血压大鼠肾上腺素和去甲肾上腺素的影响

    霍则军; 姚海江; 张莉; 李志刚

    2012-01-01

    目的 观察电针对急性高血压大鼠的降压作用.方法 36只Wistar雄性大鼠随机分为对照组(n=8)、模型组(n=8)、药物组(n=10)和电针组(n=10).应用肾上腺素法制备急性高血压大鼠模型,电针百会和足三里穴,测定电针后各组血压的变化以及血清肾上腺素和去甲肾上腺素的变化.结果 药物组和电针组大鼠收缩压和舒张压均低于模型组(P0.05).模型组血清肾上腺素和去甲肾上腺素水平高于对照组(P0.05). The adrenalin and noradrenalin levels were higher in the model group than in the control group (P<0.05), but they were lower in the drug group and the electroacupuncture group than in the model group (P<0.05). Conclusion The electroacupuncture could reduce the blood pressure of acute hypertension rats by decreasing blood adrenalin and noradrenalin levels.

  2. Pulmonary Hypertension

    ... Paul Coverdell National Acute Stroke Program Funded States History of PCNASP PCNASP Metrics/Data Elements PCNASP Logic Model 2015 PCNASP FOA DP15-1514 WISEWOMAN Sodium Reduction in Communities Building GIS Capacity for Chronic Disease Surveillance Highlights Reports Chronic ...

  3. Management of portal hypertension in children

    Roberto Gugig; Philip Rosenthal

    2012-01-01

    Portal hypertension can be caused by a wide variety of conditions.It frequently presents with bleeding from esophageal varices.The approach to acute variceal hemorrhage in children is a stepwise progression from least invasive to most invasive.Management of acute variceal bleeding is straightforward.But data on primary prophylaxis and long term management prevention of recurrent variceal bleeding in children is scarce,therefore prospective multicenter trials are needed to establish best practices.

  4. Hypertensive Emergencies in Pregnancy.

    Olson-Chen, Courtney; Seligman, Neil S

    2016-01-01

    The prevalence of hypertensive disorders in pregnancy is increasing. The etiology and pathophysiology of hypertensive disorders in pregnancy remain poorly understood. Hypertensive disorders are a major cause of maternal and perinatal morbidity and mortality. Treatment of hypertension decreases the incidence of severe hypertension, but it does not impact rates of preeclampsia or other pregnancy complications. Several antihypertensive medications are commonly used in pregnancy, although there is a lack of randomized controlled trials. Severe hypertension should be treated immediately to prevent maternal end-organ damage. Appropriate antepartum, intrapartum, and postpartum management is important in caring for patients with hypertensive disorders. PMID:26600442

  5. Hypertension in pregnancy

    Andrea Ungar; Elena Lotti; Lorella Lambertucci

    2007-01-01

    Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories: chronic hypertension, pre-eclampsia/eclampsia, pre-eclampsia superimposed on chronic hypertension, and gestational hypertension. A relative paucity of investigative data, as well as the frequent difficulty in making an etiological diagnosis, may lead to problems in its management. This case report analyses cur...

  6. Body mass index evaluation in hypertensive women

    Raimunda Magalhães da Silva

    2003-12-01

    Full Text Available Hypertension prevalence is approximately three times higher in obese people. This study analyzed the Body Mass Index (BMI in 200 hypertensive women in follow up treatment in a public hypertension center in the city of Fortaleza-CE, Brazil. Sixty-one percent or 122 have incomplete primary school levels; 118 (59% had family incomes from 1 to 2 minimum wages, (US$90.00-US$190.00. Sixty one percent were obese and 30% were overweight; 150 (75% had hypertension cases in the family, as well as 98 (49% had cases of acute myocardium infarct and 97 (48% of vascular cerebral stroke in the family. Our results indicate variation of Body Mass Index especially in obese and then in overweight women. An efficient follow up treatment is fundamental specifically for those patients due to cardiovascular and cardio cerebral risks.

  7. Treatment of ethanol-induced acute pulmonary hypertension and right ventricular dysfunction in pigs, by sildenafil analogue (UK343-664 or nitroglycerin

    Sidi Avner

    2008-01-01

    Full Text Available In patients at risk for sudden ethanol (ETOH intravascular absorption, prompt treatment of pulmonary hypertension (PHTN will minimise the risk of cardiovascular decompensation. We investigated the haemodynamic effects of intravenous ETOH and the pulmonary vasodilatory effects of a sildenafil analogue (UK343-664 and nitroglycerin (NTG during ETOH-induced PHTN in pigs. We studied pulmonary and systemic haemodynamics, and right ventricular rate or time derivate of pressure rise during ventricular contraction ( =dP/dT, as an index of contractility, in 23 pigs. ETOH was infused at a rate of 50 mg/kg/min, titrated to achieve a twofold increase in mean pulmonary arterial pressure (MPAP, and then discontinued. The animals were randomised to receive an infusion of 2 ml/kg ( n = 7 normal saline, a 500-μg/kg bolus of UK343-664 ( n = 8, or NTG 1 μg/kg ( n = 8; each was given over 60 seconds. Following ETOH infusion, dP/dT decreased central venous pressure (CVP, and MPAP increased significantly, resulting in significantly increased pulmonary vascular resistance (PVR. Within 2 minutes after treatment with either drug, CVP, heart rate (HR, and the systemic vascular resistance-to-pulmonary vascular resistance (SVR/PVR ratio returned to baseline. However, at that time, only in the UK343-664 group, MPAP and dP/dT partially recovered and were different from the respective values at PHTN stage. NTG and UK343-664 decreased PVR within 2 minutes, from 1241±579 and 1224±494 dyne · cm/sec 5 , which were threefold-to-fourfold increased baseline values, to 672±308 and 538±203 dyne · cm/sec 5 respectively. However, only in the UK343-664 group, changes from baseline PVR values after treatment were significant compared to the maximal change during target PHTN. Neither drug caused a significant change in SVR. In this model of ETOH-induced PHTN, both UK343-664 and NTG were effective pulmonary vasodilators with a high degree of selectivity. However, the changes from

  8. Caffeine provokes adverse interactions with 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy') and related psychostimulants: mechanisms and mediators.

    Vanattou-Saïfoudine, N; McNamara, R; Harkin, A

    2012-11-01

    Concomitant consumption of caffeine with recreational psychostimulant drugs of abuse can provoke severe acute adverse reactions in addition to longer term consequences. The mechanisms by which caffeine increases the toxicity of psychostimulants include changes in body temperature regulation, cardiotoxicity and lowering of the seizure threshold. Caffeine also influences the stimulatory, discriminative and reinforcing effects of psychostimulant drugs. In this review, we consider our current understanding of such caffeine-related drug interactions, placing a particular emphasis on an adverse interaction between caffeine and the substituted amphetamine, 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy'), which has been most recently described and characterized. Co-administration of caffeine profoundly enhances the acute toxicity of MDMA in rats, as manifested by high core body temperature, tachycardia and increased mortality. In addition, co-administration of caffeine enhances the long-term serotonergic neurotoxicity induced by MDMA. Observations to date support an interactive model of drug-induced toxicity comprising MDMA-related enhancement of dopamine release coupled to a caffeine-mediated antagonism of adenosine receptors in addition to inhibition of PDE. These experiments are reviewed together with reports of caffeine-related drug interactions with cocaine, d-amphetamine and ephedrine where similar mechanisms are implicated. Understanding the underlying mechanisms will guide appropriate intervention strategies for the management of severe reactions and potential for increased drug-related toxicity, resulting from concomitant caffeine consumption. PMID:22671762

  9. Cirrhosis and Portal Hypertension

    MENU Return to Web version Cirrhosis and Portal Hypertension Overview What is cirrhosis? In people who have ... lead to coma and death. What is portal hypertension? Normally, blood is carried to the liver by ...

  10. Gestational Hypertension and Preeclampsia

    Full Text Available ... Your e-mail was sent. Save to my dashboard Sign in or Sign up to save this ... saved this page It's been added to your dashboard . Gestational hypertension and preeclampsia 4:17 Gestational hypertension ...

  11. Sinistral Portal Hypertension. A Case Report

    Dinesh Singhal

    2006-11-01

    Full Text Available Sinistral portal hypertension is a clinical syndrome of gastric variceal hemorrhage in the setting of splenic vein thrombosis due to a primary pancreatic pathology. The distinguishing features from other forms of portal hypertension are preserved liver function and a patent extrahepatic portal vein. The important causes include acute and chronic pancreatitis, pancreatic pseudocysts and pancreatic carcinomas. Benign pancreatic neoplasms only rarely cause sinistral portal hypertension. Splenic vein thrombosis complicates 7-20% of patients having pancreatitis or a pancreatic pseudocyst; however, bleeding occurs in only approximately 5% of patients. The diagnosis of sinistral portal hypertension is achieved by a combination of gastroscopy, liver function tests, ultrasound examination (with Doppler and/or contrast-enhanced CT scan of the abdomen.A mere demonstration of sinistral portal hypertension does not warrant intervention. An expectant management is justifiable in asymptomatic patients with pancreatitis. However, concomitant splenectomy may be considered in patients undergoing operative treatment of symptomatic chronic pancreatitis if sinistral portal hypertension and gastroesophageal varices are present. In patients presenting with gastric variceal hemorrhage, splenectomy (with treatment for the primary pancreatic pathology, e.g. distal pancreatectomy is curative with excellent long term results.

