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

    DEFF Research Database (Denmark)

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

    2004-01-01

    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 (blood pressure to 51 +/- 3 mmHg, decreased urine output, and shifted NHE3 and NaPi2 out of the low......-density membranes enriched in apical markers. PTH at much lower doses (blood pressure and was diuretic. In conclusion, acute hypotension per se increases proximal tubule Na(+) reabsorption without changing NHE3 or NaPi2 subcellular distribution, indicating that trafficking...... in 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...

  2. Acute surgical management in idiopathic intracranial hypertension.

    LENUS (Irish Health Repository)

    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.

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

    DEFF Research Database (Denmark)

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

    1998-01-01

    Acute hypertension provokes a rapid decrease in proximal tubule sodium reabsorption with a decrease in basolateral membrane sodium-potassium-ATPase activity and an increase in the density of membranes containing apical membrane sodium/hydrogen exchangers (NHE3) [Y. Zhang, A. K. Mircheff, C. B....... Renal cortex lysate was fractionated on sorbitol gradients. Basolateral membrane sodium-potassium-ATPase activity (but not subunit immunoreactivity) decreased one-third to one-half after BP was elevated and recovered after BP was normalized. After BP was elevated, 55% of the apical NHE3 immunoreactivity......, smaller fractions of sodium-phosphate cotransporter immunoreactivity, and apical alkaline phosphatase and dipeptidyl-peptidase redistributed to membranes of higher density enriched in markers of the intermicrovillar cleft (megalin) and endosomes (Rab 4 and Rab 5), whereas density distributions...

  4. Vasopressor mechanisms in acute aortic coarctation hypertension

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    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

  5. Acute and reversible cardiomyopathy provoked by stress in a Chinese woman

    Institute of Scientific and Technical Information of China (English)

    KANG Lian-ming; ZHANG Jian; DOU Ke-fei; XU Zhi-min; GAO Xiao-jin; YANG Yue-jin

    2008-01-01

    @@ Areversible cardiomyopathy triggered by psychologically stressful events occurs in older women and may mimic evolving acute myocardial infarction or coronary syndrome.This condition is characterized by a distinctive form of systolic dysfunction that predominantly affects the distal left ventricle chamber and a favourable outcome with appropriate medical therapy.

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

    DEFF Research Database (Denmark)

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

    1998-01-01

    Acute systolic arterial hypertension provokes a rapid decrease in proximal tubule sodium reabsorption and diuresis associated with inhibition of renal cortex Na,K-ATPase activity and redistribution of apical membrane Na/H exchanger (NHE-3) to heavier density membranes containing markers of interm......Acute systolic arterial hypertension provokes a rapid decrease in proximal tubule sodium reabsorption and diuresis associated with inhibition of renal cortex Na,K-ATPase activity and redistribution of apical membrane Na/H exchanger (NHE-3) to heavier density membranes containing markers...... reabsorption and diuresis and abolishes Na,K-ATPase inhibition and NHE-3 redistribution during acute hypertension, evidence that these responses may be mediated by cytochrome P-450 arachidonate metabolites....

  7. Spores of Aspergillus versicolor isolated from indoor air of a moisture-damaged building provoke acute inflammation in mouse lungs.

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    Jussila, Juha; Komulainen, Hannu; Kosma, Veli-Matti; Nevalainen, Aino; Pelkonen, Jukka; Hirvonen, Maija-Riitta

    2002-12-01

    Microbial growth in moisture-damaged buildings has been associated with respiratory health effects, and the spores of the mycotoxin producing fungus Aspergillus versicolor are frequently present in the indoor air. To characterize the potential of these spores to cause harmful respiratory effects, mice were exposed via intratracheal instillation to a single dose of the spores of A. versicolor (1 x 10(5), 1 x 10(6), 5 x 10(6), 1 x 10(7), or 1 x 10(8) spores), isolated from the indoor air of a moisture-damaged building. Inflammation and toxicity in lungs were evaluated 24 h later by assessment of biochemical markers and histopathology. The time course of the effects was investigated with the dose of 5 x 10(6) spores for up to 28 days. The exposure to the spores increased transiently proinflammatory cytokine levels (tumor necrosis factor [TNF] alpha and interleukin [IL]-6) in bronchoalveolar lavage fluid (BALF). The cytokine responses were dose and time dependent. The highest cytokine concentrations were measured at 6 h after the dose, and they returned to the control level by 3 days. Moreover, the spores of A. versicolor recruited inflammatory cells into airways: Neutrophils peaked transiently at 24 h, macrophages at 3 days, and lymphocytes at 7 days after the dosing. The inflammatory cell response did not completely disappear during the subsequent 28 days, though no histopathological changes were seen at that time point. The spores did not induce expression of inducible nitric oxide synthase in lavaged cells. Only the highest spore dose (1 x 10(8)) markedly increased serum IL-6, increased vascular leakage, and caused cytotoxicity (i.e., increased levels of albumin, total protein, lactate dehydrogenase [LDH], and hemoglobin in BALF) in the airways. In summary, the spores of A. versicolor caused acute inflammation in mouse lungs. This indicates that they have potential to provoke adverse health effects in the occupants of moisture-damaged buildings.

  8. Therapy of acute hypertension in hospitalized children and adolescents.

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    Webb, Tennille N; Shatat, Ibrahim F; Miyashita, Yosuke

    2014-04-01

    Acute hypertension (HTN) in hospitalized children and adolescents occurs relatively frequently, and in some cases, if not recognized and treated promptly, it can lead to hypertensive crisis with potentially significant morbidity and mortality. In contrast to adults, where acute HTN is most likely due to uncontrolled primary HTN, children and adolescents with acute HTN are more likely to have secondary HTN. This review will briefly cover evaluation of acute HTN and various age-specific etiologies of secondary HTN and provide more in-depth discussion on treatment targets, potential risks of acute HTN therapy, and available pediatric data on intravenous and oral antihypertensive agents, and it proposes treatment schema including unique therapy of specific secondary HTN scenarios.

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

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    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.

  10. Risk factors for hypertensive crisis in children with acute glomerulonephritis

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    Sherly Yuniarchan

    2016-07-01

    Full Text Available Background Hypertensive crisis occurs in 1-4% of the hypertensive pediatric population, mostly due to acute glomerulonephritis (AGN. Some factors have been suggested to affect blood pressure (BP in children, such as age, sex, race/ethnicity, obesity, and socioeconomic status, but little is known for risk factors for hypertensive crisis in AGN.Objective To analyze the risk factors for hypertensive crisis in children with AGN.Methods Retrospectively, we studied possible risk factors for hypertensive crisis in children with AGN at Dr. Soetomo Hospital from 2007 to 2011. Hypertensive crisis was defined as systolic BP ≥180 mmHg or diastolic BP ≥120 mmHg (for children ≥ 6 years of age; and systolic and/or diastolic BP >50% above the 95th percentile (for children aged <6 years. We evaluated the demographic and clinical characteristics as potential risk factors. Statistical analysis was done with Chi-square, Fisher’s exact, and logistic regression tests. Variables with P <0.25 in the univariable analysis were further analyzed by the multivariable logistic regression model. A P value of < 0.05 was considered statistically significant.Results There were 101 children included (mean age 9.7 (SD 2.17 years, with a male-to-female ratio of 2.7:1. Hypertensive crisis occurred in 42 (41.6% children, of whom 8 had hypertensive urgency and 34 had hypertensive emergency. Proteinuria was seen in 53 children with AGN (52.5% and was the significant risk factor for hypertensive crisis in our subjects (OR=2.75; 95%CI 1.16 to 6.52; P=0.021. Gender, clinical profiles, ethnicity, nutritional status, blood urea nitrogen (BUN, and glomerular filtration rate (GFR were not significant risk factors for hypertensive crisis.Conclusion Proteinuria is the significant risk factor for hypertensive crisis in children with AGN.

  11. Pulmonary hypertension due to acute respiratory distress syndrome

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    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.

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

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    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.

  13. Brain death provokes very acute alteration in myocardial morphology detected by echocardiography: preventive effect of beta-blockers.

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    Ferrera, René; Hadour, Guylaine; Tamion, Fabienne; Henry, Jean-Paul; Mulder, Paul; Richard, Vincent; Thuillez, Christian; Ovize, Michel; Derumeaux, Geneviève

    2011-03-01

    Our objective was to evaluate immediate acute changes in myocardial function during the autonomic storm of brain death (BD). Wistar rats were divided into four groups (n = 8/group): controls without any treatment, β-blocker (Esmolol®, 10 mg/kg), calcium channel blocker (Diltiazem®, 10 mg/kg), or alpha-blocker (Prazosin®, 0.3 mg/kg). Treatments were administered intravenously 5 min before BD induction. Echocardiography (ATL-5000, 8 MHz) was performed to measure left ventricular (LV) dimensions and fractional shortening at baseline, during BD induction and 5 min and 15 min after BD. In controls, BD was immediately associated with an increase in wall thickness and a decrease in LV cavity dimension. This myocardial wall hypertrophy was completely prevented by β-blockers, but not with calcium- and alpha-blockers. Extensive myocardial interstitial edema was found in all groups, except in the β-blocker group. Myocardial wall hypertrophy was also prevented during a longer follow-up of 180 min after BD in β-blocker group as opposed to controls. In conclusion, BD is associated with an immediate and severe myocardial damage related to an important interstitial edema which is prevented by β-blockers.

  14. Acute hemodynamic response to vasodilators in primary pulmonary hypertension.

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    Kulkarni H

    1996-01-01

    Full Text Available Acute hemodynamic effects of high flow oxygen (O2 inhalation, sublingual isosorbide dinitrate (ISDN, intravenous aminophylline (AMN and sublingual nifedipine (NIF were studied in 32 patients with primary pulmonary hypertension (PPH. In 30 out of 32 patients the basal ratio of pulmonary to systemic vascular resistance (Rp/Rs was > 0.5 (mean = 0.77 +/- 0.20. Oxygen caused significant decrease in the mean resistance ratio to 0.68 +/- 0.20 (p = 0.005. ISDN, AMN and NIF caused increase in the resistance ratio to 0.79 +/- 0.26; 0.78 +/- 0.26; and 0.80 +/- 0.23 respectively. O2, ISDN, AMN and NIF caused a fall of Rp/Rs in 21 (65.6%, 10 (31.2%, 10(31.2% and 9(28.1% patients respectively. Thus, of the four drugs tested high flow O2 inhalation resulted in fall of Rp/Rs in two thirds of patients whereas ISDN, AMN and NIF caused a mean rise in Rp/Rs. One third of patients did respond acutely to the latter three drugs. Acute hemodynamic studies are useful before prescribing vasodilators in patients with PPH since more of the commonly used drugs like ISDN, AMN, NIF could have detrimental hemodynamic responses in some patients. However, great caution should be exercised before performing hemodynamic study as the procedure has definite mortality and morbidity.

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

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    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

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

    Institute of Scientific and Technical Information of China (English)

    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...

  17. 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

    Institute of Scientific and Technical Information of China (English)

    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

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

    DEFF Research Database (Denmark)

    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. Pl...... 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....

  19. Diuretic response to acute hypertension is blunted during angiotensin II clamp

    DEFF Research Database (Denmark)

    Leong, Patrick K K; Zhang, Yibin; Yang, Li E;

    2002-01-01

    ("ANG II clamp"). When blood pressure was acutely increased 50-60 mmHg by arterial constriction without ANG II clamp, urine output and endogenous lithium clearance increased 4.0- and 6.7-fold, respectively. With ANG II clamp, the effects of acute hypertension were reduced 50%: urine output...... and endogenous lithium clearance increased two- and threefold, respectively. We conclude that HOE-140, an inhibitor of the B(2) receptor, potentiates the sensitivity of arterial pressure to ANG II and that clamping systemic ANG II levels during acute hypertension blunts the magnitude of the pressure diuretic...

  20. Management of provoked seizure

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    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.

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

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    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.].

  2. Improvement of Acetylcholine-Induced Vasodilation by Acute Exercise in Ovariectomized Hypertensive Rats.

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    Cheng, Tsung-Lin; Lin, Yi-Yuan; Su, Chia-Ting; Hu, Chun-Che; Yang, Ai-Lun

    2016-06-30

    Postmenopause is associated with the development of cardiovascular disease, such as hypertension. However, limited information is available regarding effects of exercise on cardiovascular responses and its underlying mechanisms in the simultaneous postmenopausal and hypertensive status. We aimed to investigate whether acute exercise could enhance vasodilation mediated by acetylcholine (ACh) and sodium nitroprusside (SNP) in ovariectomized hypertensive rats. The fifteen-week-old female spontaneously hypertensive rats (SHR) were bilaterally ovariectomized, at the age of twenty-four weeks, and randomly divided into sedentary (SHR-O) and acute exercise (SHR-OE) groups. Age-matched WKY rats were used as the normotensive control group. The SHR-OE group ran on a motor-driven treadmill at a speed of 24 m/min for one hour in a moderate-intensity program. Following a single bout of exercise, rat aortas were isolated for the evaluation of the endothelium-dependent (ACh-induced) and endothelium-independent (SNP-induced) vasodilation by the organ bath system. Also, the serum levels of oxidative stress and antioxidant activities, including malondialdehyde (MDA), superoxide dismutase (SOD), and catalase, were measured after acute exercise among the three groups. We found that acute exercise significantly enhanced the ACh-induced vasodilation, but not the SNP-induced vasodilation, in ovariectomized hypertensive rats. This increased vasodilation was eliminated after the inhibition of nitric oxide synthase (NOS). Also, the activities of SOD and catalase were significantly increased after acute exercise, whereas the level of MDA was comparable among the three groups. These results indicated that acute exercise improved the endothelium-dependent vasodilating response to ACh through the NOS-related pathway in ovariectomized hypertensive rats, which might be associated with increased serum antioxidant activities.

  3. PULMONARY AND CARDIAC GENE EXPRESSION FOLLOWING ACUTE ULTRAFINE CARBON PARTICLE INHALATION IN HYPERTENSIVE RATS

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    Inhalation of ultrafine carbon particles (ufCP) causes cardiac physiological changes without marked pulmonary injury or inflammation. We hypothesized that acute ufCP exposure of 13 months old Spontaneously Hypertensive (SH) rats will cause differential effects on the lung and hea...

  4. Acute episode of cyclic vomiting syndrome preceded by arterial hypertension – Case presentation and review.

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    Keller, K; Desuki, A; Hobohm, L; Münzel, T; Ostad, M A

    2015-10-01

    Cyclic vomiting syndrome (CVS) is a functional disorder with recurrent episodes of vomiting. Between these episodes patients recover to well-being. Lack of awareness often leads to a delay in making the diagnosis. The diagnosis is based on a typical medical history and exclusion of other causes. We present a case report of a middle-aged patient who had recurrent episodes of vomiting for 12 years coinciding with hypertension. After excluding other causes, CVS was diagnosed. The episodes of acute vomiting were stopped by administration of antiemetic and sedative drugs and urapidil reduced the hypertension. Treatment with sedatives stops vomiting caused by the emetic centre of the central nervous system.

  5. [Changes in serum immunoglobulins in subjects with acute myocardial infarct and essential hypertension].

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    Campisi, D; Paterna, S; Bivona, A; Cricchio, I; Cilluffo, P; Cannistraro, F; Furitano, G

    1983-12-30

    20 (12 men and 8 women) acute myocardial infarction (AMI) patients and 17 (14 men and 3 women) patients with arterial hypertension (II degrees stage according to OMS) in comparison to controls age and sex matched, were studied, serum IgA, IgG, IgM were evaluated with radial immunodiffusion and serum IgE with RIA. Ho significant changes ef immunoglobulins were observed between hypertensive patients and controls; whereas a significant increase of IgM, IgG and IgE, with out changes of IgA, were shown in AMI patients. Serum Ig and IgM were significantly augmented in AMI patients in comparison to hypertensive patients.

  6. Systolic blood pressure reactions to acute stress are associated with future hypertension status in the Dutch Famine Birth Cohort Study

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    Carroll, Douglas; Ginty, Annie T; Painter, Rebecca C; Tessa J Roseboom; Phillips, Anna C.; de Rooij, Susanne R.

    2012-01-01

    These analyses examined the association between blood pressure reactions to acute psychological stress and subsequent hypertension status in a substantial Dutch cohort. Blood pressure was recorded during a resting baseline and during three acute stress tasks, Stroop colour word, mirror tracing and speech. Five years later, diagnosed hypertension status was determined by questionnaire. Participants were 453 (237 women) members of the Dutch Famine Birth Cohort. In analysis adjusting for a n...

  7. Effects of acute and chronic exercise in patients with essential hypertension: benefits and risks.

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    Gkaliagkousi, Eugenia; Gavriilaki, Eleni; Douma, Stella

    2015-04-01

    The importance of regular physical activity in essential hypertension has been extensively investigated over the last decades and has emerged as a major modifiable factor contributing to optimal blood pressure control. Aerobic exercise exerts its beneficial effects on the cardiovascular system by promoting traditional cardiovascular risk factor regulation, as well as by favorably regulating sympathetic nervous system (SNS) activity, molecular effects, cardiac, and vascular function. Benefits of resistance exercise need further validation. On the other hand, acute exercise is now an established trigger of acute cardiac events. A number of possible pathophysiological links have been proposed, including SNS, vascular function, coagulation, fibrinolysis, and platelet function. In order to fully interpret this knowledge into clinical practice, we need to better understand the role of exercise intensity and duration in this pathophysiological cascade and in special populations. Further studies in hypertensive patients are also warranted in order to clarify the possibly favorable effect of antihypertensive treatment on exercise-induced effects.

  8. [Hypertension].

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    Ohishi, Mitsuru

    2014-04-01

    Hypertension is well known to one of the risk factors to reduce cognitive function, however, it is still unclear whether anti-hypertensive therapy is effective to prevent development of dementia or Alzheimer's disease. Epidemiological studies suggested antihypertensive therapy from the middle-age could reduce risk of dementia. The meta-analysis including HYVET also suggested blood pressure lowering from the elderly might be also effective to prevent development of dementia. The network meta-analysis and the cohort study using mega-data bank suggested ARB might be effective to prevent development of dementia or Alzheimer's disease compared to administration with other anti-hypertensive drugs. Although the further major clinical investigation is required, anti-hypertensive treatment might be useful to manage hypertensive patients with dementia.

  9. 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

    DEFF Research Database (Denmark)

    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...... 1999 with an enzyme-verified MI to 33 Danish coronary care units. Hypertension was considered present when a previous diagnosis of hypertension was accompanied by relevant medical therapy. Survival information for all patients was obtained in January 2002. RESULTS: Of the 3,326 patients studied, 825...

  10. 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.

    Science.gov (United States)

    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.

  11. 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

    Directory of Open Access Journals (Sweden)

    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.

  12. Hypertension

    OpenAIRE

    2012-01-01

    Hypertension is responsible for roughly one-in-six adult deaths annually in the United States and is associated with five of the top nine causes of death. 1 Ten trillion dollars is the estimated annual cost worldwide of the direct and indirect effects of hypertension. 2,3 In the U.S. alone, costs estimated at almost $74 billion in 2009 placed a huge economic burden on the health care system. 4 The prevalence of hypertension increases with advancing age to the point where more than half of peo...

  13. Plasma thrombomodulin changes in acute cerebral infarction or hypertension patients An observation for verification

    Institute of Scientific and Technical Information of China (English)

    Pu Feng; Hui Zhang; Bingyi Yang; Yonggang Zheng; Jinhui Xie; Ying Wang; Jinchuan Li

    2008-01-01

    BACKGROUND: Thrombomodulin concentration greatly increases in plasma when vascular endothelial cells are injured, and it is one of the specific molecular markers for endothelial injury.OBJECTIVE: To analyze the plasma levels of thrombomodulin after cerebral infarction or hypertension, and to compare levels with those from healthy control subjects.DESIGN: A case-controlled observation. SETTING: Yuquan Hospital of Tsinghua University.PARTICIPANTS: Patients with hypertension (n = 37) and acute cerebral infarction (n = 26) were selected from the outpatient and inpatient Department of Neurology, Yuquan Hospital of Tsinghua University from February 2003 to February 2006. The cerebral infarction group consisted of 24 males and 2 females, 36–77 years of age, with a mean age of 62 years. All patients fulfilled the diagnosis criteria for cerebral infarction, according to the diagnostic standards revised by the Second National Academic Meeting for Cerebrovascular Disease, and were confirmed by CT or MRI. The hypertension group consisted of 27 males and 10 females, 36–77 years of age, with a mean age of 56 years. These patients fulfilled the diagnostic criteria for hypertension set by WHO. In addition, 43 healthy physical examinees were selected as the control group, consisting of 23 males and 20 females, 35–67 years of age.Informed consent was obtained from all participants.METHODS: In the cerebral infarction group, thrombomodulin plasma levels were determined by enzyme-linked immunoabsorbent assay at days 1, 3, 7, and 14 after attack. Thrombomodulin plasma levels were determined only once in the hypertension group and the control group. The results from the cerebral infarction group were compared with those from the hypertension group and the control group. MAIN OUTCOME MEASURES: Level of thrombomodulin in plasma.RESULTS: All 63 patients and 43 healthy volunteers were included in the final analysis of results. ① At 7 days after the attack, the plasma levels of

  14. Acute Response to Unilateral Unipolar Electrical Carotid Sinus Stimulation in Patients With Resistant Arterial Hypertension.

    Science.gov (United States)

    Heusser, Karsten; Tank, Jens; Brinkmann, Julia; Menne, Jan; Kaufeld, Jessica; Linnenweber-Held, Silvia; Beige, Joachim; Wilhelmi, Mathias; Diedrich, André; Haller, Hermann; Jordan, Jens

    2016-03-01

    Bilateral bipolar electric carotid sinus stimulation acutely reduced muscle sympathetic nerve activity (MSNA) and blood pressure (BP) in patients with resistant arterial hypertension but is no longer available. The second-generation device uses a smaller unilateral unipolar disk electrode to reduce invasiveness while saving battery life. We hypothesized that the second-generation device acutely lowers BP and MSNA in treatment-resistant hypertensive patients. Eighteen treatment-resistant hypertensive patients (9 women/9 men; 53±11 years; 33±5 kg/m(2)) on stable medications have been included in the study. We monitored finger and brachial BP, heart rate, and MSNA. Without stimulation, BP was 165±31/91±18 mm Hg, heart rate was 75±17 bpm, and MSNA was 48±14 bursts per minute. Acute stimulation with intensities producing side effects that were tolerable in the short term elicited interindividually variable changes in systolic BP (-16.9±15.0 mm Hg; range, 0.0 to -40.8 mm Hg; P=0.002), heart rate (-3.6±3.6 bpm; P=0.004), and MSNA (-2.0±5.8 bursts per minute; P=0.375). Stimulation intensities had to be lowered in 12 patients to avoid side effects at the expense of efficacy (systolic BP, -6.3±7.0 mm Hg; range, 2.8 to -14.5 mm Hg; P=0.028 and heart rate, -1.5±2.3 bpm; P=0.078; comparison against responses with side effects). Reductions in diastolic BP and MSNA (total activity) were correlated (r(2)=0.329; P=0.025). In our patient cohort, unilateral unipolar electric baroreflex stimulation acutely lowered BP. However, side effects may limit efficacy. The approach should be tested in a controlled comparative study.

  15. Impact of acute exercise on antioxidant enzymes activity and lipid status in blood of patients with hypertension

    Directory of Open Access Journals (Sweden)

    Kostić Nada

    2009-01-01

    Full Text Available Background/Aim. Many studies support the hypothesis that oxidative stress is involved in the pathogenic process of a variety of diseases including hypertension. In humans, hypertension is also considered a state of oxidative stress that can contribute to the development of arteriosclerosis and other hypertension- induced organ damage. The aim of this study was to evaluate an influence of acute physical exercise on antioxidative enzymes activity and lipid status in patients with hypertension. Methods. Forty patients with hypertension and 20 age-matched controls were included in the study. To assess an influence of acute exercise on lipids and antioxidative enzymes activity the following parameters were determined at rest and immediately after the acute cardiopulmonary exercise cycloergometer test: triglycerides (TG, total cholesterol, low density cholesterol (LDL, oxidised LDL cholesterol (OxLDL, superoxide dismutase (SOD, glutathione peroxidase (GSH-Px and plasminogen activator inhibitor (PAI. Results. In basal condition, hypertensive patients compared to the control group had increased, but not significantly, level of Ox LDL (88.61±14.06 vs 79.00±29.26 mmol/L, PAI (3.06±0.56 vs 2.6±0.35 U/mL and activity of GSH-Px (50.22±15.20 vs 44.63±13.73 U/g Hb. After acute exercise test, there was significantly greater level of Ox LDL (79.0±29.26 vs 89.3±29.07 mmol/L; p < 0.05 only in the control group. GSH-Px activity was significantly decreased only in hypertensive patients after acute exercise (50.22±15.2 vs 42.82±13.42 U/g Hb; p < 0.05, but not in the controls. Conclusion. No significantly elevated Ox LDL, GSH-Px and PAI-1 levels were found in hypertensive patients during basal condition in comparison with healthy subjects. Decreased GSH-Px activity was associated with those in acute exercise only in hypertensive patients. It could be an important indicator of deficiency of physiological antioxidative defense mechanism in hypertensive

  16. Systolic blood pressure reactions to acute stress are associated with future hypertension status in the Dutch Famine Birth Cohort Study.

    Science.gov (United States)

    Carroll, Douglas; Ginty, Annie T; Painter, Rebecca C; Roseboom, Tessa J; Phillips, Anna C; de Rooij, Susanne R

    2012-08-01

    These analyses examined the association between blood pressure reactions to acute psychological stress and subsequent hypertension status in a substantial Dutch cohort. Blood pressure was recorded during a resting baseline and during three acute stress tasks, Stroop colour word, mirror tracing and speech. Five years later, diagnosed hypertension status was determined by questionnaire. Participants were 453 (237 women) members of the Dutch Famine Birth Cohort. In analysis adjusting for a number of potential confounders, systolic blood pressure reactivity was positively related to future hypertension. This was the case irrespective of whether reactivity was calculated as the peak or the average response to the stress tasks. The association was strongest for reactions to the speech and Stroop tasks. Diastolic blood pressure reactivity was not significantly associated with hypertension. The results provide support for the reactivity hypothesis.

  17. Alpha B-crystallin improved survival of retinal ganglion cells in a rat model of acute ocular hypertension

    Institute of Scientific and Technical Information of China (English)

    Zhihong Wu; Layi Wang; Shike Hou

    2012-01-01

    Increased endogenous αB-crystallin protein levels have been shown to reduce cell apoptosis,although the effects of exogenous αB-crystallin protein remain poorly understood.The present study established an acute ocular hypertension model in the right eye of Sprague-Dawley rats.Fluorogold retrograde tracing and immunofluorescence methods showed that the number of retinal ganglion cells decreased in the right eyes and caspase-3 expression increased following acute ocular hypertension.Intravitreal injection of αB-crystallin in the right eye increased the number of retinal ganglion cells and reduced caspase-3 expression.Results demonstrated that exogenous αB-crystallin protein inhibited caspase-3 expression and improved retinal ganglion cell survival following acute ocular hypertension.

  18. Acutely exacerbated hypertension and increased inflammatory signs due to radiation treatment for metastatic pheochromocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Teno, Shinichi; Tanabe, Akiyo; Nomura, Kaoru; Demura, Hiroshi [Tokyo Women`s Medical Coll. (Japan)

    1996-10-01

    Hypertension and norepinephrine hypersecretion in a 59-year-old woman suffering from malignant pheochromocytoma with multiple metastases were appropriately controlled with {alpha}- and {beta}- blockers, and {alpha}-methyltyrosine ({alpha}-MT), a catecholamine-synthesis inhibitor. Metastasized vertebrae were treated with external radiation to relieve pain, but this treatment had to be interrupted at a total dose of 20 Gy because the patient suffered acutely exacerbated hypertension (200/110 mmHg), tachycardia (160 beats/min) and a low-grade fever. Simultaneously her serum levels of LDH, potassium, urea nitrogen, creatinine, white blood cell count, CRP and norepinephrine were significantly increased, suggesting that this episode was due to radiation-induced tissue destruction and the leakage of catecholamines and possibly interleukin-6, a cytokine mediating inflammation which is reportedly present in pheochromocytoma. The marked hypertension was controlled by continuous iv administration of phentolamine and propranolol. Although radiation therapy effectively relieves pain due to neoplasmic metastasis to the bone, physicians should be aware that life-threatening complications such as the above occur in malignant pheochromocytoma. Sufficient pretreatment with adrenergic blocking agents and/or {alpha}-MT and careful monitoring of the patient`s general condition during radiation therapy, even at a low dose, are highly recommended. (author)

  19. 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

    Directory of Open Access Journals (Sweden)

    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.

  20. Hypertension

    OpenAIRE

    2016-01-01

    Defining hypertension in pregnancy is challenging because blood pressure levels in pregnancy are dynamic, having a circadian rhythm and also changing with advancing gestational age. The accepted definition is a sustained systolic (sBP) of ≥140 mmHg or a sustained diastolic blood pressure (dBP) ≥90 mmHg, by office (or in-hospital) measurement. Measurement of blood pressure in pregnancy should follow standardised methods, as outside pregnancy. Blood pressure measurement may occur in three types...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    DEFF Research Database (Denmark)

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

    1996-01-01

    Acute arterial hypertension provokes a rapid decrease in proximal tubule (PT) Na+ reabsorption, increasing flow to the macula densa, the signal for tubuloglomerular feedback. We tested the hypothesis, in rats, that Na+ transport is decreased due to rapid redistribution of apical Na+/H+ exchangers...... 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 phosphatase...... is attributed to decreased activity of the transporters. Benzolamide did not alter Na+ transporter activity or distribution, implying that decreasing apical Na+ uptake does not initiate redistribution or inhibition of basolateral Na(+)-K(+)-ATPase. We conclude that PT natriuresis provoked by acute arterial...

  3. Hypertension and hypertensive encephalopathy.

    Science.gov (United States)

    Price, Raymond S; Kasner, Scott E

    2014-01-01

    The definition of hypertension has continuously evolved over the last 50 years. Hypertension is currently defined as a blood pressure greater than 140/90mmHg. One in every four people in the US has been diagnosed with hypertension. The prevalence of hypertension increases further with age, affecting 75% of people over the age of 70. Hypertension is by far the most common risk factor identified in stroke patients. Hypertension causes pathologic changes in the walls of small (diameter<300 microns) arteries and arterioles usually at short branches of major arteries, which may result in either ischemic stroke or intracerebral hemorrhage. Reduction of blood pressure with diuretics, β-blockers, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors have all been shown to markedly reduce the incidence of stroke. Hypertensive emergency is defined as a blood pressure greater than 180/120mmHg with end organ dysfunction, such as chest pain, shortness of breath, encephalopathy, or focal neurologic deficits. Hypertensive encephalopathy is believed to be caused by acute failure of cerebrovascular autoregulation. Hypertensive emergency is treated with intravenous antihypertensive agents to reduce blood pressure by 25% within the first hour. Selective inhibition of cerebrovascular blood vessel permeability for the treatment of hypertensive emergency is beginning early clinical trials.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Acute effect of calcium blocker on renal hemodynamics in diabetic spontaneously hypertensive rat.

    Science.gov (United States)

    Kaizu, K; Ling, Q Y; Uriu, K; Ikeda, M; Eto, S

    1995-01-01

    This study was done to examine the acute effect of a calcium channel blocker on renal hemodynamics in the diabetic spontaneously hypertensive rat (SHR). Streptozotocin was used to induce diabetes, and barnidipine (B) was used as a calcium blocker. Renal blood flow (RBF) and glomerular filtration rate (GFR) were measured by a clearance method with paraaminohypurate (PAH) and inulin, respectively. Rats were divided into two groups: nondiabetic SHR, N-SHR; diabetic SHR, DM-SHR. B increased RBF in N-SHR (7.44 +/- 1.99 versus 8.50 +/- 1.97 mL/min/g.kw) while there was no change in DM-SHR. B reduced renovascular resistance (RVR) in DM-SHR and N-SHR. B increased GFR in N-SHR (1.15 +/- 0.24 versus 1.34 +/- 0.25 mL/min/g.kw), in spite of no changes in DM-SHR. B did not modify filtration fraction (FF) in both groups. These results indicate (1) in SHR, B exerts beneficial effects on hypertensive renal damage by reducing mean arterial pressure (MAP), RVR, RBF, and GFR; (2) in diabetic SHR, B is less effective in restoring renal hyperfiltration in spite of reducing RVR.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  7. Intra-abdominal Hypertension: An Important Consideration for Diuretic Resistance in Acute Decompensated Heart Failure.

    Science.gov (United States)

    Nguyen, Vinh Q; Gadiraju, Taraka V; Patel, Hiren; Park, Minnsun; Le Jemtel, Thierry H; Jaiswal, Abhishek

    2016-01-01

    Fluid accumulation is the hallmark of heart failure decompensation. Fluid overload and congestion are associated with recurrent hospitalizations, poor quality of life, and increased mortality in heart failure. Despite the use of high-dose intravenous loop diuretic therapy, acutely decompensated heart failure patients may develop diuretic resistance. Diuretic refractoriness can be a result of elevated intra-abdominal pressure (IAP) in acutely decompensated heart failure. Increased renal venous and interstitial pressures in patients with elevated IAP may lead to renal impairment and diuretic resistance. Routine approaches such as sequential nephron blockade with a combination of loop and thiazide or thiazide-like diuretics, continuous diuretic infusion, and ultrafiltration may not be sufficient. Presented here is a case illustrating the importance of recognizing intra-abdominal hypertension in patients with diuretic resistance. Lowering IAP improves renal perfusion, renal filtration, and diuresis. When elevated, IAP is an easily reversible cause of diuretic resistance. Additionally, abdominal perfusion pressure can be used to guide therapy to reverse end-organ damage and avoid permanent renal replacement therapy.

  8. Orchid sexual deceit provokes ejaculation.

    Science.gov (United States)

    Gaskett, A C; Winnick, C G; Herberstein, M E

    2008-06-01

    Sexually deceptive orchids lure pollinators by mimicking female insects. Male insects fooled into gripping or copulating with orchids unwittingly transfer the pollinia. The effect of deception on pollinators has been considered negligible, but we show that pollinators may suffer considerable costs. Insects pollinating Australian tongue orchids (Cryptostylis species) frequently ejaculate and waste copious sperm. The costs of sperm wastage could select for pollinator avoidance of orchids, thereby driving and maintaining sexual deception via antagonistic coevolution or an arms race between pollinator learning and escalating orchid mimicry. However, we also show that orchid species provoking such extreme pollinator behavior have the highest pollination success. How can deception persist, given the costs to pollinators? Sexually-deceptive-orchid pollinators are almost exclusively solitary and haplodiploid species. Therefore, female insects deprived of matings by orchid deception could still produce male offspring, which may even enhance orchid pollination.

  9. Exercise performance in patients with uncomplicated essential hypertension. Effects of nifedipine-induced acute blood pressure reduction.

    Science.gov (United States)

    Agostoni, P; Doria, E; Berti, M; Alimento, M; Tamborini, G; Fiorentini, C

    1992-06-01

    In untreated patients with uncomplicated essential hypertension, exercise induces an abnormal increase in blood pressure; the influences of this increase on exercise were evaluated by a cardiopulmonary exercise test (CPX) performed in control conditions (step 1) and during acute blood pressure reduction (step 2). Patients were classified as (1) normotensive (resting diastolic blood pressure [BPd] less than 90 mm Hg; n = 14), (2) mildly hypertensive (BPd of 90 to 104 mm Hg; n = 9), and (3) moderately to severely hypertensive (BPd greater than or equal to 105 mm Hg; n = 16). For the three groups, peak mean blood pressure during exercise was 125 +/- 5 mm Hg (mean +/- SEM), 144 +/- 3 mm Hg (p less than 0.01 vs normotensive), and 161 +/- 4 mm Hg (p less than 0.01 vs normotensive and p less than 0.01 vs mild hypertension), respectively. Oxygen consumption (VO2) at peak exercise and at ventilatory anaerobic threshold was 26.1 +/- 1.1 and 17.2 +/- 0.5 ml/min/kg, 25.4 +/- 1.1 and 16.9 +/- 0.8 ml/min/kg, and 26.4 +/- 1.3 and 17.5 +/- 1.2 ml/min/kg in normotensive subjects, those with mild hypertension, and those with moderate to severe hypertension, respectively. Fourteen normotensive subjects, six with mild hypertension, and nine with moderate to severe hypertension participated to step 2 (nifedipine vs placebo, double-blind crossover). Nifedipine reduced blood pressure at rest and at peak exercise in those with hypertension. Peak exercise VO2 was unaffected by nifedipine in both normotensive subjects and those with hypertension. With nifedipine, ventilatory anaerobic threshold occurred earlier and at a lower VO2 in mild and in moderate to severe hypertension (delta VO2 = -1.9 and -2.4 ml/min/kg, respectively). These findings might be due to nifedipine-induced redistribution of blood flow during exercise and might be the reason for the complaint of weakness after blood pressure reduction in hypertensive subjects.

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

    Science.gov (United States)

    Patel, Ml; Sachan, Rekha; Gangwar, Radheyshyam; Sachan, Pushpalata; Natu, Sm

    2013-01-01

    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∼0.4). NGAL was found to be significantly correlated with creatinine in the cases with the value of the correlation coefficient being 0.4. This direct correlation might be a consequence of endothelial dysfunction on which hypertension and proteinuria probably depends.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  13. Cardiovascular hypertensive emergencies.

    Science.gov (United States)

    Papadopoulos, D P; Sanidas, E A; Viniou, N A; Gennimata, V; Chantziara, V; Barbetseas, I; Makris, T K

    2015-02-01

    Inevitably, a small proportion of patients with systematic hypertension will develop hypertensive crisis at some point. Hypertensive crises can be divided into hypertensive emergency or hypertensive urgency according to the presence or lack of acute target organ damage. In this review, we discuss cardiovascular hypertensive emergencies, including acute coronary syndrome, aortic dissection, congestive heart failure, and sympathomimetic hypertensive crises, including those caused by cocaine use. Each presents in a unique fashion, although some hypertensive emergency patients report nonspecific symptoms. Treatment includes several effective and rapid-acting medications to safely reduce the blood pressure, protect remaining end-organ function, relieve symptoms, minimize the risk of complications, and thereby improve patient outcomes.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Acute transient coronary sinus hypertension impairs left ventricular function and induces myocardial edema.

    Science.gov (United States)

    Pratt, J W; Schertel, E R; Schaefer, S L; Esham, K E; McClure, D E; Heck, C F; Myerowitz, P D

    1996-09-01

    This study was performed to evaluate the direct and indirect effects of acute coronary sinus hypertension (CSH) on systolic and diastolic left ventricular (LV) function. Coronary sinus pressure was elevated to 25 mmHg for 3 h in eight pentobarbital-anesthetized dogs and then relieved. LV contractility was assessed by preload recruitable stroke work (PRSW) and end-systolic elastance (Ees). Diastolic function was assessed by the time constant of isovolumic relaxation (tau) and the end-diastolic pressure volume relationship (EDPVR). PRSW and Ees decreased progressively, and tau and the slope of the EDPVR increased progressively with CSH. These changes persisted after relief of CSH. beta-Adrenergic and cholinergic receptor blockade, performed in six dogs, did not alter the effects of CSH on systolic or diastolic function. The LV wet-to-dry weight ratios of the groups with CSH were significantly greater than those of a control group without CSH. We conclude that CSH results in changes in the left ventricle that depress contractility, prolong active relaxation, and increase diastolic stiffness. The dysfunction was not the direct effect of CSH or autonomic reflex activation, but may have been induced by fluid accumulation within the interstitium.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Acute effects of aerosolized iloprost in COPD related pulmonary hypertension - a randomized controlled crossover trial.

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    Lucas Boeck

    Full Text Available BACKGROUND: Inhaled iloprost potentially improves hemodynamics and gas exchange in patients with chronic obstructive pulmonary disease (COPD and secondary pulmonary hypertension (PH. OBJECTIVES: To evaluate acute effects of aerosolized iloprost in patients with COPD-associated PH. METHODS: A randomized, double blind, crossover study was conducted in 16 COPD patients with invasively confirmed PH in a single tertiary care center. Each patient received a single dose of 10 µg iloprost (low dose, 20 µg iloprost (high dose and placebo during distinct study-visits. The primary end-point of the study was exercise capacity as assessed by the six minute walking distance. RESULTS: Both iloprost doses failed to improve six-minute walking distance (p = 0.36. Low dose iloprost (estimated difference of the means -1.0%, p = 0.035 as well as high dose iloprost (-2.2%, p<0.001 significantly impaired oxygenation at rest. Peak oxygen consumption and carbon dioxide production differed significantly over the three study days (p = 0.002 and p = 0.003, accordingly. As compared to placebo, low dose iloprost was associated with reduced peak oxygen consumption (-76 ml/min, p = 0.002, elevated partial pressure of carbon dioxide (0.27 kPa, p = 0.040 and impaired ventilation during exercise (-3.0l/min, p<0.001. CONCLUSIONS: Improvement of the exercise capacity after iloprost inhalation in patients with COPD-associated mild to moderate PH is very unlikely. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN61661881.

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

    Directory of Open Access Journals (Sweden)

    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

  19. Clinical Study of Acute Vasoreactivity Testing in Patients with Chronic Thromboembolic Pulmonary Hypertension

    Science.gov (United States)

    Xu, Qi-Xia; Yang, Yuan-Hua; Geng, Jie; Zhai, Zhen-Guo; Gong, Juan-Ni; Li, Ji-Feng; Tang, Xiao; Wang, Chen

    2017-01-01

    Background: The clinical significance of acute vasoreactivity testing (AVT) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) remains unclear. We analyzed changes in hemodynamics and oxygenation dynamics indices after AVT in patients with CTEPH using patients with pulmonary arterial hypertension (PAH) as controls. Methods: We analyzed retrospectively the results of AVT in 80 patients with PAH and 175 patients with CTEPH registered in the research database of Beijing Chao-Yang Hospital between October 2005 and August 2014. Demographic variables, cardiopulmonary indicators, and laboratory findings were compared in these two subgroups. A long-term follow-up was conducted in patients with CTEPH. Between-group comparisons were performed using the independent-sample t-test or the rank sum test, within-group comparisons were conducted using the paired t-test or the Wilcoxon signed-rank test, and count data were analyzed using the Chi-squared test. Survival was estimated using the Kaplan-Meier method and log-rank test. Results: The rates of positive response to AVT were similar in the CTEPH (25/175, 14.3%) and PAH (9/80, 11.3%) groups (P > 0.05). Factors significantly associated a positive response to AVT in the CTEPH group were level of N-terminal pro-brain natriuretic peptide (≤1131.000 ng/L), mean pulmonary arterial pressure (mPAP, ≤44.500 mmHg), pulmonary vascular resistance (PVR, ≤846.500 dyn·s−1·m−5), cardiac output (CO, ≥3.475 L/min), and mixed venous oxygen partial pressure (PvO2, ≥35.150 mmHg). Inhalation of iloprost resulted in similar changes in mean blood pressure, mPAP, PVR, systemic vascular resistance, CO, arterial oxygen saturation (SaO2), mixed venous oxygen saturation, partial pressure of oxygen in arterial blood (PaO2), PvO2, and intrapulmonary shunt (Qs/Qt) in the PAH and CTEPH groups (all P > 0.05). The survival time in patients with CTEPH with a negative response to AVT was somewhat shorter than that in AVT

  20. Effect of angiotensin converting enzyme inhibition after acute myocardial infarction in patients with arterial hypertension. TRACE Study Group, Trandolapril Cardiac Event

    DEFF Research Database (Denmark)

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

    1997-01-01

    OBJECTIVE: To evaluate the influence of a history of arterial hypertension on the efficacy of the angiotensin converting enzyme (ACE) inhibitor trandolapril in patients with acute myocardial infarction (AMI) and left ventricular dysfunction. METHODS: A retrospective analysis of data from...... to patients with a history of arterial hypertension. ACE inhibition might be of particular importance in this group of patients but further studies to establish the clinical impact are necessary....

  1. Hypermagnesemia does not prevent intracranial hypertension and aggravates cerebral hyperperfusion in a rat model of acute hyperammonemia

    DEFF Research Database (Denmark)

    Bjerring, Peter Nissen; Eefsen, Martin; Larsen, Fin Stolze;

    2011-01-01

    Intravenous infusion of magnesium sulfate prevents seizures in patients with eclampsia and brain edema after traumatic brain injury. Neuroprotection is achieved by controlling cerebral blood flow (CBF), intracranial pressure, neuronal glutamate release, and aquaporin-4 (Aqp4) expression....... These factors are also thought to be involved in the development of brain edema in acute liver failure. We wanted to study whether hypermagnesemia prevented development of intracranial hypertension and hyperperfusion in a rat model of portacaval anastomosis (PCA) and acute hyperammonemia. We also studied...... rats receiving ammonia infusion/vehicle and MgSO4) /saline. The effect of MgSO(4) on mean arterial pressure (MAP), intracranial pressure (ICP), CBF, cerebral glutamate and glutamine, and aquaporin-4 expression was studied. Finally, the effect of MgSO4 on MAP, ICP, and CBF was studied, using two...

  2. [Hypertensive urgency and emergency].

    Science.gov (United States)

    Henny-Fullin, Katja; Buess, Daniel; Handschin, Anja; Leuppi, Jörg; Dieterle, Thomas

    2015-06-01

    European and North-American guidelines for the diagnosis and therapy of arterial hypertension refer to hypertensive crisis as an acute and critical increase of blood pressure>180/120 mmHg. Presence of acute hypertensive target organ damage, such as stroke, myocardial infarction or heart failure, in this situation defines a “hypertensive emergency”. In these patients, immediate lowering of blood pressure (about 25% within one to two hours) in an intensive care setting is mandatory to prevent further progression of target organ damage. In contrast to hypertensive emergencies, hypertensive urgencies are characterized by an acute and critical increase in blood pressure without signs or symptoms of acute hypertensive target organ damage. In these patients, blood pressure should be lowered within 24 to 48 hours in order to avoid hypertensive target organ damage. In general, hospitalization is not required, and oral antihypertensive therapy usually is sufficient. However, further and continuing outpatient care has to be ensured.

  3. Acute cardiovascular effect of 1,25-dihydroxycholecalciferol in essential hypertension

    DEFF Research Database (Denmark)

    Jespersen, B; Randløv, A; Abrahamsen, Jimmi

    1998-01-01

    . In the hypertensive patients, a transient increase in blood pressure and a reciprocal fall in cardiac output measured by a CO2 rebreathing technique (-15%, P filtration rate......, which together with a transient BP increase implies a 1,25-D-induced increase in total peripheral resistance. These data suggest an enhanced cardiovascular responsiveness to 1,25-D in hypertensive compared to healthy normotensive subjects....

  4. Acute pulmonary vasodilatory properties of amlodipine in humans with pulmonary hypertension.

    OpenAIRE

    Woodmansey, P. A.; O'Toole, L.; Channer, K S; Morice, A H

    1996-01-01

    OBJECTIVE: Calcium antagonists are the only oral vasodilators shown to influence mortality in primary pulmonary hypertension, but the high doses required are often poorly tolerated. Amlodipine is a novel, relatively well tolerated, calcium antagonist. It has not been previously tested in humans with pulmonary hypertension. DESIGN: Calcium antagonists are claimed to be of benefit in the 20-30% of patients who respond--that is, whose mean pulmonary artery pressure and pulmonary vascular resista...

  5. Fractionated Concurrent Exercise throughout the Day Does Not Promote Acute Blood Pressure Benefits in Hypertensive Middle-aged Women

    Science.gov (United States)

    Azevêdo, Luan M.; de Souza, Alice C.; Santos, Laiza Ellen S.; Miguel dos Santos, Rodrigo; de Fernandes, Manuella O. M.; Almeida, Jeeser A.; Pardono, Emerson

    2017-01-01

    Hypertension is a chronic disease that affects about 30% of the world’s population, and the physical exercise plays an important role on its non-pharmacological treatment. Anywise, the dose–response of physical exercise fractionation throughout the day demands more investigation, allowing new exercise prescription possibilities. Therefore, this study aimed to analyze the acute blood pressure (BP) kinetics after 1 h of exercises and the BP reactivity after different concurrent exercise (CE) sessions and its fractioning of hypertensive middle-aged women. In this way, 11 hypertensive women voluntarily underwent three experimental sessions and one control day [control session (CS)]. In the morning session (MS) and night session (NS), the exercise was fully realized in the morning and evening, respectively. For the fractionized session (FS), 50% of the volume was applied in the morning and the remaining 50% during the evening. The MS provided the greatest moments (p ≤ 0.05) of post-exercise hypotension (PEH) for systolic BP (SBP) and highest reduction of BP reactivity for SBP (~44%) and diastolic BP (DBP) (~59%) compared to CS (p ≤ 0.05). The findings of the present study have shown that MS is effective for PEH to SBP, as well as it promotes high quality of attenuation for BP reactivity, greater than the other sessions. PMID:28261583

  6. Ciclosporin does not attenuate intracranial hypertension in rats with acute hyperammonaemia

    DEFF Research Database (Denmark)

    Larsen, Rikke Hebo; Kjær, Mette S; Eefsen, Martin;

    2013-01-01

    To investigate the neuroprotective potential of ciclosporin during acute liver failure. We evaluated the effect of intrathecally administered ciclosporin on intracranial pressure, brain water content and aquaporin-4 expression in a rat model with acute hyperammonaemia....

  7. Role of clevidipine butyrate in the treatment of acute hypertension in the critical care setting: a review

    Directory of Open Access Journals (Sweden)

    Ahmed S Awad

    2010-06-01

    Full Text Available Ahmed S Awad, Michael E GoldbergDepartment of Anesthesiology, Cooper University Hospital, UMDNJ-Robert Wood Johnson Medical School, Camden Campus, Camden, New Jersey, USAAbstract: Acutely elevated blood pressure in the critical care setting is associated with a higher risk of acute end-organ damage (eg, myocardial ischemia, stroke, and renal failure and perioperative bleeding. Urgent treatment and careful blood pressure control are crucial to prevent significant morbidity. Clevidipine butyrate (Cleviprex™ is an ultrashort-acting, third-generation intravenous calcium channel blocker. It is an arterial-selective vasodilator with no venodilatory or myocardial depressive effects. Clevidipine has an extremely short half-life of approximately 1 minute as it is rapidly metabolized by blood and tissue esterases. These metabolites are then primarily eliminated through urine and fecal pathways. The rapid onset and the short duration of action permit tighter and closer adjustment of the blood pressure than is possible with other intravenous agents.Keywords: calcium channel blocker, antihypertensive medications, end-organ damage, hypertensive crisis, hypertensive urgency

  8. Correlation between neurologic defect and blood pressure regulation in acute phase of ischemic stroke caused by hypertension%高血压缺血性脑卒中神经功能缺损与急性期 血压调控的相关分析

    Institute of Scientific and Technical Information of China (English)

    刘江; 翟明; 丁里; 朱之庄

    2001-01-01

    @@Background:Various managements were employed for acute phase of ischemic stroke caused by hypertension.Regulation of hypertension in acute phase was closely associated with prognosis of ischemic stroke . Objective:To study relationship between neurologic function defect and blood pressure regulation in acute phase of ischemic stroke caused by hypertension.

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

    Directory of Open Access Journals (Sweden)

    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

  10. A patient with possible TRALI who developed pulmonary hypertensive crisis and acute pulmonary edema during cardiac surgery.

    Science.gov (United States)

    Kojima, Taiki; Nishisako, Ryo; Sato, Hideo

    2012-06-01

    There are very few case reports of transfusion-related acute lung injury (TRALI) under close hemodynamic monitoring. We encountered a case of possible TRALI during on-pump coronary artery bypass grafting (CABG). A 66-year-old man who had undergone on-pump CABG was administered fresh frozen plasma (FFP). One hour after FFP transfusion, pulmonary hypertensive crisis and subsequent hypoxic decompensation occurred. A second cardiopulmonary bypass (CPB) was needed for circulatory and respiratory deterioration. Extracorporeal life support (ECLS), intraaortic balloon pumping (IABP), and nitric oxide therapy were required after the surgery. Despite the severity of the initial state, his recovery was comparatively smooth. ECLS and IABP were removed on postoperative day (POD)1; the patient was extubated and discharged from the ICU on POD7 and POD12, respectively. The diagnosis of TRALI was confirmed by human leukocyte antigen antibody detection in the administered FFP. In addition, lymphocytic immunofluorescence test showed that a cross-match of the plasma from the pooled FFP against the recipient leukocytes was positive. The clinical course of the pulmonary artery hypertension was followed by a decrease in dynamic lung compliance. The mechanism of this phenomenon is unclear. However, it might suggest the possibility of vasoconstriction or obstruction of the peripheral pulmonary artery preceding lung damage, as in the case in animal models reported previously.

  11. Protection of retinal ganglion cells and retinal vasculature by Lycium barbarum polysaccharides in a mouse model of acute ocular hypertension.

    Directory of Open Access Journals (Sweden)

    Xue-Song Mi

    Full Text Available Acute ocular hypertension (AOH is a condition found in acute glaucoma. The purpose of this study is to investigate the protective effect of Lycium barbarum polysaccharides (LBP and its protective mechanisms in the AOH insult. LBP has been shown to exhibit neuroprotective effect in the chronic ocular hypertension (COH experiments. AOH mouse model was induced in unilateral eye for one hour by introducing 90 mmHg ocular pressure. The animal was fed with LBP solution (1 mg/kg or vehicle daily from 7 days before the AOH insult till sacrifice at either day 4 or day 7 post insult. The neuroprotective effects of LBP on retinal ganglion cells (RGCs and blood-retinal-barrier (BRB were evaluated. In control AOH retina, loss of RGCs, thinning of IRL thickness, increased IgG leakage, broken tight junctions, and decreased density of retinal blood vessels were observed. However, in LBP-treated AOH retina, there was less loss of RGCs with thinning of IRL thickness, IgG leakage, more continued structure of tight junctions associated with higher level of occludin protein and the recovery of the blood vessel density when compared with vehicle-treated AOH retina. Moreover, we found that LBP provides neuroprotection by down-regulating RAGE, ET-1, Aβ and AGE in the retina, as well as their related signaling pathways, which was related to inhibiting vascular damages and the neuronal degeneration in AOH insults. The present study suggests that LBP could prevent damage to RGCs from AOH-induced ischemic injury; furthermore, through its effects on blood vessel protection, LBP would also be a potential treatment for vascular-related retinopathy.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  13. Oral sildenafil as a rescue therapy in presumed acute pulmonary hypertensive crisis.

    Science.gov (United States)

    Maxted, Andrew Peter; Hill, Abigail; Davies, Patrick

    2013-02-01

    A 23-week-old baby, born at 26(+2) weeks, presented to the hospital with critical respiratory failure, which was impossible to stabilize. She had unstable oxygen saturations between 35% and 95%. A presumptive diagnosis of bronchopulmonary dysplasia with associated pulmonary hypertensive crisis was made. In the absence of inhaled nitric oxide, 2 oral doses of 1 mg/kg sildenafil were given, with a dramatic improvement 30 to 45 minutes later. Her oxygenation index fell from 43 to 14. She made a full recovery and was discharged from the hospital 2 weeks later.

  14. Approach to Severe Hypertension in Children

    Directory of Open Access Journals (Sweden)

    Muhammet Şükrü Paksu

    2011-12-01

    Full Text Available Severe symptomatic hypertension which is also called hypertensive crisis is an acute elevation in blood pressure to a level that has the potential to cause end-organ damage. Although not common in childhood, it is a life-threatening medical emergency. Hypertensive crises are classically distinguished into hypertensive urgency and hypertensive emergency depending on end-organ involvement including central nervous system (CNS, heart, eye, and kidney. A severe elevation in blood pressure without evidence of acute target organ damage describes hypertensive urgency. Hypertensive emergency is defined as severe hypertension complicated with severe symptoms or acute target organ dysfunction. (Journal of Current Pediatrics 2011; 9: 133-6

  15. 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

    DEFF Research Database (Denmark)

    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...... for a 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...

  16. Acute hemodynamic effects of inhaled sodium nitrite in pulmonary hypertension associated with heart failure with preserved ejection fraction

    Science.gov (United States)

    Simon, Marc A.; Vanderpool, Rebecca R.; Nouraie, Mehdi; Bachman, Timothy N.; White, Pamela M.; Sugahara, Masataka; Gorcsan, John; Parsley, Ed L.; Gladwin, Mark T.

    2016-01-01

    BACKGROUND. Pulmonary hypertension (PH) is associated with poor outcomes, yet specific treatments only exist for a small subset of patients. The most common form of PH is that associated with left heart disease (Group 2), for which there is no approved therapy. Nitrite has shown efficacy in preclinical animal models of Group 1 and 2 PH, as well as in patients with left heart failure with preserved ejection fraction (HFpEF). We evaluated the safety and efficacy of a potentially novel inhaled formulation of nitrite in PH-HFpEF patients as compared with Group 1 and 3 PH. METHODS. Cardiopulmonary hemodynamics were recorded after acute administration of inhaled nitrite at 2 doses, 45 and 90 mg. Safety endpoints included change in systemic blood pressure and methemoglobin levels. Responses were also compared with those administered inhaled nitric oxide. RESULTS. Thirty-six patients were enrolled (10 PH-HFpEF, 20 Group 1 pulmonary arterial hypertension patients on background PH-specific therapy, and 6 Group 3 PH). Drug administration was well tolerated. Nitrite inhalation significantly lowered pulmonary, right atrial, and pulmonary capillary wedge pressures, most pronounced in patients with PH-HFpEF. There was a modest decrease in cardiac output and systemic blood pressure. Pulmonary vascular resistance decreased only in Group 3 PH patients. There was substantial increase in pulmonary artery compliance, most pronounced in patients with PH-HFpEF. CONCLUSIONS. Inhaled nitrite is safe in PH patients and may be efficacious in PH-HFpEF and Group 3 PH primarily via improvements in left and right ventricular filling pressures and pulmonary artery compliance. The lack of change in pulmonary vascular resistance likely may limit efficacy for Group 1 patients. TRIAL REGISTRATION. ClinicalTrials.gov NCT01431313 FUNDING. This work was supported in part by the NIH grants P01HL103455 (to MAS and MTG), R01HL098032 (to MTG), and R01HL096973 (to MTG), and Mast Therapeutics, Inc. PMID

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

    Science.gov (United States)

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

    2015-06-01

    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 > 270 dyn·s·cm(-5), mean pulmonary artery pressure ≥ 23 mmHg, ratio of forced expiratory volume in 1 second [FEV1] to forced vital capacity 70%, and partial pressure of oxygen and carbon dioxide in arterial blood > 50 and ≤ 55 mmHg, respectively) received riociguat 1 or 2.5 mg during right heart catheterization. Twenty-two patients completed the study (11 men, 11 women, aged 56-82 years; 1-mg group: n = 10 [mean FEV1: 43.1%]; 2.5-mg group: n = 12 [mean FEV1: 41.2%]). Riociguat caused significant improvements (P mmHg [-11.44%]; 2.5 mg: -4.83 mmHg [-14.76%]) and pulmonary vascular resistance (1 mg: -58.32 dyn·s·cm(-5) [-15.35%]; 2.5 mg: -123.8 dyn·s·cm(-5) [-32.96%]). No relevant changes in lung function or gas exchange were observed. Single doses of riociguat were well tolerated and showed promising hemodynamic effects without untoward effects on gas exchange or lung function in patients with COPD-associated PH. Placebo-controlled studies of chronic treatment with riociguat are warranted.

  18. SUPPRESSION OF ANGⅡ AFTER ACUTE SALINE LOAD ASSOCIATED WITH THE CHANGES OF PLASMA ANP AND SODIUM METABOLISM IN SALT-SENSITIVE HYPERTENSION PATIENTS

    Institute of Scientific and Technical Information of China (English)

    王永兴; 刘治全; 刘艳; 侯嵘; 叶涛

    2003-01-01

    Objective To observe the changes of plasma AngⅡ,ANP and their relationship with urine sodium excretion in salt sensitive hypertension. Methods The salt sensitivity was determined by acute saline loading test in 173 primary hypertensives of Stage Ⅰ or Stage Ⅱ. Plasma AngⅡand ANP was determined by radioimmunoassay. Results After acute salt load, AngⅡ was suppressed inadequately. The plasma ANP secretion was not increased. The urine sodiun excretion was delayed, Na+ in RBC was increased in salt sensitive subjects. The plasma ANP was decreased in the salt sensitive subjects without AngⅡ suppressed. The 24 hours urine sodium excretion was lower than those AngⅡ suppressed.Conclusion The changes of plasma RAS are not homogeneous after salt load. Those without the plasma AngⅡ suppressed have more severe sodium metabolism abnormalities and the endogenous ANP secretion is impaired in salt sensitive patients.

  19. Modified Da-Cheng-Qi Decoction reduces intra-abdominal hypertension in severe acute pancreatitis: a pilot study

    Institute of Scientific and Technical Information of China (English)

    WAN Mei-hua; LI Juan; HUANG Wei; Rajarshi Mukherjee; GONG Han-lin; XIA Qing; ZHU Lin; CHENG Gui-lan; TANG Wen-fu

    2012-01-01

    Background Intra-abdominal hypertension (IAH) is a recognized prognostic marker for severity of severe acute pancreatitis (SAP) and has a strong impact on the clinical course of SAP.Previous studies indicate that a Da-Cheng-Qi Decoction (DCQD) is beneficial in the treatment of SAP.The purpose of this study was to evaluate the effect of modified DCQD on IAH in patients with SAP.Methods Between January 2008 and December 2008,42 patients from the West China Hospital were randomized into either the DCQD or control group (n=21 in each group).Mortality,intra-abdominal pressure (lAP),Acute Physiology and Chronic Health Evaluation II (APACHE II) score,C-reactive protein (CRP),oxygenation index,Balthazar CT score,rate of renal failure,decompression rate,intensive care unit (ICU) transfer rate,and length of hospital stay (LOS) were compared between the two groups.Results Compared to the control group,the modified DCQD treatment significantly decreased lAP (P <0.05) and APACHE Ⅱ (P <0.05) scores on days 4-8,CRP on day 8 (P <0.01 ),renal failure rate (P <0.05),and LOS (P <0.05).The oxygenation index was significantly improved in the DCQD group compared with the control group (P <0.05).No significant differences in the Balthazar CT score,shock rate,ICU transfer rate,or mortality occurred between the two groups.Conclusions The modified DCQD can effectively relieve IAH and decrease LOS for patients with SAP.Larger clinical trials are needed to confirm these findings.

  20. [Hypertension in women].

    Science.gov (United States)

    Tagle, Rodrigo; Tagle V, Rodrigo; Acevedo, Mónica; Valdés, Gloria

    2013-02-01

    The present review examines the types of hypertension that women may suffer throughout life, their physiopathological characteristics and management. In early life, the currently used low-dose oral contraceptives seldom cause hypertension. Pregnancy provokes preeclampsia, its main medical complication, secondary to inadequate transformation of the spiral arteries and the subsequent multisystem endothelial damage caused by deportation of placental factors and microparticles. Hypertension in preeclampsia is an epiphenomenon which needs to be controlled at levels that reduce maternal risk without impairing placental perfusion. The hemodynamic changes of pregnancy may unmask a hypertensive phenotype, may exacerbate a chronic hypertension, or may complicate hypertension secondary to lupus, renovascular lesions, and pheochromocytoma. On the other hand a primary aldosteronism may benefit from the effect of progesterone and present as a postpartum hypertension. A hypertensive pregnancy, especially preeclampsia, represents a risk for cardiac, vascular and renal disease in later life. Menopause may mimic a pheochromocytoma, and is associated to endothelial dysfunction and salt-sensitivity. Among women, non-pharmacological treatment should be forcefully advocated, except for sodium restriction during pregnancy. The blockade of the renin-angiotensin system should be avoided in women at risk of pregnancy; betablockers could be used with precautions during pregnancy; diuretics, ACE inhibitors and angiotensin receptor antagonists should not be used during breast feeding. Collateral effects of antihypertensives, such as hyponatremia, cough and edema are more common in women. Thus, hypertension in women should be managed according to the different life stages.

  1. β-Blockers in hypertension, diabetes, heart failure and acute myocardial infarction: a review of the literature.

    Science.gov (United States)

    DiNicolantonio, James J; Fares, Hassan; Niazi, Asfandyar K; Chatterjee, Saurav; D'Ascenzo, Fabrizio; Cerrato, Enrico; Biondi-Zoccai, Giuseppe; Lavie, Carl J; Bell, David S; O'Keefe, James H

    2015-01-01

    β-Blockers (BBs) are an essential class of cardiovascular medications for reducing morbidity and mortality in patients with heart failure (HF). However, a large body of data indicates that BBs should not be used as first-line therapy for hypertension (HTN). Additionally, new data have questioned the role of BBs in the treatment of stable coronary heart disease (CHD). However, these trials mainly tested the non-vasodilating β1 selective BBs (atenolol and metoprolol) which are still the most commonly prescribed BBs in the USA. Newer generation BBs, such as the vasodilating BBs carvedilol and nebivolol, have been shown not only to be better tolerated than non-vasodilating BBs, but also these agents do not increase the risk of diabetes mellitus (DM), atherogenic dyslipidaemia or weight gain. Moreover, carvedilol has the most evidence for reducing morbidity and mortality in patients with HF and those who have experienced an acute myocardial infarction (AMI). This review discusses the cornerstone clinical trials that have tested BBs in the settings of HTN, HF and AMI. Large randomised trials in the settings of HTN, DM and stable CHD are still needed to establish the role of BBs in these diseases, as well as to determine whether vasodilating BBs are exempt from the disadvantages of non-vasodilating BBs.

  2. Medical management of acute ocular hypertension in a western screech owl (Megascops kennicottii).

    Science.gov (United States)

    Jayson, Stephanie; Sanchez-Migallon Guzman, David; Petritz, Olivia; Freeman, Kate; Maggs, David J

    2014-03-01

    A wild young adult western screech owl (Megascops kennicottii) of unknown sex was presented for evaluation of an abnormal left eye (OS). Ophthalmic examination OS revealed raised intraocular pressure (37 mm Hg; reference interval 7-16 mm Hg), mydriasis, conjunctival and episcleral hyperemia, shallow anterior chamber due to anterior displacement of the lens and iris, rubeosis iridis, and engorgement of the pecten. The intraocular pressure in the right eye (OD) was 11 mm Hg. Multifocal pale, variably translucent, curvilinear to vermiform opacities were observed in the medial and ventral peripheral regions of the retina OD, consistent with focal retinitis. Mannitol (0.46 g/kg IV) was administered over 10 minutes. Forty minutes later, the intraocular pressure was 27 mm Hg OS and 13 mm Hg OD. Dorzolamide (one drop OS q12h), diclofenac (one drop OU q8-12h), and meloxicam (0.5 mg/kg PO q24h) were administered for 3 days. The intraocular pressure OS was within normal limits 1 day (11 mm Hg), 7 days (13 mm Hg), and 4 weeks (14 mm Hg) after this treatment. Complications arising during hospitalization and rehabilitation included superficial corneal ulceration of both eyes presumed secondary to trauma on being caught and superficial damage to a talon. The owl was released after a period of rehabilitation. Characteristic presenting signs as well as response to therapy suggest aqueous misdirection was the cause of ocular hypertension in this owl. To our knowledge, this is the first report of suspected aqueous misdirection and its medical management in a raptor.

  3. Acute and chronic systemic CB1 cannabinoid receptor blockade improves blood pressure regulation and metabolic profile in hypertensive (mRen2)27 rats.

    Science.gov (United States)

    Schaich, Chris L; Shaltout, Hossam A; Brosnihan, K Bridget; Howlett, Allyn C; Diz, Debra I

    2014-08-01

    We investigated acute and chronic effects of CB1 cannabinoid receptor blockade in renin-angiotensin system-dependent hypertension using rimonabant (SR141716A), an orally active antagonist with central and peripheral actions. In transgenic (mRen2)27 rats, a model of angiotensin II-dependent hypertension with increased body mass and insulin resistance, acute systemic blockade of CB1 receptors significantly reduced blood pressure within 90 min but had no effect in Sprague-Dawley rats. No changes in metabolic hormones occurred with the acute treatment. During chronic CB1 receptor blockade, (mRen2)27 rats received daily oral administration of SR141716A (10 mg/kg/day) for 28 days. Systolic blood pressure was significantly reduced within 24 h, and at Day 21 of treatment values were 173 mmHg in vehicle versus 149 mmHg in drug-treated rats (P < 0.01). This accompanied lower cumulative weight gain (22 vs. 42 g vehicle; P < 0.001), fat mass (2.0 vs. 2.9% of body weight; P < 0.05), and serum leptin (2.8 vs. 6.0 ng/mL; P < 0.05) and insulin (1.0 vs. 1.9 ng/mL; P < 0.01), following an initial transient decrease in food consumption. Conscious hemodynamic recordings indicate twofold increases occurred in spontaneous baroreflex sensitivity (P < 0.05) and heart rate variability (P < 0.01), measures of cardiac vagal tone. The beneficial actions of CB1 receptor blockade in (mRen2)27 rats support the interpretation that an upregulated endocannabinoid system contributes to hypertension and impaired autonomic function in this angiotensin II-dependent model. We conclude that systemic CB1 receptor blockade may be an effective therapy for angiotensin II-dependent hypertension and associated metabolic syndrome.

  4. Effects of tumor necrosis factor, endothelin and nitric oxide on hyperdynamic circulation of rats with acute and chronic portal hypertension

    Institute of Scientific and Technical Information of China (English)

    Ji-Jian Wang; Gen-Wu Gao; Ren-Zhong Gao; Chang-An Liu; Xiong Ding; Zhen-Xiang Yao

    2004-01-01

    AIM: To evaluate the effect of tumor necrosis factor (TNF),endothelin (ET) and nitric oxide (NO) on hyperdynamic circulation (HC) of rats with acute and chronic portal hypertension(PHT).METHODS: Chronic portal hypertension was induced in Wistar rats by injection of carbon tetrachloride. After two weeks of cirrhosis formation, L-NMMA (25 mg/kg) was injected into one group of cirrhotic rats via femoral vein and the experiment was begun immediately. Another group of cirrhotic rats was injected with anti-rat TNFa(300 mg/kg)via abdominal cavity twice within 48 h and the experiment was performed 24 h after the second injection. The blood concentrations of TNFc, ET-1 and NO in portal vein and the nitric oxide synthase (NOS) activity in hepatic tissue were determined pre-and post-injection of anti-rat TNFa or LNMMA. Stroke volume (SV), cardiac output (CO), portal pressure (PP), superior mesenteric artery blood flow (SMA flow) and lilac artery blood flow (IAflow) were measured simultaneously. Acute portal hypertension was established in Wistar rats by partial portal-vein ligation (PVL). The parameters mentioned above were determined at 0.5 h,24 h, 48 h, 72 h and 120 h after PVL. After the formation of stable PHT, the PVL rats were injected with anti-rat TNFa or L-NMMA according to different groups, the parameters mentioned above were also determined.RESULTS: In cirrhotic rats, the blood levels of TNFa, NO in portal vein and the liver NOS activity were significantly increased (P<0.05) while the blood level of ET-1 was not statistically different (P>0.05) from the control animals (477.67±83.81 pg/mL vS48.87±32.79 pg/mL, 278.41±20.11 μmol/L vs 113.28±14.51 μmol/L, 1.81±0.06 u/mg.prot vs 0.87±0.03 u/mg.prot and 14.33±4.42 pg/mL vs 8.72±0.79 pg/mL, respectively). After injection of anti-rat TNFa,the blood level of TNFa was lower than that in controls (15.17±18.79 pg/mL vs48.87±32.79 pg/mL). The blood level of NO and the liver NOS activity were significantly

  5. Hypertensive crisis in children.

    Science.gov (United States)

    Chandar, Jayanthi; Zilleruelo, Gastón

    2012-05-01

    Hypertensive crisis is rare in children and is usually secondary to an underlying disease. There is strong evidence that the renin-angiotensin system plays an important role in the genesis of hypertensive crisis. An important principle in the management of children with hypertensive crisis is to determine if severe hypertension is chronic, acute, or acute-on-chronic. When it is associated with signs of end-organ damage such as encephalopathy, congestive cardiac failure or renal failure, there is an emergent need to lower blood pressures to 25-30% of the original value and then accomplish a gradual reduction in blood pressure. Precipitous drops in blood pressure can result in impairment of perfusion of vital organs. Medications commonly used to treat hypertensive crisis in children are nicardipine, labetalol and sodium nitroprusside. In this review, we discuss the pathophysiology, differential diagnosis and recent developments in management of hypertensive crisis in children.