  12. Depression in hypertensive subjects.

    Ramachandran, V; Parikh, G J; Srinivasan, V

    1983-10-01

    168 patients attending hypertension clinic were randomly selected for the study. They were thoroughly investigated using E.C.G., X-ray chest, Urine analysis, Blood sugar, Blood urea, Serum cholesterol, Serum K, Serum Na, Scrum creatinine and Uric acid level. Detailed psychiatric case history and mental examination was carried out. Beck Rating Scale was used to measure the depression. 25% of hypertensive subjects exhibited depressive features and their mean score in Beck Rating scale is 21.76. The mean score of non-depressives is 4.46. All patients were receiving methyl dopa.25 mg. twice or thrice daily with thiazide diuretic. No significant difference in the incidence of depression with the duration of medication was observed.The hypertension was classified into mild, moderate and severe depending on the diastolic pressure. Depression was more frequent in severe hypertensives but not to the statistically significant level.Further hypertensives were classified into:1. Hypertension without organ involvement2. Hypertension with LVH only3. Hypertension with additional organ involvement4. Malignant hypertensionDepression was significantly more frequent in hypertensives with complications and also hypertensives in whom the B.P. remained uncontrolled. As all the patients were on the same drug, the drug effect is common to all; hence, the higher incidence of depression in hypertensives with complications is due to the limitation and distress caused by the illness. PMID:21847301

  13. Hypertension in pregnancy

    Andrea Ungar

    2007-03-01

    Full Text Available Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories: chronic hypertension, pre-eclampsia/eclampsia, pre-eclampsia superimposed on chronic hypertension, and gestational hypertension. A relative paucity of investigative data, as well as the frequent difficulty in making an etiological diagnosis, may lead to problems in its management. This case report analyses current concepts regarding the hypertensive disorders of gestation, focusing on chronic hypertension. Chronic hypertension is defined as blood pressure exceeding 140/90 mmHg before pregnancy or before 20 weeks gestation. Hypertensive disorders in pregnancy may cause maternal and fetal morbidity and remain a leading source of maternal mortality. A prompt diagnosis is needed also because hypertension may be an indicator of pre-eclampsia, a condition which can evolve into serious complications. Maintaining blood pressure below 140/90 mmHg is recommended, although treatment should be determined on an individual basis. Many anti-hypertensive agents appear to be safe for use during pregnancy: methildopa has been the most studied of the anti-hypertensive drugs and has the best safety record. Labetalol, idralazine and nifedipine also have been found to be safe; ACE-inhibitors are absolutely contraindicated, because they are associated with intrauterine growth retardation.

  14. Anatomical Closure of Left-to-Right Shunts in Premature Infants with Bronchopulmonary Dysplasia and Pulmonary Hypertension: A Cautionary Tale

    Dereddy, Narendra R.; Chilakala, Sandeep R.; Divya Rana

    2015-01-01

    Closure of a systemic to pulmonary shunt in premature infants with bronchopulmonary dysplasia may be beneficial, but in the presence of pulmonary hypertension is controversial. Here, we discuss two premature infants with pulmonary hypertension who developed acute pulmonary hypertensive crisis after closure of these shunts and hence advise caution.

  15. Anatomical Closure of Left-to-Right Shunts in Premature Infants with Bronchopulmonary Dysplasia and Pulmonary Hypertension: A Cautionary Tale

    Narendra R. Dereddy

    2015-10-01

    Full Text Available Closure of a systemic to pulmonary shunt in premature infants with bronchopulmonary dysplasia may be beneficial, but in the presence of pulmonary hypertension is controversial. Here, we discuss two premature infants with pulmonary hypertension who developed acute pulmonary hypertensive crisis after closure of these shunts and hence advise caution.

  16. Idiopathic portal hypertension

    To describe the radiologic findings of idiopathic portal hypertension and to find the points of differentiation between idiopathic portal hypertension and liver cirrhosis. Four portograms in five patients who for four years had suffered from pathologically confirmed idiopathic portal hypertension were retrospectively analyzed and compared with a portogram obtained from a control subject with liver cirrhosis. Portographic finding s of idiopathic portal hypertension were paucity of medium-sized portal branches, irregular and obtuse-angled division of peripheral branches, abrupt interruption and an avascular area beneath the liver margin. A portogram of idiopathic portal hypertension may be useful in differentiation this and liver cirrhosis

  17. Personality and Aggressive Behavior under Provoking and Neutral Conditions: A Meta-Analytic Review

    Bettencourt, Ann B.; Talley, Amelia; Benjamin, Arlin James; Valentine, Jeffery

    2006-01-01

    The authors conducted a comprehensive review to understand the relation between personality and aggressive behavior, under provoking and nonprovoking conditions. The qualitative review revealed that some personality variables influenced aggressive behavior under both neutral and provocation conditions, whereas others influenced aggressive…

  18. Experimental activation of the sphenopalatine ganglion provokes cluster-like attacks in humans

    Schytz, Henrik W; Barløse, Mads; Guo, Song; Selb, Juliette; Caparso, Anthony; Jensen, Rigmor; Ashina, Messoud

    2013-01-01

    stimulation may activate the SPG, causing increased parasympathetic outflow and thereby provoking cluster attacks in CH patients.MethodsIn a double-blind randomized cross-over study, seven CH patients implanted with an SPG neurostimulator were randomly allocated to receive HF or LF stimulation for 3 min on 2...

  19. Insulin Resistance and Hypertension

    张建华; 张春秀

    2002-01-01

    Summary: The insulin sensitivity in hypertensive patients with normal glucose tolerance (NGT),impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM) and the insulin resistance(IR) under the disorder of glucose metabolism and hypertension were studied. By glucose toler-ance test and insulin release test, insulin sensitivity index (ISI) and the ratio of area under glucosetolerance curve (AUCG) to area under insulin release curve (AUC1) were calculated and analyzed.The results showed that ISI was decreased to varying degrees in the patients with hypertension,the mildest in the group of NGT with hypertension, followed by the group of IGT without hyper-tension, the group of IGT with hypertension and DM (P=0). There was very significant differ-ence in the ratio of AUCG/AUC1 between the hypertensive patients with NGT and controls (P=0). It was concluded that a significant IR existed during the development of IGT both in hyperten-sion and nonhypertension. The increase of total insulin secretion (AUC1) was associated with non-hypertension simultaneously. IR of the hypertensive patients even existed in NGT and was wors-ened with the deterioration of glucose metabolism disorder, but the AUC1 in the HT groupchanged slightly. A relative deficiency of insulin secretion or dysfunction of β-cell of islet existed inIGT and DM of the hypertensive patients.

  20. Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Intensive care management of pulmonary hypertension

    Al-Azem, M. Ali; Al-Hazmi, Manal S.

    2014-01-01

    Pulmonary hypertension (PH) in the Intensive Care Unit (ICU) may be due to preexisting pulmonary vascular lung disease, liver disease, or cardiac diseases. PH also may be caused by critical illnesses, such as acute respiratory distress syndrome (ARDS), acute left ventricular dysfunction and pulmonary embolism, or may occur after cardiac or thoracic surgery. Regardless of the underlying cause of PH, the final common pathway for hemodynamic deterioration and death is RV failure, which is the most challenging aspect of patient management. Therapy is thus aimed at acutely relieving RV overload by decreasing PVR and reversing RV failure with pulmonary vasodilators and inotropes. PMID:25076990

  1. Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Intensive care management of pulmonary hypertension

    M. Ali Al-Azem

    2014-01-01

    Full Text Available Pulmonary hypertension (PH in the Intensive Care Unit (ICU may be due to preexisting pulmonary vascular lung disease, liver disease, or cardiac diseases. PH also may be caused by critical illnesses, such as acute respiratory distress syndrome (ARDS, acute left ventricular dysfunction and pulmonary embolism, or may occur after cardiac or thoracic surgery. Regardless of the underlying cause of PH, the final common pathway for hemodynamic deterioration and death is RV failure, which is the most challenging aspect of patient management. Therapy is thus aimed at acutely relieving RV overload by decreasing PVR and reversing RV failure with pulmonary vasodilators and inotropes.

  2. Cadmium and hypertension in exposed workers: A meta-analysis

    Tiziana Caciari; Angela Sancini; Mario Fioravanti; Teodorico Casale; Lucio Montuori; Maria Fiaschetti; Maria Pia Schifano; Giorgia Andreozzi; Nadia Nardone; Gianfranco Tomei; Manuela Ciarrocca; Maria Valeria Rosati; Francesco Tomei

    2013-01-01

    Objectives: In the general population, cadmium seems to be responsible for hypertension, atherosclerosis and an increase in acute coronary events. Therefore, the purpose of this meta-analysis was to analyze controlled studies conducted on cadmium and arterial pressure in occupationally-exposed workers. Materials and Methods: After analyzing all the relevant articles found in the literature, 6 publications were selected. Results: A higher prevalence of hypertension and higher values of systoli...

  3. Evaluation and treatment of hypertensive crises in children

    Stein DR

    2016-03-01

    Full Text Available Deborah R Stein, Michael A Ferguson Division of Nephrology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA Abstract: Hypertensive crises in children are medical emergencies that must be identified, evaluated, and treated promptly and appropriately to prevent end-organ injury and even death. Treatment in the acute setting typically includes continuous intravenous antihypertensive medications with monitoring in the intensive care unit setting. Medications commonly used to treat severe hypertension have been poorly studied in children. Dosing guidelines are available, although few pediatric-specific trials have been conducted to facilitate evidence-based therapy. Regardless of what medication is used, blood pressure should be lowered gradually to allow for accommodation of autoregulatory mechanisms and to prevent cerebral ischemia. Determining the underlying cause of the blood pressure elevation may be helpful in guiding therapy. Keywords: hypertensive crisis, hypertensive urgency, hypertensive emergency, antihypertensive medications

  4. Management of Hypertension among Patients with Coronary Heart Disease

    Oladipupo Olafiranye

    2011-01-01

    Full Text Available Evidence suggests that coronary heart disease (CHD is the most common outcome of hypertension. Hypertension accelerates the development of atherosclerosis, and sustained elevation of blood pressure (BP can destabilize vascular lesions and precipitate acute coronary events. Hypertension can cause myocardial ischemia in the absence of CHD. These cardiovascular risks attributed to hypertension can be reduced by optimal BP control. Although several antihypertensive agents exist, the choice of agent and the appropriate target BP for patients with CHD remain controversial. In this succinct paper, we examine the evidence and the mechanisms for the linkage between hypertension and CHD and we discuss the treatment options and the goals of therapy that are consistent with the report of the seventh Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7 and American Heart Association scientific statement. We anticipate changes in the recommendations of the forthcoming JNC 8.

  5. Cadmium and hypertension in exposed workers: A meta-analysis

    Tiziana Caciari

    2013-06-01

    Full Text Available Objectives: In the general population, cadmium seems to be responsible for hypertension, atherosclerosis and an increase in acute coronary events. Therefore, the purpose of this meta-analysis was to analyze controlled studies conducted on cadmium and arterial pressure in occupationally-exposed workers. Materials and Methods: After analyzing all the relevant articles found in the literature, 6 publications were selected. Results: A higher prevalence of hypertension and higher values of systolic and diastolic blood pressure were recorded in the exposed subjects. Conclusions: Cadmium in occupationallyexposed individuals appears to induce an increase in systolic and diastolic blood pressure and an increase in the prevalence of hypertension.

  6. Hypertension og hyperlipidaemi

    Hansen, Henrik Steen; Larsen, Mogens Lytken

    2009-01-01

    Hypertension and hyperlipidemia are well-established and partially overlapping risk factors for cardiovascular disease. Analyses of cardiovascular morbidity in relationship to changes in blood pressure and in serum cholesterol levels have shown that combined reduction of both risk factors are...... important to achieve a reduction in morbidity. Statins have been shown to be effective in preventing both coronary and cerebrovascular events in both hypertensive and normotensive cases. Consequently, most recent guidelines recommend that statin treatment be considered in hypertensive patients aged less...

  7. Hypertension in Malaysia

    Naing, Cho; Yeoh, Peng Nam; Wai, Victor Nyunt; Win, Ni Ni; Kuan, Lai Pei; Aung, Kyan

    2016-01-01

    Abstract This study aimed to determine trends in prevalence, awareness, and control of hypertension in Malaysia and to assess the relationship between socioeconomic determinants and prevalence of hypertension in Malaysia. The distribution of hypertension in Malaysia was assessed based on available data in 3 National Health and Morbidity Surveys (NHMSs) and 1 large scale non-NHMS during the period of 1996 to 2011. Summary statistics was used to characterize the included surveys. Differences in...

  8. TCM Dietotherapy for Hypertension

    DENG Zi; DUAN Shu-min

    2010-01-01

    @@ Hypertension is a common cardiovascular disease with a group of symptoms and signs, mainly the increased blood pressure of the arteries.It may be primary or secondary.The former, accounting for90%, refers to an independent disease mainly manifested by increased blood pressure with the cause unknown.Primary hypertension is related to nervousness, emotional fluctuation, heredity, obesity and high-salt diet.Secondary hypertension is one of the manifestations in certain disorders.

  9. Hypertension in Renal Transplantation: Saudi Arabian Experience

    Souqiyyeh Muhammad

    1999-01-01

    Full Text Available To evaluate the prevalence, etiologic factors and therapy of hypertension in actively followed up transplant population in Saudi Arabia; we retrospectively reviewed the records of the active renal transplant patients at two large transplant centers in Riyadh and Jeddah in Saudi Arabia. These subjects were transplanted between January 1979 and November 1998. The patients were grouped according to the measurement of blood pressure; group 1 (considered normo-tensive: blood pressure below 140/90 mmHg, group2: blood pressure between 140-159/90-99, group 3: blood pressure 160-179/100-109 group 4: equal to or above 180/110. There were 1115 patients′ records included in the study. The mean duration of transplantation was 66.9 ± 50.1 months. According to the level of measured blood pressure, there were 641 (57.5% patients in the normotensive group (group 1, 404 (36.3% patients in the mildly hypertensive group (group 2 64 (5.7% patients in the moderately severe hypertension group (group 3 and only six (0.5% patients in the severe hypertension group (group 4. The estimated prevalence of hypertension in this study was almost 85%. We found no significant difference in the prevalence of hypertension in terms of gender, year of transplantation, duration of transplantation, type of donor, number of previous transplants, diagnosis of renal artery stenosis, etiology of kidney disease, diagnosis of diabetes after transplantation, diagnosis of cerebrovascular accidents, or mean dose of prednisolone and cyclosporine. There was a statistically significant association between increased level of blood pressure and old age (above 50 years, original disease associated with hypertension, history of hypertension on dialysis, acute rejection (once or more, presence of protienuria (more than 0.3 mg/day, abnormality of ECG, or serum creatinine above 300 µmol/L. We conclude that hypertension is highly prevalent in the renal transplant population in Saudi Arabia. Risk

  10. Inhibition of Bcl-2 or IAP proteins does not provoke mutations in surviving cells

    Graphical abstract: - Highlights: • Mutagenicities of anti-cancer drugs were tested using HPRT, γH2AX and comet assays. • TRAIL, doxorubicin and etoposide were more mutagenic than BH3- or Smac-mimetics. • Physiologically achievable levels of the BH3-mimetic ABT-737 were not mutagenic. • High concentrations of ABT-737 provoked mutations via an off-target mechanism. • Even very high concentrations of IAP antagonists were not mutagenic. - Abstract: Chemotherapy and radiotherapy can cause permanent damage to the genomes of surviving cells, provoking severe side effects such as second malignancies in some cancer survivors. Drugs that mimic the activity of death ligands, or antagonise pro-survival proteins of the Bcl-2 or IAP families have yielded encouraging results in animal experiments and early phase clinical trials. Because these agents directly engage apoptosis pathways, rather than damaging DNA to indirectly provoke tumour cell death, we reasoned that they may offer another important advantage over conventional therapies: minimisation or elimination of side effects such as second cancers that result from mutation of surviving normal cells. Disappointingly, however, we previously found that concentrations of death receptor agonists like TRAIL that would be present in vivo in clinical settings provoked DNA damage in surviving cells. In this study, we used cell line model systems to investigate the mutagenic capacity of drugs from two other classes of direct apoptosis-inducing agents: the BH3-mimetic ABT-737 and the IAP antagonists LCL161 and AT-406. Encouragingly, our data suggest that IAP antagonists possess negligible genotoxic activity. Doses of ABT-737 that were required to damage DNA stimulated Bax/Bak-independent signalling and exceeded concentrations detected in the plasma of animals treated with this drug. These findings provide hope that cancer patients treated by BH3-mimetics or IAP antagonists may avoid mutation-related illnesses that afflict

  11. Biogenesis of Salmonella enterica Serovar Typhimurium Membrane Vesicles Provoked by Induction of PagC▿

    Kitagawa, Ryo; Takaya, Akiko; Ohya, Mai; Mizunoe, Yoshimitsu; Takade, Akemi; Yoshida, Shin-ichi; Isogai, Emiko; Yamamoto, Tomoko

    2010-01-01

    Gram-negative bacteria ubiquitously release membrane vesicles (MVs) into the extracellular milieu. Although MVs are the product of growing bacteria, not of cell lysis or death, the regulatory mechanisms underlying MV formation remained unknown. We have found that MV biogenesis is provoked by the induction of PagC, a Salmonella-specific protein whose expression is activated by conditions that mimic acidified macrophage phagosomes. PagC is a major constituent of Salmonella MVs, and increased ex...

  12. CONDITIONS PROVOKING AGGRESSIVE DRIVING IN PERCEPTION OF DRIVERS AND ROAD TRAFFIC INSPECTORS

    JENENKOVA OKSANA VJACHESLAVOVNA

    2012-01-01

    This article considers such a phenomenon like aggressive driving, which is the most dangerous violation, from the point of view of the road traffic safety. Analysis of the world statistical data shows the necessity of singling out young people, which manifest dangerous driving by car more often than other drivers and who are tended to road traffic traumatism the most. To improve work in this direction, it is required to understand, which conditions provoking aggressive driving exist in the pe...