  6. Cerebral lesions in acute arterial hypertension: the characteristic MRI in hypertensive encephalopathy; Zerebrale Veraenderungen bei krisenhafter arterieller Hypertonie: MRT-Befunde der hypertensiven Enzephalopathie sind wegweisend fuer Diagnose und Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, J.P.; Krohmer, S. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Abt. Neuroradiologie, Universitaetsklinikum Leipzig AoeR (Germany); Guenther, A. [Klinik und Poliklinik fuer Neurologie, Universitaetsklinikum Leipzig AoeR (Germany); Zimmer, C. [Abt. fuer Neuroradiologie, Klinikum rechts der Isar der TU Muenchen (Germany)

    2006-06-15

    Purpose: in the nine years since the posterior reversible (leuc) encephalopathy syndrome (PRES) was first described, a number of causes have been under discussion. These not only include arterial hypertension, i. e. hypertensive crises, but also various toxic substances, i. e. immunosuppressive or chemotherapeutic agents, that are responsible for the formation of the symptoms and characteristic MR tomographic brain findings. Materials and methods: initial and follow-up MRI examinations of 8 patients were analyzed. All patients had acute neurological symptoms (headaches, seizures, visual disorders and vigilance disturbances) together with a detectable hypertensive crisis. Results: MRI disclosed increased signal intensity in subcortical and some cortical lesions in all patient FLAIR sequences. These changes were particularly extensive in the posterior circulation (occipital, cerebellum and brain stem) although they were also detected in brain areas supplied by the carotid artery. However, a cytotoxic genesis of the changes was ruled out in each patient by means of a normal DWI. Furthermore, when the blood pressure was normalized, reversibility of the lesions as proof of the diagnosis was detectable. (orig.)

  7. Latrodectism: variations in clinical manifestations provoked by Latrodectus species of spiders.

    Science.gov (United States)

    Maretić, Z

    1983-01-01

    The clinical picture caused by the bite of Latrodectus spp. is described, including the patient's general condition with agonizing pains, cramps, spasms, motor unrest, boardlike abdomen, "facies latrodectismica", sweating, oliguria, hypertension, anxiety, mental excitation and an extended convalescence. The notorious biters are mainly L. mactans, L. variolus, L. hesperus, L. tredecimguttatus, L. hasselti, L. indistinctus and L. menavodi, all of which appear to provoke somewhat similar clinical pictures. For some species, however, there is limited data and for the toxicity of some spiders, such as L. rhodesiensis, no data are available, However, it would appear that the clinical manifestations of the venom are similar in all species.

  8. H型高血压与急性心肌梗死的相关性分析%Correlation analysis of H-hypertension and acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    邬梅芳

    2011-01-01

    Objective: To investigate the correlation between H -hypertension and acute myocardial infarction (AMI). Methods: 120 patients with hypertension combined with coronary heart diseases admitted and treated in our hospital from June 2009 to December 2010 were selected. According to different levels of hypertension homocysteine (Hey), they were di -vided into the H-hypertension group (Hcy ≥ 10 μmol/L) with 59 patients and the simple hypertension group (Hcy0.05). In the simple hypertension group, the Hcy level of the patients with AMI was significantly lower than that of those without AMI while TC and LDL-C were significantly higher (P0.05). The multilevel regression analysis showed that H-hypertension was an independent influencing factor of AMI. Conclusion: H-hypertension is closely related to AMI and can effectively reduce Hcy levels and the incidence of cardiovascular events.%目的:探讨H型高血压与急性心肌梗死(AMI)的相关性.方法:选取我院2009年6月~2010年12月收治的120例高血压合并冠心病的患者为研究对象,其中按照高血压同型半胱氨酸(Hcy)水平的不同,将其分为H型高血压组(Hcy≥10 μmol/L)59例和单纯性高血压组(Hcy<10 μmol/L)61例,比较H型高血压组中AMI患者及非AMI患者的Hcy、三酰甘油(TG)、胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C),并比较单纯性高血压组的AMI患者及非AMI患者的以上指标.结果:H型高血压组AMI患者的比例显著高于单纯性高血压组(P0.05).单纯性高血压组中,AMI患者的Hcy水平显著低于非AMI患者,TC、LDL-C显著高于非AMI患者(P0.05).经多元性回归分析发现,H型高血压是AMI的一个独立影响因素.结论:H型高血压与AMI密切相关,能降低Hcy水平,可有效降低心血管事件的发生率.

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

    LENUS (Irish Health Repository)

    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.

  10. An update on hypertensive emergencies and urgencies.

    Science.gov (United States)

    Muiesan, Maria Lorenza; Salvetti, Massimo; Amadoro, Valentina; di Somma, Salvatore; Perlini, Stefano; Semplicini, Andrea; Borghi, Claudio; Volpe, Massimo; Saba, Pier Sergio; Cameli, Matteo; Ciccone, Marco Matteo; Maiello, Maria; Modesti, Pietro Amedeo; Novo, Salvatore; Palmiero, Pasquale; Scicchitano, Pietro; Rosei, Enrico Agabiti; Pedrinelli, Roberto

    2015-05-01

    Severe acute arterial hypertension is usually defined as 'hypertensive crisis', although 'hypertensive emergencies' or 'hypertensive urgencies', as suggested by the Joint National Committee and the European Society of Hypertension, have completely different diagnostic and therapeutic approaches.The prevalence and demographics of hypertensive emergencies and urgencies have changed over the last four decades, but hypertensive emergencies and urgencies are still associated with significant morbidity and mortality.Different scientific societies have repeatedly produced up-to-date guidelines; however, the treatment of hypertensive emergencies and urgencies is still inappropriate, with potential clinical implications.This review focuses on hypertensive emergencies and urgencies management and treatment, as suggested by recent data.

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

    Institute of Scientific and Technical Information of China (English)

    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

  12. The Effect of acute exercise on changes Liver enzymes (ALT،ALP،AST) in Non-athletes middle-aged women with hypertension

    OpenAIRE

    Aidin Valizadeh; Omid Yousefi Bilehsavar; Habib Abdi; Zahra Jahanshahi; Behnam Madadi

    2016-01-01

    Purpose of this study was to investigate The Effect of acute exercise on changes Liver enzymes (ALT،ALP،AST) in Non-athletes middle-aged women with hypertension. The study population included non-athletic women ages 45 to 55 years old with high blood pressure and high cholesterol in two groups of 8 people who were in the aerobic exercise group and control group, respectively. Participant’s non-random sampling were selected purposefully and voluntarily consent form after filling participated i...

  13. [Cardiovascular complications of hypertensive crisis].

    Science.gov (United States)

    Rosas-Peralta, Martín; Borrayo-Sánchez, Gabriela; Madrid-Miller, Alejandra; Ramírez-Arias, Erick; Pérez-Rodríguez, Gilberto

    2016-01-01

    It is inexorable that a proportion of patients with systemic arterial hypertension will develop a hypertensive crisis at some point in their lives. The hypertensive crises can be divided in hypertensive patients with emergency or hypertensive emergency, according to the presence or absence of acute end-organ damage. In this review, we discuss the cardiovascular hypertensive emergencies, including acute coronary syndrome, congestive heart failure, aortic dissection and sympathomimetic hypertensive crises (those caused by cocaine use included). Each is presented in a unique way, although some patients with hypertensive emergency report non-specific symptoms. Treatment includes multiple medications for quick and effective action with security to reduce blood pressure, protect the function of organs remaining, relieve symptoms, minimize the risk of complications and improve patient outcomes.

  14. Acute pancreatitis associated left-sided portal hypertension with severe gastrointestinal bleeding treated by transcatheter splenic artery embolization: a case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Zhi-yu LI; Bin LI; Yu-lian WU; Qiu-ping XIE

    2013-01-01

    Left-sided portal hypertension (LSPH) followed by acute pancreatitis is a rare condition with most patients being asymptomatic.In cases where gastrointestinal (GI) bleeding is present,however,the condition is more complicated and the mortality is very high because of the difficulty in diagnosing and selecting optimal treatment.A successfully treated case with severe GI bleeding by transcatheter splenic artery embolization is reported in this article.The patient exhibited severe uncontrollable GI bleeding and was confirmed as gastric varices secondary to LSPH by enhanced computed tomography (CT) scan and CT-angiography.After embolization,the bleeding stopped and stabilized for the entire follow-up period without any severe complications.In conclusion,embolization of the splenic artery is a simple,safe,and effective method of controlling gastric variceal bleeding caused by LSPH in acute pancreatitis.

  15. Acute pancreatitis associated left-sided portal hypertension with severe gastrointestinal bleeding treated by transcatheter splenic artery embolization: a case report and literature review.

    Science.gov (United States)

    Li, Zhi-yu; Li, Bin; Wu, Yu-lian; Xie, Qiu-ping

    2013-06-01

    Left-sided portal hypertension (LSPH) followed by acute pancreatitis is a rare condition with most patients being asymptomatic. In cases where gastrointestinal (GI) bleeding is present, however, the condition is more complicated and the mortality is very high because of the difficulty in diagnosing and selecting optimal treatment. A successfully treated case with severe GI bleeding by transcatheter splenic artery embolization is reported in this article. The patient exhibited severe uncontrollable GI bleeding and was confirmed as gastric varices secondary to LSPH by enhanced computed tomography (CT) scan and CT-angiography. After embolization, the bleeding stopped and stabilized for the entire follow-up period without any severe complications. In conclusion, embolization of the splenic artery is a simple, safe, and effective method of controlling gastric variceal bleeding caused by LSPH in acute pancreatitis.

  16. Blood Pressure Interventions Affect Acute and Four-Week Diesel Exhaust Induced Pulmonary Injury in Healthy and Hypertensive Rats

    Science.gov (United States)

    Rationale: We recently showed that inhalation exposure of normotensive Wistar Kyoto (WKY) rats to whole diesel exhaust (DE) elicits changes in cardiac gene expression that broadly mimics expression in spontaneously hypertensive (SH) rats without DE. We hypothesized that pharmacol...

  17. Hypertensive Encephalopathy

    Directory of Open Access Journals (Sweden)

    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

  18. Acute effect of a single bout of aerobic exercise on vascular and baroreflex function of young males with a family history of hypertension.

    Science.gov (United States)

    Boutcher, Y N; Hopp, J P; Boutcher, S H

    2011-05-01

    The effect of one single bout of aerobic exercise on the vascular and baroreceptor function of individuals with a family history of hypertension was investigated. Forty young males, mean age 21 years, comprising offspring with (FH(+); n=20) and without (FH(-); n=20) a family history of hypertension participated in this study. Acute exercise was performed on a stationary bike for 20 min at 60% of maximal oxygen uptake. Peak forearm blood flow (FBF) was assessed using plethysmography and was determined as the highest blood flow after 5 min of reactive hyperaemia. Cardiopulmonary baroreceptor (CPBR) sensitivity was measured using lower-body negative pressure (LBNP) for 5 min at -20 mm Hg. CPBR was determined by calculating change of stroke volume and forearm vascular resistance (FVR) at baseline and during LBNP. Carotid baroreceptor (CBR) sensitivity was assessed using neck suction at -20, -40, -60 and -80 mm Hg pressures and was determined from RR interval divided by systolic blood pressure. Augmentation index (AIx), a measure of wave reflection, was assessed using applanation tonometry, and was calculated as the ratio of augmented pressure and pulse pressure. The peak FBF at pre-exercise was lower in FH(+) than in FH(-) subjects. Twenty minutes of acute cycle exercise resulted in significantly increased peak FBF by 22% in FH(+) and by 11% in FH(-) subjects, whereas peak FVR of both groups decreased by 17% and 11%, respectively. No change occurred in CPBR, CBR or AIx. It is concluded that 20 min of acute cycle exercise normalised baseline FBF and forearm vasodilation during hyperaemia in FH(+) subjects.

  19. Novel acute stressor effects on interscapular brown adipose tissue sympathetic inervation and UCP-1 content in chronically isolated and spontaneously hypertensive rats

    Directory of Open Access Journals (Sweden)

    Lakić Iva

    2011-01-01

    Full Text Available Interscapular brown adipose tissue (IBAT is an energy storing organ involved in the maintenance of homeostasis in stress conditions when the balance of energy supplies is disturbed. The major regulator of IBAT activity is the sympathetic nervous system (SNS. Since genetic background is responsible for the individual differences in neuroendocrine stress responsivity, spontaneously hypertensive rats (SHR that have a genetically increased general sympathetic output are a useful model for studying adaptive processes in stress conditions. Our aim was to test the effect of acute and/or chronic exposure to various stressors (thermal-cold, psychophysical-immobilization and psychosocial-isolation on IBAT SNS and the metabolic activity in SHR, by measuring the number of monoamine-containing nerve endings and uncoupling protein-1 (UCP-1 content. The obtained results show that the IBAT SNS activity of unstressed SHR was stimulated by the administration of a single acute or chronic stressor and was independent of the duration or type of stressor, while chronic pre-stress of isolation suppressed further the SNS reaction to novel acute stress exposure. The IBAT UCP-1 content followed SNS changes, suggesting that this system is dominant in the regulation of IBAT metabolic rate in SHR.

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

    DEFF Research Database (Denmark)

    Milman, Nils; Svendsen, Claus Bo; Iversen, Martin;

    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....... Methods: A retrospective chart review of 25 patients with recalcitrant pulmonary sarcoidosis being evaluated for lung transplantation at our centre. Haemodynamics were evaluated by right heart catheterisation in 24 patients of whom 19 had PH. Eight of the 19 patients received vasodilator challenge...... with inhaled nitric oxide (iNO). Results: The study group of eight patients (seven men) had a median age of 51 years (range 38 years-58 years). During iNO we observed a reduction in all patients' mean pulmonary arterial pressure (MPAP) of median 9 mmHg (range 1 mmHg-20 mmHg) (P = 0.01) and in all patients...

  1. [Effects of solcoseryl on the cerebral blood flow, intracranial pressure, systemic blood pressure and EEG in acute intracranial hypertensive cats (author's transl)].

    Science.gov (United States)

    Kubota, S; Asakura, T; Kitamura, K

    1976-02-01

    The experiment was performed on 86 cases under intraperitoneal pentobarbital anesthesia. One balloon was placed in the extradural space of right frontal region, and the other balloon was placed in the left extradural space and the intracranial pressure was measured. A needle was stereotaxically inserted into the subcortical area in order to measure the cerebral blood flow. Systemic blood pressure was recorded by inserting a catheter into the femoral artery, and electrocorticogram was also recorded. An expanding intracranial lesion was made by inflating the extradural balloon with physiological saline. The animals were arbitrarily divided into two groups.: 1) light or moderate groups which intracranial pressure before the injection of drug was below 400 mmH2O. 2) severe groups above 400 mmH2O. After the maintenance of the pressure, Solcoseryl was infused intravenously. The investigation was focused to observe whether Solcoseryl reveales any potent effect on cerebral blood flow, intracranial pressure, systemic blood pressure and on electroencephalogram in acute intracranial hypertension. Results 1) Intravenous injection of Solcoseryl had the effect of lowering intracranial pressure in the light or moderate and severe groups. Particularly, dose of 80 mg/kg showed the marked effect, though with a rebound phenomenon in the light or moderate groups. Furthermore, the effect was more marked and lasting by drip infusion of Solcoseryl and also by intravenous injection of Solcoseryl after pretreatment with hydrocortisone, and at this time no rebound phenomenon was recognized. 2) Solcoseryl had the effect of increasing the cerebral blood flow accompained with the lowering of intracranial pressure. 3) Systemic blood pressure was transiently lowered by the injection of Solcoseryl 20 mg/kg or 80 mg/kg and recovered immediately. 4) Solcoseryl had no effect on electroencephalogram in the severe groups. Conclusion On the basis of these results, it is rational to conclude that

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

    DEFF Research Database (Denmark)

    Bruun, N E; Ibsen, H; Skøtt, P

    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...... 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...

  3. Thyroid Storm Provoked by Interleukin-2 Therapy for Metastatic Melanoma

    Directory of Open Access Journals (Sweden)

    Yao-Chung Liu

    2014-06-01

    Full Text Available With the growing use of immunotherapy in the treatment of cancer and autoimmune disease, severe autoimmune thyroid dysfunction may be provoked at an increasing rate. We herein report a 49-year-old male patient experiencing a life- threatening thyroid storm provoked by interleukin-2 (IL-2. This was a case of pulmonary metastasis of melanoma without a previous history of thyroid dysfunction. For the metastatic melanoma, he underwent combined immunochemotherapy including dacarbazine and IL-2. The 3rd course of immunochemotherapy was complicated with a thyroid storm manifested by high fever, tachycardia and even transient cardiac arrest. Fortunately, he recovered eventually from this crisis by immediate resuscitation followed by antithyroid dugs. Our case highlights the rare complication of a thyroid storm provoked by IL-2 treatment. Precaution against autoimmune thyroid dysfunction is required during treatment with IL-2 and probably also other kinds of newly-developed immunotherapy to avoid life-threatening complications.

  4. Different reactivity to angiotensin II of peripheral and renal arteries in spontaneously hypertensive rats: effect of acute and chronic angiotensin converting enzyme inhibition

    Science.gov (United States)

    Guidi, E.; Hollenberg, N. K.

    1986-01-01

    We assessed renal blood flow and pressor responses to graded angiotensin II doses in spontaneously hypertensive (SHR) and Wistar-Kyoto (WKY) rats ingesting a diet containing 1.6% sodium basally and after acute and chronic angiotensin converting enzyme (ACE) inhibition with captopril. In the basal state the pressor response to angiotensin II was enhanced (Prenal vascular response was blunted (Pacute captopril administration the pressor response was enhanced in both strains, and the difference between them was maintained, while the renal vascular response was enhanced in both, but more in SHR, so that the renal vascular response in the SHR became larger than in WKY (Prenal responses in WKY rats, but only the pressor response in SHR. The renal vessels of SHR seem to be different from those of WKY rats in reaction to exogenous angiotensin II, and in response to both acute administration of captopril (probably acting through blockade of angiotensin II production) and chronic administration of captopril (probably acting mainly through accumulation of kinin or production of prostaglandins).

  5. Management of Hypertension in Pregnancy

    OpenAIRE

    Nurike S Mudjari; Nur Samsu

    2015-01-01

    Hypertension-related maternal mortality reaches 16% when it is compared to other causes of maternal mortality such as sepsis, bleeding or abortus. Pregnant women with hypertension disorder are at increased risk for experiencing numerous complications including disseminated intravascular coagulation (DIC), cerebral hemorrhage, liver dysfunction and acute renal failure; while to the fetus, it may cause intrauterine growth retardation, prematurity and perinatal mortality. Hypertension in pregnan...

  6. [The influence of ITGB3 gene polymorphism on the frequency of arterial hypertension in patients with acute coronary syndrome].

    Science.gov (United States)

    Zotova, T Iu; Miandina, G I; Frolov, V A; Komarova, A G; Zotov, A K

    2013-01-01

    PLA polymorphism of platelet integrin receptor, GpIIIa glycoprotein, (PLA polymorphism of the ITGB3 gene) is associated with the risk of myocardial infarction and CHD especially in young subjects. We analyzed ITGB3 gene polymorphism in patients with acute coronary insufficiency. It was shown that increased AP and altered blood lipid spectrum in the acute period of disease in carriers of the PLA allele (PLA1/PLA2 and PLA2/PLA2 genotypes) can be regarded as manifestations of stress reaction. The data obtained indicate that the PLA2 allele is a predictor of complications of acute coronary insufficiency. This observation is of importance for the choice of adequate therapy for the patients with this disorder.

  7. Are seizures in the setting of sleep deprivation provoked?

    Science.gov (United States)

    Lawn, Nicholas; Lieblich, Sam; Lee, Judy; Dunne, John

    2014-04-01

    It is generally accepted that sleep deprivation contributes to seizures. However, it is unclear whether a seizure occurring in the setting of sleep deprivation should be considered as provoked or not and whether this is influenced by seizure type and etiology. This information may have an important impact on epilepsy diagnosis and management. We prospectively analyzed the influence of sleep deprivation on the risk of seizure recurrence in patients with first-ever unprovoked seizures and compared the findings with patients with first-ever provoked seizures. Of 1026 patients with first-ever unprovoked seizures, 204 (20%) were associated with sleep deprivation. While the overall likelihood of seizure recurrence was slightly lower in sleep-deprived patients with first-ever seizures (log-rank p=0.03), sleep deprivation was not an independent predictor of seizure recurrence on multivariate analysis. Seizure recurrence following a first-ever unprovoked seizure associated with sleep deprivation was far more likely than for 174 patients with a provoked first-ever seizure (log-rank psleep deprivation should not be regarded as provoked.

  8. Phenomenon of isomorphic provoking responses in cases of limited scleroderma

    Directory of Open Access Journals (Sweden)

    Talnikova Е.Е.

    2015-09-01

    Full Text Available The article presents the historical origin of the term "Koebner phenomenon". The literature data reflect the etiology, pathogenesis and epidemiology of isomorphic mechanisms provoking responses in lichen planus, psoriasis, scleroder-ma, syphilis. Variants of the Koebner phenomenon's classifications are given. The clinical cases of limited scleroderma after mechanical injury are described.

  9. New Attacks on Animal Researchers Provoke Anger and Worry

    Science.gov (United States)

    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…

  10. 分析硝普钠治疗高血压急性心力衰竭的护理干预%Analysis of Sodium Nitroprusside Treatment of Hypertension Nursing Intervention of Acute Heart Failure

    Institute of Scientific and Technical Information of China (English)

    许禄颖

    2015-01-01

    目的 分析硝普钠治疗高血压急性心力衰竭患者的护理干预效果.方法 60例高血压急性心力衰竭患者被随机分为两组,在硝普钠治疗期间,对照组给予常规护理,观察组给予护理干预,比较两组治疗及护理效果.结果 观察组总有效率高于对照组;且护理满意度评分高于对照组.结论 护理干预在高血压急性心力衰竭采用硝普钠治疗患者中的临床应用效果显著.%Objective To analyze the SNP treatment of acute heart failure in patients with hypertension nursing intervention.Methods 60 cases of hypertension in patients with acute heart failure were randomly divided into two groups, in sodium nitroprusside during treatment, the control group was given routine nursing, the observation group given nursing intervention, compared two groups of treatment and nursing effect.Results The total efficiency of the control group; and care satisfaction scores higher than the control.Conclusion Nursing intervention in hypertensive acute heart failure patients using sodium nitroprusside treatment effect is remarkable.

  11. The Effect of acute exercise on changes Liver enzymes (ALT،ALP،AST in Non-athletes middle-aged women with hypertension

    Directory of Open Access Journals (Sweden)

    Aidin Valizadeh

    2016-06-01

    Full Text Available Purpose of this study was to investigate The Effect of acute exercise on changes Liver enzymes (ALT،ALP،AST in Non-athletes middle-aged women with hypertension. The study population included non-athletic women ages 45 to 55 years old with high blood pressure and high cholesterol in two groups of 8 people who were in the aerobic exercise group and control group, respectively. Participant’s non-random sampling were selected purposefully and voluntarily consent form after filling participated in the research. In order to investigate the effect of acute exercise on changes of enzymes AST, ALT, ALP, sampling in three stages (before and six hours after the exercise activities immediately after the exercise were each 5 cc of blood in the vein of anti-cubital arm and was kept in tubes containing EDTA anticoagulant and samples sent to the laboratory immediately. Using the Shapiro-Wilk test, normal distribution data were analyzed in two groups in pretest. In order to analyze the results of descriptive statistics for within group comparison analysis of variance with repeated measures at different times of the Bonferroni correction was used. To compare two groups using independent t-test. All statistical calculations were performed using SPSS version 21 software. The results showed that the changes AST, ALT, ALP, between control and experimental groups different sampling procedures after an aerobic exercise there is no significant difference (P≤ 0/795, (P≤ 0/483, (P≤ 0/656. According to the results of this study can be tailored and women to do aerobic activity with respect pushed under the relevant experts.

  12. 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.

    Science.gov (United States)

    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.

  13. Incidence of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism: a contemporary view of the published literature.

    Science.gov (United States)

    Ende-Verhaar, Yvonne M; Cannegieter, Suzanne C; Vonk Noordegraaf, Anton; Delcroix, Marion; Pruszczyk, Piotr; Mairuhu, Albert T A; Huisman, Menno V; Klok, Frederikus A

    2017-02-01

    The incidence of chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary embolism (PE) is relevant for management decisions but is currently unknown.We performed a meta-analysis of studies including consecutive PE patients followed for CTEPH. Study cohorts were predefined as "all comers", "survivors" or "survivors without major comorbidities". CTEPH incidences were calculated using random effects models.We selected 16 studies totalling 4047 PE patients who were mostly followed up for >2-years. In 1186 all comers (two studies), the pooled CTEPH incidence was 0.56% (95% CI 0.1-1.0). In 999 survivors (four studies) CTEPH incidence was 3.2% (95% CI 2.0-4.4). In 1775 survivors without major comorbidities (nine studies), CTEPH incidence was 2.8% (95% CI 1.5-4.1). Both recurrent venous thromboembolism and unprovoked PE were significantly associated with a higher risk of CTEPH, with odds ratios of 3.2 (95% CI 1.7-5.9) and 4.1 (95% CI 2.1-8.2) respectively. The pooled CTEPH incidence in 12 studies that did not use right heart catheterisation as the diagnostic standard was 6.3% (95% CI 4.1-8.4).The 0.56% incidence in the all-comer group probably provides the best reflection of the incidence of CTEPH after PE on the population level. The ∼3% incidences in the survivor categories may be more relevant for daily clinical practice. Studies that assessed CTEPH diagnosis by tests other than right heart catheterisation provide overestimated CTEPH incidences.

  14. [Hypertensive emergency and urgence].

    Science.gov (United States)

    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

  15. Portal Hypertension

    Science.gov (United States)

    ... Obesity to Liver Cancer Additional Content Medical News Portal Hypertension By Steven K. Herrine, MD, Thomas Jefferson ... Liver Hepatic Encephalopathy Jaundice in Adults Liver Failure Portal Hypertension (See also Overview of Liver Disease .) Portal ...

  16. Hypertensive Crisis

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Hypertensive Crisis: When You Should Call 9-1-1 for ... 18,2017 Know the two types of HBP crisis to watch for A hypertensive ( high blood pressure ) ...

  17. Dutch guideline for the management of hypertensive crisis -- 2010 revision.

    Science.gov (United States)

    van den Born, B J H; Beutler, J J; Gaillard, C A J M; de Gooijer, A; van den Meiracker, A H; Kroon, A A

    2011-05-01

    Hypertensive crises are divided into hypertensive urgencies and emergencies. Together they form a heterogeneous group of acute hypertensive disorders depending on the presence or type of target organs involved. Despite better treatment options for hypertension, hypertensive crisis and its associated complications remain relatively common. In the Netherlands the number of patients starting renal replacement therapy because of 'malignant hypertension' has increased in the past two decades. In 2003, the first Dutch guideline on hypertensive crisis was released to allow a standardised evidence-based approach for patients presenting with a hypertensive crisis. In this paper we give an overview of the current management of hypertensive crisis and discuss several important changes incorporated in the 2010 revision. These changes include a modification in terminology replacing 'malignant hypertension' with 'hypertensive crisis with retinopathy and reclassification of hypertensive crisis with retinopathy under hypertensive emergencies instead of urgencies. With regard to the treatment of hypertensive emergencies, nicardipine instead of nitroprusside or labetalol is favoured for the management of perioperative hypertension, whereas labetalol has become the drug of choice for the treatment of hypertension associated with pre-eclampsia. For the treatment of hypertensive urgencies, oral administration of nifedipine retard instead of captopril is recommended as first-line therapy. In addition, a section on the management of hypertensive emergencies according to the type of target organ involved has been added. Efforts to increase the awareness and treatment of hypertension in the population at large may lower the incidence of hypertensive crisis and its complications.

  18. Manejo da hipertensão arterial na isquemia cerebral aguda Management of arterial hypertension in patients with acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    WALTER JOSÉ FAGUNDES-PEREYRA

    1999-12-01

    Full Text Available OBJETIVO: Avaliar o nível de conhecimento dos médicos, através de sua conduta, em paciente com quadro de hipertensão arterial na fase aguda da isquemia cerebral. Também comentamos as principais condutas nesta fase, com ênfase na tensão arterial (TA. MÉTODO: Foram entrevistados 120 médicos da clínica médica e da cirurgia geral, em dez dos maiores Hospitais de Belo Horizonte, em 1997. Todos responderam a um questionário contendo um caso clínico de paciente hipertenso leve, admitido com quadro de isquemia cerebral e tensão arterial de 186x110 mmHg. Os profissionais deveriam optar por reduzir, aumentar ou manter a TA. RESULTADOS: Dos entrevistados, 38 (31,7% responderam que reduziriam os níveis tensionais, 82 (68,3% optaram pela manutenção e nenhum aumentaria (pPURPOSE: We aimed with study to assess the current clinical practice about the management of high blood pressure in patients in the acute phase of ischemic stroke. We also comment some topics of ischemic stroke treatment. METHODS: A case report of a patient admitted 8 hours after onset of ischemic stroke and with blood pressure of 186x110 mmHg was presented to 120 surgeons and clinician. They were asked to decide the best therapeutic option: to increase, decrease or maintenance blood pressure. RESULTS: Thirty-eight physicians (31,7% considered decreasing blood pressure the best therapeutics, 82 (68,3% considered maintenance and none decided to increase it (p < 0.05. There was no difference between the two specialties conduct. The physicians, with more than 10 years of graduation, had a tendency to decrease the blood pressure (p <0.05. CONCLUSION: The maintenance of blood pressure may present a sufficient blood support to compensate brain flow. A high percentage of the physicians (31,7% do not know about the current concepts of therapeutics considering hypertension in acute ischemic stroke. The development on special units to treat these patients ("stroke units" may eventually

  19. Effect of the systemic inflammatory response, as provoked by elective orthopaedic surgery, on HbA1c.

    Science.gov (United States)

    Chadburn, Andrew J; Garman, Elizabeth; Abbas, Raad; Modupe, Anu; Ford, Clare; Thomas, Osmond L; Chugh, Sanjiv; Deshpande, Shreeram; Gama, Rousseau

    2017-01-01

    Background In acutely ill patients with new onset hyperglycaemia, plasma glucose cannot reliably distinguish between stress hyperglycaemia and undiagnosed diabetes mellitus. We, therefore, investigated the diagnostic reliability of glycated haemoglobin (HbA1c) in acute illness by prospectively evaluating the effect of the systemic inflammatory response, as provoked by elective orthopaedic surgery, on HbA1c. Methods HbA1c and serum C-reactive protein concentrations were compared before and two days after elective knee or hip surgery in 30 patients without diabetes. C-reactive protein was used to assess the systemic inflammatory response. Results The mean (standard deviation) serum C-reactive protein increased following surgery (4.8 [7.5] vs. 179.7 [61.9] mg/L; P<0.0001). HbA1c was similar before and after surgery (39.2 [5.4] vs. 38.1 [5.1] mmol/moL, respectively; P = 0.4363). Conclusions HbA1c is unaffected within two days of a systemic inflammatory response as provoked by elective orthopaedic surgery. This suggests that HbA1c may be able to differentiate newly presenting type 2 diabetes mellitus from stress hyperglycaemia in acutely ill patients with new onset hyperglycaemia.

  20. An Update on Inpatient Hypertension Management.

    Science.gov (United States)

    Axon, R Neal; Turner, Mason; Buckley, Ryan

    2015-11-01

    Hypertension is highly prevalent affecting nearly one third of the US adult population. Though generally approached as an outpatient disorder, elevated blood pressure is observed in a majority of hospitalized patients. The spectrum of hypertensive disease ranges from patients with hypertensive emergency including markedly elevated blood pressure and associated end-organ damage to asymptomatic patients with minimally elevated pressures of unclear significance. It is important to note that current evidence-based hypertension guidelines do not specifically address inpatient hypertension. This narrative review focuses primarily on best practices for diagnosing and managing nonemergent hypertension in the inpatient setting. We describe examples of common hypertensive syndromes, provide suggestions for optimal post-acute management, and point to evidence-based or consensus guidelines where available. In addition, we describe a practical approach to managing asymptomatic elevated blood pressure observed in the inpatient setting. Finally, arranging effective care transitions to ensure optimal ongoing hypertension management is appropriate in all cases.