  13. A noncoding plant pathogen provokes both transcriptional and posttranscriptional alterations in tomato

    Lisón Párraga, María Purificación; Tarraga Herrero, Susana; López Gresa, Mª Pilar; Sauri Ferrando, Asunción; Torres Vidal, Cristina; Campos Beneyto, Laura; Belles Albert, José Mª; Conejero Tomás, Vicente; Rodrigo Bravo, Ismael

    2013-01-01

    This is the accepted version of the following article: Lisón, P., Tárraga, S., López-Gresa, P., Saurí, A., Torres, C., Campos, L., Bellés, J. M., Conejero, V. and Rodrigo, I. (2013), A noncoding plant pathogen provokes both transcriptional and posttranscriptional alterations in tomato. Proteomics, 13: 833–844, which has been published in final form at http://dx.doi.org/10.1002/pmic.201200286.

  14. Inhibition of Bcl-2 or IAP proteins does not provoke mutations in surviving cells

    Shekhar, Tanmay M. [Department of Biochemistry, La Trobe Institute for Molecular Science, La Trobe University, Bundoora 3083 (Australia); Green, Maja M. [Department of Biochemistry, La Trobe Institute for Molecular Science, La Trobe University, Bundoora 3083 (Australia); Department of Anatomy & Neuroscience, The University of Melbourne, Parkville 3010 (Australia); Rayner, David M.; Miles, Mark A.; Cutts, Suzanne M. [Department of Biochemistry, La Trobe Institute for Molecular Science, La Trobe University, Bundoora 3083 (Australia); Hawkins, Christine J., E-mail: c.hawkins@latrobe.edu.au [Department of Biochemistry, La Trobe Institute for Molecular Science, La Trobe University, Bundoora 3083 (Australia)

    2015-07-15

    Graphical abstract: - Highlights: • Mutagenicities of anti-cancer drugs were tested using HPRT, γH2AX and comet assays. • TRAIL, doxorubicin and etoposide were more mutagenic than BH3- or Smac-mimetics. • Physiologically achievable levels of the BH3-mimetic ABT-737 were not mutagenic. • High concentrations of ABT-737 provoked mutations via an off-target mechanism. • Even very high concentrations of IAP antagonists were not mutagenic. - Abstract: Chemotherapy and radiotherapy can cause permanent damage to the genomes of surviving cells, provoking severe side effects such as second malignancies in some cancer survivors. Drugs that mimic the activity of death ligands, or antagonise pro-survival proteins of the Bcl-2 or IAP families have yielded encouraging results in animal experiments and early phase clinical trials. Because these agents directly engage apoptosis pathways, rather than damaging DNA to indirectly provoke tumour cell death, we reasoned that they may offer another important advantage over conventional therapies: minimisation or elimination of side effects such as second cancers that result from mutation of surviving normal cells. Disappointingly, however, we previously found that concentrations of death receptor agonists like TRAIL that would be present in vivo in clinical settings provoked DNA damage in surviving cells. In this study, we used cell line model systems to investigate the mutagenic capacity of drugs from two other classes of direct apoptosis-inducing agents: the BH3-mimetic ABT-737 and the IAP antagonists LCL161 and AT-406. Encouragingly, our data suggest that IAP antagonists possess negligible genotoxic activity. Doses of ABT-737 that were required to damage DNA stimulated Bax/Bak-independent signalling and exceeded concentrations detected in the plasma of animals treated with this drug. These findings provide hope that cancer patients treated by BH3-mimetics or IAP antagonists may avoid mutation-related illnesses that afflict

  15. The vascular smooth muscle alpha-actin gene is reactivated during cardiac hypertrophy provoked by load.

    Black, F M; Packer, S E; Parker, T G; Michael, L H; Roberts, R; R J Schwartz; Schneider, M D

    1991-01-01

    Cardiac hypertrophy triggered by mechanical load possesses features in common with growth factor signal transduction. A hemodynamic load provokes rapid expression of the growth factor-inducible nuclear oncogene, c-fos, and certain peptide growth factors specifically stimulate the "fetal" cardiac genes associated with hypertrophy, even in the absence of load. These include the gene encoding vascular smooth muscle alpha-actin, the earliest alpha-actin expressed during cardiac myogenesis; howeve...

  16. Idiopathic Intracranial Hypertension (Pseudotumor Cerebri)

    ... Asked Questions Español Condiciones Chinese Conditions Idiopathic Intracranial Hypertension (Pseudotumor Cerebri) En Español Read in Chinese What is idiopathic intracranial hypertension? Idiopathic intracranial hypertension (IIH) is a disorder that ...

  17. How Is Pulmonary Hypertension Diagnosed?

    ... from the NHLBI on Twitter. How Is Pulmonary Hypertension Diagnosed? Your doctor will diagnose pulmonary hypertension (PH) ... To Look for the Underlying Cause of Pulmonary Hypertension PH has many causes, so many tests may ...

  18. Mechanical ventilation and intra-abdominal hypertension: 'Beyond Good and Evil'

    Pelosi, Paolo; Vargas, Maria

    2012-01-01

    Intra-abdominal hypertension is frequent in surgical and medical critically ill patients. Intra-abdominal hypertension has a serious impact on the function of respiratory as well as peripheral organs. In the presence of alveolar capillary damage, which occurs in acute respiratory distress syndrome (ARDS), intra-abdominal hypertension promotes lung injury as well as edema, impedes the pulmonary lymphatic drainage, and increases intra-thoracic pressures, leading to atelectasis, airway closure, ...

  19. Hypertension and cognitive function.

    Paglieri, Cristina; Bisbocci, Daniela; Caserta, Mimma; Rabbia, Franco; Bertello, Chiara; Canadè, Antonella; Veglio, Franco

    2008-11-01

    Arterial hypertension, cerebrovascular disease, and dementia are related pathologies. This paper has reviewed comparatively the incidence of arterial hypertension and adult-onset dementia disorders. Hypertension is associated with cerebrovascular disease, which is in turn associated with dementia. It is the most important modifiable risk factor for stroke, which is a recognized cause of vascular dementia. In terms of pathophysiology of hypertensive brain damage, several hypotheses were developed, such as that vascular alterations induced by hypertension can induce lacunar or cortical infarcts and leucoaraiosis, that hypertension is responsible for cerebrovascular disease and acts into the contest of a pre-existing subclinic Alzheimer's disease (AD), that hypertension determines neurobiologic alterations (such as beta-amyloid accumulation) resulting in neuropathologic damage, and that aging and cerebrovascular risk factors act together to cause cerebral capillary degeneration, mitochondrial disruption, reduced glucose oxidation, and reduced ATP synthesis. The consequence of these alterations are neuronal death and dementia. Macroscopic results of these mechanisms are the so-called white matter lesions (WML), the significance of which is analyzed. Increasing clinical evidence suggests a close relationship between the reduction of elevated blood pressure and countering of both vascular dementia and AD. Antihypertensive treatment probably influences cognitive performances and prevents cognitive function alterations and the development of dementia. It is therefore important to evaluate as soon as possible cognitive functions of hypertensive patients. PMID:19021021

  20. Hypertension og hjernen

    Christensen, Hanne; Strandgaard, Svend

    2009-01-01

    Hypertension is a major and modifiable risk factor of stroke and dementia. Hypertension causes remodelling of the cerebral resistance vessels, impairing their tolerance to very low blood pressure. In primary prevention of stroke, the effect of beta-blockers is inferior to other classes of...

  1. Noncirrotisk intrahepatisk portal hypertension

    Dam Fialla, Annette; Havelund, Troels

    2007-01-01

    Non-cirrhotic intrahepatic portal hypertension is characterized by portal hypertension in the absence of liver cirrhosis or portal vein thrombosis. The disease is common in the East and rarely seen in the West. Two cases with oesophageal varices are described. The histopathology is heterogeneous...

  2. Hypertension and liver disease

    Henriksen, Jens H; Møller, Søren

    2004-01-01

    Arterial hypertension is a common disorder with a frequency of 10% to 15% in subjects in the 40- to 60-year age group. Yet most reports find the prevalence of arterial hypertension in patients with chronic liver disease (cirrhosis) much lower. In this review, we consider the alterations in systemic...

  3. Guanfacine in essential hypertension: Effect on blood pressure, plasma noradrenaline concentration and plasma renin activity

    Schoeppe, W; Brecht, H. M.

    1980-01-01

    1 The acute and chronic effects of guanfacine on blood pressure, plasma noradrenaline concentration and plasma renin activity were investigated in 23 patients (15 males, 8 females) with essential hypertension (WHO grade I-II).

  4. Hypertension in the Elderly

    Blas Gil-Extremera

    2012-01-01

    Full Text Available Background. The incidence of hypertension in the Western countries is continuously increasing in the elderly population and remains the leading cause of cardiovascular and morbidity. Methods. we analysed some significant clinical trials in order to present the relevant findings on those hypertensive population. Results. Several studies (SYST-EUR, HYVET, CONVINCE, VALUE, etc. have demonstrated the benefits of treatment (nitrendipine, hydrochrotiazyde, perindopril, indapamide, verapamil, or valsartan in aged hypertensive patients not only concerning blood pressure values but also the other important risk factors. Conclusion. Hypertension is the most prevalent cardiovascular disorder in the Western countries, and the relevance of receiving pharmacological treatment of hypertension in aged patients is crucial; in addition, the results suggest that combination therapy—nitrendipine plus enalapril—could have more benefits than those observed with the use of nitrendipine alone.

  5. Hypertension and cognitive impairment

    Su-hang SHANG

    2015-08-01

    Full Text Available As a leading risk factor for stroke, hypertension is also an important risk factor for cognitive impairment. Midlife hypertension doubles the risk of dementia later in life and accelerates the progression of dementia, but the correlation between late-life blood pressure and cognitive impairment is still unclear. Beside blood pressure, the effect of pulse pressure, blood pressure variability and circadian rhythm of blood pressure on cognition is currently attracting more and more attention. Hypertension induces alterations in cerebrovascular structure and functions, which lead to brain lesions including cerebral atrophy, stroke, lacunar infarcts, diffuse white matter damage, microinfarct and microhemorrhage, resuling in cognitive impairment. Hypertension also impairs the metabolism and transfer of amyloid-β protein (Aβ, thus accelerates cognitive impairment. Individualized therapy, focusing on characteristics of hypertensive patients, may be a good choice for prevention and treatment of cognitive impairment. DOI: 10.3969/j.issn.1672-6731.2015.08.004

  6. Overweight, adipocytokines and hypertension

    Seven, Ekim; Husemoen, Lise L N; Wachtell, Kristian;

    2014-01-01

    OBJECTIVE: The adipocytokines, leptin, adiponectin, and interleukin-6, which stimulate liver C-reactive protein (CRP) production, are regarded as potential candidate intermediates between adipose tissue and overweight-induced hypertension. METHODS: We examined the associations between leptin......, adiponectin, and CRP levels with both prevalent and 5-year incident hypertension (IHT) in a general population of Danish adults (n = 5,868, 51.3% women, mean age 45.8 ± 7.9 years). RESULTS: We recorded 2195 prevalent and 379 incident cases of hypertension. In models including leptin, CRP, adiponectin, sex...... fully adjusted model. The population attributable risk estimate of IHT owing to overweight was 31%. CONCLUSION: Leptin, but not adiponectin or CRP, may play a mediating role in overweight-induced hypertension. However, as BMI was a strong independent predictor of hypertension, other factors than leptin...

  7. Hypertension and liver disease

    Henriksen, Jens Henrik; Møller, Søren

    2004-01-01

    Arterial hypertension is a common disorder with a frequency of 10% to 15% in subjects in the 40- to 60-year age group. Yet most reports find the prevalence of arterial hypertension in patients with chronic liver disease (cirrhosis) much lower. In this review, we consider the alterations in systemic...... to increased arterial blood pressure. Subjects with established arterial hypertension (essential, secondary) may become normotensive during the development of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high...... circulating renin activity. There is much dispute as to the understanding of homeostatic regulation in cirrhotic patients with manifest arterial hypertension. This is a topic for future research....

  8. Toxicity of Ambient Particulate Matter IV: Acute toxicity study in pulmonary hypertensive rats after exposure to model compounds for the secondary aerosol fraction of PM10 - ammonium bisulfate, ferrosulfate and nitrate

    Cassee FR; Boere AJF; Fokkens PHB; Dormans JAMA; Bree L van; Rombout PJA; LEO; LPI

    1999-01-01

    This (4th) report on the toxicity of ambient particulate matter (PM) presents effects of the model compounds for PM in ambient air - ammonium bisulfate, ammonium ferrosulfate and ammonium nitrate - on healthy rats and rats with monocrotaline-induced pulmonary hypertension (PH). The objective was bas

  9. Pulmonary hypertension CT imaging

    Full text: The right heart catheterization is the gold standard in the diagnosis and determines the severity of pulmonary hypertension. The significant technical progress of noninvasive diagnostic imaging methods significantly improves the pixel density and spatial resolution in the study of cardiovascular structures, thus changes their role and place in the overall diagnostic plan. Learning points: What is the etiology, clinical manifestation and general pathophysiological disorders in pulmonary hypertension. What are the established diagnostic methods in the diagnosis and follow-up of patients with pulmonary hypertension. What is the recommended protocol for CT scanning for patients with clinically suspected or documented pulmonary hypertension. What are the important diagnostic findings in CT scan of a patient with pulmonary hypertension. Discussion: The prospect of instantaneous complex - anatomical and functional cardiopulmonary and vascular diagnostics seems extremely attractive. The contrast enhanced multislice computed (CT ) and magnetic resonance imaging are very suitable methods for imaging the structures of the right heart, with the possibility of obtaining multiple projections and three-dimensional imaging reconstructions . There are specific morphological features that, if carefully analyzed, provide diagnostic information. Thus, it is possible to avoid or at least reduce the frequency of use of invasive diagnostic cardiac catheterization in patients with pulmonary hypertension. Conclusion: This review focuses on the use of contrast-enhanced CT for comprehensive evaluation of patients with pulmonary hypertension and presents the observed characteristic changes in the chest, lung parenchyma , the structures of the right half of the heart and pulmonary vessels

  10. Vasculopathy and pulmonary hypertension in sickle cell disease

    Potoka, Karin P.; Gladwin, Mark T.

    2014-01-01

    Sickle cell disease (SCD) is an autosomal recessive disorder in the gene encoding the β-chain of hemoglobin. Deoxygenation causes the mutant hemoglobin S to polymerize, resulting in rigid, adherent red blood cells that are entrapped in the microcirculation and hemolyze. Cardinal features include severe painful crises and episodic acute lung injury, called acute chest syndrome. This population, with age, develops chronic organ injury, such as chronic kidney disease and pulmonary hypertension. ...

  11. Mechanisms responsible for pulmonary hypertension

    2008-01-01

    @@ Pulmonary hypertension is a pathophysiologic process characterized by progressive elevation of pulmonary vascular resistance and right heart failure, which is a common complication of many diseases. Pulmonary hypertension with no apparent causes (unknown etiology) is termed primary pulmonary hypertension or, more recently, idiopathic pulmonary arterial hypertension (IPAH).

  12. Anxiety-provoked gait changes are selectively dopa-responsive in Parkinson's disease.

    Ehgoetz Martens, Kaylena A; Ellard, Colin G; Almeida, Quincy J

    2015-08-01

    In order to understand how dopamine modulates the effect of anxiety on gait, the goal of this study was to use virtual reality to provoke anxiety in Parkinson's disease (PD) (in both ON and OFF states) and quantify its effect on gait. Seventeen participants with PD and 20 healthy age-matched controls were instructed to walk in a virtual environment in two anxiety-provoking conditions: (i) across a plank that was located on the GROUND and (ii) across an ELEVATED plank. All participants with PD completed this experiment in both the ON and OFF states, and were then striated into groups based on baseline trait anxiety scores for further analyses. Anxiety (skin conductance and self-report) and spatiotemporal aspects of gait were measured. Overall, the ELEVATED condition resulted in greater skin conductance levels and self-reported anxiety levels. Additionally, all participants demonstrated slower gait with increased step-to-step variability when crossing the ELEVATED plank compared with the plank on the GROUND. The results showed that dopaminergic treatment selectively improved gait in only the highly anxious PD group, by significantly improving velocity, step length, step time and step-to-step variability specifically when walking across the ELEVATED plank (ON vs. OFF comparison). In conclusion, only highly trait anxious participants with PD benefitted from dopaminergic treatment, specifically when walking in the anxiety-provoking environment. Improvements to gait during anxious walking might be a result of dopaminergic medication acting in two ways: (i) improving the basal ganglia's capacity to process information and (ii) reducing the load from anxiety and subsequently making more resources available to effectively process other competing inputs. PMID:25899750

  13. [Hypertension and renal disease

    Kamper, A.L.; Pedersen, E.B.; Strandgaard, S.

    2009-01-01

    hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive......Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...

  14. Hypertension og nyresygdom

    Kamper, Anne-Lise; Pedersen, Erling B; Strandgaard, Svend

    2009-01-01

    Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...... hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...

  15. Awareness and control of hypertension in Bangladesh: follow-up of a hypertensive cohort

    Alam, Dewan Shamsul; Chowdhury, Muhammad Ashique Haider; Siddiquee, Ali Tanweer; Ahmed, Shyfuddin; Niessen, Louis Wilhelmus

    2014-01-01

    Objectives To assess the effect of awareness and advice to seek care on blood pressure (BP) control among patients with hypertension in Bangladesh. Design Longitudinal study. Setting The study was carried out in icddr,b surveillance sites at rural Matlab in Chandpur district and semi-urban Kamalapur in Dhaka, Bangladesh. Participants Randomly selected men and non-pregnant women aged 20 years or older without any acute illness or history of any vascular events such as stroke or acute myocardia...

  16. Liver cirrhosis and arterial hypertension

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development of...... cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most...

  17. Hypertensive portal colopathy in schistosomiasis mansoni: proposal for a classification

    Maria Angelina C Miranda

    2004-08-01

    Full Text Available Portal hypertension is a frequent complication of chronic liver disease, detected not only in schistosomiasis, but also in cirrhosis of any etiology. Vascular alterations in the colonic mucosa are a potential source for acute or chronic bleeding and have been observed in patients with portal hypertension. The purpose of this prospective study was to describe and propose a classification for the vascular alterations of portal hypertension in the colonic mucosa among patients with hepatosplenic schistosomiasis mansoni. One or more alterations of portal colopathy were observed in all patients and they were classified according to their intensity, obeying the classification proposed by the authors. Portal colopathy is an important finding in hepatosplenic schistosomiasis and might be the cause of lower gastrointestinal bleeding in patients with severe portal hypertension.

  18. Chronic Hypertension in Pregnancy

    ... very commonly used to treat chronic hypertension. This drug class can cause problems in the fetus, in- cluding an increased risk of birth de- fects 4 and kidney failure. Angiotensin II receptor blockers also should be avoided ...