  1. H 型高血压与脑梗死后早期康复效果的相关性%Correlation between early rehabilitation efficacy of patients with acute cerebral infarction and H-type hypertension

    Institute of Scientific and Technical Information of China (English)

    王慧; 李嘉民; 赵素霞; 肖辉

    2015-01-01

    Objective To analyze the relationship between early rehabilitation efficacy of patients with acute cerebral infarction and H-type hypertension.Methods The study involved a total of 123 patients with acute cerebral infarction undergoing early rehabilitation.All cases were divided into two groups,group A:patients with hypertension and group B:patients without hypertension.Group A was subdivided into group A1 and group A2 according to the level of homocysteine. Fug-l Meyer (FM) and Barthel index (BI ) scores were observed before and after early rehabilitation in all groups.Results The scores after early rehabilitation and the improved scores of FM and BI were significantly different between group A and B,and between group A1 and A2 (P <0.05).Conclusion Hypertension, especially H-type hypertension,was considered risk factor in patients with acute cerebral infarction undergoing early rehabilitation.%目的:探讨高血压、H 型高血压与脑梗死后早期康复效果的相关性。方法脑梗死后行早期康复的患者123例,根据其是否有高血压分为高血压组(A 组)84例,男50例,女34例;非高血压组(B 组)39例,男24例,女15例;A 组根据同型半胱氨酸水平分为 H 型高血压组(A1组)56例,男36例,女20例;非 H 型高血压组(A2组)28例,男18例,女10例。分别比较各组康复治疗前后日常生活能力评分(Barthel index,BI),肢体运动功能评分(Fug-l Meyer,FM)差值。结果 B 组 FM、BI 前后评分及康复前后评分差值高于 A 组(P <0.05);A2组 FM、BI 康复前后评分及评分差值高于 A1组(P <0.05)。结论高血压尤其是 H 型高血压是脑梗死早期预后不利的危险因素。

  2. Mucosal versus muscle pain sensitivity in provoked vestibulodynia

    Directory of Open Access Journals (Sweden)

    Witzeman K

    2015-08-01

    Full Text Available Kathryn Witzeman,1 Ruby HN Nguyen,2 Alisa Eanes,3 Sawsan As-Sanie,4 Denniz Zolnoun51Department of Obstetrics and Gynecology, Denver Health Medical Center, Denver, CO, 2Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, 3Pelvic Pain Research Unit, Division of Advanced Laparoscopy and Pelvic Pain, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, 4Department of Obstetrics and Gynecology, Division of Minimally Invasive Gynecologic Surgery, University of Michigan, Ann Arbor, MI, 5Department of Obstetrics and Gynecology and Center for Neurosensory Disorders, University of North Carolina, Chapel Hill, NC, USABackground: An estimated 8.3%–16% of women experience vulvovaginal discomfort during their lifetime. Frequently these patients report provoked pain on contact or with attempted intercourse, commonly referred to as provoked vestibulodynia (PVD. Despite the burden of this condition, little is known about its potential etiologies including pelvic floor muscular dysfunction and mucosal components. This knowledge would be beneficial in developing targeted therapies including physical therapy.Objective: To explore the relative contribution of mucosal versus muscle pain sensitivity on pain report from intercourse among women with PVD.Design: In this proof of concept study, 54 women with PVD underwent a structured examination assessing mucosal and pelvic muscle sensitivity.Methods: We examined three mucosal sites in the upper and lower vestibule. Patients were asked to rate their pain on cotton swab palpation of the mucosa using a 10-point visual analog scale. Muscle pain was assessed using transvaginal application of pressure on right and left puborectalis, and the perineal muscle complex. The Gracely pain scale (0–100 was used to assess the severity of pain with intercourse, with women rating the lowest, average, and highest pain levels; a 100 rating the

  3. Arterial pulmonary hypertension in noncardiac intensive care unit

    Directory of Open Access Journals (Sweden)

    Mykola V Tsapenko

    2008-10-01

    Full Text Available Mykola V Tsapenko1,5, Arseniy V Tsapenko2, Thomas BO Comfere3,5, Girish K Mour1,5, Sunil V Mankad4, Ognjen Gajic1,51Division of Pulmonary and Critical Care Medicine; 3Division of Critical Care Medicine; 4Division of Cardiovascular Diseases, Mayo Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C, Mayo Clinic, Rochester, MN, USA; 2Division of Pulmonary and Critical Care Medicine, Brown University, Miriam Hospital, Providence, RI, USAAbstract: Pulmonary artery pressure elevation complicates the course of many complex disorders treated in a noncardiac intensive care unit. Acute pulmonary hypertension, however, remains underdiagnosed and its treatment frequently begins only after serious complications have developed. Significant pathophysiologic differences between acute and chronic pulmonary hypertension make current classification and treatment recommendations for chronic pulmonary hypertension barely applicable to acute pulmonary hypertension. In order to clarify the terminology of acute pulmonary hypertension and distinguish it from chronic pulmonary hypertension, we provide a classification of acute pulmonary hypertension according to underlying pathophysiologic mechanisms, clinical features, natural history, and response to treatment. Based on available data, therapy of acute arterial pulmonary hypertension should generally be aimed at acutely relieving right ventricular (RV pressure overload and preventing RV dysfunction. Cases of severe acute pulmonary hypertension complicated by RV failure and systemic arterial hypotension are real clinical challenges requiring tight hemodynamic monitoring and aggressive treatment including combinations of pulmonary vasodilators, inotropic agents and systemic arterial vasoconstrictors. The choice of vasopressor and inotropes in patients with acute pulmonary hypertension should take into consideration their effects on vascular resistance and cardiac output when used alone or in

  4. The Clinical Observation of 26 Cases Old Age Hypertension Diabetes Complicating Acute Myocardial Infarction%老年高血压糖尿病合并急性心肌梗死26例临床观察

    Institute of Scientific and Technical Information of China (English)

    陈源; 董亚辉

    2015-01-01

    Objective To observe the elderly hypertension diabetes complicating acute myocardial infarction (mi) of clinical manifestations, complications and prognosis. Methods 26 patients with senile hypertension diabetes complicating acute myocardial infarction (observation group) and the other at the same time, with the department of hypertension diabetes complicating acute myocardial infarction treated 30 cases as control (control group), two groups of patients with clinical data were retrospectively analyzed, compare two groups of fasting blood glucose (FBG), glycosylated hemoglobin (HbAlc), complications. Results Observation group of arrhythmiaFBG, HbAlc, myocardial enzymes were higher than control group, signiifcant difference (P<0.05). Conclusion Old age hypertension diabetes complicating acute myocardial infarction, painless type, more complications, mortality is higher, should strictly control the patients' blood sugar, blood lipid levels.%目的:观察老年高血压糖尿病合并急性心肌梗死的临床表现、并发症及预后情况。方法老年高血压糖尿病合并急性心肌梗死患者26例(观察组),另选取同期、同科室收治的非高血压糖尿病合并急性心肌梗死30例作对照(对照组),回顾性分析两组患者临床资料,观察比较两组空腹血糖(FBG)、糖化血红蛋白(HbAlc)、血清酶学情况。结果观察组FBG、HbAlc、心肌酶谱均高于对照组,差异显著(P<0.05)。结论老年高血压糖尿病合并急性心肌梗死无痛型多见,应严格控制患者血糖、血脂水平。

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

    Directory of Open Access Journals (Sweden)

    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

  6. Secondary Headaches Attributed to Arterial Hypertension

    Directory of Open Access Journals (Sweden)

    Farhad Assarzadegan

    2013-07-01

    Full Text Available Mild (140 to 159/90 to 99 mmHg or moderate (160 to 179/100 to 109 mmHg chronic arterial hypertension does not appear to cause headache. Whether moderate hypertension predisposes patients to headache at all remains controversial, but there is little evidence that it does. Ambulatory blood pressure monitoring in patients with mild and moderate hypertension has shown no convincing relationship between blood pressure fluctuations over a 24-hour period and presence or absence of headache. However, headaches are associated to various disorders that lead to abrupt, severe, and paroxysmal elevations in blood pressure. In this paper, the secondary headaches attributed to acute crises of hypertension and the criteria for diagnosing each of them have been reviewed. These are headaches attributed to pheochromocytoma, hypertensive crisis without encephalopathy, hypertensive encephalopathy, pre-eclampsia, eclampsia, and acute pressure response to exogenous agents.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  8. Impaired suppression of plasma free fatty acids and triglycerides by acute hyperglycaemia-induced hyperinsulinaemia and alterations in high density lipoproteins in essential hypertension

    NARCIS (Netherlands)

    Ligtenberg, JJM; vanTol, A; vanHaeften, TW; Sluiter, WJ; Dullaart, RPF

    1996-01-01

    Objectives. Essential hypertension may be associated with abnormalities in free fatty acids (FFA) and triglyceride metabolism, which could lead to alterations in high density lipoproteins (HDL). Lecithin: cholesterol acyltransferase (LCAT) and cholesteryl ester transfer protein (CETP) are key factor

  9. Hastigt progredierende synstab ved idiopatisk intrakraniel hypertension

    DEFF Research Database (Denmark)

    Skau, Maren; Jensen, Rigmor; Milea, Dan

    2009-01-01

    Idiopathic intracranial hypertension (IIH) is a condition of increased intracranial pressure of unknown aetiology. Slowly progressing visual defects secondary to papilloedema are well-known complications. Rapidly progressing visual loss is rare. A case of acute and rapidly progressing visual loss...... in idiopathic intracranial hypertension is presented. Rapid recognition and treatment of IIH is important, and may occasionally prompt acute surgical treatment. Udgivelsesdato: 2009-Jan...

  10. Alteration in the gut microbiota provokes susceptibility to tuberculosis

    Directory of Open Access Journals (Sweden)

    Nargis Khan

    2016-11-01

    Full Text Available AbstractThe microbiota that resides in the gastrointestinal tract provides essential health benefits to the host. In particular, they regulate immune homeostasis. Recently, several evidences indicate that alteration in the gut microbial community can cause infectious and non-infectious diseases. Tuberculosis (TB is the most devastating disease, inflicting mortality and morbidity. It remains unexplored, whether changes in the gut microbiota can provoke or prevent TB. In the current study, we have demonstrated the antibiotics driven changes in the gut microbial composition and their impact on the survival of Mtb in the lungs, liver and spleen of infected mice, compared to those with intact microbiota. Interestingly, dysbiosis of microbes showed significant increase in the bacterial burden in lungs and dissemination of Mtb to spleen and liver. Further, elevation in the number of Tregs and decline in the pool of IFN-γ and TNF-α releasing CD4 T cells was noticed. Interestingly, fecal transplantation in the gut microbiota disrupted animals exhibited improved Th1 immunity and lesser Tregs population. Importantly, these animals displayed reduced severity to Mtb infection. This study for the first time demonstrated the novel role of gut microbes in the susceptibility to TB and its prevention by microbial implants. In future, microbial therapies may help in treating patients suffering from TB.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. EVALUATION OF PULMONARY HYPERTENSION AND STRATIFICATION OF RISK BY FIRST-PASS RADIONUCLIDE PULMONARY PERFUSION IMAGING IN PATIENTS WITH PULMONARY HYPERTENSION OF ACUTE PULMONARY EMBOLISM%应用首次通过法肺灌注显像对急性肺栓塞合并肺动脉高压的评价

    Institute of Scientific and Technical Information of China (English)

    王静; 李国华; 王雪梅

    2014-01-01

    Objective:The purpose of this study was to evaluate pulmonary hypertension( PH) and stratification of risk by first-pass radionuclide pulmonary perfusion imaging( FPPPI) in patients with PH of acute pulmonary embolism( APE) . Methods:twenty healthy volunteers(12 males,8 females,average age of 48. 47±13. 47)Twenty patients(11 males,9 females,average age of 49. 95±16. 13,accumulated from 2007-10~2009-02 ) with acute pulmonary embolism were included in our study. FPPPI were performed in all Subjects. Calculated by FPPPI lung equilibration time( LET) . Results:LET by FPPPI in healthy volunteers and APE patients were 12. 18±3. 28 sec and 32. 90±14. 29 sec,respectively. It is the significance between healthy volunteers and APE patients ( P<0 . 01 ) . Conclusion:FPPPI was a reliable,convenient andnon-invasivemethod in evaluating pulmonary hypertension in acute pulmonary embolism.%目的:应用首次通过法肺灌注显像( First-pass radionuclide pulmonary perfusion imaging,FPPPI)对急性肺栓塞( Acute pulmonary embolism APE)合并肺动脉高压( Pulmonary hypertension,PH)的评价。方法:20例健康自愿者,男12例,女8例,平均年龄为48.47依13.47岁(21~71岁),20例(2007-10~2009-02)临床诊断为急性肺栓塞病人,男11例,9例,平均年龄为49.95依16.13岁(23~82岁),所有受试者均行FPPPI检查,按FPPPI计算肺平衡时间(Lung equilibrium time LET)。结果:FPPPI法测定的肺平衡时间(LET),正常组LET 12.18依3.28 sec, APE组LET 32.90依14.29 sec 两组进行t检验,t=6.32,P<0.01,有统计学差别。结论:FPPPI是评价急性肺栓塞合并肺动脉高压的可靠、简便、无创性的方法。

  13. PREVALENCE, CLINICAL PRESENTATION, DIAGNOSIS AND TREATMENT OF ACUTE PULMONARY OEDEMA IN SEVERE PREGNANCY-INDUCED HYPERTENSION AND ECLAMPSIA CASES IN TRIBAL POPULATION OF SOUTH RAJASTHAN

    Directory of Open Access Journals (Sweden)

    (Brig. Pradeep Kuma

    2016-05-01

    Full Text Available BACKGROUND Pulmonary oedema in severe pregnancy-induced hypertension is a life threatening complication with high maternal mortality, particularly in tribal population of South Rajasthan. METHODS Thirteen cases which occurred in the duration of two and half years were analysed through medical records and findings were recorded. RESULTS Maximum cases 10(76.92% were in less than 20 years of age. 12 (92.30% cases were nulliparous. Out of 13 cases of PIH, pulmonary oedema developed in 5 (38.46% cases of eclampsia and 8 (61.54% cases of severe pregnancy-induced hypertension. 10 (76.92%cases were 28 to 30 weeks of gestation and 3 (23.08% were 31 to 34 weeks of gestation. 8 (61.54% cases were severely anaemic. 12 (92.30% were unbooked cases. CONCLUSION Regular antenatal checkups, early diagnosis, prompt treatment of hypertension and pulmonary oedema and termination of pregnancy is required to prevent maternal death.

  14. Treatment of portal hypertension

    Institute of Scientific and Technical Information of China (English)

    Khurram Bari; Guadalupe Garcia-Tsao

    2012-01-01

    Portal hypertension is the main complication of cirrhosis and is defined as an hepatic venous pressure gradient (HVPG) of more than 5 mmHg.Clinically significant portal hypertension is defined as HVPG of 10 mmHg or more.Development of gastroesophageal varices and variceal hemorrhage are the most direct consequence of portal hypertension.Over the last decades significant advancements in the field have led to standard treatment options.These clinical recommendations have evolved mostly as a result of randomized controlled trials and consensus conferences among experts where existing evidence has been reviewed and future goals for research and practice guidelines have been proposed.Management of varices/variceal hemorrhage is based on the clinical stage of portal hypertension.No specific treatment has shown to prevent the formation of varices.Prevention of first variceal hemorrhage depends on the size/characteristics of varices.In patients with small varices and high risk of bleeding,nonselective β-blockers are recommended,while patients with medium/large varices can be treated with either β-blockers or esophageal band ligation.Standard of care for acute variceal hemorrhage consists of vasoactive drugs,endoscopic band ligation and antibiotics prophylaxis.Transjugular intrahepatic portosystemic shunt (TIPS) is reserved for those who fail standard of care or for patients who are likely to fail ("early TIPS").Prevention of recurrent variceal hemorrhage consists of the combination of β-blockers and endoscopic band ligation.

  15. Management of Hypertension in Pregnancy

    Directory of Open Access Journals (Sweden)

    Nurike S Mudjari

    2015-03-01

    Full Text Available Hypertension-related maternal mortality reaches 16% when it is compared to other causes of maternal mortality such as sepsis, bleeding or abortus. Pregnant women with hypertension disorder are at increased risk for experiencing numerous complications including disseminated intravascular coagulation (DIC, cerebral hemorrhage, liver dysfunction and acute renal failure; while to the fetus, it may cause intrauterine growth retardation, prematurity and perinatal mortality. Hypertension in pregnancy should be managed appropriately to reduce maternal and fetal morbidity and mortality rate, i.e. by preventing women from getting the risks of increased blood pressure, preventing disease progression and preventing the development of seizure and considering termination of pregnancy in lifethreatening situation for maternal and fetal health. Key words: blood pressure, hypertension, eclampsia, preeclampsia, pregnant women, gestational.

  16. The management of hypertension in pregnancy.

    Science.gov (United States)

    Kattah, Andrea G; Garovic, Vesna D

    2013-05-01

    Hypertensive pregnancy disorders complicate 6% to 8% of pregnancies and cause significant maternal and fetal morbidity and mortality. The goal of treatment is to prevent significant cerebrovascular and cardiovascular events in the mother without compromising fetal well-being. Current guidelines differentiate between the treatment of women with acute hypertensive syndromes of pregnancy and women with preexisting chronic hypertension in pregnancy. This review will address the management of hypertension in pregnancy, review the various pharmacologic therapies, and discuss the future directions in this field.

  17. Management of severe hypertension in pregnancy.

    Science.gov (United States)

    Moroz, Leslie A; Simpson, Lynn L; Rochelson, Burton

    2016-03-01

    While hemorrhage is the leading cause of maternal death in most of the world, hypertensive disorders of pregnancy are the leading cause of maternal mortality in the United States. The opportunity to improve outcomes lies in timely and appropriate response to severe hypertension. The purpose of this article is to review the diagnostic criteria for severe hypertension, choice of antihypertensive agents, and recommended algorithms for evaluation and management of acute changes in clinical status. Adhering to standard practices ensures that care teams can timely and appropriate care to these high risk patients. With heightened surveillance and prompt evaluation of signs and symptoms of worsening hypertension, maternal morbidity and mortality can be decreased.

  18. 高血压对青年女性心肌梗死患者的影响及其与冠状动脉病变的关系%Impact of hypertension on young women with acute myocardial infarction and the relation between hypertension and the severity of coronary artery lesions

    Institute of Scientific and Technical Information of China (English)

    李昭; 王松涛; 李志忠; 张京梅; 黄觊; 吴翔宇; 张冬花; 王茜; 孙涛

    2014-01-01

    目的 探讨高血压对青年女性急性心肌梗死的影响及其与冠状动脉病变程度的关系.方法 收集2003年6-12月在首都医科大学附属北京安贞医院及武装警察部队北京市总队医院住院诊断为急性心肌梗死并行冠状动脉造影的64例青年女性(年龄≤44岁)患者的临床资料进行回顾性分析,根据冠状动脉造影结果,分为单支病变患者(46例)和多支病变患者(18例);选取同时期住院行冠状动脉造影排除冠心病诊断的青年女性60例作为对照组.观察高血压与冠状动脉病变程度在急性心肌梗死患者中的关系.结果 ①青年女性中,心肌梗死组高血压比例(56.2%,36/64)高于对照组(8.3%,5/60),多支病变患者高血压比例(77.8%,14/18)高于单支病变患者(47.8%,22/46) (P <0.05).②Logistic回归分析显示,青年女性患者中,高血压[比值比(OR)=16.173,95%置信区间(CI):4.130 ~ 63.328]、血红蛋白(OR=1.039,95% CI:1.002 ~1.078)及尿酸(OR=1.008,95% CI:1.001 ~ 1.016)是急性心肌梗死的独立危险因素(均P<0.05).③心肌梗死组中,高血压合并冠状动脉多支病变患者(38.9%,14/36)多于非高血压合并多支病变患者(14.3%,4/28) (P<0.05);急性ST段抬高型心肌梗死患者中,高血压合并冠状动脉多支病变(77.8%,14/18)的比例高于单支病变组(46.2%,18/39) (P <0.05).结论 高血压是青年女性急性心肌梗死的独立危险因素,合并高血压的心肌梗死患者冠状动脉病变更为严重.%Objective To investigate the characteristics of hypertension and the relation between hypertension and the severity of coronary artery lesions in young women with acute myocardial infarction (AMI).Methods We retrospectively studied 64 young women with acute myocardial infarction.All patients were admitted to hospital from Jun.2003 to Dec.2013 and undergone coronary angiography; the clinic and coronary angiographic features were assessed.According to

  19. Hypertension screening

    Science.gov (United States)

    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.

  20. Malignant hypertension

    Science.gov (United States)

    ... systemic lupus erythematosus, systemic sclerosis, and periarteritis nodosa) Kidney problems Pregnancy-induced high blood pressure ( toxemia ) You are at ... Hypertensive kidney References Badr KF, Brenner BM. Vascular injury to the kidney. In: Fauci A , Kasper D, Longo DL, et ...

  1. Pulmonary hypertension

    OpenAIRE

    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...

  2. Endokrin hypertension

    DEFF Research Database (Denmark)

    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...

  3. Pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Lauro Martins Júnior

    2014-12-01

    Full Text Available Pulmonary hypertension is a pathological condition associated with various diseases, which must be remembered by the physicians, since early diagnosis may anticipate and avoid dangerous complications and even death if appropriate measures were not taken. The relationship with chronic obstructive pulmonary disease (COPD, important pathological process that is in increasing prevalence in developing countries, and leading position as cause of death, emphasizes its importance. Here are presented the classifications, pathophysiology, and general rules of treatment of pulmonary hypertension.

  4. 酚妥拉明治疗小儿急性肾小球肾炎高血压疗效探讨%Effect of phentolamine on hypertension in children with acute glomerulonephritis

    Institute of Scientific and Technical Information of China (English)

    张宁

    2015-01-01

    Objective To investigate the effect of phentolamine on hypertension in children with acute glomerulonephritis.Methods Randomly divided 80 children with hypertension and acute glomerulonephritis into study group and the control group,with 40 cases in each group.The control group was given diuretics and antibiotics,while the study group was treated with phenol plus phentolamine.Compared and analyzed the clinical effects of the two groups.Results The incidence of adverse reactions,edema disappeared time,blood pressure recovery time,gross hematuria disappeared time in study group were significantly lower than those in the control group,and the differences were significant (P < 0.05).Conclusions Phentolamine treating hypertension in children with acute glomerulonephritis can achieve relatively good results with fast recovery and fewer adverse reactions,so it is worth of being promoted.%目的 探讨小儿急性肾小球肾炎高血压采用酚妥拉明治疗的效果.方法 随机将80例小儿急性肾小球肾炎高血压患儿均分为研究组与对照组各40例.对照组采取利尿剂与抗生素治疗,而研究组加用酚妥拉明治疗,对比分析两组患儿临床疗效.结果 研究组患儿不良反应发生率、水肿消失时间、血压恢复时间、内眼血尿消失时间均明显低于对照组,组间比较差异有统计学意义(P<0.05).结论 小儿急性肾小球肾炎高血压应用酚妥拉明治疗可取得比较良好的效果,患儿病情康复快,不良反应少,值得推广应用.

  5. Perioperative hypertension

    Directory of Open Access Journals (Sweden)

    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

  6. Managing hypertension in the newborn infants

    Directory of Open Access Journals (Sweden)

    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.

  7. Emergency Management of Hypertension in Children

    Directory of Open Access Journals (Sweden)

    Dinesh Singh

    2012-01-01

    Full Text Available Systemic arterial hypertension in children has traditionally been thought to be secondary in origin. Increased incidence of risk factors like obesity, sedentary life-styles, and faulty dietary habits has led to increased prevalence of the primary arterial hypertension (PAH, particularly in adolescent age children. PAH has become a global epidemic worldwide imposing huge economic constraint on health care. Sudden acute increase in systolic and diastolic blood pressure can lead to hypertensive crisis. While it generally pertains to secondary hypertension, occurrence of hypertensive crisis in PAH is however rare in children. Hypertensive crisis has been further subclassified depending on presence or absence of end-organ damage into hypertensive emergency or urgency. Both hypertensive emergencies and urgencies are known to cause significant morbidity and mortality. Increasing awareness among the physicians, targeted at investigation of the pathophysiology of hypertension and its complications, better screening methods, generation, and implementation of novel treatment modalities will impact overall outcomes. In this paper, we discuss the etiology, pathogenesis, and management of hypertensive crisis in children. An extensive database search using keywords was done to obtain the information.

  8. Repeated stressors do not provoke habituation or accumulation of the stress response in the catfish Rhamdia quelen

    Directory of Open Access Journals (Sweden)

    Gessi Koakoski

    2013-06-01

    Full Text Available Fish repeatedly experience stressful situations under experimental and aquaculture conditions, even in their natural habitat. Fish submitted to sequential stressors can exhibit accumulation or habituation on its cortisol response. We posed a central question about the cortisol response profiles after exposure to successive acute stressors of a similar and different nature in Rhamdia quelen. We have shown that successive acute stressors delivered with 12-h, 48-h, and 1-week intervals provoked similar cortisol responses in juvenile R. quelen, without any habituation or accumulation. The cumulative stress response is more associated to short acute stressors with very short intervals of minutes to hours. In our work, we used an interval as short as 12h, and no cumulative response was found. However, if the length of time between stressors is of a day or week as used in our work the most common and an expected phenomenon is the attenuation of the response. Thus, also, the absence of both accumulation of the stress response and the expected habituation is an intriguing result. Our results show that R. quelen does not show habituation or accumulation in its stress responses to repeated stressors, as reported for other fish species

  9. Open abdomen in the treatment of intra-abdominal hypertension in patients with severe acute pancreatitis%重症急性胰腺炎的腹腔高压与腹腔开放治疗

    Institute of Scientific and Technical Information of China (English)

    李宁

    2010-01-01

    @@ 早在20世纪初期,就有学者注意到腹腔高压对患者心血管、肾脏等的功能产生不利影响.重症急性胰腺炎(severe acute pancreatitis,SAP)常导致腹腔高压,不仅限制腹式呼吸,减少机体氧供,而且对泌尿、循环、消化和中枢神经系统等产生一系列严重影响,如不及时治疗,将导致腹腔间室综合征(abdominal compartment syndrome,ACS).%Severe acute pancreatitis (SAP) can induce intra-abdominal hypertension, which has an adverse effect on the function of urinary, circulatory, digestive and neurological system, and finally leads to abdominal compartment syndrome (ACS) if patients were not timely treated. This article focuses on the close relationship between SAP and ACS, which included the definition, classification, pathogenesis of ACS and its pathophysiologic effects on other important organs. The different types and indications of surgical interventions of ACS were discussed in detail. For SAP patients complicated with ACS, urgent open abdomen is important to decrease the abdominal pressure and to prevent the incidence of multi-organ dysfunction syndrome. Complications after open abdomen, such as intestine fistula,abdominal sepsis, intestinal dysfunction and abdominal deficit,should be managed prudently.

  10. 酚妥拉明治疗小儿急性肾小球肾炎高血压疗效分析%Effect of phentolamine on hypertension in children with acute glomerulonephritis

    Institute of Scientific and Technical Information of China (English)

    张灵献

    2015-01-01

    Objective To investigate the clinical efficacy of phentolamine on hypertension in children with acute glomerulonephritis.Methods From July 2011 and November 2013, ninety cases of acute glomerulonephritis children with high blood pressure were chosen, and were randomly divided into the experiment group and the control group.The patients in control group were treated with reserpine treatment, and the patients in the experiment group were given phentolamine in addition, the clinical out-comes of the two groups were compared.Results The clinical results and clinical symptoms improve-ment time in children of the experiment group were significantly better than those in the control group, the differences were significant( P<0.05) .Conclusions Phentolamine for the treatment of hypertension in children with acute glomerulonephritis can effectively promote the rapid recovery of blood pressure, is safe and reliable, so it is recommended to be further promoted in clinical practice.%目的:探讨酚妥拉明治疗小儿急性肾小球肾炎高血压的临床疗效。方法随机选取嵩县人民医院2011年7月至2013年11月收治的确诊为急性肾小球肾炎高血压患儿90例,将其随机平均分配为实验组和对照组,其中对照组患者采用利血平进行治疗,实验组患儿在对照组的治疗基础上加用酚妥拉明进行治疗,对比两组患儿的临床治疗效果。结果实验组患儿的临床治疗效果及临床症状改善时间均明显优于对照组患儿,差异有统计学意义( P<0.05)。结论采用酚妥拉明治疗小儿急性肾小球肾炎高血压,能够有效促进患儿血压的快速平复,疗效显著,安全可靠,建议在临床上进一步推广。

  11. Management of hypertension in pregnancy.

    Science.gov (United States)

    Mudjari, Nurike S; Samsu, Nur

    2015-01-01

    Hypertension-related maternal mortality reaches 16% when it is compared to other causes of maternal mortality such as sepsis, bleeding or abortus. Pregnant women with hypertension disorder are at increased risk for experiencing numerous complications including disseminated intravascular coagulation (DIC), cerebral hemorrhage, liver dysfunction and acute renal failure; while to the fetus, it may cause intrauterine growth retardation, prematurity and perinatal mortality. Hypertension in pregnancy should be managed appropriately to reduce maternal and fetal morbidity and mortality rate, i.e. by preventing women from getting the risks of increased blood pressure, preventing disease progression and preventing the development of seizure and considering termination of pregnancy in life-threatening situation for maternal and fetal health.

  12. Hypertension Briefing

    OpenAIRE

    2012-01-01

    Blood pressure is the force exerted on artery walls as the heart pumps blood through the body. Hypertension, or high blood pressure, occurs when blood pressure is constantly higher than the pressure needed to carry blood through the body. The Chronic Conditions Hub is a website that brings together information on chronic health conditions. It allows you to easily access, manage and share relevant information resources. The Chronic Conditions Hub includes the Institute of Public Health in Irel...

  13. 猪急性颅高压损伤模型的病理生理及超微结构改变%Pathophysiological and ultrastructural changes in porcine model of acute intracranial hypertension brain injury

    Institute of Scientific and Technical Information of China (English)

    吴伟; 成惠林; 杭春华; 史继新; 印红霞; 吴晋荣; 黎介寿

    2012-01-01

    目的 观察猪急性颅高压损伤模型的病理生理变化及超微结构改变.方法 选用中型猪5只,采用微量泵注射自体动脉血法建立急性颅高压损伤控制模型,模型制备过程中及制备后2h持续监测颅内压、平均动脉压变化,注血后2h行头部CT扫描,24 h取脑行大体切片,苏木精-伊红染色光镜观察组织学病理改变、超微电镜观察受损神经元的超微结构改变.结果 注血后颅内压、平均动脉压均明显上升,最高分别达(51.2±2.5) mmHg和(152.7±12.8) mmHg,颅内压升至约50 mmHg时,出现呼吸、心率改变;头部CT扫描、大体切片均显示脑内血肿形成;电镜检查显示血肿区神经元肿胀,胞质内细胞器数量减少,线粒体肿胀,嵴排列不整齐,粗面内质网颗粒扩张,血管内皮细胞肿胀,基膜不完整,血管周围可见明显水肿带.结论 采用微量泵注射自体动脉血法可建立稳定、可靠的猪急性颅高压损伤控制模型.%Objective To observe the pathophysiological and ultrastructural changes in the porcine model of acute intracranial hypertension brain injury. Methods Autologous arterial blood was injected into the brain in 5 middle-weighted pigs by micro-pump for establishing the brain injury model due to acute intracranial hypertension. And the change of intracranial pressure (ICP) and mean arterial pressure (MAP) were monitored. CT scanning was performed 2 h after blood injection. After H&E staining, histological changes were observed under light microscope and ultrastructural changes under electron microscope. Results ICP and MAP significantly increased after the blood injection, and the peak reached 51.2 ± 2.5 mmHg and 152.7 ± 12.8 mmHg respectively. The porcine respiration and heart rate changed when the ICP increased to about 50 mmHg. CT scanning and pathological examination all showed the brain hematoma formed. Electron microscope examination showed that the neuronal swelling in hematoma area

  14. HYPERTENSION IN PSYCHIATRIC PATIENTS

    OpenAIRE

    Chaturvedi, Santosh K.; Michael, Albert

    1986-01-01

    SUMMARY Known cases of hypertension and those fulfilling WHO criteria for diagnosis of hypertension were identified in psychiatric patients and compared with non - hypertensive psychiatric patients. Hypertension was detected in 141 (9.98%) cases, and was significantly more associated with elder age, married status, urban background and neurotic illness. The implications are in early detection and effective management of hypertension in psychiatric patients.

  15. Hypertension hos gravide

    DEFF Research Database (Denmark)

    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...... and disadvantages of different classes of antihypertensive drugs during pregnancy and lactation are described....

  16. [Hypertension during pregnancy

    DEFF Research Database (Denmark)

    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...... and disadvantages of different classes of antihypertensive drugs during pregnancy and lactation are described Udgivelsesdato: 2009/6/15...

  17. Bleed caused by varicose veins rupture in a rare site in portal hypertension. Differential diagnosis with causes of acute hypovolemic shock in emergency.

    Directory of Open Access Journals (Sweden)

    Rosarino Procopio

    2011-09-01

    Full Text Available Portal hypertension is the increase in the pressure of the venous portal system, which receives around 1,500 mL/m of blood from the intestinum tenue, colon, spleen, and pancreas. A blocking of the flux or an increase in the resistance at any level of the portal tree results in an increase in the pressure in the system and the appearance of lateral circles between the portal vein and the inferior and superior, thus allowing for varicose veins to spread in the whole system. The present paper reports the case of a woman with liver cirrhosis, great ascites and bleeding out of varicose veins’ rupture at the spleen axis level, which presented the problem of differential diagnosis with other causes of hypovolemic shock. This cases resulted in the patient’s exitus.

  18. Bradycardia without hypertension and bradypnea in acute traumatic subdural hematoma is a sensitive predictor of the Cushing triad: 3 case reports

    OpenAIRE

    2016-01-01

    Acute traumatic subdural hematomas (SDHs) are very common. These hematomas are usually neurosurgical emergencies, although conservative therapy is indicated in certain cases. SDH can increase intracranial pressure (ICP) and compress or stretch the brainstem. Lately, it has been recognized that increased ICP can lead to hemodynamic instability and bradycardia. Bradycardia can be an early warning sign in many neurosurgical conditions. We observed bradycardia in serial cases of the patient witho...

  19. Pulmonary Arterial Hypertension

    Science.gov (United States)

    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 ...

  20. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  1. Hypertensive Disorders of Pregnancy

    OpenAIRE

    Mammaro, Alessia; Carrara, Sabina; Cavaliere, Alessandro; Ermito, Santina; Dinatale, Angela; Pappalardo, Elisa Maria; Militello, Mariapia; Pedata, Rosa

    2009-01-01

    Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories, as recommended by the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy: 1) chronic hypertension, 2) preeclampsia-eclampsia, 3) preeclampsia superimposed on chronic hypertension, and 4) gestational hypertension (transient hypertension of pregnancy or chronic hyper...

  2. Treating Hypertension in Pregnancy.

    Science.gov (United States)

    Schlembach, Dietmar; Homuth, Volker; Dechend, Ralf

    2015-08-01

    Hypertension is present in about 10 % of all pregnancies. The frequency of chronic hypertension and that of gestational hypertension is increasing. The management of pregnant women with hypertension remains a significant, but controversial, public health problem. Although treatment of hypertension in pregnancy has shown to reduce maternal target organ damage, considerable debate remains concerning treatment. We review current evidence regarding treatment goals, the ideal treatment starting time, and which drugs are available for the treatment of hypertension in pregnancy.

  3. Hypertensive crisis during pregnancy and postpartum period.

    Science.gov (United States)

    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.

  4. How Is Pulmonary Hypertension Treated?

    Science.gov (United States)

    ... 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 ...

  5. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  6. [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].

    Science.gov (United States)

    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.

  7. 硫酸镁对杂种犬急性肺动脉高压模型抗炎机制研究%Study on the anti-inflammatory mechanism of magnesium sulfate in mongrel dog with acute pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    卢宏志; 刘翠萍; 张冰

    2013-01-01

    Objective To investigate the effect of magnesium sulfate on acute pulmonary hypertension and its anti-inflammatory mechanism in mongrel dogs .Methods 18 mongrel dogs were randomly divided into three groups:blank group,control group and magnesium sulfate group (2.0mm/kg),with 6 dogs in each group.The dogs in blank group were not given any treatment ,the dogs in control group were operated to induce acute pulmonary hypertension,and the dogs in magnesium sulfate group were given magnesium sulfate 2.0mm/kg by intravenous infusion for 10 minutes after the animal models with acute pulmonary hypertension were established .The mean pulmonary artery pressure ( MPAP) and circulation mean arterial pressure ( MAP) were detected by pulmonary artery and femoral artery cannulation , IL-6 and TNF-αlevels in serum were detected by enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay,respectively,and MCP-1 protein expression was determined by Western blot .Results The MPAP in control group was significantly higher than that in blank group;however MPAP in magnesium sulfate group was significantly lower than that in control group ( P <0.05 or P <0.01).The MAP in control group was significantly lower than that in blank group ,however,MAP in magnesium sulfate group was significantly higher than that in control group ( P <0.05 or P <0.01).The serum levels of TNF-αand IL-6 in control group were significantly higher that those in blank group , however , which in magnesium sulfate group were significantly lower than those in control group ( P <0.05 or P <0.01).The MCP-1 protein expression levels in control group were significantly higher than those in blank group ,however ,which in magnesium sulfate group was significantly lower than those in control group ( P <0.05 or P <0.01).Conclusion Magnesium sulfate can significantly reduce acute pulmonary hypertension ,which may be related to its effects of inhibiting the expression of MCP-1 in lung tissue,decrease TNF-αand IL-6 levels

  8. Management of portal hypertension in children

    Institute of Scientific and Technical Information of China (English)

    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.

  9. MLA Report on Foreign-Language Education Continues to Provoke Debate

    Science.gov (United States)

    Wasley, Paula

    2008-01-01

    This article reports that, nearly one year after its release, the report on foreign language and higher education issued by an ad hoc committee of the Modern Language Association (MLA) is still provoking discussion about reforms in the teaching of foreign languages and the role of the association in any revamp. The debate continued at a panel held…

  10. Long-Term Results of an Individualized, Multifaceted, and Multidisciplinary Therapeutic Approach to Provoked Vestibulodynia

    NARCIS (Netherlands)

    Spoelstra, Symen K.; Dijkstra, Jeroen R.; van Driel, Mels F.; Schultz, Willibrord C. M. Weijmar

    2011-01-01

    Introduction. Although it is highly recommended to use a multifaceted approach to treat provoked vestibulodynia (PVD), the large majority of treatment studies on PVD used a one-dimensional approach. Aim. To evaluate the long-term treatment outcome of a multifaceted approach to vulvar pain, sexual fu

  11. Hypertensive Emergencies in Pregnancy.

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  13. Cupping for hypertension: a systematic review.