  19. Hypertension (High Blood Pressure)

    ... blood pressure with the development of a practical method to measure it. Physicians began to note associations between hypertension and risk of heart failure, stroke, and kidney failure. Although scientists had yet to prove that lowering blood pressure ...

  20. Gestational Hypertension and Preeclampsia

    Full Text Available ... Just a moment, please. You've saved this page It's been added to your dashboard . Gestational hypertension ... Map Premature birth report card Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness ...

  1. High Blood Pressure (Hypertension)

    ... Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products For Consumers Home For Consumers Consumer Information by Audience For Women High Blood Pressure (Hypertension) Share Tweet Linkedin Pin ...

  2. Screening for hypertension.

    Tomson, P R V

    1983-01-01

    In an open access screening campaign for hypertension lasting six weeks 6259 individuals were screened with a Vita-Stat blood pressure computer and an estimated 4.2% to 5.4% of new cases were detected.

  3. Study of the generation and suppression of runaway currents in provoked disruptions in J-TEXT

    Runaway currents following disruptions have an important effect on the first wall for the next generation tokamak. The behaviors of runaway currents following intentional provoked disruptions have been investigated in the J-TEXT tokamak. It is found that the runaway current generation following provoked disruptions depends on both the toroidal magnetic field and the plasma current. The conversion efficiency of pre-disruptive plasma currents into runaway currents is in the ranges of 30% to 60% in J-TEXT. The runaway currents can be avoided by the intensive gas puffing of H2 due to the low multiplication factor in J-TEXT. -- Highlights: ► The regime of runaway generation in disruptions in J-TEXT has been established. ► The magnetic field threshold for runaway current generation in disruptions is 2.2 T. ► The conversion efficiency of runaway current is in the ranges of 30% to 60%. ► The runaway currents can be avoided by the intensive gas puffing of H2.

  4. Current Injection Provokes Rapid Expansion of the Guard Cell Cytosolic Volume and Triggers Ca(2+) Signals.

    Voss, Lena J; Hedrich, Rainer; Roelfsema, M Rob G

    2016-03-01

    High-resolution microscopy opens the door for detailed single-cell studies with fluorescent reporter dyes and proteins. We used a confocal spinning disc microscope to monitor fluorescent dyes and the fluorescent protein Venus in tobacco and Arabidopsis guard cells. Multi-barreled microelectrodes were used to inject dyes and apply voltage pulses, which provoke transient rises in the cytosolic Ca(2+) level. Voltage pulses also caused changes in the distribution of Lucifer Yellow and Venus, which pointed to a reversible increase of guard cell cytosolic volume. The dynamic cytosolic volume changes turned out to be provoked by current injection of ions. A reduction of the clamp current, by blocking K(+) uptake channels with Cs(+), strongly suppressed the cytosolic volume changes. Cs(+) not only inhibited the expansion of the cytosol, but also inhibited hyperpolarization-induced elevations of the cytosolic Ca(2+) concentration. A complete loss of voltage-induced Ca(2+) signals occurred when Ca(2+)-permeable plasma membrane channels were simultaneously blocked with La(3+). This shows that two mechanisms cause hyperpolarization-induced elevation of the cytosolic Ca(2+)-concentration: (i) activation of voltage-dependent Ca(2+)-permeable channels, (ii) osmotically induced expansion of the cytosol, which leads to a release of Ca(2+) from intracellular stores. PMID:26902185

  5. H型高血压与急性脑梗死患者预后的关系研究%The Correlation of H Type Hypertension and Prognosis of Patients with Acute Cerebral Infarction

    王晶; 刘晶晶; 吴杨; 刘家丰; 于洋

    2013-01-01

    目的 探讨H型高血压与急性脑梗死患者预后的关系.方法 选择于2010年1月-2012年1月在我院住院的急性脑梗死合并高血压患者324例,根据血浆同型半胱氨酸(Hcy)水平将其分为H型高血压组(Hcy≥10 μmol/L)241例与对照组(Hcy0. 05 ) . H type hypertension group had higher NIHSS score , lower BI score, and lower proportion of 0 - 2 scoring in mRS than the control group both on admission and at 90 days ( P <0.05). Logistic analysis results showed that H type hypertension [ OR = 2. 447 , 95% CI( 1.878, 5.248), P= 0.027] was an independent risk factor for poor prognosis of ACI. Conclusion ACI patients with H type hypertension have serious neurological dysfunction and poor diagnosis.

  6. Diabetes Mellitus and Hypertension

    Tuğrul, Armağan

    2002-01-01

    Hypertension is a major worldwide health problem. Its prevalence is 1.5-2 times higher in diabetic population than that in non-diabetic individuals. Its pathogenesis depends on diabetic nephropathy in type 1, whereas may be multifactorial in type 2 diabetes mellitus. In diabetics, angiotensin converting enzyme inhibitors are most widely preferred in the treatment of hypertension because of their numerous desirable effects. In this article, the most recent data are presented on the relationshi...

  7. Apelin and pulmonary hypertension

    Andersen, Charlotte Uggerhøj; Hilberg, Ole; Mellemkjær, Søren;

    2011-01-01

    Pulmonary arterial hypertension (PAH) is a devastating disease characterized by pulmonary vasoconstriction, pulmonary arterial remodeling, abnormal angiogenesis and impaired right ventricular function. Despite progress in pharmacological therapy, there is still no cure for PAH. The peptide apelin...... vasoconstriction, and has positive inotropic and cardioprotective effects. Apelin attenuates vasoconstriction in isolated rat pulmonary arteries, and chronic treatment with apelin attenuates the development of pulmonary hypertension in animal models. The existing literature thus renders APLNR an interesting...

  8. Thromboembolic chronicle pulmonary Hypertension

    The thromboembolic chronicle pulmonary Hypertension, also well known as chronic lung thromboembolism not resolved; it is a form not very common of lung thromboembolism. Until very recently was considered a rare curiosity of autopsy, but as the methods of diagnoses have improved and our attitude has changed, the incidence of this nosological entity has experienced a notable increment, but the most excellent in this illness is maybe that it is a form of lung hypertension, potentially recoverable

  9. Idiopathic pulmonary arterial hypertension

    Firth, Amy L.; Mandel, Jess; Yuan, Jason X.-J.

    2010-01-01

    Despite improved understanding of the pathobiology of pulmonary arterial hypertension (PAH), it remains a severe and progressive disease, usually culminating in right heart failure, significant morbidity and early mortality. Over the last decade, some major advances have led to substantial improvements in the management of PAH. Much of this progress was pioneered by work in animal models. Although none of the current animal models of pulmonary hypertension (PH) completely recapitulate the hum...

  10. Myocardial stress in patients with acute cerebrovascular events

    Jespersen, C.M.; Hansen, J.F.

    2008-01-01

    patients. The huge majority of these findings are fully reversible. The changes may mimic myocardial infarction, but are not necessarily identical to coronary thrombosis. Based on the literature these signs may represent an acute catecholamine release provoked by the cerebrovascular catastrophe itself and...

  11. Hypertension in Women—Part II

    Pemu, Priscilla Igho; Ofili, Elizabeth

    2008-01-01

    In Part I, we reviewed the pathophysiology of hypertension in women This section focuses on the treatment of hypertension in special circumstances and special populations: pregnancy, preeclampsia, and lactation; hypertension in black women; and hypertension in the elderly.

  12. Pulmonary hypertension associated with acute or chronic lung diseases in the preterm and term neonate and infant. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK.

    Hilgendorff, Anne; Apitz, Christian; Bonnet, Damien; Hansmann, Georg

    2016-05-01

    Persistent pulmonary hypertension of the newborn (PPHN) is the most common neonatal form and mostly reversible after a few days with improvement of the underlying pulmonary condition. When pulmonary hypertension (PH) persists despite adequate treatment, the severity of parenchymal lung disease should be assessed by chest CT. Pulmonary vein stenosis may need to be ruled out by cardiac catheterisation and lung biopsy, and genetic workup is necessary when alveolar capillary dysplasia is suspected. In PPHN, optimisation of the cardiopulmonary situation including surfactant therapy should aim for preductal SpO2between 91% and 95% and severe cases without post-tricuspid-unrestrictive shunt may receive prostaglandin E1 to maintain ductal patency in right heart failure. Inhaled nitric oxide is indicated in mechanically ventilated infants to reduce the need for extracorporal membrane oxygenation (ECMO), and sildenafil can be considered when this therapy is not available. ECMO may be indicated according to the ELSO guidelines. In older preterm infant, where PH is mainly associated with bronchopulmonary dysplasia (BPD) or in term infants with developmental lung anomalies such as congenital diaphragmatic hernia or cardiac anomalies, left ventricular diastolic dysfunction/left atrial hypertension or pulmonary vein stenosis, can add to the complexity of the disease. Here, oral or intravenous sildenafil should be considered for PH treatment in BPD, the latter for critically ill patients. Furthermore, prostanoids, mineralcorticoid receptor antagonists, and diuretics can be beneficial. Infants with proven or suspected PH should receive close follow-up, including preductal/postductal SpO2measurements, echocardiography and laboratory work-up including NT-proBNP, guided by clinical improvement or lack thereof. PMID:27053698