    Science.gov (United States)

    Lee, Myeong Soo; Choi, Tae-Young; Shin, Byung-Cheul; Kim, Jong-In; Nam, Sang-Soo

    2010-01-01

    The objective of this review is to assess the clinical evidence for or against cupping as a treatment for hypertension. We searched the literature using 15 databases from their inception to 30 June 2009, without language restrictions. We included all clinical trials (CTs) of cupping to treat hypertension in human patients. Risk of bias was assessed using the Cochrane criteria. Two CTs met all inclusion criteria. One RCT (randomized CT) assessed the effectiveness of dry cupping on changes in cerebral vascular function compared with drug therapy. Their results suggested significant effect in favor of cupping on vascular compliance and degree of vascular filling. One uncontrolled observational study (UOS) tested wet cupping for acute hypertension and found that a one-time treatment reduced blood pressure. In conclusion, the evidence is not significantly convincing to suggest cupping is effective for treating hypertension. Further research is required to investigate whether it generates any specific effects for that condition.

  14. Patients with hypertensive crises who are admitted to a coronary care unit: clinical characteristics and outcomes.

    Science.gov (United States)

    González Pacheco, Héctor; Morales Victorino, Neisser; Núñez Urquiza, Juan Pablo; Altamirano Castillo, Alfredo; Juárez Herrera, Ursulo; Arias Mendoza, Alexandra; Azar Manzur, Francisco; Briseño de la Cruz, Jose Luis; Martínez Sánchez, Carlos

    2013-03-01

    Patients with hypertensive crises, especially hypertensive emergencies, require immediate admittance to an intensive care unit for rapid blood pressure (BP) control. The authors analyzed the prevalence of hypertensive crisis, the clinical characteristics, and the evolution of patients with hypertensive emergencies and urgencies. Patients were divided into 3 groups according to their BP values: group I, predominant systolic hypertension (≥180/≤119 mm Hg); group II, severe systolic and diastolic hypertension (≥180/≥120 mm Hg); and group III, predominant diastolic hypertension (≤179/≥120 mm Hg). Of all of the patients admitted to a coronary care unit, 538 experienced a hypertensive crisis, which represented 5.08% of all admissions. Hypertensive emergency was predominant in 76.6% of the cases, which corresponded to acute coronary syndrome and acute decompensated heart failure in 59.5% and 25.2% of the cases, respectively. A pattern of predominant systolic hypertension (≥180/≤119 mm Hg) was most commonly observed in the hypertensive crisis group (71.4%) and the hypertensive emergency group (72.1%). The medications that were most commonly used at onset included intravenous vasodilators (nitroglycerin in 63.4% and sodium nitroprusside in 16.4% of the patients). The overall mortality rate was 3.7%. The mortality rate was 4.6% for hypertensive emergency cases and 0.8% for hypertensive urgencies cases.

  15. Management of Hypertensive patient in the Dental Office - Current Concepts

    Directory of Open Access Journals (Sweden)

    T Maheswaran

    2006-01-01

    Full Text Available Dental patients with a significant medical condition like hypertension are more likely to be encountered in the dental office. Those with very high blood pressure are at great risk for acute medical problems while receiving dental treatment. Adverse oral effects and drug interactions of antihypertensive medications further indicates special considerations for the hypertensive patient. This article highlights the recent advances in the dental management of hypertension. It is important for the dentist to be aware of hypertension in relation to the practice of dentistry.

  16. Cerebral blood flow autoregulation in hypertension and effects of antihypertensive drugs

    DEFF Research Database (Denmark)

    Barry, David; Lassen, N A

    1984-01-01

    If antihypertensive treatment, especially emergency blood pressure lowering, is always to be safe, more thought should be given to autoregulation of cerebral blood in the hypertensive patient. This topic is reviewed in the present article, in the hypertensive patient. This topic is reviewed...... in the present article, particular emphasis being placed on the resetting of the lower limit of autoregulation to higher pressure in hypertension and the effects of acute administration of anti-hypertensive drugs on CBF and CBF-autoregulation....

  17. Severe hypertension in children and adolescents: pathophysiology and treatment.

    Science.gov (United States)

    Flynn, Joseph T; Tullus, Kjell

    2009-06-01

    Severe, symptomatic hypertension occurs uncommonly in children, usually only in those with underlying congenital or acquired renal disease. If such hypertension has been long-standing, then rapid blood pressure reduction may be risky due to altered cerebral hemodynamics. While many drugs are available for the treatment of severe hypertension in adults, few have been studied in children. Despite the lack of scientific studies, some agents, particularly continuous intravenous infusions of nicardipine and labetalol, are preferred in many centers. These agents generally provide the ability to control the magnitude and rapidity of blood pressure reduction and should--in conjunction with careful patient monitoring--allow the safe reduction of blood pressure and the avoidance of complications. This review provides a summary of the underlying causes and pathophysiology of acute severe hypertension in childhood as well as a detailed discussion of drug treatment and the optimal clinical approach to managing children and adolescents with acute severe hypertension.

  18. 腹腔高压对重症急性胰腺炎病人预后的影响与机制初探%Effects on prognosis and mechanism of intra-abdominal hypertension in severe acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    李磊; 闵东; 武钧; 张泓; 张如愿; 瞿洪平; 汤耀卿

    2013-01-01

    目的:分析腹腔高压对重症急性胰腺炎(severe acute pancreatitis,SAP)病人脓毒血症发生率和生存率等预后指标的影响,并从胆道压力梯度分析其发病机制.方法:回顾性分析2007年1月至2008年12月间我院外科重症监护病房收治的63例SAP病人资料.根据腹腔压力水平和持续时间,分为腹腔高压(intra-abdominal hypertension,IAH)组31例和非腹腔高压(NIAH)组32例,比较两组病人的APACHEⅡ评分、发病4周内脓毒血症发生率、转手术率和生存率.进一步将IAH组病人分为胆道高压(biliary hypertation,BH)组27例和非胆道高压(NBH)组4例,比较两组病人的上述指标.结果:IAH组病人APACHEⅡ平均评分显著高于NIAH组(P=0.007).IAH组病人发病4周内脓毒血症发生率高于NIAH组(22.6%比15.6%,P=0.28),而生存率较NIAH组降低(67.7%比100%,P<0.01).入院当天NBH组与BH组病人APECHEⅡ评分差异无统计学意义.BH组病人发病4周内脓毒血症发生率、中转手术率和生存率分别为25.9%、11.1%和62.9%,NBH组病人4周内均无需手术治疗,未并发脓毒血症,且最终全部生存(P<0.01).结论:IAH是SAP病人并发脓毒血症的原因之一,胆道压力梯度被破坏可能导致感染机会增加、预后差.%Objective To compare the incidence of sepsis and the prognosis of severe acute pancreatitis(SAP) in patients with the intra-abdominal hypertension (IAH),and to explore whether the loss of biliary pressure gradient is the mechanisms of sepsis resulting from the SAP.Methods We retrospectively enrolled sixty-three patients with SAP who were admitted to the surgical intensive care unit during Jan 2007 to Dec 2008.According to IAH and the duration,the subjects were divided into IAH group and non-IAH (NIAH) group (31 vs.32).The clinical and prognosis data were collected.The APACHE Ⅱ score on admission,the first 4 weeks sepsis and operation rates,and survival rates were compared between the two groups

  19. Hospital admissions for hypertensive crisis in the emergency departments: a large multicenter Italian study.

    Science.gov (United States)

    Pinna, Giuliano; Pascale, Claudio; Fornengo, Paolo; Arras, Sebastiana; Piras, Carmela; Panzarasa, Pietro; Carmosino, Gianpaolo; Franza, Orietta; Semeraro, Vincenzo; Lenti, Salvatore; Pietrelli, Susanna; Panzone, Sergio; Bracco, Christian; Fiorini, Roberto; Rastelli, Giovanni; Bergandi, Daniela; Zampaglione, Bruno; Musso, Roberto; Marengo, Claudio; Santoro, Giancarlo; Zamboni, Sergio; Traversa, Barbara; Barattini, Maddalena; Bruno, Graziella

    2014-01-01

    Epidemiological data on the impact of hypertensive crises (emergencies and urgencies) on referral to the Emergency Departments (EDs) are lacking, in spite of the evidence that they may be life-threatening conditions. We performed a multicenter study to identify all patients aged 18 years and over who were admitted to 10 Italian EDs during 2009 for hypertensive crises (systolic blood pressure ≥220 mmHg and/or diastolic blood pressure ≥120 mmHg). We classified patients as affected by either hypertensive emergencies or hypertensive urgencies depending on the presence or the absence of progressive target organ damage, respectively. Logistic regression analysis was then performed to assess variables independently associated with hypertensive emergencies with respect to hypertensive urgencies. Of 333,407 patients admitted to the EDs over the one-year period, 1,546 had hypertensive crises (4.6/1,000, 95% CI 4.4-4.9), and 23% of them had unknown hypertension. Hypertensive emergencies (n = 391, 25.3% of hypertensive crises) were acute pulmonary edema (30.9%), stroke (22.0%,), myocardial infarction (17.9%), acute aortic dissection (7.9%), acute renal failure (5.9%) and hypertensive encephalopathy (4.9%). Men had higher frequency than women of unknown hypertension (27.9% vs 18.5%, phypertensive patients, a larger proportion of men than women reported not taking anti-hypertensive drug (12.6% among men and 9.4% among women (phypertensive emergencies than urgencies (OR = 1.34, 95% CI 1.06-1.70), independently of presenting symptoms, creatinine, smoking habit and known hypertension. This study shows that hypertensive crises involved almost 5 out of 1,000 patients-year admitted to EDs. Sex differences in frequencies of unknown hypertension, compliance to treatment and risk of hypertensive emergencies might have implications for public health programs.

  20. 优视胶囊对急性高眼压家兔眼压及神经节细胞的影响%Effects of Youshi capsule on the intraocular pressure(IOP) and retinal ganglion cells (RGC) of rabbits under artificial acute intraocular hypertension

    Institute of Scientific and Technical Information of China (English)

    张宗端; 段俊国

    2001-01-01

    目的:观察优视胶囊对急性高眼压兔眼压的影响及对视网膜视神经的保护作用。方法:采用自行设计的上巩膜静脉结扎法建立18只兔眼急性高眼压动物模型,于造模前1周至造模后3天共10天内给予具活血化瘀、开窍明目功效的优视胶囊灌胃,18只造模眼随机分为模型组、低剂量组和高剂量组,每组6眼,与18只正常眼进行对照。实验过程中测量眼压并行视网膜神经节细胞计数。结果:①造模后即可获得平均眼压高于6.83kPa并能持续3天以上的高眼压动物模型,优视胶囊高、低剂量组表现出轻微的降眼压作用。②持续性的高眼压可造成视网膜神经节细胞减少,但高、低剂量组经优视胶囊治疗后高眼压模型眼神经节细胞数高于模型组,提示优视胶囊具有保护或改善急性高眼压后兔眼视网膜神经节细胞的作用。结论:优视胶囊对急性高眼压兔眼视网膜视神经具有保护的作用。%Objective:To observe the effects of Youshi capsule on the intraocular pressure(IOP) and retinal ganglion cells(RGC) of rabbits under artificial acute intraocular hypertension.Methods:We used episcleral veins ligation on rabbit to establish an acute intraocular hypertension animal model devised by ourselves. Between one week before and 3 days after the models were induced, Youshi capsule was irrigated into the stomachs, having the function of promoting blood circulation and removing blood stasis,opening porus and improving vision. 18 model-established eyes were randomly divided into model group, high and low dosage group(6 eyes each group) and compared with other 18 normal eyes. Then examined IOP and counted RGC.Results:①Acute intraocular hypertension animal model was produced just after model was established and its average IOP above 6.83kPa could maintain 3 days. High and low dosage Youshi capsule showed slight effect on the reduction of IOP in intraocluar

  1. Anti-inflammation of MgSO4 on acute pulmonary hypertension%硫酸镁抗急性肺动脉高压的炎症机制

    Institute of Scientific and Technical Information of China (English)

    卢宏志; 高国芹; 李昨飞; 单冰竹

    2013-01-01

    Objective To investigate the effect and the anti-inflammatory mechanism of magnesium sulfate (MgSO4) on acute pulmonary hypertension.Methods 30 mongrel dogs were randomly divided into five groups:control group,surgical group,MgSO4 7.0 group,MgSO4 8.0 group,and MgSO4 9.0 group.The control group was not given any treatment,and the surgical group was operated to induce acute pulmonary hypertension,and the three MgSO4 groups were given MgSO4 to maintain intravenous concentration with 7.0 mmol/L,8.0 mmol/L,and 9.0 mmol/L respectively after acute pulmonary hypertension.The mean pulmonary artery pressure (MPAP) and circulation mean arterial pressure (MAP) were detected.Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in serum were measured by enzyme-linked immunosorbent assay and radioimmunoassay,monocyte chemoattractant protein-1 (MCP-1) expression in the lung tissue was determined by western blot.Results ①MPAP,TNF-α,IL-6,and MCP 1 protein expression were significantly higher in surgical group than those in control group,and were decreased significantly in MgSO4 7.0 group,MgSO4 8.0 group,and MgSO4 9.0 group with dose dependence.②MAP was significantly lower in surgical group than that in control group.MAP in MgSO4 7.0 group,MgSO4 8.0 group,and MgSO4 9.0 group was significantly increased compared with surgical group and MAP in MgSO4 9.0 group was the highest.Conclusions MgSO4 significantly reduces pulmonary hypertension,which is probably associated with reduction of the inflammatory response by inhibition of MCP-1 expression in lung tissue and decrease of TNF-α and IL-6 in serum.%目的 探讨硫酸镁(MgSO4)对急性肺栓塞肺动脉高压的影响及其抗炎机制.方法 30只雄性杂种犬,体质量(15±2.1) kg,随机分为5组:空白组、对照组以及MgSO47.0组、MgSO48.0组、MgSO4 9.0组,每组6只,其中空白组不给予任何处理;对照组造成急性肺动脉高压;其余三组造成急性肺动脉高压后给予MgSO4静滴,稳定30

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  3. Pelvic floor muscle function in women with provoked vestibulodynia and asymptomatic controls

    OpenAIRE

    2015-01-01

    Introduction and hypothesis: The purpose of the present study was to assess vaginal resting pressure (VRP), pelvic floor muscle (PFM) strength and endurance, and surface EMG activity in women with and without provoked vestibulodynia (PVD). Methods: This was an assessor-masked comparison study including 70 women. Exclusion criteria were any previous pregnancy and presence of candida. Sensitivity of the vulvar vestibule was rated at three sites with Q-tip pressure measurement and a...

  4. Hypertensive heart disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000163.htm Hypertensive heart disease To use the sharing features on this page, please enable JavaScript. Hypertensive heart disease refers to heart problems that occur because of ...

  5. Hypertension (High Blood Pressure)

    Science.gov (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Hypertension (High Blood Pressure) KidsHealth > For Teens > Hypertension (High Blood Pressure) Print ... rest temperature diet emotions posture medicines Why Is High Blood Pressure Bad? High blood pressure means a person's heart ...

  6. High Blood Pressure (Hypertension)

    Science.gov (United States)

    ... al. Overview of hypertension in adults. http://www.uptodate.com/home. Accessed March 19, 2015. Egan BM. Treatment of hypertension in blacks. http://www.uptodate.com/home. Accessed March 19, 2015. Kaplan NM. ...

  7. 超声引导下犬自体血栓栓塞性急性肺动脉高压模型的建立及意义%Establishment of a canine model with acute thrombo-embolic pulmonary hypertension guided by echocardiography

    Institute of Scientific and Technical Information of China (English)

    孙丹丹; 陈洪茂; 段云友; 尚福军; 梁宁南; 曹玮; 刘禧; 曹铁生

    2010-01-01

    目的 探讨超声引导下建立肺动脉血栓栓塞所致犬急性肺动脉高压模型的可行性.方法 模拟人体急性肺动脉血栓栓塞的病理生理过程,建立肺动脉血栓栓塞所致的犬急性肺动脉高压模型.超声引导下经股静脉穿刺,放置右心导管监测肺动脉压力,同时对侧股静脉推注自体血栓,以肺动脉收缩压超过30 mmHg为模型建立成功的标准.结果 超声可以准确引导右心导管的放置.实验用犬27只,成功建立急性肺动脉高压模型24只,成功率88.9%.结论 超声引导下建立肺动脉血栓栓塞所致犬急性肺动脉高压模型的方法具有良好的可行性和可重复性.%Objective To establish a canine model with acute thrombo-embolic pulmonary hypertension monitored by echocardiography. Methods Simulated the pathophysiologic process of acute thrombo-embolic pulmonary hypertension in human, the canine model was developed. The femoral vein puncture and the right heart catheterization to monitor pulmonary artery pressure were operated guided by echocardiography, while the autologous blood clot was injected to the contralateral femoral vein. The criteria of model was the pulmonary artery systolic pressure was higher than 30 mmHg. Results Echocardiography can accurately guide the placement of right heart catheterization and ancillarily observe the pressure testing of pulmonary artery. Of twenty seven healthy experiment dogs, twenty four models with acute thromboembolic pulmonary hypertension were successfully developed. The successful rate was 88.9 %. Conclusions This canine model with acute thrombo-embolic pulmonary hypertension guided by echocardiography is easy to operate and its repeatability is good.

  8. Sinistral Portal Hypertension. A Case Report

    Directory of Open Access Journals (Sweden)

    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.

  9. Cortical blindness in a child with acute glomerulonephritis.

    Science.gov (United States)

    Kaarthigeyan, K; Vijayalakshmi, A M

    2012-01-01

    The association between hypertensive encephalopathy and cortical blindness in children with acute glomerulonephritis is extremely rare. We report the case of a 9-year old girl who presented with headache, seizures, altered sensorium, hematuria, and transient cortical blindness as a complication of hypertensive encephalopathy which showed complete reversal following normalization of blood pressure and an underlying post-infectious acute glomerulonephritis was revealed.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Hypertension in developing countries.

    Science.gov (United States)

    Tibazarwa, Kemi B; Damasceno, Albertino A

    2014-05-01

    The past 2 decades have seen a considerable global increase in cardiovascular disease, with hypertension remaining by far the most common. More than one-third of adults in Africa are hypertensive; as in the urban populations of most developing countries. Being a condition that occurs with relatively few symptoms, hypertension remains underdetected in many countries; especially in developing countries where routine screening at any point of health care is grossly underutilized. Because hypertension is directly related to cardiovascular disease, this has led to hypertension being the leading cause of adverse cardiovascular outcomes, as a result of patients living, often unknowingly, with uncontrolled hypertension for prolonged periods of time. In Africa, hypertension is the leading cause of heart failure; whereas at global levels, hypertension is responsible for more than half of deaths from stroke, just less than half of deaths from coronary artery disease, and for more than one-tenth of all global deaths. In this review, we discuss the escalating occurrence of hypertension in developing countries, before exploring the strengths and weaknesses of different measures to control hypertension, and the challenges of adopting these measures in developing countries. On a broad level, these include steps to curb the ripple effect of urbanization on the health and disease profile of developing societies, and suggestions to improve loopholes in various aspects of health care delivery that affect surveillance and management of hypertension. Furthermore, we consider how the industrial sectors' contributions toward the burden of hypertension can also be the source of the solution.

  12. Pulmonary Hypertension Association

    Science.gov (United States)

    ... at www.AHeartCures.org . Help Kickoff November’s Pulmonary Hypertension Awareness Month Want to help raise awareness for ... Heart2CurePH | Help promote Awareness Month Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Awareness Chronic thromboembolic pulmonary hypertension (CTEPH) is ...

  13. Hypertension in pregnancy

    Directory of Open Access Journals (Sweden)

    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. Treatment of pediatric pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Amy Hawkins

    2009-06-01

    Full Text Available Amy Hawkins, Robert TullohDepartment of Congenital Heart Disease, Bristol Royal Hospital for Children, Bristol UKAbstract: Pulmonary hypertension was once thought to be a rare condition and only managed in specialized centers. Now however, with the advent of echocardiography, it is found in many clinical scenarios, in the neonate with chronic lung disease, in the acute setting in the intensive care unit, in connective tissue disease and in cardiology pre- and postoperatively. We have a better understanding of the pathological process and have a range of medication which is starting to be able to palliate this previously fatal condition. This review describes the areas that are known in this condition and those that are less familiar. The basic physiology behind pulmonary hypertension and pulmonary vascular disease is explained. The histopathologic process and the various diagnostic tools are described and are followed by the current and future therapy at our disposal.Keywords: pulmonary hypertension, congenital heart disease, pulmonary vascular resistance, pulmonary vasodilators

  15. CT灌注成像在急性自发性高血压性脑出血中的应用%Application of CT perfusion imaging in acute spontaneous hypertension intracerebral hemorrhage patients

    Institute of Scientific and Technical Information of China (English)

    许化致; 曹国全; 王美豪; 朱姬莹; 谢福荣

    2012-01-01

    Objective To quantify hemodynamic changes in patients with acute spontaneous hypertensive intracerebral hemorrhage (shICH) using computed tomography perfusion (CTP) imaging. Methods 26 patients (22 men and 4 women, age range 33~74, mean age 55. 08 years) who suffered from a supratentorial shICH, were at admission and received CTP scanning within 8~19 h (mean 14. 88 h) after symptom onset. At the maximum levels of the hematoma, cerebral blood flow (CBF) , cerebral blood volume (CBV) and mean transit time (MTT) were measured in three different regions of interest (ROI)manually outlined on CT scan: ① hemorrhagic core( hyperdense on unenhanced CT image); ② perihematomal area (isodense within 1 cm rim of perilesion area); ③ normal area far from ipsilateral hemorrhage, and ④ a mirrored area(CBVn, CBFn, MTTn) , including the clot and the perihematomal region located in the contralateral hemisphere. rCBF, rCBV, rMTT were calculated (rCBV=CBV/CBVn, rCBF=CBF/CBFn, rMTT= MTT/MTTn). Results The CBF, CBV, and MTT color maps showed a centrifugal distribution with a gradual improvement from the core of hematoma to the periphery. The CBV, CBF, and MTT value of perihematoma area were (16. 48 ± 17. 38) ml ·100g-1 · min-1), (1.61±1. 53) ml· 100g-1), (9.12 ± 2.57) s, respectively. There was significantly decreased CBF, CBV and prolonged MTT in perihematomal group against contralateral mirrored area (ZCBV=-2. 603, ZCBF=-4. 178, tMTT = 4. 747, P0. 05). Mean CBF value of perihematomal group was lower than that of remote area ( Z =-2. 288, P 0. 05). Conclusion Multi parametric CTP imaging can indicate low perfusion states around hematoma in acute shICH patients, but there is no evidence of ischemic penumbra.%目的 应用CT灌注成像(CT perfusion,CTP)对急性自发性高血压出血性脑卒中(acute spontaneously hypertensive intracerebral hemorrhage,shICH)血肿周围脑血液动力学变化进行定量研究,验证血肿周围是否存在缺血半暗带.方法 对26

  16. Insulin Resistance and Hypertension

    Institute of Scientific and Technical Information of China (English)

    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.

  17. Secondary Hypertension in Pregnancy.

    Science.gov (United States)

    Malha, Line; August, Phyllis

    2015-07-01

    Hypertension is a common medical complication of pregnancy. Although 75-80 % of women with preexisting essential hypertension will have uncomplicated pregnancies, the presence of secondary forms of hypertension adds considerably to both maternal and fetal morbidity and mortality. Renovascular hypertension, pheochromocytoma, and Cushing's syndrome in particular are associated with accelerating hypertension, superimposed preeclampsia, preterm delivery, and fetal loss. Primary aldosteronism is a more heterogeneous disorder; there are well-documented cases where blood pressure and hypokalemia are improved during pregnancy due to elevated levels of progesterone. However, superimposed preeclampsia, worsening hypertension, and early delivery are also reported. When possible, secondary forms of hypertension should be diagnosed and treated prior to conception in order to avoid these complications.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Hypertensive crisis: clinical-epidemiological profile.

    Science.gov (United States)

    Vilela-Martin, José Fernando; Vaz-de-Melo, Renan Oliveira; Kuniyoshi, Cristina Hiromi; Abdo, André Neder Ramires; Yugar-Toledo, Juan Carlos

    2011-03-01

    Hypertensive crisis (HC) stands out as one type of acute elevation in blood pressure (BP) and can manifest as hypertensive emergency (HE-with target-organ damage (TOD)) or hypertensive urgency (HU-without TOD), usually accompanied by levels of diastolic BP ≥120 mmHg. The aim of this study was to characterize the clinical-epidemiological profile of HC over the course of 1 year in a university reference hospital and perform a review of the literature. The study was a cross-sectional study, conducted over a period of 1 year (2006) in 362 patients who presented for treatment at the emergency hospital with HC, as described above. Among all patients examined, 231 individuals met the criteria for HE and 131 met the criteria for HU. Patients with HE were older (Phypertension.

  20. The significance of changes in cerebral oxygen and glucose metabolism in patients with cerebral hemorrhage caused by acute hypertension%急性高血压脑出血患者脑糖氧代谢变化及意义

    Institute of Scientific and Technical Information of China (English)

    马骏; 陈锷峰; 屠传建; 钱辉; 骆明; 顾志伟; 张建民

    2014-01-01

    Objective To study the clinical significance of early changes in cerebral oxygen and glucose metabolism in patients with cerebral hemorrhage and with Glasgow coma score (GCS) of 5-8 caused by acute hypertension in order to find relationship between those changes and prognosis.Methods From January 1,2011 to June 30,2012,a cohort of 43 patients with cerebral hemorrhage caused by acute hypertension were enrolled for retrospective study.Radial artery and internal jugular vein were separately cannulated retrogradely for collecting blood for blood gas analysis and blood glucose tests carried out 24 hours after the onset of the cerebral hemorrhage and then every 6-8 hours and as any major changes in physical signs of patients occurred.And this monitoring kept for consecutive 3 days.The data of these laboratory findings were analyzed and calculated to determine internal jugular vein oxygen saturation (SjVO2),cerebral oxygen utilization rate (CEO2),cerebral arterio-venous oxygen difference (AVDO2),arterio-venous blood glucose difference (V-Aglu),arterio-venous lactic acid difference (V-Alac) and absolute value of carbon dioxide pressure difference between jugular vein and artery (V-APCO2).All patients met the diagnostic criteria of hypertensive cerebral hemorrhage revised by the 4th National Academic Conference on cerebrovascular disease in 1995 requiring diagnosis confirmed by brain CT,admitted within 24 hours of onset,Glasgow coma score (GCS) 5-8 and a history of hypertension.Exclusion criteria were:cerebral hemorrhage caused by traumatic intracranial hematoma,spontaneous subarachnoid hemorrhage,arteriovenous malformation and Moyamoya disease,intracranial tumor apoplexy,cerebral bleeding derived from the disturbance of blood coagulation system,and cerebral hemorrhagic infarction.According to the short-term prognosis,the patients were divided into the death group and the survival group.Then the differences in biomarkers mentioned above between two groups were compared to

  1. Effects of Probucol on Plasma Oxidized Low-Density Lipoproteins in Hypertensive Patients with Acute Cerebral Infarction%普罗布考对高血压合并脑梗死患者氧化型低密度脂蛋白水平的影响

    Institute of Scientific and Technical Information of China (English)

    夏晓爽; 李新; 王林; 王纪佐

    2013-01-01

    Objective To investigate the changes of oxidized low-density lipoproteins (ox-LDL) in patients with acute cerebral infarction, and to evaluate the effect of the supplement therapy with probucol on the plasma concentrations of ox-LDL. Methods One hundred and twenty patients with acute cerebral infarction were divided into normal blood pressure group (n=60) and hypertension group (n=60) according to whether the cerebral infarction combinated with hypertension. The two groups were randomly divided into two subgroups, intervention group (n=30) and nonintervention group (n=30) respectively. Patients were treated with probucol and routine treatment for 12 weeks in intervention group. The levels of ox-LDL, nitric oxide (NO) and endothelial nitric oxide synthase (eNOS) were detected before treatment and 2-week and 12-week after treatment in all groups of patients. Results The level of ox-LDL was significantly higher, but the serum levels of eNOS and NO were significantly lower, in patients with acute cerebral infarction conbinated with hypertension than those in patients with acute cerebral infarction and normal blood pressure (P < 0.05). The levels of total cholesterol (TC), high density lipoprotein (HDL) and ox-LDL were significantly increased after supplement therapy with probucol for 12 weeks in patients with acute cerebral infarction and normal blood pressure, and the level of eNOS was significantly increased (P < 0.05). For hypertensive patients with acute cerebral infarction, the levels of TC, triglycerides (TG), LDL and ox-LDL were significantly decreased, and levels of eNOS and NO were significantly increased after supplement therapy with probucol forl2 weeks (P < 0.05). Conclusion The present study demonstrated that probucol can reduce the level of ox-LDL, improve endothelial function, stabilize plaque and help prevent atherosclerosis in patients with acute cerebral infarcton.%目的 探讨急性脑梗死患者氧化型低密度脂蛋白(ox-LDL)水平的特点

  2. Emergency Neurological Life Support: Intracranial Hypertension and Herniation.

    Science.gov (United States)

    Stevens, Robert D; Shoykhet, Michael; Cadena, Rhonda

    2015-12-01

    Sustained intracranial hypertension and acute brain herniation are "brain codes," signifying catastrophic neurological events that require immediate recognition and treatment to prevent irreversible injury and death. As in cardiac arrest, a brain code mandates the organized implementation of a stepwise management algorithm. The goal of this emergency neurological life support protocol is to implement an evidence-based, standardized approach to the evaluation and management of patients with intracranial hypertension and/or herniation.

  3. Inflammation and Arterial Hypertension: From Pathophysiological Links to Risk Prediction.

    Science.gov (United States)

    Pietri, Panagiota; Vlachopoulos, Charalambos; Tousoulis, Dimitris

    2015-01-01

    Over the last years, ample data have demonstrated the pivotal role of low-grade inflammation in the pathophysiology of atherosclerosis and cardiovascular disease. It is well established that inflammatory activation, serving either as a substrate, in the chronic phase of atherosclerotic disease, or as a trigger, in the acute phase, increases cardiovascular events. Considering hypertension, the inflammatory process is implicated in its pathophysiology through a bidirectional relationship since arterial hypertension may enhance inflammation and vice versa. Inflammatory biomarkers such as high-sensitivity C-reactive protein, have shown predictive value for both the incidence of hypertension and the clinical outcomes in hypertensive patients. In the present review, data on the association between arterial hypertension and low-grade inflammation will be reported and potential pathophysiological pathways and clinical implications underlying this association will be discussed.

  4. Evaluation and treatment of hypertensive crises in children

    Directory of Open Access Journals (Sweden)

    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

  5. Hypertension Management in the High Cardiovascular Risk Population

    Directory of Open Access Journals (Sweden)

    Ilir Maraj

    2013-01-01

    Full Text Available The incidence of hypertension is increasing every year. Blood pressure (BP control is an important therapeutic goal for the slowing of progression as well as for the prevention of Cardiovascular disease. The management of hypertension in the high cardiovascular risk population remains a real challenge as the population continues to age, the incidence of diabetes increases, and more and more people survive acute myocardial infarction. We will review hypertension management in the high cardiovascular risk population: patients with coronary heart disease (CHD and heart failure (HF as well as in diabetic patients.

  6. [Acute pulmonary edema secondary to acute upper airway obstruction].

    Science.gov (United States)

    Sánchez-Ortega, J L; Carpintero-Moreno, F; Olivares-López, A; Borrás-Rubio, E; Alvarez-López, M J; García-Izquierdo, A

    1992-01-01

    We report a 72 years old woman with mild arterial hypertension and no other pathological history who presented an acute pulmonary edema due to acute obstruction of the upper airway secondary to vocal chord paralysis developing during the immediate postoperative phase of thyroidectomy. The acute pulmonary edema resolved after application of tracheal reintubation, mechanical ventilation controlled with end expiratory positive pressure, diuretics, morphine, and liquid restriction. We discuss the possible etiopathogenic possibilities of this infrequent clinical picture and we suggest that all patients who suffered and acute obstruction of the upper airways require a careful clinical surveillance in order to prevent the development of the pulmonary syndrome.

  7. Beer Flavor Provokes Striatal Dopamine Release in Male Drinkers: Mediation by Family History of Alcoholism

    Science.gov (United States)

    Oberlin, Brandon G; Dzemidzic, Mario; Tran, Stella M; Soeurt, Christina M; Albrecht, Daniel S; Yoder, Karmen K; Kareken, David A

    2013-01-01

    Striatal dopamine (DA) is increased by virtually all drugs of abuse, including alcohol. However, drug-associated cues are also known to provoke striatal DA transmission- a phenomenon linked to the motivated behaviors associated with addiction. To our knowledge, no one has tested if alcohol's classically conditioned flavor cues, in the absence of a significant pharmacologic effect, are capable of eliciting striatal DA release in humans. Employing positron emission tomography (PET), we hypothesized that beer's flavor alone can reduce the binding potential (BP) of [11C]raclopride (RAC; a reflection of striatal DA release) in the ventral striatum, relative to an appetitive flavor control. Forty-nine men, ranging from social to heavy drinking, mean age 25, with a varied family history of alcoholism underwent two [11C]RAC PET scans: one while tasting beer, and one while tasting Gatorade. Relative to the control flavor of Gatorade, beer flavor significantly increased self-reported desire to drink, and reduced [11C]RAC BP, indicating that the alcohol-associated flavor cues induced DA release. BP reductions were strongest in subjects with first-degree alcoholic relatives. These results demonstrate that alcohol-conditioned flavor cues can provoke ventral striatal DA release, absent significant pharmacologic effects, and that the response is strongest in subjects with a greater genetic risk for alcoholism. Striatal DA responses to salient alcohol cues may thus be an inherited risk factor for alcoholism. PMID:23588036

  8. Feed exposure to FB1 can aggravate pneumonic damages in pigs provoked by P. multocida.

    Science.gov (United States)

    Kovács, Melinda; Pósa, Roland; Tuboly, Tamás; Donkó, Tamás; Repa, Imre; Tossenberger, János; Szabó-Fodor, Judit; Stoev, Stoycho; Magyar, Tibor

    2016-10-01

    The possible interaction between Pasteurella multocida and the mycotoxin fumonisin B1 (FB1), recognised as one of the most often food/feed contaminant, was studied with the aim to evaluate whether and how FB1 can influence and/or complicate the development and severity of various pathological damages provoked by Pasteurella multocida in some internal organs of pigs. Heavier lung pathology was seen in pigs experimentally infected with Pasteurella multocida, when the same were exposed to 20ppm dietary levels of fumonisin B1 (FB1) as was assessed by gross pathology, pathomorphological examinations, clinical biochemistry and some immunological investigations. The most typical damages in FB1 treated pigs were the strong oedema in the lung and the slight oedema in the other internal organs and mild degenerative changes in the kidneys, whereas the typical pathomorphological findings in pigs infected with Pasteurella multocida was broncho-interstitial pneumonia. FB1 was found to aggravate pneumonic changes provoked by P. multocida in the cranial lobes of the lung and to complicate pneumonic damages with interstitial oedema in the lung. No macroscopic damages were observed in the pigs infected only with Pasteurella multocida. It can be concluded that the feed intake of FB1 in pigs may complicate or exacerbate the course of P. multocida serotype A infection.

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

    Science.gov (United States)

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

    2016-03-07

    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.

  10. Hypertension in young adults.

    Science.gov (United States)

    De Venecia, Toni; Lu, Marvin; Figueredo, Vincent M

    2016-01-01

    Hypertension remains a major societal problem affecting 76 million, or approximately one third, of US adults. While more prevalent in the older population, an increasing incidence in the younger population, including athletes, is being observed. Active individuals, like the young and athletes, are viewed as free of diseases such as hypertension. However, the increased prevalence of traditional risk factors in the young, including obesity, diabetes mellitus, and renal disease, increase the risk of developing hypertension in younger adults. Psychosocial factors may also be contributing factors to the increasing incidence of hypertension in the younger population. Increased left ventricular wall thickness and mass are increasingly found in young adults on routine echocardiograms and predict future cardiovascular events. This increasing incidence of hypertension in the young calls for early surveillance and prompt treatment to prevent future cardiac events. In this review we present the current epidemiological data, potential mechanisms, clinical implications, and treatment of hypertension in young patients and athletes.