  13. Peroxisome Proliferator-Activated Receptor-α Activation Decreases Mean Arterial Pressure, Plasma Interleukin-6, and COX-2 While Increasing Renal CYP4A Expression in an Acute Model of DOCA-Salt Hypertension

    Dexter L. Lee

    2011-01-01

    Full Text Available Peroxisome proliferator-activated receptor-alpha (PPAR-α activation by fenofibrate reduces blood pressure and sodium retention during DOCA-salt hypertension. PPAR-α activation reduces the expression of inflammatory cytokines, such as interleukin-6 (IL-6. Fenofibrate also induces cytochrome P450 4A (CYP4A and increases 20-hydroxyeicosatetraenoic acid (20-HETE production. This study tested whether the administration of fenofibrate would reduce blood pressure by attenuating plasma IL-6 and renal expression of cyclooxygenase-2 (COX-2, while increasing expression of renal CYP4A during 7 days of DOCA-salt hypertension. We performed uni-nephrectomy on 12–14 week old male Swiss Webster mice and implanted biotelemetry devices in control, DOCA-salt (1.5 mg/g treated mice with or without fenofibrate (500 mg/kg/day in corn oil, intragastrically. Fenofibrate significantly decreased mean arterial pressure and plasma IL-6. In kidney homogenates, fenofibrate increased CYP4A and decreased COX-2 expression. There were no differences in renal cytochrome P450, family 2, subfamily c, polypeptide 23 (CYP2C23 and soluble expoxide hydrolase (sEH expression between the groups. Our results suggest that the blood pressure lowering effect of PPAR-α activation by fenofibrate involves the reduction of plasma IL-6 and COX-2, while increasing CYP4A expression during DOCA-salt hypertension. Our results may also suggest that PPAR-α activation protects the kidney against renal injury via decreased COX-2 expression.

  14. Generalized seizure with falling and unresponsive staring provoked by somatosensory stimulation: a video-EEG study.

    Suzuki, Sayaka; Sassa, Kaori; Abe, Yuichi; Yamanouchi, Hideo

    2015-09-01

    We report a 4-year-old boy with generalized seizures with abrupt falling and unresponsive staring provoked by somatosensory stimuli of the face. Ictal manifestation comprised a sudden fall immediately after wiping the face, followed by unresponsive staring for around 10 seconds, during which time the video-EEG recorded paroxysmal 3-Hz diffuse spike-wave complexes, which were followed by high-voltage 3.5 to 4-Hz delta wave discharges, predominantly appearing in the bilateral frontal areas. Seizures were not controlled by clonazepam, valproate or levetiracetam, but were successfully treated with lamotrigine added to valproate. This type of generalized reflex seizure has so far not been reported in the literature. [Published with video sequence]. PMID:26235696

  15. A model for provoking ischemic necrosis in rat liver parenchyma and its quantitative analysis.

    Frederiks, W M; James, J; Bosch, K S; Schröder, M J; Schuyt, H C

    1982-01-01

    Ischemia in the left lateral and median lobe of the rat liver was provoked by means of a small clip, as applied in human microvascular surgery. After various periods of ischemia (30, 40, 50, 60 and 90 min) the blood flow to these lobes was restored. Twenty-four hours after restoration, the extent of necrosis was estimated quantitatively via morphometric measurements of the relative surfaces of necrotic tissue in photomicrographs of gallocyanin-stained serial sections. After periods of ischemia longer than 40 min, the percentage of necrotic tissue increased linearly with the period of clamping. After 40 min of total ischemia the changes in hepatocytes are for the greater part reversible, whereas after 90 min the majority of the cells have passed the "point of no return" and will no more be able to maintain their integrity. PMID:7160451

  16. Effect of Gingko Injection on the Expression of NF-κB in Pulmonary Vessels of Rats with Portal Hypertension

    2005-01-01

    1 Introduction Domestic scholars have originated the conception of “portal hypertensive vasculopathy(PHV)”, which concerns multiple organ vasculopathies in portal hypertensive patients. Portal hypertensive pulmonary vasculopathy is also a kind of internal organ vasculopathy. The transcription factor nuclear factor κB (NF-κB) regulates the expressions of genes that contribute to acute inflammatory reactions in endothelium. Few have reported about the expression of NF-κB in pulmonary vessels of rats related w...

  17. Emergências hipertensivas Hypertensive emergencies

    Gilson Soares Feitosa-Filho

    2008-09-01

    ão controlada. Este conhecimento deve ser rotineiro ao emergencista e Intensivista no momento de decidir sobre a conduta.Emergencies and hypertensive crises are clinical situations which may represent more than 25% of all medical emergency care. Considering such high prevalence, physicians should be prepared to correctly identify these crises and differentiate between urgent and emergent hypertension. Approximately 3% of all visits to emergency rooms are due to significant elevation of blood pressure. Across the spectrum of blood systemic arterial pressure, hypertensive emergency is the most critical clinical situation, thus requiring special attention and care. Such patients present with high blood pressure and signs of acute specific target organ damage (such as acute myocardial infarction, unstable angina, acute pulmonary edema, eclampsia, and stroke. Key elements of diagnosis and specific treatment for the different presentations of hypertensive emergency will be reviewed in this article. The MedLine and PubMed databases were searched for pertinent abstracts, using the key words "hypertensive crises" and "hypertensive emergencies". Additional references were obtained from review articles. Available English language clinical trials, retrospective studies and review articles were identified, reviewed and summarized in a simple and practical way. The hypertensive crisis is a clinical situation characterized by acute elevation of blood pressure followed by clinical signs and symptoms. These signs and symptoms may be mild (headache, dizziness, tinnitus or severe (dyspnea, chest pain, coma or death. If the patient presents with mild symptoms, but without acute specific target organ damage, diagnosis is hypertensive urgency. However, if severe signs and symptoms and acute specific target organ damage are present, then the patient is experiencing a hypertensive emergency. Some patients arrive at the emergency rooms with high blood pressure, but without any other sign or symptom. In

  18. Hypertensive effects of the iv administration of picomoles of ouabain

    A.S. Padilha

    2011-09-01

    Full Text Available Ouabain, an endogenous digitalis compound, has been detected in nanomolar concentrations in the plasma of several mammals and is associated with the development of hypertension. In addition, plasma ouabain is increased in several hypertension models, and the acute or chronic administration of ouabain increases blood pressure in rodents. These results suggest a possible association between ouabain and the genesis or development and maintenance of arterial hypertension. One explanation for this association is that ouabain binds to the α-subunit of the Na+ pump, inhibiting its activity. Inhibition of this pump increases intracellular Na+, which reduces the activity of the sarcolemmal Na+/Ca2+ exchanger and thereby reduces Ca2+ extrusion. Consequently, intracellular Ca2+ increases and is taken up by the sarcoplasmic reticulum, which, upon activation, releases more calcium and increases the vascular smooth muscle tone. In fact, acute treatment with ouabain enhances the vascular reactivity to vasopressor agents, increases the release of norepinephrine from the perivascular adrenergic nerve endings and promotes increases in the activity of endothelial angiotensin-converting enzyme and the local synthesis of angiotensin II in the tail vascular bed. Additionally, the hypertension induced by ouabain has been associated with central mechanisms that increase sympathetic tone, subsequent to the activation of the cerebral renin-angiotensin system. Thus, the association with peripheral mechanisms and central mechanisms, mainly involving the renin-angiotensin system, may contribute to the acute effects of ouabain-induced elevation of arterial blood pressure.

  19. Liver Disease and Pulmonary Hypertension

    Liver Disease Pulmonary & PH Hypertension Did you know that if you have liver disease, you are at risk for pulmonary ... to the liver without cirrhosis. How does liver disease relate to pulmonary hypertension? Liver disease can cause what is known ...

  20. Hypertension and cerebrovascular damage.

    Veglio, Franco; Paglieri, Cristina; Rabbia, Franco; Bisbocci, Daniela; Bergui, Mauro; Cerrato, Paolo

    2009-08-01

    Hypertension is the most important modifiable factor for cerebrovascular disease. Stroke and dementia are growing health problems that have considerable social and economical consequences. Hypertension causes brain lesions by several mechanisms predisposing to lacunar infarctions, leucoaraiosis, and white matter changes as well as to intracerebral haemorrhages. These parenchymal damages determine evident or silent neurological alterations that often precede the onset of cognitive decline. It is important to recognize cerebrovascular disease and, above all, to correlate typical lesions to hypertension. Antihypertensive therapy has shown clinical benefits in primary and secondary prevention of stroke. These drugs represent important instruments against cerebrovascular disease but their effects on cognition are still matter of debate. Cerebral parenchymal and functional damages have to be considered together to make medical intervention more incisive. PMID:19100549

  1. Knowing hypertension and diabetes

    Whyte, Susan Reynolds

    2015-01-01

    In Uganda, hypertension and diabetes have only recently been included in the health policy agenda. As they become treatable disorders, they take on more distinct contours in people's minds. This article relates knowledge about these two conditions to health institutions and technology for diagnos......In Uganda, hypertension and diabetes have only recently been included in the health policy agenda. As they become treatable disorders, they take on more distinct contours in people's minds. This article relates knowledge about these two conditions to health institutions and technology...... for diagnosing and treating them. The response to the AIDS epidemic in Uganda provides an important context for, and contrast with, the emergence of hypertension and diabetes as social phenomena. Ethnographic fieldwork shows the interplay between experience of these conditions and the political economy...