  11. Hypertension in Danish seafarers

    DEFF Research Database (Denmark)

    Tu, Mingshan; Jepsen, Jørgen Riis

    2016-01-01

    who had statutory medical examinations was studied from the beginning of October 2011 to the end of June 2012. The medical examination included measurements of blood pressure. The prevalence of hypertension in the study po- pulation was stratified by age, work place on board, smoking status, alcohol......Background: Due to the high prevalence of arterial hypertension and its role in the development of athe- rosclerosis, myocardial infarction and stroke, hypertension is a major public health challenge worldwide. There is limited knowledge of the prevalence of hypertension among seafarers who......, however, are known to have an excess morbidity and mortality from these disorders. This article addresses the prevalence of hypertension among Danish seafarers and discusses potential risk factors for hypertension in maritime settings. Materials and methods: A representative sample of 629 Danish seafarers...

  12. Valproate Induced Hypertensive Urgency

    Directory of Open Access Journals (Sweden)

    Mauran Sivananthan

    2016-01-01

    Full Text Available Valproate is a medication used in the treatment of seizures, bipolar disorder, migraines, and behavioral problems. Here we present a case of an 8-year-old boy who presented with hypertensive urgency after initiation of valproate. Primary treatment of his hypertension was ineffective. Blood pressure stabilization was achieved following discontinuation of valproate. Clinicians should be aware of the risk of developing hypertensive urgency with administration of valproate.

  13. Hypertension og hyperlipidaemi

    DEFF Research Database (Denmark)

    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...

  14. TCM Dietotherapy for Hypertension

    Institute of Scientific and Technical Information of China (English)

    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.

  15. Obesity-Related Hypertension

    OpenAIRE

    Re, Richard N.

    2009-01-01

    Obesity-associated arterial hypertension is characterized by activation of the sympathetic nervous system, activation of the renin-angiotensin system, and sodium retention, among other abnormalities. In this review, the following 3 facets of the obesity/hypertension nexus will be discussed: the potential mechanisms by which obesity can lead to elevated arterial pressure, the interaction of obesity with the sequelae of hypertension, and the therapies that are believed to optimally treat obesit...

  16. Hypertension in Renal Transplantation: Saudi Arabian Experience

    Directory of Open Access Journals (Sweden)

    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

  17. Dopamine receptor and hypertension.

    Science.gov (United States)

    Zeng, Chunyu; Eisner, Gilbert M; Felder, Robin A; Jose, Pedro A

    2005-01-01

    Dopamine plays an important role in the pathogenesis of hypertension by regulating epithelial sodium transport and reactive oxygen and by interacting with vasopressin, renin-angiotensin, and the sympathetic nervous system. Decreased renal dopamine production and/or impaired dopamine receptor function have been reported in hypertension. Disruption of any of the dopamine receptors (D(1), D(2), D(3), D(4), and D(5)) results in hypertension. In this paper, we review the mechanisms by which hypertension develops when dopamine receptor function is perturbed.

  18. Hypertension og hjernen

    DEFF Research Database (Denmark)

    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 antihyp......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...

  19. 42. Hypertension: Morbidity review

    Directory of Open Access Journals (Sweden)

    Hamzullah khan

    2015-10-01

    Conclusions: hypertension is a major modifiable risk factor for coronary artery disease, stroke, eye abnormalities and end stage renal disease, which require proper counseling and management of patients.

  20. How Is Pulmonary Hypertension Diagnosed?

    Science.gov (United States)

    ... 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 ...

  1. Risk assessment of different grades of hypertension during the treatment of patients with acute pulpitis%不同高血压分级患者急性牙髓炎开髓治疗的风险评估

    Institute of Scientific and Technical Information of China (English)

    陈红涛; 王文英; 王津; 梁亚平; 王小婷; 侯光敏; 姬爱平

    2016-01-01

    施来规避风险。%Objective:To evaluate the vital signs changes,influence factors in different grades of hy-pertension patients during the treatment of acute pulpitis,in order to obtain the risk prevention measures. Methods:In this study,90 different grades of hypertension patients with acute pulpitis were recruited from February 201 4 to February 201 5 in the Department of Oral Emergency,Peking University School and Hospital of Stomatology.The information about the patients’general health,oral treatment,life signs of change information was collected.Patients were divided into high risk group,middle risk group, and low risk group (30 patients for each group).Results:(1 )Compared with the preoperative,systolic blood pressure (90%),diastolic blood pressure (80%),heart rate increase (1 00%)were increased in the high risk group.The increase rates of the middle risk group and the low risk group were significantly lower than those of the high risk group (P<0.01 ).At the same time,the systolic blood pressure of 1 /4 (26.7%)patients in high risk group increased more than 20 mmHg (1 mmHg=0.1 33 kPa),and the diastolic blood pressure of 2/5 patients in high risk group increased more than 1 0 mmHg,the difference was statistically significant compared with the other two groups (P<0.05).(2)Compared with the pre-operative,the average increase of the maximum peak were increased [systolic blood pressure (1 8.0 ± 1 .5)mmHg,diastolic blood pressure (8.0 ±1 .7)mmHg],the mean of heart rate changes [(7.0 ± 0.3)beats per minute]was also increased in the high risk group,while these two indicators were de-creased in the low risk group and the middle risk group.The electrocardiogram (ECG)was changed in 6 cases during the treatment in the high risk group.No significantly changed were observed in the low risk group and the middle risk group.(3 ) Compared the risk assessment in preoperative with that in postoperative,in the middle risk group,23 cases were evaluated as medium risk in final evaluation,6 as low risk,and 1 as

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

    OpenAIRE

    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).

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

    DEFF Research Database (Denmark)

    Schytz, Henrik W; Barløse, Mads; Guo, Song

    2013-01-01

    BackgroundHigh frequency (HF) stimulation of the sphenopalatine ganglion (SPG) is an emerging abortive treatment for cluster headache (CH) attacks. HF SPG stimulation is thought to exert its effect by physiologically blocking parasympathetic outflow. We hypothesized that low frequency (LF) SPG...... separate days. We recorded headache characteristics and autonomic symptoms during and after stimulation.ResultsSix patients completed the study. Three out of six patients (50%) reported ipsilateral cluster-like attacks during or within 30 min of LF SPG stimulation. These cluster-like attacks were all...... 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...

  4. Functional disability of rat splenocytes provoked to lipid peroxidation by cumene hydroperoxide.

    Science.gov (United States)

    Shimura, J; Shimura, F; Hosoya, N

    1985-04-22

    Rat splenocytes were provoked to lipid peroxidation in a dose-dependent manner by cumene hydroperoxide. After exposure to cumene hydroperoxide, formation of high molecular weight protein, presumably through cross-linking of lower molecular weight protein, was stimulated in splenocytes as well as in erythrocyte ghosts. The mitogenic response to concanavalin A of splenocytes was remarkably depressed by addition of cumene hydroperoxide to cultures. This depression was due rather to failures of splenocytes in responding to concanavalin A than deactivation of concanavalin A molecules. It is notworthy that the viability of splenocytes was unaffected by cumene hydroperoxide under the culture conditions where the mitogenic response was depressed. The addition of alpha-tocopherol or thiourea could block the depression of mitogenic response by cumene hydroperoxide, indicating that the depressed response to concanavalin A was related to radical formation. Overall evidence suggests that the function of immunocompetent cells can be depressed through lipid peroxidation-associated mechanisms without suffering from lethal damage.

  5. 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

    NARCIS (Netherlands)

    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

  6. Pregnancy and pulmonary hypertension

    NARCIS (Netherlands)

    Pieper, Petronella G.; Lameijer, Heleen; Hoendermis, Elke S.

    2014-01-01

    Pulmonary hypertension during pregnancy is associated with considerable risks of maternal mortality and morbidity. Our systematic review of the literature on the use of targeted treatments for pulmonary arterial hypertension during pregnancy indicates a considerable decrease of mortality since a pre

  7. Hypertension Briefing: Technical documentation

    OpenAIRE

    Institute of Public Health in Ireland

    2012-01-01

    Blood pressure is the force exerted on artery walls as the heart pumps blood through the body. Hypertension, or high blood pressure, occurs when blood pressure is constantly higher than the pressure needed to carry blood through the body. This document details how the IPH uses a systematic and consistent method to produce prevalence data for hypertension on the island of Ireland.

  8. Hypertension (High Blood Pressure)

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Hypertension (High Blood Pressure) KidsHealth > For Teens > Hypertension (High Blood Pressure) A ... rest temperature diet emotions posture medicines Why Is High Blood Pressure Bad? High blood pressure means a person's heart ...

  9. Noncirrotisk intrahepatisk portal hypertension

    DEFF Research Database (Denmark)

    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...... but includes vascular lesions and portal fibrosis. Patient management follows the current recommendations for variceal bleeding....

  10. Pulmonary Hypertension Overview

    Science.gov (United States)

    ... chest X-ray, a breathing test called a pulmonary function test and an echocardiogram (sometimes called an “echo”). Your doctor may also need to do other tests to find out whether another medical condition is causing your pulmonary hypertension. TreatmentHow is pulmonary hypertension treated?If the ...

  11. Hypertension after clonidine withdrawal.

    Science.gov (United States)

    Husserl, F E; deCarvalho, J G; Batson, H M; Frohlich, E D

    1978-05-01

    Rebound hypertension occurred in two patients upon clonidine withdrawal. Treatment of the hypertensive crisis consists of both alpha- and beta-adrenergic receptor blockade, reserpine, or the reintroduction of clonidine. With effective control of pressure during the crisis, long-term antihypertensive therapy must be resumed.

  12. Hospital admissions for hypertensive crisis in the emergency departments: a large multicenter Italian study.

    Directory of Open Access Journals (Sweden)

    Giuliano Pinna

    Full Text Available Epidemiological data on the impact of hypertensive crises (emergencies and urgencies on referral to the Emergency Departments (EDs are lacking, in spite of the evidence that they may be life-threatening conditions. We performed a multicenter study to identify all patients aged 18 years and over who were admitted to 10 Italian EDs during 2009 for hypertensive crises (systolic blood pressure ≥220 mmHg and/or diastolic blood pressure ≥120 mmHg. We classified patients as affected by either hypertensive emergencies or hypertensive urgencies depending on the presence or the absence of progressive target organ damage, respectively. Logistic regression analysis was then performed to assess variables independently associated with hypertensive emergencies with respect to hypertensive urgencies. Of 333,407 patients admitted to the EDs over the one-year period, 1,546 had hypertensive crises (4.6/1,000, 95% CI 4.4-4.9, and 23% of them had unknown hypertension. Hypertensive emergencies (n = 391, 25.3% of hypertensive crises were acute pulmonary edema (30.9%, stroke (22.0%,, myocardial infarction (17.9%, acute aortic dissection (7.9%, acute renal failure (5.9% and hypertensive encephalopathy (4.9%. Men had higher frequency than women of unknown hypertension (27.9% vs 18.5%, p<0.001. Even among known hypertensive patients, a larger proportion of men than women reported not taking anti-hypertensive drug (12.6% among men and 9.4% among women (p<0.001. Compared to women of similar age, men had higher likelihood of having hypertensive emergencies than urgencies (OR = 1.34, 95% CI 1.06-1.70, independently of presenting symptoms, creatinine, smoking habit and known hypertension. This study shows that hypertensive crises involved almost 5 out of 1,000 patients-year admitted to EDs. Sex differences in frequencies of unknown hypertension, compliance to treatment and risk of hypertensive emergencies might have implications for public health programs.

  13. Arterial hypertension and cancer.

    Science.gov (United States)

    Milan, Alberto; Puglisi, Elisabetta; Ferrari, Laura; Bruno, Giulia; Losano, Isabel; Veglio, Franco

    2014-05-15

    Arterial hypertension and cancer are two of the most important causes of mortality in the world; correlations between these two clinical entities are complex and various. Cancer therapy using old (e.g., mitotic spindle poisons) as well as new (e.g., monoclonal antibody) drugs may cause arterial hypertension through different mechanisms; sometimes the increase of blood pressure levels may be responsible for chemotherapy withdrawal. Among newer cancer therapies, drugs interacting with the VEGF (vascular endothelial growth factors) pathways are the most frequently involved in hypertension development. However, many retrospective studies have suggested a relationship between antihypertensive treatment and risk of cancer, raising vast public concern. The purposes of this brief review have then been to analyse the role of chemotherapy in the pathogenesis of hypertension, to summarize the general rules of arterial hypertension management in this field and finally to evaluate the effects of antihypertensive therapy on cancer disease.

  14. [Hypertension and arteriosclerosis].

    Science.gov (United States)

    Sasamura, Hiroyuki; Itoh, Hiroshi

    2011-01-01

    Hypertension is a known risk factor for arteriosclerosis, and causes both atherosclero= sis of medium-large arteries and arteriolosclerosis of the arterioles. Elevated blood pressure causes damage to the endothelium and vascular wall through both mechanical and humoral factors. We and others have shown that inhibition of the renin-angiotensin system at a 'critical period' during the development of hypertension results in a permanent suppression of hypertension in animal models. We have also reported that high-dose renin-angiotensin inhibition results in regression of hypertension, possibly by regression of renal arteriolar hypertrophy. These results suggest that understanding the process of arterial remodeling may play a key role in the development of new strategies for prevention and regression of hypertension and arteriosclerosis.

  15. Hypertension in pregnancy.

    Science.gov (United States)

    Vest, Amanda R; Cho, Leslie S

    2014-03-01

    Hypertensive disorders of pregnancy represent the second commonest cause of direct maternal death and complicate an estimated 5-10 % of pregnancies. Classification systems aim to separate hypertension similar to that seen outside pregnancy (chronic and gestational hypertension) from the potentially fatal pregnancy-specific conditions. Preeclampsia, HELLP syndrome, and eclampsia represent increasing severities of this disease spectrum. The American College of Obstetricians and Gynecologists' 2013 guidelines no longer require proteinuria as a diagnostic criterion, because of its variable appearance in the disease spectrum. The cause involves inadequate cytotrophoblastic invasion of the myometrium, resulting in placental hypoperfusion and diffuse maternal endothelial dysfunction. Changes in angiogenic and antiangiogentic peptide profiles precede the onset of clinical preeclampsia. Women with preeclampsia should be closely monitored and receive magnesium sulfate intravenously if severe features, HELLP syndrome, or eclampsia occur. Definitive therapy is delivery of the fetus. Hypertension in pregnancy increases future maternal risk of hypertension and cardiovascular disorders.

  16. Overweight, adipocytokines and hypertension

    DEFF Research Database (Denmark)

    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 = 5868, 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.......023) in the 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...

  17. Hypertension in the Elderly

    Directory of Open Access Journals (Sweden)

    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.

  18. Hypertension in pregnancy.

    Science.gov (United States)

    Lindheimer, Marshall D; Taler, Sandra J; Cunningham, F Gary

    2010-01-01

    Hypertension complicates 5% to 7% of all pregnancies. A subset of preeclampsia, characterized by new-onset hypertension, proteinuria, and multisystem involvement, is responsible for substantial maternal and fetal morbidity and is a marker for future cardiac and metabolic disease. This American Society of Hypertension (ASH) position paper summarizes the clinical spectrum of hypertension in pregnancy, focusing on preeclampsia. Recent research breakthroughs relating to etiology are briefly reviewed. Topics include classification of the different forms of hypertension during pregnancy, and status of the tests available to predict preeclampsia, and strategies to prevent preeclampsia and to manage this serious disease. The use of antihypertensive drugs in pregnancy, and the prevention and treatment of the convulsive phase of preeclampsia, eclampsia, with intravenous MgSO(4) is also highlighted. Of special note, this guideline article, specifically requested, reviewed, and accepted by ASH, includes solicited review advice from the American College of Obstetricians and Gynecologists.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. [Acute cardiac failure in pheochromocytoma.

    DEFF Research Database (Denmark)

    Jønler, Morten; Munk, Kim

    2008-01-01

    Pheochromocytoma (P) is an endocrine catecholamine-secreting tumor. Classical symptoms like hypertension, attacks of sweating, palpitations, headache and palor are related to catecholamine discharge. We provide a case of P in a 71 year-old man presenting with acute cardiac failure, severe reduction...

  1. Acute generalized exanthematous pustulosis caused by terazosin hydrochloride.

    Science.gov (United States)

    Speck, Laura M; Wilkerson, Michael G; Perri, Anthony J; Kelly, Brent C

    2008-04-01

    Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous eruption mainly provoked by drugs. A case of AGEP in a 74-year-old male that was attributed to the ingestion of terazosin hydrochloride is presented. This is the first reported case of this association in medical literature. The history, clinical presentation, and pathogenesis of AGEP are discussed.

  2. Mechanisms responsible for pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    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).

  3. Hypertension in pregnancy.

    Science.gov (United States)

    Solomon, Caren G; Seely, Ellen W

    2011-12-01

    Hypertension is a common complication of pregnancy. Preeclampsia, in particular, is associated with substantial risk to both the mother and the fetus. Several risk factors have been recognized to predict risk for preeclampsia. However, at present no biomarkers have sufficient discriminatory ability to be useful in clinical practice, and no effective preventive strategies have yet been identified. Commonly used medications for the treatment of hypertension in pregnancy include methyldopa and labetalol. Blood pressure thresholds for initiating antihypertensive therapy are higher than outside of pregnancy. Women with prior preeclampsia are at increased risk of hypertension, cardiovascular disease, and renal disease.

  4. Anesthesia and pulmonary hypertension.

    Science.gov (United States)

    McGlothlin, Dana; Ivascu, Natalia; Heerdt, Paul M

    2012-01-01

    Anesthesia and surgery are associated with significantly increased morbidity and mortality in patients with pulmonary hypertension due mainly to right ventricular failure, arrhythmias, postoperative hypoxemia, and myocardial ischemia. Preoperative risk assessment and successful management of patients with pulmonary hypertension undergoing cardiac surgery involve an understanding of the pathophysiology of the disease, screening of patients at-risk for pulmonary arterial hypertension, analysis of preoperative and operative risk factors, thorough multidisciplinary planning, careful intraoperative management, and early recognition and treatment of postoperative complications. This article will cover each of these aspects with particular focus on the anesthetic approach for non-cardiothoracic surgeries.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Hypertension and hydronephrosis: rapid resolution of high blood pressure following relief of bilateral ureteric obstruction.

    Science.gov (United States)

    Chalisey, Anil; Karim, Mahzuz

    2013-03-01

    Hypertension secondary to hydronephrosis is not commonly reported in the medical literature. Tubuloglomerular feedback and the renin-angiotensin-aldosterone axis are thought to mediate this process. We describe a patient presenting with acute kidney injury and bilateral hydronephrosis secondary to pelvic malignancy in which peripheral venous renin and aldosterone were elevated. Her blood pressure improved rapidly following insertion of bilateral nephrostomies. The speed of resolution of hypertension following relief of obstruction suggests that humorally mediated vasoconstriction can play an important role in the mechanism by which hydronephrosis causes hypertension. We also discuss other causes of renal parenchymal compression that may lead to the development of hypertension.

  7. Unveiling The Hidden Eagle: Acute Parotitis-Induced Eagle Syndrome

    OpenAIRE

    Nitipong Permpalung; Promporn Suksaranjit; Daych Chongnarungsin; Hyman, Charles L.

    2014-01-01

    Context: A cervicofacial pain and foreign body sensation in pharynx associated with styloid process elongation is called Eagle syndrome. Typically, this syndrome is provoked by tonsillectomy or trauma. We report the first case of acute parotitis-induced Eagle syndrome. Case Report: A 65-year-old woman presented with right facial pain. CT scan of neck revealed asymmetric enhancement of the right parotid gland compatible with acute parotitis. All inflammation was resolved with antibiotics. Howe...

  8. 急性脑梗死患者血浆同型半胱氨酸水平高血压与脑微出血的相关性分析%Correlation between plasma homocysteine level hypertension and cerebral microbleeds in patients with acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    曹昌权; 刘维洲

    2015-01-01

    Objective To investigate the correlation between plasma homocysteine(Hcy) level, hypertension and cerebral microb-leeds(CMBs) in patients with acute cerebral infarction. Methods The clinical and imaging data of 74 patients with acute cerebral infarction who had been admitted in this hospital from January 2011 to January 2012 were analyzed retrospectively. According to the existence of cere-bral microbleeds, the patients were divided into two groups, namely the CMB group and the non-CMB group. Blood pressure, blood lipids, blood glucose, and plasma homocysteine were recorded in the two groups of patients, and the risk factors for cerebral microbleeds in acute cerebral infarction were explored. Results A total of 74 patients with acute cerebral infarction were enrolled, 23 of them were females and 51 were males (mean age 66. 22 ± 8. 96 years). Multivariate logistic regression analysis showed that cerebral microbleeds was associated closely with hypertension(OR=4. 67,95% CI:1. 2~17. 65,P=0. 02), but plasma Hcy level was not related to CMBs(OR=1. 01,95%CI:0. 97~1. 06,P=0. 38). Conclusion The level of elevated plasma Hcy in patients with acute cerebral infarction is unrelated to CMBs. Hypertension is significantly associated with CMBs, which might be the independent risk factor for CMBs.%目的:探讨急性脑梗死患者血浆同型半胱氨酸( Hcy)水平、高血压与脑微出血( CMB)的关系。方法选择铜陵市人民医院神经内科2011年1月至2012年1月收治的急性脑梗死患者74例,对其临床及影像学资料进行回顾性分析。根据是否存在CMB分为CMB组和无CMB组。记录两组患者血压、血脂、血糖、血浆Hcy水平等情况,并探讨CMB的危险因素。结果74例急性脑梗死患者中,男性51例,女性23例,平均(66.22±8.96)岁。 logistic回归分析显示,CMB的发生与高血压密切相关(OR=4.67,95% CI ∶1.23~17.65,P=0.02),与血浆Hcy水平无明显相关(OR=1.01,95% CI ∶0.97~1.06,P

  9. Orexin, Stress and Central Cardiovascular Control. A Link with Hypertension?

    Science.gov (United States)

    Carrive, Pascal

    2017-03-01

    Orexin, the arousal peptide, originates from neurons located in an area of the dorsal hypothalamus well known for integrating defense responses and their cardiovascular component. Orexin neurons, which are driven in large part by the limbic forebrain, send projections to many regions in the brain, including regions involved in cardiovascular control, as far down as sympathetic preganglionic neurons in the spinal cord. Central injections of orexin evoke sympathetically mediated cardiovascular responses. Conversely, blockade of orexin receptors reduce the cardiovascular responses to acute stressors, preferentially of a psychological nature. More importantly, lasting upregulation of orexin signaling can lead to a hypertensive state. This can be observed in rats exposed to chronic stress as well as in strains known to display spontaneous hypertension such as the spontaneously hypertensive rat (SHR) or the hypertensive BPH/2J Schlager mouse. Thus, there is a link between orexin, stress and hypertension, and orexin upregulation could be a factor in the development of essential hypertension. Orexin receptor antagonists have anti-hypertensive effects that could be of clinical use.

  10. High Blood Pressure (Hypertension)

    Science.gov (United States)

    ... Print Page Text Size: A A A Listen High Blood Pressure (Hypertension) Nearly 1 in 3 American adults has ... weight. How Will I Know if I Have High Blood Pressure? High blood pressure is a silent problem — you ...

  11. Hypertension and liver disease

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2004-01-01

    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......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...... hemodynamics in cirrhosis. The most characteristic findings in cirrhotic patients are vasodilatation with low systemic vascular resistance, increased cardiac output, high arterial compliance, secondary activation of counterregulatory systems (sympathetic nervous system, renin-angiotensin-aldosterone system...

  12. High Blood Pressure (Hypertension)

    Science.gov (United States)

    ... already been diagnosed with high blood pressure. Try yoga and meditation. Yoga and meditation not only can strengthen your body ... Accessed Sept. 21, 2015. Hu B, et al. Effects of psychological stress on hypertension in middle-aged ...

  13. Hypertension and liver disease

    DEFF Research Database (Denmark)

    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......, neuropituitary release of vasopressin), and resistance to vasopressors. The vasodilatory state is mediated through nitric oxide, calcitonin gene-related peptide, adrenomedullin, and other vasodilators, and is most pronounced in the splanchnic area. This constitutes an effective (although relative) counterbalance...... 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...

  14. Allegheny County Hypertension Hospitalization

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Hypertension Hospitalization data for 2013-2015, by age group, for Allegheny County. The information provided shows the number of individuals who were diagnosed...

  15. Exit from dormancy provokes DNA-damage-induced attrition in haematopoietic stem cells.

    Science.gov (United States)

    Walter, Dagmar; Lier, Amelie; Geiselhart, Anja; Thalheimer, Frederic B; Huntscha, Sina; Sobotta, Mirko C; Moehrle, Bettina; Brocks, David; Bayindir, Irem; Kaschutnig, Paul; Muedder, Katja; Klein, Corinna; Jauch, Anna; Schroeder, Timm; Geiger, Hartmut; Dick, Tobias P; Holland-Letz, Tim; Schmezer, Peter; Lane, Steven W; Rieger, Michael A; Essers, Marieke A G; Williams, David A; Trumpp, Andreas; Milsom, Michael D

    2015-04-23

    Haematopoietic stem cells (HSCs) are responsible for the lifelong production of blood cells. The accumulation of DNA damage in HSCs is a hallmark of ageing and is probably a major contributing factor in age-related tissue degeneration and malignant transformation. A number of accelerated ageing syndromes are associated with defective DNA repair and genomic instability, including the most common inherited bone marrow failure syndrome, Fanconi anaemia. However, the physiological source of DNA damage in HSCs from both normal and diseased individuals remains unclear. Here we show in mice that DNA damage is a direct consequence of inducing HSCs to exit their homeostatic quiescent state in response to conditions that model physiological stress, such as infection or chronic blood loss. Repeated activation of HSCs out of their dormant state provoked the attrition of normal HSCs and, in the case of mice with a non-functional Fanconi anaemia DNA repair pathway, led to a complete collapse of the haematopoietic system, which phenocopied the highly penetrant bone marrow failure seen in Fanconi anaemia patients. Our findings establish a novel link between physiological stress and DNA damage in normal HSCs and provide a mechanistic explanation for the universal accumulation of DNA damage in HSCs during ageing and the accelerated failure of the haematopoietic system in Fanconi anaemia patients.

  16. Spatiotemporal patterns provoked by environmental variability in a predator-prey model.

    Science.gov (United States)

    Fras, Maja; Gosak, Marko

    2013-12-01

    The emergence of spatiotemporal patterns in the distribution of species is one of the most striking phenomena in ecology and nonlinear science. Since it is known that spatial inhomogeneities can significantly affect the dynamics of ecological populations, in the present paper we investigate the impact of environmental variability on the formation of patterns in a spatially extended predator-prey model. In particular, we utilize a predator-prey system with a Holling III functional response and introduce random spatial variations of the kinetic parameter signifying the intrinsic growth rate of the prey, reflecting the impact of a heterogeneous environment. Our results reveal that in the proximity of the Hopf bifurcation environmental variability is able to provoke pattern formation, whereby the coherence of the patterns exhibits a resonance-like dependence on the variability strength. Furthermore, we show that the phenomenon can only be observed if the spatial heterogeneities exhibit large enough regions with high growth rates of the prey. Our findings thus indicate that variability could be an essential pattern formation mechanism of the populations.

  17. Original article Coffee consumption and propensity to experience aggressive feelings in provoking and frustrating situations

    Directory of Open Access Journals (Sweden)

    Anna Zajenkowska

    2015-07-01

    Full Text Available The present study focused on examining whether coffee intake is related to the intensity of aggressive feelings in reaction to various provoking or frustrating situations, along with consideration of sex and culture. Previous studies focused mainly on the dose of caffeine (not the habit of coffee drinking and aggressive behavior. Many of these studies showed a positive relation between the amount of caffeine consumed and aggression, so it was expected that also habitual coffee consumption would be positively related to propensity for aggressive feelings in situ ations of provocation and frustration. Participants from Greece (n = 299 and Poland (n = 300 declared whether they were coffee drinkers (at least 1 mug of coffee per day and completed the Situational Triggers of Aggressive Responses questionnaire. The results showed that in females, coffee drinkers had higher scores in Sensitivity to Provocation (SP and Frustration (SF than nondrinkers, while no differences between drinkers and nondrinkers appeared in males. Moreover, amongst coffee drinkers, females had higher scores in SP and SF than males, while no sex differences were found in nondrinkers. Furthermore, in Poland coffee drinkers had higher SP scores than nondrinkers. Poles also had higher SP scores than Greeks, but only when coffee drinkers were compared.

  18. Optimal duration of anticoagulation. Provoked versus unprovoked VTE and role of adjunctive thrombophilia and imaging tests.

    Science.gov (United States)

    Prandoni, Paolo; Barbar, Sofia; Milan, Marta; Campello, Elena; Spiezia, Luca; Piovella, Chiara; Pesavento, Raffaele

    2015-06-01

    Once anticoagulation is stopped, the risk of recurrent venous thromboembolism (VTE) over years after a first episode is consistently around 30%. This risk is higher in patients with unprovoked than in those with (transient) provoked VTE, and among the latter in patients with medical than in those with surgical risk factors. Baseline parameters that have been found to be related to the risk of recurrent VTE are the proximal location of deep-vein thrombosis, obesity, old age, male sex and non-0 blood group, whereas the role of inherited thrombophilia is controversial. The persistence of residual vein thrombosis at ultrasound assessment has consistently been shown to increase the risk, as do persistently high values of D-dimer and the early development of the post-thrombotic syndrome. Although the latest international guidelines suggest indefinite anticoagulation for most patients with the first episode of unprovoked VTE, strategies that incorporate the assessment of residual vein thrombosis and D-dimer have the potential to identify subjects in whom anticoagulation can be safely discontinued. Moreover, new opportunities are offered by a few emerging anti-Xa and anti-IIa oral compounds, which are likely to induce fewer haemorrhagic complications than vitamin K antagonists while preserving the same effectiveness; and by low-dose aspirin, which has the potential to prevent the occurrence of both venous and arterial thrombotic events.

  19. Mesenchymal Stem Cells Reshape and Provoke Proliferation of Articular Chondrocytes by Paracrine Secretion

    Science.gov (United States)

    Xu, Lei; Wu, Yuxi; Xiong, Zhimiao; Zhou, Yan; Ye, Zhaoyang; Tan, Wen-Song

    2016-09-01

    Coculture between mesenchymal stem cells (MSCs) and articular chondrocytes (ACs) represents a promising strategy for cartilage regeneration. This study aimed at elaborating how ACs were regulated by MSCs. Rabbit ACs (rACs) and rabbit MSCs (rMSCs) were seeded separately in a Transwell system to initiate non-contact coculture in growth medium without chondrogenic factors. Cell morphology, cell proliferation, production of extracellular matrix (ECM), and gene expression of rACs were characterized. Upon coculture, rACs underwent a morphological transition from a rounded or polygonal shape into a fibroblast-like one and proliferation was provoked simultaneously. Such effects were dependent on the amount of rMSCs. Along with these changes, ECM production and gene expression of rACs were also perturbed. Importantly, when a ROCK inhibitor (Y27632) was supplemented to coculture, the effects except that on cell proliferation were inhibited, suggesting the involvement of RhoA/ROCK signaling. By applying an inhibitor (BIBF1120) of VEGFR1/2/3, FGFR1/2/3 and PDGFRα/β in coculture, or supplementing FGF-1, VEGF-A and PDGFbb in monoculture, it was confirmed that the paracrine factors by rMSCs mediated the compounding effects on rACs. These findings shed light on MSCs-ACs interactions and might confer an insight view on cell-based cartilage regeneration.

  20. Role of Vasodilator Testing in Pulmonary Hypertension.

    Science.gov (United States)

    Sharma, Abhishek; Obiagwu, Chukwudi; Mezue, Kenechukwu; Garg, Aakash; Mukherjee, Debabrata; Haythe, Jennifer; Shetty, Vijay; Einstein, Andrew J

    2016-01-01

    Pulmonary hypertension is clinically defined by a mean pulmonary artery (PA) pressure of 25mm Hg or more at rest, as measured by right heart catheterization. To identify patients who are likely to have a beneficial response to calcium channel blockers (CCBs) and therefore a better prognosis, acute vasodilator testing should be performed in patients in certain subsets of pulmonary arterial hypertension (PAH). A near normalization of pulmonary hemodynamics is needed before patients can be considered for therapy with CCBs. Intravenous adenosine, intravenous epoprostenol, inhaled nitric oxide, or inhaled iloprost are the standard agents used for vasoreactivity testing in patients with idiopathic PAH. In this review we describe the various aspects of vasodilator testing including the rationale, pathophysiology and agents used in the procedure.

  1. Monoassociation of SCID mice with Helicobacter muridarum, but not four other enterics, provokes IBD upon receipt of T cells

    NARCIS (Netherlands)

    Jiang, HQ; Kushnir, N; Thurnheer, MC; Bos, NA; Cebra, JJ

    2002-01-01

    Background & Aims: Recently, a number of animal models for different aspects of inflammatory bowel disease (IBD) have been developed. The aim of this study was to use one of these to determine whether particular, ostensibly innocuous, intestinal bacteria could provoke or exacerbate IBD. Methods: Con

  2. Hypertension and pregnancy.

    Science.gov (United States)

    Deak, Teresa M; Moskovitz, Joshua B

    2012-11-01

    Hypertension in pregnancy is increasing in prevalence and incidence and its treatment becoming more commonplace. Associated complications of pregnancy, including end-organ damage, preeclampsia, eclampsia, and postpartum eclampsia, are leading sources of maternal and fetal morbidity and mortality, requiring an emergency physician to become proficient with their identification and treatment. This article reviews hypertension in pregnancy as it relates to outcomes, with special emphasis on preeclampsia, eclampsia, and postpartum eclampsia.

  3. Apelin and pulmonary hypertension

    DEFF Research Database (Denmark)

    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...

  4. Resistant Hypertension and Chronotherapy

    Science.gov (United States)

    Prkacin, Ingrid; Balenovic, Diana; Djermanovic-Dobrota, Vesna; Lukac, Iva; Drazic, Petra; Pranjic, Iva-Klara

    2015-01-01

    Resistant hypertension is defined as blood pressure that remains above 140/90 mmHg in spite of the continuous use of three antihypertensive agents in optimal dose, including diuretic, and lifestyle changes. According to data from United States of America and Europe, the prevalence ranges from 10 up to 30% in patients with hypertension. Numerous biological and lifestyle factors can contribute to the development of resistant hypertension: medications, volume overload, obesity, diabetes mellitus, older age, renal parenchymal and renovascular disease, primary aldosteronism, obstructive sleep apnea, pheochormocytoma, Cushing’s syndrome, thyroid diseases, aortic coarctation. For diagnosing patient’s history is important, assessing compliance, regular blood pressure measurement, physical examination, biochemical evaluation and noninvasive imaging. The evaluation including 24h ambulatory monitoring of blood pressure (ABPM) in the identification of “non-dipper” hypertension. Non-dipper has particular importance and the prevalence of abnormally high sleep blood pressure is very often in chronic kidney patients. Therapeutic restoration of normal physiologic blood pressure reduction during night-time sleep (circadial variation) is the most significant independent predictor of decreased risk and the basis for the chronotherapy. The resistant hypertension treatment is achieved with nonpharmacological and pharmacological approach, treating secondary hypertension causes and invasive procedures. PMID:26005390

  5. Renal dysfunction in African patients with acute heart failure

    NARCIS (Netherlands)

    Sani, Mahmoud U.; Davison, Beth A.; Cotter, Gad; Sliwa, Karen; Edwards, Christopher; Liu, Licette; Damasceno, Albertino; Mayosi, Bongani M.; Ogah, Okechukwu S.; Mondo, Charles; Dzudie, Anastase; Ojji, Dike B.; Voors, Adrian A.