  2. Hypertension in the elderly

    Giuliano Pinna

    2012-12-01

    Full Text Available IntroductionThere is a high prevalence of hypertension in the elderly, as evidenced by clinical and health behavioral policies. Still, there are uncertainties on the treatment of hypertension, especially treatment of the very elderly. These considerations have largely been ignored in clinical trials due to concern regarding contamination by other pathologies that are difficult to frame and manage.Methods We performed an effective and ample literature review and provided reflections on the Consensus Conference ACCF/AHA 2011 on the principle types of hypertension found in the elderly. We also considered the associated principle pathologies for various treatments and related organs.Discussion Even if the goal of treatment of elevated blood pressure in the elderly is same as in younger population, it is no longer certain that a target systolic blood pressure (SBP <140 mmHg should be persistently reached in the very elderly. It is important to note that for all studies these values have never been reached. In the treatment of isolated systolic hypertension (ISH the preferred target is a SBP >160 mmHg. Treating hypertension in the elderly and very elderly reduces the risk of stroke and heart failure, though the evidence is inconclusive for all-cause mortality.Conclusion Hypertension in the elderly is very common and needs to be treated with criteria that consider the patient's age, comorbidities, lifestyle and adherence. Above all, in the very elderly, therapeutic treatment should be personalized according to the above criteria. Where possible pharmaceutical therapy should be limited at the preference of healthy lifestyle changes (physical activity, diet, etc..

  3. Serum Calcium Level in Hypertension

    Hazari, Mohammed Abdul Hannan; Arifuddin, Mehnaaz Sameera; Muzzakar, Syed; Reddy, Vontela Devender

    2012-01-01

    Background: The alterations in extracellular calcium level may influence intracellular calcium level and possibly play a role in the pathogenesis of essential hypertension. Aim: The purpose was to find out the association between serum calcium levels and hypertension; and to compare the serum calcium levels between normotensive controls, hypertensive subjects on calcium channel blockers, and hypertensive subjects on antihypertensive medication other than calcium channel blockers. Materials an...

  4. Clinical hypertension: a new era

    Ha, Jong-Won

    2014-01-01

    We are delighted to announce the launch of the new journal Clinical Hypertension. Clinical Hypertension is an open-access, peer-reviewed, online journal, which will publish scientific investigation of the highest quality in the field of blood pressure regulation and pathophysiology, treatment, and prevention of hypertension. The editors encourage the submission of original articles that deal with basic, clinical, and population studies of hypertension and related fields, such as cardiology, n...

  5. Idiopathic intracranial hypertension

    Yri, Hanne M; Jensen, Rigmor H

    2015-01-01

    AIMS: The aims of this article are to characterize the headache in idiopathic intracranial hypertension (IIH) and to field-test the ICHD diagnostic criteria for headache attributed to IIH. MATERIALS AND METHODS: We included 44 patients with new-onset IIH. Thirty-four patients with suspected but...... tinnitus may suggest intracranial hypertension. Based on data from a well-defined IIH cohort, we propose a revision of the ICDH-3 beta diagnostic criteria with improved clinical applicability and increased sensitivity and specificity....

  6. Experimental study on the establishment and haemodynamic outcome of different acute pulmonary hypertension models%不同急性肺动脉高压模型的建立及其血流动力学转归的实验研究

    吴文振; 郝恩魁; 程义伟; 解崔环; 孟彦; 苏国海

    2012-01-01

    Objectives To evaluate the advantages and disadvantages of different methods of establishing experimental dog models with acute pulmonary hypertension, and to evaluate the hemodynamic changes of pulmonary hypertension caused by the suture line method. Methods Fifteen anesthetized mongrel dogs were randomly divided into the glucan group, suture group and thrombosis group, five in each group. The injection of glucan, suture line and autologous blood clots through the pulmonary artery catheter established corresponding animal models of acute pulmonary embolism. The cardiac catheter indexes RVSP were measured to evaluate the advantages and disadvantages of the different experimental methods. The measured cardiac catheterization indexes and the capacity index measured by echocardiography were used to study hemodynamic changes in the suture line group. Results The glucan group and suture group showed more repeatability (stability) than that of thrombosis group (P0.05). Moderate increasing of pulmonary artery pressure and right ventricle pressure load resulted in expansion of pulmonary artery and right ventricle, mild decrease of aortic systolic pressure and cardiac output(P>0.05). Severe pulmonary hypertension and right ventricle pressure load increase resulted in further expansion of the pulmonary artery and right ventricle, severe decrease of aortic systolic pressure and cardiac output(P < 0.05). Conclusion The method using the suture line is simpler and more effective to establish the acute pulmonary hypertension model and research hemodynamic changes. Biventricular hemodynamic changes derived from acute pulmonary hypertension will be helpful for clinical evaluation and treatment of acute pulmonary embolism.%目的 探讨葡聚糖法、缝线线段法和自体血栓法建立急性肺动脉高压模型的优劣及缝线线段法造成急性肺动脉高压的血流动力学变化.方法 实验犬l5只,随机分成葡聚糖法组、缝线线段法

  7. Special Situations in Pulmonary Hypertension: Pregnancy and Right Ventricular Failure.

    Svetlichnaya, Jana; Janmohammed, Munir; De Marco, Teresa

    2016-08-01

    Despite rapid advances in medical therapy, pregnancy and right ventricular (RV) failure predicts a poor prognosis in patients with pulmonary arterial hypertension. Evidence-based therapy for pulmonary arterial hypertension should be initiated early in the disease course to decrease RV wall stress and prevent RV remodeling and fibrosis. In patients with acutely decompensated RV failure, an aggressive and multifaceted approach must be used; a thorough search for triggering factors for the decompensation is a key part of the successful management strategy. Patients with refractory RV failure who are not candidates for surgical intervention should be referred to palliative care to maximize quality of life and symptom relief. PMID:27443142

  8. Referred pain patterns provoked on intra-pelvic structures among women with and without chronic pelvic pain: a descriptive study.

    Thomas Torstensson

    Full Text Available To describe referred pain patterns provoked from intra-pelvic structures in women with chronic pelvic pain (CPP persisting after childbirth with the purpose to improve diagnostics and give implications for treatment.In this descriptive and comparative study 36 parous women with CPP were recruited from a physiotherapy department waiting list and by advertisements in newspapers. A control group of 29 parous women without CPP was consecutively assessed for eligibility from a midwifery surgery. Inclusion criterion for CPP was: moderate pain in the sacral region persisting at least six months after childbirth confirmed by pelvic pain provocation tests. Exclusion criteria in groups with and without CPP were: persistent back or pelvic pain with onset prior to pregnancy, previous back surgery and positive neurological signs. Pain was provoked by palpation of 13 predetermined intra-pelvic anatomical landmarks. The referred pain distribution was expressed in pain drawings and described in pain maps and calculated referred pain areas.Pain provoked by palpation of the posterior intra-pelvic landmarks was mostly referred to the sacral region and pain provoked by palpation of the ischial and pubic bones was mostly referred to the groin and pubic regions, with or without pain referred down the ipsilateral leg. The average pain distribution area provoked by palpation of all 13 anatomical landmarks was 30.3 mm² (19.2 to 53.7 in women with CPP as compared to 3.2 mm² (1.0 to 5.1 in women without CPP, p< 0.0001.Referred pain patterns provoked from intra-pelvic landmarks in women with CPP are consistent with sclerotomal sensory innervation. Magnification of referred pain patterns indicates allodynia and central sensitization. The results suggest that pain mapping can be used to evaluate and confirm the pain experience among women with CPP and contribute to diagnosis.

  9. A systematic review of nicardipine vs labetalol for the management of hypertensive crises.

    Peacock, W Frank; Hilleman, Daniel E; Levy, Phillip D; Rhoney, Denise H; Varon, Joseph

    2012-07-01

    Hypertensive emergencies are acute elevations in blood pressure (BP) that occur in the presence of progressive end-organ damage. Hypertensive urgencies, defined as elevated BP without acute end-organ damage, can often be treated with oral agents, whereas hypertensive emergencies are best treated with intravenous titratable agents. However, a lack of head-to-head studies has made it difficult to establish which intravenous drug is most effective in treating hypertensive crises. This systematic review presents a synthesis of published studies that compare the antihypertensive agents nicardipine and labetalol in patients experiencing acute hypertensive crises. A MEDLINE search was conducted using the term "labetalol AND nicardipine AND hypertension." Conference abstracts were searched manually. Ultimately, 10 studies were included, encompassing patients with hypertensive crises across an array of indications and practice environments (stroke, the emergency department, critical care, surgery, pediatrics, and pregnancy). The results of this systematic review show comparable efficacy and safety for nicardipine and labetalol, although nicardipine appears to provide more predictable and consistent BP control than labetalol. PMID:21908132

  10. Primary lung hypertension in-patient with hypertension portal

    Thorax x-rays were reviewed in 18 patients with portal hypertension. In 28% of these we found radiologic signs of pulmonary hypertension of the precapillary type. The existing relation between primary pulmonary hypertension and portal hypertension has been established in different scientific papers. In the published series the incidence of primary pulmonary hypertension is less than the one of found in these patients the physiopathology of this association is reviewed, and as a hypothetic manner it is postulated the possible roll of the hypoxaemia of the residents, at the altitude of the Bogota city. (2.640 mts) as a helping factor in this phenomenon