    2014-01-01

    Aims In Western countries with typically elderly ischaemic acute heart failure patients, predictors and clinical outcome of renal dysfunction and worsening renal function are well described. However, the prevalence, predictors and clinical outcome of renal dysfunction in younger, mainly hypertensive

  6. Recurrence of Acute Page Kidney in a Renal Transplant Allograft

    Science.gov (United States)

    Zayas, Carlos; Mulloy, Laura; Jagadeesan, Muralidharan

    2016-01-01

    Acute Page Kidney (APK) phenomenon is a rare cause of secondary hypertension, mediated by activation of renin-angiotensin-aldosterone system (RAAS). Timely intervention is of great importance to prevent any end organ damage from hypertension. We present a unique case of three episodes of APK in the same renal transplant allograft. PMID:27725836

  7. Recurrence of Acute Page Kidney in a Renal Transplant Allograft

    Directory of Open Access Journals (Sweden)

    Rajan Kapoor

    2016-01-01

    Full Text Available Acute Page Kidney (APK phenomenon is a rare cause of secondary hypertension, mediated by activation of renin-angiotensin-aldosterone system (RAAS. Timely intervention is of great importance to prevent any end organ damage from hypertension. We present a unique case of three episodes of APK in the same renal transplant allograft.

  8. Recurrence of Acute Page Kidney in a Renal Transplant Allograft.

    Science.gov (United States)

    Kapoor, Rajan; Zayas, Carlos; Mulloy, Laura; Jagadeesan, Muralidharan

    2016-01-01

    Acute Page Kidney (APK) phenomenon is a rare cause of secondary hypertension, mediated by activation of renin-angiotensin-aldosterone system (RAAS). Timely intervention is of great importance to prevent any end organ damage from hypertension. We present a unique case of three episodes of APK in the same renal transplant allograft.

  9. [Sodium and hypertension].

    Science.gov (United States)

    de Wardener, H E

    1996-09-01

    Over several million years the human race was programmed to eat a diet which contained about 15 mmol of sodium (1 g of sodium chloride) per day. It is only five to ten thousand years ago that we became addicted to salt. Today we eat about 150 mmol of sodium (9-12 g of salt) per day. It is now apparent that this sudden rise in sodium intake (in evolutionary terms) is the most likely cause for the rise in blood pressure with age that occurs in the majority of the world's population. Those which consume less than 60 mmol/day do not develop hypertension. The reason for the rise in sodium intake is not known but it is probable that an important stimulus was the discovery that meat could be preserved by immersion into a concentrated salt solution. This seemingly miraculous power endowed salt with such magical and medicinal qualities that it became a symbol of goodness and health. It was not until 1904 Ambard and Beaujard suggested that on the contrary dietary salt could be harmful and raise the blood pressure. At first the idea did not prosper and it continues to be opposed by a diminishing band. The accumulated evidence that sodium intake is related to the blood pressure in normal man and animals and in inherited forms of hypertension has been obtained from experimental manipulations and studies of human populations. The following observation links sodium and hypertension. An increase in sodium intakes raises the blood pressure of the normal rat, dog, rabbit, baboon, chimpanzee and man. Population studies have demonstrated a significant correlation between sodium intake and the customary rise in blood pressure with age. The development of hypertensive strains of rats has revealed that the primary genetic lesion which gives rise to hypertension resides in the kidney where it impairs the urinary excretion of sodium. There is similar but less convincing evidence in essential hypertension. The kidney in both essential hypertension and hypertensive strains of rats share a

  10. Hypertension and atherosclerotic (ischaemic) heart disease.

    Science.gov (United States)

    Davies, M J

    1991-08-01

    Epidemiological surveys show the clear association of hypertension with an increased risk of developing ischaemic heart disease. One method of quantifying atherosclerosis is to measure, at necropsy, the percentage of the intimal surface of the coronary arteries or aorta which is occupied by raised plaques. When this is done in a large number of subjects the amount of intimal involvement in any particular geographical population correlates directly with the frequency of ischaemic heart disease. In all these populations, whether at a high risk or low risk of developing ischaemic heart disease, hypertensive subjects have a greater intimal involvement by plaques than normotensive subjects. Thus, the increased risk in hypertension is, in part, mediated by possession of more plaques. Plaque growth is due to the accumulation of lipid from the plasma, the ingress of monocytes with their conversion to lipid filled foam cells and the formation of collagen by smooth muscle cells. Hypertension may act by altering endothelial function to potentiate all these processes. Mechanical stress on endothelial cells will evoke the formation of growth factors for smooth muscle cells. Plaque growth in man is also episodic due to the formation of thrombi; a proportion of these episodes are symptomatic producing acute myocardial ischaemia but the majority are silent leading to sudden plaque expansion. Thrombi over plaques are either due to endothelial denudation injury or more commonly due to the tearing of the cap of a plaque leading to deep intimal injury. Necropsy surveys of control populations show that subjects with hypertension have a greater frequency of recent plaque tears compared with normotensive subjects.

  11. I RBH - First Brazilian Hypertension Registry

    Science.gov (United States)

    Jardim, Paulo César Brandão Veiga; de Souza, Weimar Kunz Sebba Barroso; Lopes, Renato Delascio; Brandão, Andréa Araújo; Malachias, Marcus V. Bolívar; Gomes, Marco Mota; Moreno Júnior, Heitor; Barbosa, Eduardo Costa Duarte; Póvoa, Rui Manoel dos Santos

    2016-01-01

    Background: A registry assessing the care of hypertensive patients in daily clinical practice in public and private centers in various Brazilian regions has not been conducted to date. Such analysis is important to elucidate the effectiveness of this care. Objective: To document the current clinical practice for the treatment of hypertension with identification of the profile of requested tests, type of administered treatment, level of blood pressure (BP) control, and adherence to treatment. Methods: National, observational, prospective, and multicenter study that will include patients older than 18 years with hypertension for at least 4 weeks, following up in public and private centers and after signing a consent form. The study will exclude patients undergoing dialysis, hospitalized in the previous 30 days, with class III or IV heart failure, pregnant or nursing, with severe liver disease, stroke or acute myocardial infarction in the past 30 days, or with diseases with a survival prognosis < 1 year. Evaluations will be performed at baseline and after 1 year of follow-up. The parameters that will be evaluated include anthropometric data, lifestyle habits, BP levels, lipid profile, metabolic syndrome, and adherence to treatment. The primary outcomes will be hospitalization due to hypertensive crisis, cardiocirculatory events, and cardiovascular death, while secondary outcomes will be hospitalization for heart failure and requirement of dialysis. A subgroup analysis of 15% of the sample will include noninvasive central pressure evaluation at baseline and study end. The estimated sample size is 3,000 individuals for a prevalence of 5%, sample error of 2%, and 95% confidence interval. Results: The results will be presented after the final evaluation, which will occur at the end of a 1-year follow-up. Conclusion: The analysis of this registry will improve the knowledge and optimize the treatment of hypertension in Brazil, as a way of modifying the prognosis of

  12. I RBH - First Brazilian Hypertension Registry

    Directory of Open Access Journals (Sweden)

    Paulo César Brandão Veiga Jardim

    Full Text Available Abstract Background: A registry assessing the care of hypertensive patients in daily clinical practice in public and private centers in various Brazilian regions has not been conducted to date. Such analysis is important to elucidate the effectiveness of this care. Objective: To document the current clinical practice for the treatment of hypertension with identification of the profile of requested tests, type of administered treatment, level of blood pressure (BP control, and adherence to treatment. Methods: National, observational, prospective, and multicenter study that will include patients older than 18 years with hypertension for at least 4 weeks, following up in public and private centers and after signing a consent form. The study will exclude patients undergoing dialysis, hospitalized in the previous 30 days, with class III or IV heart failure, pregnant or nursing, with severe liver disease, stroke or acute myocardial infarction in the past 30 days, or with diseases with a survival prognosis < 1 year. Evaluations will be performed at baseline and after 1 year of follow-up. The parameters that will be evaluated include anthropometric data, lifestyle habits, BP levels, lipid profile, metabolic syndrome, and adherence to treatment. The primary outcomes will be hospitalization due to hypertensive crisis, cardiocirculatory events, and cardiovascular death, while secondary outcomes will be hospitalization for heart failure and requirement of dialysis. A subgroup analysis of 15% of the sample will include noninvasive central pressure evaluation at baseline and study end. The estimated sample size is 3,000 individuals for a prevalence of 5%, sample error of 2%, and 95% confidence interval. Results: The results will be presented after the final evaluation, which will occur at the end of a 1-year follow-up. Conclusion: The analysis of this registry will improve the knowledge and optimize the treatment of hypertension in Brazil, as a way of

  13. Acute tubular nephropathy in a patient with acute HIV infection: review of the literature.

    Science.gov (United States)

    Ananworanich, Jintanat; Datta, Anandita A; Fletcher, James Lk; Townamchai, Natavudh; Chomchey, Nitiya; Kroon, Eugene; Sereti, Irini; Valcour, Victor; Kim, Jerome H

    2014-01-01

    We report a 57-year old man with diabetes mellitus and hypertension who presented with acute HIV infection. Routine blood tests showed an elevated blood urea nitrogen and creatinine. Renal biopsy showed acute tubular nephropathy, which has not been reported to occur during acute HIV infection, in the absence of rhabdomyolysis or multiple organ system failure. Antiretroviral therapy was initiated. His renal failure gradually resolved without further intervention. At one year of follow-up his HIV RNA was undetectable, and his renal function was normal. The case illustrates a rare manifestation of acute HIV infection - acute renal failure - in an older man with diabetes and hypertension. In this setting acute kidney injury might mistakenly have been attributed to his chronic comorbidities, and this case supports early HIV-1 testing in the setting of a high index of suspicion.

  14. Endocrine hypertension in small animals.

    Science.gov (United States)

    Reusch, Claudia E; Schellenberg, Stefan; Wenger, Monique

    2010-03-01

    Hypertension is classified as idiopathic or secondary. In animals with idiopathic hypertension, persistently elevated blood pressure is not caused by an identifiable underlying or predisposing disease. Until recently, more than 95% of cases of hypertension in humans were diagnosed as idiopathic. New studies have shown, however, a much higher prevalence of secondary causes, such as primary hyperaldosteronism. In dogs and cats, secondary hypertension is the most prevalent form and is subclassified into renal and endocrine hypertension. This review focuses on the most common causes of endocrine hypertension in dogs and cats.

  15. [Hypertensive crisis in kidney patients].

    Science.gov (United States)

    Scrivano, Jacopo; Giuliani, Anna; Pettorini, Laura; Punzo, Giorgio; Mene', Paolo; Pirozzi, Nicola

    2011-01-01

    The classification and management of hypertensive crisis have been recently reviewed in the context of both European and American guidelines. The key points for proper blood pressure control in severe arterial hypertension are: 1 - Distinction between urgent intervention and emergencies 2 - Choice of the best drug(s) 3 - Choice of the correct route of administration. In patients with renal disease, beside the common causes of hypertension/ hypertensive crises, kidney-specific causes should be taken into account such as renal parenchymal hypertension, renovascular hypertension, sclerodermic crises, and preeclampsia.

  16. Pulmonary arterial hypertension in pregnancy.

    Science.gov (United States)

    Običan, Sarah G; Cleary, Kirsten L

    2014-08-01

    Pulmonary hypertension is a medical condition characterized by elevated pulmonary arterial pressure and secondary right heart failure. Pulmonary arterial hypertension is a subset of pulmonary hypertension, which is characterized by an underlying disorder of the pulmonary arterial vasculature. Pulmonary hypertension can also occur secondarily to structural cardiac disease, autoimmune disorders, and toxic exposures. Although pregnancies affected by pulmonary hypertension and pulmonary arterial hypertension are rare, the pathophysiology exacerbated by pregnancy confers both high maternal and fetal mortality and morbidity. In light of new treatment modalities and the use of a multidisciplinary approach to care, maternal outcomes may be improving.

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

    Institute of Scientific and Technical Information of China (English)

    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...

  18. Hypertension in postmenopausal women: how to approach hypertension in menopause.

    Science.gov (United States)

    Modena, Maria Grazia

    2014-09-01

    During fertile life women are usually normo or hypotensive. Hypertension may appear during pregnancy and this represents a peculiar phenomenon increasing nowadays for delay time of pregnancy. Gestational hypertension appears partially similar to hypertension in the context of metabolic syndrome for a similar condition of increased waste circumference. Parity, for the same pathogenesis, has been reported to be associated to peri and postmenopausal hypertension, not confirmed by our study of parous women with transitional non persistent perimenopausal hypertension. Estrogen's deficiency inducing endothelial dysfunction and increased body mass index are the main cause for hypertension in this phase of life. For these reasons lifestyle modification, diet and endothelial active drugs represent the ideal treatment. Antioxidant agents may have a role in prevention and treatment of hypertension. In conclusion, hypertension in women represents a peculiar constellation of different biological and pathogenic factors, which need a specific gender related approach, independent from the male model.

  19. 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

    Institute of Scientific and Technical Information of China (English)

    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

  20. Hypertensive Disorders of Pregnancy.

    Science.gov (United States)

    Leeman, Lawrence; Dresang, Lee T; Fontaine, Patricia

    2016-01-15

    Elevated blood pressure in pregnancy may represent chronic hypertension (occurring before 20 weeks' gestation or persisting longer than 12 weeks after delivery), gestational hypertension (occurring after 20 weeks' gestation), preeclampsia, or preeclampsia superimposed on chronic hypertension. Preeclampsia is defined as hypertension and either proteinuria or thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema, or cerebral or visual symptoms. Proteinuria is not essential for the diagnosis and does not correlate with outcomes. Severe features of preeclampsia include a systolic blood pressure of at least 160 mm Hg or a diastolic blood pressure of at least 110 mm Hg, platelet count less than 100 × 103 per µL, liver transaminase levels two times the upper limit of normal, a doubling of the serum creatinine level or level greater than 1.1 mg per dL, severe persistent right upper-quadrant pain, pulmonary edema, or new-onset cerebral or visual disturbances. Preeclampsia without severe features can be managed with twice-weekly blood pressure monitoring, antenatal testing for fetal well-being and disease progression, and delivery by 37 weeks' gestation. Preeclampsia with any severe feature requires immediate stabilization and inpatient treatment with magnesium sulfate, antihypertensive drugs, corticosteroids for fetal lung maturity if less than 34 weeks' gestation, and delivery plans. Preeclampsia can worsen or initially present after delivery. Women with hypertensive disorders should be monitored as inpatients or closely at home for 72 hours postpartum.

  1. Dopamine receptors and hypertension.

    Science.gov (United States)

    Banday, Anees Ahmad; Lokhandwala, Mustafa F

    2008-08-01

    Dopamine plays an important role in regulating renal function and blood pressure. Dopamine synthesis and dopamine receptor subtypes have been shown in the kidney. Dopamine acts via cell surface receptors coupled to G proteins; the receptors are classified via pharmacologic and molecular cloning studies into two families, D1-like and D2-like. Two D1-like receptors cloned in mammals, the D1 and D5 receptors (D1A and D1B in rodents), are linked to adenylyl cyclase stimulation. Three D2-like receptors (D2, D3, and D4) have been cloned and are linked mainly to adenylyl cyclase inhibition. Activation of D1-like receptors on the proximal tubules inhibits tubular sodium reabsorption by inhibiting Na/H-exchanger and Na/K-adenosine triphosphatase activity. Reports exist of defective renal dopamine production and/or dopamine receptor function in human primary hypertension and in genetic models of animal hypertension. In humans with essential hypertension, renal dopamine production in response to sodium loading is often impaired and may contribute to hypertension. A primary defect in D1-like receptors and an altered signaling system in proximal tubules may reduce dopamine-mediated effects on renal sodium excretion. The molecular basis for dopamine receptor dysfunction in hypertension is being investigated, and may involve an abnormal posttranslational modification of the dopamine receptor.

  2. Migraine and hypertension

    Directory of Open Access Journals (Sweden)

    G. R. Tabeeva

    2015-01-01

    Full Text Available Investigations of a relationship between migraine and hypertension are being continued. In spite of numerous studies, the association of some types of migraine (migraine with aura and migraine without aura with hypertension has not been fully elucidated. This issue is particularly relevant since these forms differ both clinically and pathophysiologically. Of even greater importance are the analysis and prediction of associations between migraine and cardiovascular diseases (ischemic stroke, myocardial infarction, coronary heart disease. The review deals with the clinical and pathophysiological features of the relationship between hypertension and migraine. There is evidence for the anatomic and functional correlation between the antinociceptive system and blood pressure (BP regulation control. It has been speculated that the increase in pain threshold is not the result of just hypertension as a disease, but it is caused by elevated BP-related hypalgesia. The efficacy of antihypertensive drugs is the fact that supports the association between hypertension and endothelial dysfunction. Identification of groups of patients having migraine and a high cardiovascular risk will allow timely early primary prevention and therapy. Introduction of a stratification approach at diagnostic stages may cause a reduction in cardiovascular morbidity and mortality rates.

  3. Nonnarcotic analgesics and hypertension.

    Science.gov (United States)

    Gaziano, J Michael

    2006-05-01

    In 2004, individuals in the United States spent >$2.5 billion on over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) and filled >100 million NSAID prescriptions. The most commonly used OTC analgesics include aspirin, acetaminophen, and nonaspirin NSAIDs. Nonnarcotic analgesics are generally considered safe when used as directed but do have the potential to increase blood pressure in patients with hypertension treated with antihypertensives. This is important because hypertension alone has been correlated with an increased risk of cardiovascular disease or stroke. Small increases in blood pressure in patients with hypertension also have been shown to increase cardiovascular morbidity and mortality. Therefore, when nonnarcotic analgesics are taken by patients with hypertension, there may be important implications. This review explores the potential connection among analgesic agents, blood pressure, and hypertension, and discusses possible mechanisms by which analgesics might cause increases in blood pressure. This is followed by a summary of data on the relation between analgesics and blood pressure from both observational and randomized trials.

  4. Pathogenic Mechanisms of Pulmonary Arterial Hypertension

    Science.gov (United States)

    Chan, Stephen Y.; Loscalzo, Joseph

    2008-01-01

    Pulmonary arterial hypertension (PAH)1 is a complex disease that causes significant morbidity and mortality and is clinically characterized by an increase in pulmonary vascular resistance. The histopathology is marked by vascular proliferation/fibrosis, remodeling, and vessel obstruction. Development of PAH involves the complex interaction of multiple vascular effectors at all anatomic levels of the arterial wall. Subsequent vasoconstriction, thrombosis, and inflammation ensue, leading to vessel wall remodeling and cellular hyperproliferation as the hallmarks of severe disease. These processes are influenced by genetic predisposition as well as diverse endogenous and exogenous stimuli. Recent studies have provided a glimpse at certain molecular pathways that contribute to pathogenesis; these have led to the identification of attractive targets for therapeutic intervention. We will review our current understanding of the mechanistic underpinnings of the genetic and exogenous/acquired triggers of PAH. The resulting imbalance of vascular effectors provoking pathogenic vascular changes will also be discussed, with an emphasis on common and overarching regulatory pathways that may relate to the primary triggers of disease. The current conceptual framework should allow for future studies to refine our understanding of the molecular pathogenesis of PAH and improve the therapeutic regimen for this disease. PMID:17950310

  5. Emergências hipertensivas Hypertensive emergencies

    Directory of Open Access Journals (Sweden)

    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

  6. Hypertension, pre-eclampsia and eclampsia: Monitoring and outcome of pregnancy

    Directory of Open Access Journals (Sweden)

    Grujić Ilija

    2006-01-01

    Full Text Available Introduction. Pregnancy-induced hypertension, pre-eclampsia and eclampsia are parts of the hypertensive syndrome which is a life-threatening condition both for mother and fetus. Apart from being associated with unpredictable onset, it is incurable, except by ending the pregnancy. Its incidence is approximately between 6 - 10% of pregnant women. There is no unique definition and classification of the hypertensive syndrome in pregnancy, i.e. they differ from one expert group to another. Risks of pregnancy-induced hypertension. Pregnancy-induced hypertension syndrome can cause placental abruption, intracranial hemorrhage, liver lesions, acute renal disorders and disseminated intravascular coagulation (DIC, adult respiratory distress syndrome (ARDS, hypervolemia and inhalation of gastric content, due to deep sedation. Treatment of pregnancy-induced hypertension. Delivery is always appropriate therapy for the mother, but may not be a good solution for the fetus. Standard treatment of pre-eclampsia includes: anticonvulsive therapy, antihypertensive therapy, excessive fluid administration, and if necessary, management of oliguria, DIC, pulmonary edema and recovery of liver function. The outcome of pregnancy-induced hypertension (perinatal and maternal mortality. Maternal mortality due to pregnancy-induced hypertension is 15 - 33% out of the total number of maternal deaths. Newborn infants of mothers with pregnancy-induced hypertension present with intrauterine growth retardation, prematurity, dysmaturity and necrotizing enterocolitis. Pregnancy-induced hypertension is one of the major causes of maternal and fetal/neonatal morbidity and mortality. .

  7. Renovascular Hypertension: Clinical Features, Differential Diagnoses and Basic Principles of Treatment

    Directory of Open Access Journals (Sweden)

    Petrovic Dejan

    2016-09-01

    Full Text Available Renovascular hypertension is caused by renal artery stenosis. Its prevalence in populations of hypertensive patients is 1-8%, and in populations of patients with resistant hypertension, it is up to 20%. The two main causes of stenosis are atherosclerosis and fibromuscular dysplasia of the renal artery. The main clinical consequences of renal artery stenosis include renovascular hypertension, ischemic nephropathy and “flash” acute pulmonary oedema. Unilateral stenosis of the renal artery causes angiotensin II-dependent hypertension, and bilateral stenosis of the renal arteries produces volume-dependent hypertension. Renovascular aetiology of hypertension should be questioned in patients with resistant hypertension, hypertension with a murmur identified upon auscultation of the renal arteries, and a noticeable side-to-side difference in kidney size. Non-invasive diagnostic tests include the determination of concentrations of peripheral vein plasma renin activity, the captopril test, captopril scintigraphy, colour Doppler ultrasonography, computed tomography angiography, and nuclear resonance angiography. Renovasography represents the gold standard for the diagnosis of renovascular hypertension. The indications for revascularization of the renal artery include haemodynamically significant renal artery stenosis (with a systolic pressure gradient at the site of stenosis of - ΔP ≥ 20 mmHg, along with the ratio of the pressure in the distal part of the renal artery (Pd and aortic pressure (Pa less than 0.9 (Pd/Pa 0.8, chronic kidney disease (GFR <30 ml/min/1.73 m2 and negative captopril scintigraphy (lack of lateralization.

  8. Hypertensive Crisis, Burden, Management, and Outcome at a Tertiary Care Center in Karachi

    Directory of Open Access Journals (Sweden)

    Aysha Almas

    2014-01-01

    Full Text Available Objectives. Hypertension, if uncontrolled, can lead to hypertensive crisis. We aim to determine the prevalence of hypertensive crisis, its management, and outcome in patients presenting to a tertiary care center in Karachi. Methods. This was a cross-sectional study conducted at the Aga Khan University, Karachi, Pakistan. Adult inpatients (>18 yrs presenting to the ER who were known hypertensive and had uncontrolled hypertension were included. Results. Out of 1336 patients, 28.6% (387 had uncontrolled hypertension. The prevalence of hypertensive crisis among uncontrolled hypertensive was 56.3% (218. Per oral calcium channel blocker; 35.4% (137 and intravenous nitrate; 22.7% (88 were the most commonly administered medication in the ER. The mean (SD drop in SBP in patients with hypertensive crisis on intravenous treatment was 53.1 (29 mm Hg and on per oral treatment was 43 (27 mm Hg. The maximum mean (SD drop in blood pressure was seen by intravenous sodium nitroprusside; 80 (51 mm Hg in SBP. Acute renal failure was the most common complication with a prevalence of 11.5% (24. Conclusion. The prevalence of hypertensive crisis is high. Per oral calcium channel blocker and intravenous nitrate are the most commonly administered medications in our setup.

  9. Hypertensive Crisis, Burden, Management, and Outcome at a Tertiary Care Center in Karachi.

    Science.gov (United States)

    Almas, Aysha; Ghouse, Ayaz; Iftikhar, Ahmed Raza; Khursheed, Munawwar

    2014-01-01

    Objectives. Hypertension, if uncontrolled, can lead to hypertensive crisis. We aim to determine the prevalence of hypertensive crisis, its management, and outcome in patients presenting to a tertiary care center in Karachi. Methods. This was a cross-sectional study conducted at the Aga Khan University, Karachi, Pakistan. Adult inpatients (>18 yrs) presenting to the ER who were known hypertensive and had uncontrolled hypertension were included. Results. Out of 1336 patients, 28.6% (387) had uncontrolled hypertension. The prevalence of hypertensive crisis among uncontrolled hypertensive was 56.3% (218). Per oral calcium channel blocker; 35.4% (137) and intravenous nitrate; 22.7% (88) were the most commonly administered medication in the ER. The mean (SD) drop in SBP in patients with hypertensive crisis on intravenous treatment was 53.1 (29) mm Hg and on per oral treatment was 43 (27) mm Hg. The maximum mean (SD) drop in blood pressure was seen by intravenous sodium nitroprusside; 80 (51) mm Hg in SBP. Acute renal failure was the most common complication with a prevalence of 11.5% (24). Conclusion. The prevalence of hypertensive crisis is high. Per oral calcium channel blocker and intravenous nitrate are the most commonly administered medications in our setup.

  10. Intravenous methylphenidate: an unusual way to provoke ST-elevation myocardial infarction.

    Science.gov (United States)

    Hay, Emile; Shklovski, Vitaly; Blaer, Yossef; Shlakhover, Vladimir; Katz, Amos

    2015-02-01

    Acute ST-T elevation is a sign of myocardial ischemia or infarction usually due to coronary artery atherosclerosis or coronary spasm. Coronary spasm may be spontaneous or can occur as a result of a drug that causes arterial spam. Ritalin, Novartis Pharmaceut. Corporation, USA (methylphenidate hydrochloride), a dopamine reuptake inhibitor,is an oral drug used to treat attention-deficit/hyperactivity disorder and narcolepsy. Sudden deaths, stroke, and myocardial infarction have been reported in adults taking stimulant drugs at usual dose for attention-deficit/hyperactivity disorder [1]. This drug is not supplied as solution for injection [2]. We report here, what we believe to be, the first case report of a 40-year-old male patient who was admitted for acute chest pain and ST-elevation myocardial infarction after intravenous self-injection of Ritalin. His coronary angiogram demonstrated nonobstructive coronary disease.

  11. Determining the Feasibility of Ambulance-Based Randomised Controlled Trials in Patients with Ultra-Acute Stroke: Study Protocol for the "Rapid Intervention with GTN in Hypertensive Stroke Trial" (RIGHT, ISRCTN66434824).

    Science.gov (United States)

    Ankolekar, Sandeep; Sare, Gillian; Geeganage, Chamila; Fuller, Michael; Stokes, Lynn; Sprigg, Nikola; Parry, Ruth; Siriwardena, A Niroshan; Bath, Philip M W

    2012-01-01

    Background. Time from acute stroke to enrolment in clinical trials needs to be reduced to improve the chances of finding effective treatments. No completed randomised controlled trials of ambulance-based treatment for acute stroke have been reported in the UK, and the practicalities of recruiting, consenting, and treating patients are unknown. Methods. RIGHT is an ambulance based, single-blind, randomised controlled trial with blinded-outcome assessment. The trial will assess feasibility of using ambulance services to deliver ultra-acute stroke treatments; a secondary aim is to assess the effect of glyceryl trinitrate (GTN) on haemodynamic variables and functional outcomes. Initial consent, randomisation, and treatment are performed by paramedics prior to hospitalisation. Patients with ultra-acute stroke (≤4 hours of onset) are randomised to transdermal GTN (5 mg/24 hours) or gauze dressing daily for 7 days. The primary outcome is systolic blood pressure at 2 hours. Secondary outcomes include feasibility, haemodynamics, dependency, and other functional outcomes. A nested qualitative study is included. Trial Status. The trial has all relevant ethics and regulatory approvals and recruitment started on February 15, 2010. The trial stopped recruitment in December 2011 after 41 patients were recruited. Trial Registration. The trial registration number is ISRCTN66434824 and EudraCT number is 2007-004766-40.

  12. Lung Transplantation for Pulmonary Hypertension

    Science.gov (United States)

    ... the page. Answers about Lung Transplantation for PULMONARY HYPERTENSION Part One: Overview From the development of epoprostenol ... decades, expansion of medical treatment of pulmonary arterial hypertension (PAH) has improved survival and quality of life ...

  13. Hypertension og det metaboliske syndrom

    DEFF Research Database (Denmark)

    Olsen, Michael Hecht; Jeppesen, Jørgen; Larsen, Mogens Lytken

    2009-01-01

    The metabolic syndrome is a relatively prevalent condition characterized by co-existence of several metabolic and cardiovascular risk factors including hypertension. Patients with hypertension have an increased risk of developing the metabolic syndrome which, in turn, increases the cardiovascular...

  14. [Prolonged hypothermia in refractory intracranial hypertension. Report of one case].

    Science.gov (United States)

    Rovegno, Maximiliano; Valenzuela, José Luis; Mellado, Patricio; Andresen, Max

    2012-02-01

    The use of hypothermia after cardiac arrest caused by ventricular fibrillation is a standard clinical practice, however its use for neuroprotection has been extended to other conditions. We report a 23-year-old male with intracranial hypertension secondary to a parenchymal hematoma associated to acute hydrocephalus. An arterial malformation was found and embolized. Due to persistent intracranial hypertension, moderate hypothermia with a target temperature of 33°C was started. After 12 hours of hypothermia, intracranial pressure was controlled. After 13 days of hypothermia a definitive control of intracranial pressure was achieved. The patient was discharged 40 days after admission, remains with a mild hemiparesia and is reassuming his university studies.

  15. Knowing hypertension and diabetes

    DEFF Research Database (Denmark)

    Whyte, Susan Reynolds

    2016-01-01

    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...

  16. Hypertension and Atrial Fibrillation

    DEFF Research Database (Denmark)

    Dzeshka, Mikhail S.; Shahid, Farhan; Shantsila, Alena

    2017-01-01

    Atrial fibrillation (AF) is the most prevalent sustained arrhythmia found in clinical practice. AF rarely exists as a single entity but rather as part of a diverse clinical spectrum of cardiovascular diseases, related to structural and electrical remodeling within the left atrium, leading to AF o...... of complications as the first clinical manifestation of the disease. Antithrombotic prevention in AF combined with strict blood pressure control is of primary importance, since stroke risk and bleeding risk are both greater with underlying hypertension....... onset, perpetuation, and progression. Due to the high overall prevalence within the AF population arterial hypertension plays a significant role in the pathogenesis of AF and its complications. Fibroblast proliferation, apoptosis of cardiomyocytes, gap junction remodeling, accumulation of collagen both...... in atrial and ventricular myocardium all accompany ageing-related structural remodeling with impact on electrical activity. The presence of hypertension also stimulates oxidative stress, systemic inflammation, rennin-angiotensin-aldosterone and sympathetic activation, which further drives the remodeling...

  17. Snakes and Hypertension.

    Science.gov (United States)

    Miller, Edward D

    2017-02-01

    Inhibition of Angiotensin Conversion in Experimental Renovascular Hypertension. By Miller ED Jr, Samuels A, Haber E, and Barger AC. Science 1972; 177:1108-9. Reprinted with permission from AAAS.Constriction of the renal artery and controlled reduction of renal perfusion pressure is followed by a prompt increase in systemic renin activity and a concomitant rise in blood pressure in trained, unanesthetized dogs. The elevated blood pressure induced by the renal artery stenosis can be prevented by prior treatment with the nonapeptide Pyr-Trp-Pro-Arg-Pro-Gln-Ile-Pro-Pro, which blocks conversion of angiotensin I to angiotensin II. Further, the nonapeptide can restore systemic pressure to normal in the early phase of renovascular hypertension. These results offer strong evidence that the renin- angiotensin system is responsible for the initiation of hypertension in the unilaterally nephrectomized dog with renal artery constriction.

  18. [Obesity and hypertension].

    Science.gov (United States)

    Simonyi, Gábor; Kollár, Réka

    2013-11-01

    The frequency of hypertension and obesity is gradually growing in Hungary. At present 68.5% of men and 78% of women are obese. Hypertension and obesity are the most important risk factors of morbidity and mortality from cardiovascular disease. The relationship between increased sympathetic activity and hypertension is well known. Waist circumference and body fat mass correlate significantly with sympathetic activity, in which hyperlipidemia plays also a role. The increased activity of renin-angiotensin-aldosterone system via its vascular and renal effects also contributes to an increase of blood pressure. Increased sympathetic activity with decreasing vagal tone accompanying the imbalance of the autonomous nervous system is independent and significant risk factor of cardiovascular events including sudden cardiac death.

  19. Oxidative stress and hypertension.

    Science.gov (United States)

    Harrison, David G; Gongora, Maria Carolina

    2009-05-01

    This review has summarized some of the data supporting a role of ROS and oxidant stress in the genesis of hypertension. There is evidence that hypertensive stimuli, such as high salt and angiotensin II, promote the production of ROS in the brain, the kidney, and the vasculature and that each of these sites contributes either to hypertension or to the untoward sequelae of this disease. Although the NADPH oxidase in these various organs is a predominant source, other enzymes likely contribute to ROS production and signaling in these tissues. A major clinical challenge is that the routinely used antioxidants are ineffective in preventing or treating cardiovascular disease and hypertension. This is likely because these drugs are either ineffective or act in a non-targeted fashion, such that they remove not only injurious ROS Fig. 5. Proposed role of T cells in the genesis of hypertension and the role of the NADPH oxidase in multiple cells/organs in modulating this effect. In this scenario, angiotensin II stimulates an NADPH oxidase in the CVOs of the brain, increasing sympathetic outflow. Sympathetic nerve terminals in lymph nodes activate T cells, and angiotensin II also directly activates T cells. These stimuli also activate expression of homing signals in the vessel and likely the kidney, which attract T cells to these organs. T cells release cytokines that stimulate the vessel and kidney NADPH oxidases, promoting vasoconstriction and sodium retention. SFO, subfornical organ. 630 Harrison & Gongora but also those involved in normal cell signaling. A potentially important and relatively new direction is the concept that inflammatory cells such as T cells contribute to hypertension. Future studies are needed to understand the interaction of T cells with the CNS, the kidney, and the vasculature and how this might be interrupted to provide therapeutic benefit.

  20. Malignant hypertension: a preventable emergency.

    Science.gov (United States)

    van der Merwe, Walter; van der Merwe, Veronica

    2013-08-16

    The Waitemata Hypertension Clinic Database 2009-2012 (Auckland, New Zealand) was searched for patients meeting the definition of Malignant Hypertension. Eighteen of 565 patients met the criteria. All patients had essential hypertension which was either undiagnosed, untreated or undertreated. Most cases responded satisfactorily to standard drug therapy, but a number were left with significant chronic kidney disease. Malignant hypertension is a life-threatening disease which should be entirely preventable with regular blood pressure checks in primary care.

  1. Addison's disease presenting with idiopathic intracranial hypertension in 24-year-old woman: a case report

    Directory of Open Access Journals (Sweden)

    Moore Peter

    2010-02-01

    Full Text Available Abstract Introduction Idiopathic intracranial hypertension can rarely be associated with an underlying endocrine disorder such as Cushing's syndrome, hyperthyroidism, or with administration of thyroxine or growth hormone. Though cases of idiopathic intracranial hypertension associated with Addison's disease in children have been reported, there is only one documented case report of this association in adults. We describe a case of an acute adrenal insufficiency precipitated by idiopathic intracranial hypertension in a Caucasian female. Case presentation A 24-year-old Caucasian woman was acutely unwell with a background of several months of generalised fatigue and intermittent headaches. She had unremarkable neurological and systemic examination with a normal computerised tomography and magnetic resonance imaging of the brain. Normal cerebrospinal fluid but increased opening pressure at lumbar puncture suggested intracranial hypertension. A flat short synacthen test and raised level of adrenocorticotrophic hormone were consistent with primary adrenal failure. Conclusion Addison's disease can remain unrecognised until precipitated by acute stress. This case suggests that idiopathic intracranial hypertension can rarely be associated with Addison's disease and present as an acute illness. Idiopathic intracranial hypertension is possibly related to an increase in the levels of arginine vasopressin peptide in serum and cerebrospinal fluid secondary to a glucocorticoid deficient state.

  2. Tumores perianais provocados pelo herpes simples Perianal tumors provoked by herpes simplex

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2007-03-01

    Full Text Available O Herpes simplex (HSV é um DNA vírus que provoca afecções perianais, sendo considerada a causa mais comum das úlceras na região. Apesar da forma ulcerativa ser a mais conhecida, a literatura relata o aparecimento de lesões tumorais, nodulares ou hipertróficas relacionadas ao vírus. O exame proctológico mostra tumores dolorosos, achatados, com superfície recoberta por ulceração rasa e com bordas bem delimitadas, elevadas e lobuladas, localizados na margem anal e/ou no sulco interglúteo, algumas vezes imitando condilomas virais ou carcinoma. A anamnese revela instalação insidiosa com crescimento lento e progressivo, além da história de tratamentos anteriores para úlceras herpéticas. O diagnóstico diferencial com carcinoma impõe a realização de biópsia para confirmação histológica. Esse exame revela hiperplasia epitelial moderada e denso processo inflamatório com linfócitos e plasmócitos. Células gigantes e multinucleadas são observadas na epiderme. Os testes imunohistoquímicos sugerem o HSV. A opção terapêutica inicial deve ser o tratamento medicamentoso. Importante definir o diagnóstico etiológico para aliviar o desconforto e evitar operação radical desnecessária, e introduzir medicação anti-retroviral nos portadores do HIV para melhora da imunidade.Herpes simplex is a DNA virus which provokes perianal lesions, and it is the most frequent etiology of anal ulcer. Despite the ulcerative herpes being known worldwide, literature relates a tumoral, or nodular, or hypertrophic form related to this virus. Proctological examination showed nodules with a verrucous appearance and an ulcerated surface at the anal margin, sometimes mimicking viral condylomas or carcinomas. Anamnesis reveals insidious installation, slow growth and prior treatments for herpetic ulcers. The differential diagnoses with cancer allow us to perform biopsies for histological confirmation. This exam reveals mild epithelial hyperplasia and

  3. Carnitine Deficiency and Oxidative Stress Provoke Cardiotoxicity in an Ifosfamide-Induced Fanconi Syndrome Rat Model

    Directory of Open Access Journals (Sweden)

    Mohamed M. Sayed-Ahmed

    2010-01-01

    Full Text Available In addition to hemorrhagic cystitis, Fanconi Syndrome is a serious clinical side effect during ifosfamide (IFO therapy. Fanconi syndrome is a generalized dysfunction of the proximal tubule which is characterized by excessive urinary excretion of glucose, phosphate, bicarbonate, amino acids and other solutes excreted by this segment of the nephron including L-carnitine. Carnitine is essential cofactor for β-oxidation of long-chain fatty acids in the myocardium. IFO therapy is associated with increased urinary carnitine excretion with subsequent secondary deficiency of the molecule. Cardiac abnormalities in IFO-treated cancer patients were reported as isolated clinical cases. This study examined whether carnitine deficiency and oxidative stress, secondary to Fanconi Syndrome, provoke IFO-induced cardiomyopathy as well as exploring if carnitine supplementation using Propionyl-L-carnitine (PLC could offer protection against this toxicity. In the current study, an animal model of carnitine deficiency was developed in rats by D-carnitine-mildronate treatment Adult male Wistar albino rats were assigned to one of six treatment groups: the first three groups were injected intraperitoneally with normal saline, D-carnitine (DC, 250 mg/kg/day combined with mildronate (MD, 200 mg/kg/day and PLC (250 mg/kg/day, respectively, for 10 successive days. The 4th, 5th and 6th groups were injected with the same doses of normal saline, DC-MD and PLC, respectively for 5 successive days before and 5 days concomitant with IFO (50 mg/kg/day. IFO significantly increased serum creatinine, blood urea nitrogen (BUN, urinary carnitine excretion and clearance, creatine phosphokinase isoenzyme (CK-MB, lactate dehydrogenase (LDH, intramitochondrial acetyl-CoA/CoA-SH and thiobarbituric acid reactive substances (TBARS in cardiac tissues and significantly decreased adenosine triphosphate (ATP and total carnitine and reduced glutathione (GSH content in cardiac tissues. In carnitine

  4. Hypertension in postmenopausal women.

    Science.gov (United States)

    Lima, Roberta; Wofford, Marion; Reckelhoff, Jane F

    2012-06-01

    Blood pressure is typically lower in premenopausal women than in men. However, after menopause, the prevalence of hypertension in women is higher than it is in men. Hypertension is a major risk factor for cardiovascular disease in women and men, but cardiovascular disease is the leading cause of death in women. Furthermore, there is evidence that blood pressure may not be as well-controlled in women as in men, despite the fact that most women adhere better to their therapeutic regimens and medications than do men, and have their blood pressures measured more frequently than do men. This review describes possible mechanisms by which blood pressure may be increased in postmenopausal women.

  5. Idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    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 u...... 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. 强化护理干预在高血压病合并脑血管意外后急性昏迷患者中的应用%Application of strengthening nursing intervention on acute coma patients with hypertension combined cerebral vascular accident

    Institute of Scientific and Technical Information of China (English)

    毛云霞

    2015-01-01

    目的:探讨强化护理干预在高血压病合并脑血管意外后急性昏迷患者护理中的应用效果。方法于2013年4月—2014年4月选取102例高血压病合并脑血管意外后急性昏迷患者,根据入院时间分为对照组50例和观察组52例,其中对照组采用常规急救与护理方法,观察组在对照组基础上采用强化护理干预。比较两组治疗结局、护理相关性并发症发生率和护理满意度的差异。结果两组治愈率、残疾率、植物生存率和病死率比较差异无统计学意义(P >0.05)。观察组感染、应激性溃疡、脑水肿、脑疝和下肢深静脉血栓等护理相关并发症发生率均低于对照组,护理满意率高于对照组,差异均有统计学意义(P <0.05)。结论严密观察病情,有效的强化护理干预措施有助于降低高血压病合并脑血管意外患者的护理相关并发症发生率,提高护理质量。%Objective To investigate the influence of strengthening nursing intervention on acute coma patients with hypertension combined cerebral vascular accident. Methods From April 2013 to April 2014,a total of 102 acute coma patients with hypertension combined cerebral vascular accident,were divided into the control group(n = 50),which were given the conventional treatment and nursing methods,and the observation group(n = 52),which were given the strengthening nursing intervention. The effects and nursing related complications rate were compared. Results The rates of cure,morbidity,mortality and plants survival of two groups had no significant differences( P > 0. 05). Nursing complication of infection,pressure ulcer,brain edema,cerebral hernia and low extremity deep vein thrombosis of the observation group were significantly lower than those of the control group(P < 0. 05). The nursing satisfaction rate between two groups was significantly different(P < 0. 05). The nursing satisfaction of the observation group was

  7. Capsule Endoscopy for Portal Hypertensive Enteropathy

    Directory of Open Access Journals (Sweden)

    Seong Ran Jeon

    2016-01-01

    Full Text Available Portal hypertensive enteropathy (PHE is a mucosal abnormality of the small bowel that is observed in patients with portal hypertension (PH and can lead to gastrointestinal bleeding and anemia. The pathogenesis is still not completely understood. The introduction of new endoscopic methods, including capsule endoscopy (CE or balloon-assisted enteroscopy, has increased the detection of these abnormalities. CE can also serve as a road map for deciding subsequent interventions and evaluating the treatment effect. The prevalence of PHE is reportedly 40–70% in patients with PH. Endoscopic findings can be roughly divided into vascular and nonvascular lesions such as inflammatory-like lesions. Traditionally, PHE-associated factors include large esophageal varices, portal hypertensive gastropathy or colopathy, Child-Turcotte-Pugh class B or C, a history of variceal treatment, and acute gastrointestinal bleeding. More recently, on using scoring systems, a high computed tomography or transient elastography score was reportedly PHE-related factors. However, the prevalence of PHE and its related associated factors remain controversial. The management of PHE has not yet been standardized. It should be individualized according to each patient’s situation, the availability of therapy, and each institutional expertise.

  8. [Hypertension in the elderly: particularities and precautions].

    Science.gov (United States)

    Hanon, Olivier

    2009-04-01

    Hypertension is very common and inadequately controlled among the elderly. The HYVET study showed that antihypertensive therapy significantly reduces total mortality and cardiovascular events in people aged 80 years and older. The therapeutic goal for patients aged from 60 to 80 years is systolic blood pressure (SBP) less than 140 mmHg and a diastolic blood pressure (DBP) less than 90 mmHg, without orthostatic hypotension. For patients older than 80 years, the aim is keep SBP < 150 mmHg. This goal also depends on comorbidities, iatrogenic risk, and life expectancy. The choice of treatment must be adapted to the patient's clinical situation, taking into account any cardiovascular diseases, organ damage, and comorbidities. All of the principal antihypertensive drugs can be used in the elderly, with a preference for thiazide diuretics or calcium channel blockers for those with systolic hypertension. Generally, no more than three antihypertensive drugs should be prescribed for octogenarians (including a thiazide diuretic). Particular attention must be paid to the renal risk (estimated by glomerular filtration rate), especially for nephrotoxic and multiple drugs. Blood levels of potassium, sodium, and creatinine must be monitored in patients receiving diuretics or renin angiotensin system blockers, particularly during acute events (e.g., fever, infection, dehydration, and diarrhea). Cognitive function should be assessed in patients with hypertension older than 80 years, with the MMSE (Mini-Mental-State-Examination) to assess the risk of poor adherence, in view of the increased risk of dementia.

  9. Hypertensive Heart Disease

    DEFF Research Database (Denmark)

    Wachtell, Kristian

    2011-01-01

    Abstract Hypertensive heart disease is prevalent and during the last decade it has been determined that patients with left ventricular (LV) hypertrophy have increased cardiovascular morbidity and mortality. However, many have doubted the effectiveness of LV mass assessment because it is difficult...

  10. Hydrogen sulfide in hypertension

    NARCIS (Netherlands)

    van Goor, Harry; van den Born, Joost C.; Hillebrands, Jan-Luuk; Joles, Jaap A.

    2016-01-01

    PURPOSE OF REVIEW: Hypertension is an important determinant of cardiovascular disease, and strict blood pressure regulation is beneficially associated with the risk for cardiovascular events or all-cause mortality. However, intensive antihypertensive treatment is not always sufficient to reach normo

  11. What Is Pulmonary Hypertension?

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Pulmonary Hypertension - High Blood Pressure in the Heart-to-Lung System Updated:Dec ... illness. This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  12. Fermented milk for hypertension

    DEFF Research Database (Denmark)

    Usinger, Lotte; Reimer, Christina; Ibsen, Hans

    2012-01-01

    Fermented milk has been suggested to have a blood pressure lowering effect through increased content of proteins and peptides produced during the bacterial fermentation. Hypertension is one of the major risk factors for cardiovascular disease world wide and new blood pressure reducing lifestyle...... interventions, such as fermented milk, would be of great importance....

  13. Hypertension og hjertet

    DEFF Research Database (Denmark)

    Wachtell, Kristian; Andersen, Niels Holmark; Svendsen, Tage Lysbo

    2009-01-01

    of left ventricular mass is associated with substantial and significant reduction of cardiovascular morbidity and mortality. Hypertension is strongly associated with increased risk of subsequent heart failure. Meta analysis data suggests that reduction in blood pressure is also associated with very...

  14. Nitroglycerin kan give hypertension

    DEFF Research Database (Denmark)

    Mørup, Peter; Levinsen, Tine Holbæk; Hovind, Peter

    2011-01-01

    Hg. The conclusion was that her response was a paradoxical response to glycerylnitrate, orthostatism and a pathological response to massage of the carotid artery. This is the third reported case on paradoxical hypertension induced by glyceryl nitrates. It is speculated that dysfunction of the cerebral bloodflow...

  15. Types of Pulmonary Hypertension

    Science.gov (United States)

    ... on the cause of the condition. In all groups, the average pressure in the pulmonary arteries is higher than 25 ... mitral valve disease or long-term high blood pressure , can cause left ... of PH. Group 3 Pulmonary Hypertension Group 3 includes PH associated ...

  16. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

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

    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...

  17. [Hypertension and renal disease

    DEFF Research Database (Denmark)

    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...

  18. Studies in portal hypertension

    NARCIS (Netherlands)

    H.R. van Buuren (Henk)

    2002-01-01

    textabstractOur work focussed on one of the most frequent and serious complications of portal hypertension i.e. variceal bleeding. In particular, studies were initiated aimed at developing a more effective therapeutic strategy for the primary and secondary prevention of variceal bleeding. Aspects of

  19. [Hypertension In pregnancy: practical considerations].

    Science.gov (United States)

    Jaafar, Jaafar; Pechère-Bertschi, Antoinette; Ditisheim, Agnès

    2014-09-10

    Hypertension is the most frequent medical disorder of pregnancy. Whether in the form of a chronic hypertension or a pregnancy induced-hypertension, or preeclampsia, it is associated with major maternal and neonatal morbidity and mortality. Improvement of prenatal care allowed a reduction in the number of poor outcomes. However, our partial understanding of the origin of gestational hypertension and preeclampsia limits the establishment of robust prediction models and efficient preventive interventions. This review discusses actual considerations on the clinical approach to hypertension in pregnancy.

  20. Evaluation of hypertension in children.

    Science.gov (United States)

    Kapur, Gaurav; Baracco, Rossana

    2013-10-01

    Hypertension is an important public health problem, and increasingly children are being diagnosed with primary hypertension. As the list of secondary causes of hypertension is extensive, pediatric practitioners increasingly need to decide on investigations needed for evaluating children presenting with high blood pressure. The differentiation between primary and secondary hypertension is paramount to understanding this important health issue, since many forms of secondary hypertension require specific treatment. The review evaluates the current available guidelines and practice patterns for evaluating children with elevated blood pressure. The review also aims to provide a framework for cost-effective evaluation strategies for children with elevated blood pressure based on current recommendations and evidence.

  1. Hypertension, a health economics perspective.

    Science.gov (United States)

    Alcocer, Luis; Cueto, Liliana

    2008-06-01

    The economic aspects of hypertension are critical to modern medicine. The medical, economic, and human costs of untreated and inadequately controlled hypertension are enormous. Hypertension is distributed unequally and with iniquity in different countries and regions of the world. Treatment of hypertension requires an investment over many years to prolong disease-free quality years of life. The high prevalence and high cost of the disease impacts on the microeconomics and macroeconomics of countries and regions. The criteria used for inclusion in clinical guidelines for hypertension impact on the cost and cost/utility of diagnosis or treatment.

  2. Acute Ischemic Stroke and Acute on Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Raja Ahsan Aftab

    2016-06-01

    Full Text Available Ischemic stroke is due to either local thrombus formation or emboli that occlude a cerebral artery, together with chronic kidney disease represent major mortality and morbidity. Here wer present a case of 53 years old Malay man, admitted to a hospital in Malaysia complaining of sudden onset of weakness on right sided upper and lower limb associated with slurred speech. Patient was also suffering from uncontrolled hypertension, hyperlipidemia, chronic kidney disease stage 4, and diabetes mellitus(un controlled. He was diagnosed with acute ischemic stroke with cranial nerve 7 palsy (with right hemiparesis, acute on chronic kidney disease precipitated by dehydration and ACE inhibitor, and hyperkalemia. Patients with ischemic disease and chronic kidney disaese require constant monitering and carefull selected pharmacotherapy. Patient was placed under observation and was prescribed multiple pharamacotherpay to stabalise detoriating condition. Keywords: ischemic disease; chronic kidney disease; uncontrolled hypertension. | PubMed

  3. Masked hypertension: a systematic review.

    Science.gov (United States)

    Bobrie, Guillaume; Clerson, Pierre; Ménard, Joël; Postel-Vinay, Nicolas; Chatellier, Gilles; Plouin, Pierre-François

    2008-09-01

    The purpose of this research was to review the literature on masked hypertension. Studies, reviews and editorials on masked hypertension were identified by PubMed, Pascal BioMed and Cochrane literature systematic searches. Then, we carried out a meta-analysis of the six cohort studies reporting quantitative data for masked hypertension prognosis. There is still no clear consensus definition of masked hypertension and the reproducibility of the phenomenon is unknown. Nevertheless, the prevalence of masked hypertension seems to lie between 8 and 20%, and can be up to 50% in treated hypertensive patients. Subjects with masked hypertension have a higher risk of cardiovascular accidents [hazard ratios: 1.92 (1.51-2.44)] than normotensive subjects. This is due to a possible failure to recognize and appropriately manage this particular form of hypertension, the frequent association with other risk factors and coexisting target organ damage. The remaining unresolved questions are as follows: is masked hypertension a clinical entity that requires identification and characterization or a statistical phenomenon linked to the variability of blood pressure measurements?; because screening of the entire population is not feasible, how to identify individuals with masked hypertension?; and, in the absence of randomized trial, how to treat masked hypertension?

  4. Pharmacologic Management of Pediatric Hypertension.

    Science.gov (United States)

    Misurac, Jason; Nichols, Kristen R; Wilson, Amy C

    2016-02-01

    Hypertension in children is common, and the prevalence of primary hypertension is increasing with the obesity epidemic and changing dietary choices. Careful measurement of blood pressure is important to correctly diagnose hypertension, as many factors can lead to inaccurate blood pressure measurement. Hypertension is diagnosed based on comparison of age-, sex-, and height-based norms with the average systolic and diastolic blood pressures on three separate occasions. In the absence of hypertensive target organ damage (TOD), stage I hypertension is managed first by diet and exercise, with the addition of drug therapy if this fails. First-line treatment of stage I hypertension with TOD and stage II hypertension includes both lifestyle changes and medications. First-line agents include angiotensin-converting enzyme (ACE) inhibitors, thiazide diuretics, and calcium-channel blockers. Hypertensive emergency with end-organ effects requires immediate modest blood pressure reduction to alleviate symptoms. This is usually accomplished with IV medications. Long-term reduction in blood pressure to normal levels is accomplished gradually. Specific medication choice for outpatient hypertension management is determined by the underlying cause of hypertension and the comparative adverse effect profiles, along with practical considerations such as cost and frequency of administration. Antihypertensive medication is initiated at a starting dose and can be gradually increased to effect. If ineffective at the recommended maximum dose, an additional medication with a complementary mechanism of action can be added.

  5. Comparative proteomics of inhaled silver nanoparticles in healthy and allergen provoked mice

    Directory of Open Access Journals (Sweden)

    Su CL

    2013-08-01

    Full Text Available Chien-Ling Su,1,2 Tzu-Tao Chen,1,3 Chih-Cheng Chang,1,3 Kai-Jen Chuang,4,5 Cheng-Kuan Wu,6 Wen-Te Liu,1,2 Kin Fai Ho,7 Kang-Yun Lee,1,8 Shu-Chuan Ho,2,8 Hsiu-Er Tseng,9 Hsiao-Chi Chuang,1,2 Tsun-Jen Cheng6,10 On behalf of the Taiwan CardioPulmonary Research Group (T-CPR 1Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, 2School of Respiratory Therapy, College of Medicine, 3Graduate Institute of Clinical Medicine, College of Medicine, 4Department of Public Health, School of Medicine, College of Medicine, 5School of Public Health, College of Public Health and Nutrition, Taipei Medical University, 6Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan; 7School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China; 8Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 9Division of Consultation and Promotion, Taiwan Drug Relief Foundation, 10Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan Background: Silver nanoparticles (AgNPs have been associated with the exacerbation of asthma; however, the immunological basis for the adjuvant effects of AgNPs is not well understood. Objective: The aim of the study reported here was to investigate the allergic effects of AgNP inhalation using proteomic approaches. Methods: Allergen provoked mice were exposed to 33 nm AgNPs at 3.3 mg/m3. Following this, bronchoalveolar lavage fluid (BALF and plasma were collected to determine protein profiles. Results: In total, 106 and 79 AgNP-unique proteins were identified in the BALF of control and allergic mice, respectively. Additionally, 40 and 26 AgNP-unique proteins were found in the plasma of control and allergic mice, respectively. The BALF and plasma protein profiles suggested that metabolic, cellular, and

  6. The use of hemospray in portal hypertensive bleeding; a case series.

    Science.gov (United States)

    Smith, L A; Morris, A J; Stanley, A J

    2014-02-01

    Hemospray is a haemostatic agent licensed for endoscopic haemostasis of non-variceal upper gastrointestinal bleeding (NVUGIB) in Europe and Canada. Hemospray has been shown to be safe and effective in achieving haemostasis in bleeding peptic ulcers in a prospective clinical study and several further case series have described the use of hemospray in other non-variceal causes of gastrointestinal bleeding. Portal hypertensive gastropathy and colopathy are common in patients with portal hypertension. As hemospray is an easy to apply, non-contact method, which can cover large areas of mucosa, it may be of benefit in acute non-variceal portal hypertensive bleeding. We present data from the first four consecutive patients presenting to our institution with acute haemorrhage secondary to non-variceal diffuse portal hypertensive bleeding treated with hemospray.

  7. Exaggerated natriuresis and lithium clearance in spontaneously hypertensive rats

    DEFF Research Database (Denmark)

    Holstein-Rathlou, N H; Kanters, J K; Leyssac, P P

    1988-01-01

    Since hypertension is associated with changes in the handling of various cations (including sodium and lithium) across the cell membrane, the present study investigated the validity of the lithium clearance method in hypertension by comparing two measures of proximal reabsorption. Thus, fractional...... lithium excretion and transit time (TT)-occlusion time (OT; e-TT/T) were determined successively in the same spontaneously hypertensive rat (SHR, Okamoto strain). The rats were examined both before and after an acute saline load. The results show that the lithium clearance method can be used...... for the determination of proximal reabsorption in SHR. Utilizing the lithium clearance method, the changes in renal sodium handling underlying the exaggerated natriuresis were investigated in unanaesthetized catheterized rats. It was found that the exaggerated natriuresis was associated with an increased output from...

  8. Diagnosis and treatment of hypertensive crises in the elderly patients

    Institute of Scientific and Technical Information of China (English)

    Joseph Varon; Neil E. Strickman

    2007-01-01

    Hypertension is a common clinical problem in the elderly worldwide and physicians of all types are likely to encounter patients with hypertensive urgencies and emergencies in these patients. Although various terms have been applied to these conditions,they are all characterized by acute elevations in blood pressure and evidence of end-organ injury. Prompt, but carefully considered therapy is necessary to limit morbidity and mortality. A wide range of pharmacologic alternatives are available to the practitioner to control blood pressure and treat complications in these patients. The management of the elderly patient with hypertensive crises needs to include close monitoring and a gentle decline in blood pressure to avoid catastrophic complications, exacerbation of ischemic myopathy, and vascular insufficiency.

  9. Acute pancreatitis

    Science.gov (United States)

    ... its blood vessels. This problem is called acute pancreatitis. Acute pancreatitis affects men more often than women. Certain ... pancreatitis; Pancreas - inflammation Images Digestive system Endocrine glands Pancreatitis, acute - CT scan Pancreatitis - series References Forsmark CE. Pancreatitis. ...

  10. Cystitis - acute

    Science.gov (United States)

    Uncomplicated urinary tract infection; UTI - acute cystitis; Acute bladder infection; Acute bacterial cystitis ... cause. Menopause also increases the risk for a urinary tract infection. The following also increase your chances of having ...

  11. Acute variceal bleeding: general management

    Institute of Scientific and Technical Information of China (English)

    David Patch; Lucy Dagher

    2001-01-01

    @@ TREATMENT STRATEGIES FOR ACUTE VARICEAL BLEEDING Backgound Acute variceal bleeding has a significant mortality which ranges form 5% to 50% in patients with cirrhosis[1].Overall survival is probably improving,because of new therapeutic approaches,and improved medical care.However,mortality is still closely related to failure to control hacmorrhage or carly rebleeding,which is a distinct characteristic of portal hypertensive bleeding and occures in as many as 50% of patients in the first days to 6 weeks after admission et al[2].

  12. Exercise training normalizes skeletal muscle vascular endothelial growth factor levels in patients with essential hypertension

    DEFF Research Database (Denmark)

    Hansen, Ane Håkansson; Nielsen, Jens Jung; Saltin, Bengt;

    2010-01-01

    METHODS: Vascular endothelial growth factor (VEGF) protein and capillarization were determined in muscle vastus lateralis biopsy samples in individuals with essential hypertension (n = 10) and normotensive controls (n = 10). The hypertensive individuals performed exercise training for 16 weeks....... Muscle samples as well as muscle microdialysis fluid samples were obtained at rest, during and after an acute exercise bout, performed prior to and after the training period, for the determination of muscle VEGF levels, VEGF release, endothelial cell proliferative effect and capillarization. RESULTS...

  13. Pulmonary hypertensive crisis following ethanol sclerotherapy for a complex vascular malformation.

    Science.gov (United States)

    Cordero-Schmidt, G; Wallenstein, M B; Ozen, M; Shah, N A; Jackson, E; Hovsepian, D M; Palma, J P

    2014-09-01

    Anhydrous ethanol is a commonly used sclerotic agent for treating vascular malformations. We describe the case of a full-term 15-day-old female with a complex venolymphatic malformation involving the face and orbit. During treatment of the lesion with ethanol sclerotherapy, she suffered acute pulmonary hypertensive crisis. We discuss the pathophysiology of pulmonary hypertension related to ethanol sclerotherapy, and propose that hemolysis plays a significant role. Recommendations for evaluation, monitoring and management of this complication are also discussed.

  14. Enrichment of Inorganic Martian Dust Simulant with Carbon Component can Provoke Neurotoxicity

    Science.gov (United States)

    Pozdnyakova, Natalia; Pastukhov, Artem; Dudarenko, Marina; Borysov, Arsenii; Krisanova, Natalia; Nazarova, Anastasia; Borisova, Tatiana

    2017-02-01

    Carbon is the most abundant dust-forming element in the interstellar medium. Tremendous amount of meteorites containing plentiful carbon and carbon-enriched dust particles have reached the Earth daily. National Institute of Health panel accumulates evidences that nano-sized air pollution components may have a significant impact on the central nervous system (CNS) in health and disease. During inhalation, nano-/microsized particles are efficiently deposited in nasal, tracheobronchial, and alveolar regions and can be transported to the CNS. Based on above facts, here we present the study, the aims of which were: 1) to upgrade inorganic Martian dust simulant derived from volcanic ash (JSC-1a/JSC, ORBITEC Orbital Technologies Corporation, Madison, Wisconsin) by the addition of carbon components, that is, nanodiamonds and carbon dots; 2) to analyse acute effects of upgraded simulant on key characteristics of synaptic neurotransmission; and 3) to compare above effects with those of inorganic dust and carbon components per se. Acute administration of carbon-containing Martian dust analogues resulted in a significant decrease in transporter-mediated uptake of L-[14C]glutamate (the major excitatory neurotransmitter) and [3H]GABA (the main inhibitory neurotransmitter) by isolated rat brain nerve terminals. The extracellular level of both neurotransmitters increased in the presence of carbon-containing Martian dust analogues. These effects were associated with action of carbon components of upgraded Martian dust simulant, but not with its inorganic constituent. This fact indicates that carbon component of native Martian dust can have deleterious effects on extracellular glutamate and GABA homeostasis in the CNS, and so glutamate- and GABA-ergic neurotransmission disballansing exitation and inhibition.

  15. Enrichment of Inorganic Martian Dust Simulant with Carbon Component can Provoke Neurotoxicity

    Science.gov (United States)

    Pozdnyakova, Natalia; Pastukhov, Artem; Dudarenko, Marina; Borysov, Arsenii; Krisanova, Natalia; Nazarova, Anastasia; Borisova, Tatiana

    2017-01-01

    Carbon is the most abundant dust-forming element in the interstellar medium. Tremendous amount of meteorites containing plentiful carbon and carbon-enriched dust particles have reached the Earth daily. National Institute of Health panel accumulates evidences that nano-sized air pollution components may have a significant impact on the central nervous system (CNS) in health and disease. During inhalation, nano-/microsized particles are efficiently deposited in nasal, tracheobronchial, and alveolar regions and can be transported to the CNS. Based on above facts, here we present the study, the aims of which were: 1) to upgrade inorganic Martian dust simulant derived from volcanic ash (JSC-1a/JSC, ORBITEC Orbital Technologies Corporation, Madison, Wisconsin) by the addition of carbon components, that is, nanodiamonds and carbon dots; 2) to analyse acute effects of upgraded simulant on key characteristics of synaptic neurotransmission; and 3) to compare above effects with those of inorganic dust and carbon components per se. Acute administration of carbon-containing Martian dust analogues resulted in a significant decrease in transporter-mediated uptake of L-[14C]glutamate (the major excitatory neurotransmitter) and [3H]GABA (the main inhibitory neurotransmitter) by isolated rat brain nerve terminals. The extracellular level of both neurotransmitters increased in the presence of carbon-containing Martian dust analogues. These effects were associated with action of carbon components of upgraded Martian dust simulant, but not with its inorganic constituent. This fact indicates that carbon component of native Martian dust can have deleterious effects on extracellular glutamate and GABA homeostasis in the CNS, and so glutamate- and GABA-ergic neurotransmission disballansing exitation and inhibition.

  16. The treatment of acute vertigo.

    Science.gov (United States)

    Cesarani, A; Alpini, D; Monti, B; Raponi, G

    2004-03-01

    Vertigo and dizziness are very common symptoms in the general population. The aim of this paper is to describe the physical and pharmacological treatment of symptoms characterized by sudden onset of rotatory vertigo. Acute vertigo can be subdivided into two main groups: (1) spontaneous vertigo and (2) provoked vertigo, usually by postural changes, generally called paroxysmal positional vertigo (PPV). Sudden onset of acute vertigo is usually due to acute spontaneous unilateral vestibular failure. It can be also fluctuant as, e.g., in recurrent attacks of Ménière's disease. Pharmacotherapy of acute spontaneous vertigo includes Levo-sulpiride i.v., 50 mg in 250 physiologic solution, once or twice a day, methoclopramide i.m., 10 mg once or twice a day, or triethilperazine rectally, once or twice a day, to reduce neurovegetative symptoms; diazepam i.m., 10 mg once or twice a day, to decrease internuclear inhibition, sulfate magnesium i.v., two ampoules in 500 cc physiological solution, twice a day, or piracetam i.v., one ampoule in 500 cc physiological solution, twice a day, to decrease vestibular damage. At the onset of the acute symptoms, patients must lie on their healthy side with the head and trunk raised 20 degrees. The room must be quiet but not darkened. If the patient is able to swallow without vomiting, it is important to reduce nystagmus and stabilize the visual field with gabapentine, per os, 300 mg twice or three times a day. The first step of the physical therapy of acute vertigo is vestibular electrical stimulation, that is to say, a superficial paravertebral electrical stimulation of neck muscles, aimed to reduce antigravitary failure and to increase proprioceptive cervical sensory substitution. PPV is a common complaint and represents one of the most common entities in peripheral vestibular pathology. While the clinical picture is well known and widely described, the etiopathogenesis of PPV is still a matter of debate. Despite the different

  17. 高血压合并急性冠脉综合征患者AT1-AA水平变化及AT1-AA对大鼠冠状动脉血管的影响%Levels of autoantibodies against AT1-receptor in hypertensive patients with acute coronary syndromes and its role in coronary artery vasoconstriction

    Institute of Scientific and Technical Information of China (English)

    王敬萍; 张月安; 王慧仙; 曾晓霞; 杨晋静; 董晋; 王建玲; 杨燕; 王日军

    2015-01-01

    目的 观察高血压合并急性冠脉综合征(ACS)患者血清抗血管紧张素Ⅱ1型受体自身抗体(AT1-AA)水平及AT1-AA对离体高脂大鼠冠状动脉前降支血管环静息张力影响.方法 将2007年6月至2008年8月山西省心血管病医院心内科患者分为:高血压合并ACS组(n=120)、单纯高血压组(n =253)及单纯ACS组(n=115例),同期门诊健康体检者作为健康对照组(n=188).合成AT1受体胞外第二环肽段作为抗原(AT1-Ag),SA-ELISA检测血清AT1-AA水平;微血管环张力技术测定离体大鼠冠状动脉前降支血管环静息张力.结果 单纯高血压和单纯ACS组血清AT1-AA阳性率均明显高于对照组[(35.2%比7.2%)和(30.4%比7.2%)](均P<0.01);高血压合并ACS组AT1-AA阳性率明显高于单纯高血压组(43.3%比35.2%,P<0.05)和单纯ACS组(43.3%比30.4%,P<0.05);AT1-AA可增加离体高脂大鼠冠脉前降支血管环静息张力,其增加血管环静息张力幅度相当于血管紧张素Ⅱ的46.4%,并呈现浓度依赖性;且该收缩血管作用可被氯沙坦及AT1-Ag阻断.结论 高血压合并ACS患者血清AT1-AA水平显著增高;AT1-AA可增加离体大鼠冠脉前降支血管环静息张力引起的血管收缩效应.%Objective To explore the levels of autoantibodies against AT1-receptor (AT1-AA) in hypertensive patients with acute coronary syndrome (ACS) and observe the in vitro effects of AT1-AA on resting tension of isolated anterior descending artery of vascular ring in male Wistar rats.Methods All patients were recruited from June 2007 to August 2008.There were hypertensive patients with ACS (n =120),those with simple hypertension (n =253) and those with simple ACS (n =115).And the outpatients for health examination during the same period were selected as healthy control group (n =188).The second extracellular loop amino acid sequences of peptides of ATI receptor was synthesized and used as antigen (AT1-Ag) and sialic acid

  18. Outcomes after hypertensive crisis: Comparison between diabetics and nondiabetics

    Directory of Open Access Journals (Sweden)

    Rashed Al Bannay

    2015-06-01

    Full Text Available To study the long-term cardiovascular and non-cardiovascular outcomes among patients admitted with hypertensive crisis. A total of 297 (145 diabetics, 152 nondiabetics patients with hypertensive crisis were followed up for a median of 30 months. Fatal and nonfatal events were tracked. The traced events defined as hypertensive urgency, acute coronary syndrome, left ventricular failure, atrial fibrillation, cerebrovascular or renal failure were consecutively analyzed during the follow-up.Overall, 140 (47% patients had nonfatal clinical events (115 diabetics and 25 nondiabetics; 37 (12% patients had fatal clinical events (26 diabetics and 11 nondiabetics. The rate of fatal and nonfatal events was significantly higher in diabetics. The mean time of survival was 25.7 months, with the shortest periods for stroke and left ventricular failure. For nondiabetic participants, the mean time of survival was 31 months. Cox regression analysis identified diabetes mellitus, acute left ventricular failure, stroke and renal impairment as predictors of mortality. In conclusion, hypertensive crisis is associated with a markedly increased risk for subsequent cardiovascular morbidity and mortality, especially among diabetics who present with heart failure.

  19. Hypertensive crisis-induced electrocardiographic changes: a case series

    Directory of Open Access Journals (Sweden)

    Farha Khalid Abou

    2009-08-01

    Full Text Available Abstract Introduction Myocardial injury is one of the most notorious complications of a hypertensive crisis. Key electrocardiograph signs used to detect cardiac injury such as ST segment changes and cardiac arrhythmias usually indicate acute ongoing end-organ damage. Lack of early signs to predict end-organ damage might lead to a delay in the initiation of therapy and selection of the incorrect therapeutic strategy. Case presentation We describe five cases of tall, hyper acute symmetrical T-waves alone or accompanied by other electrocardiograph abnormalities in five healthy participants: three women aged 52, 60 and 62-years and two men aged 49 and 66-years, during a tyramine-monoamine oxidase-inhibitor interaction, phase I clinical trial. T-wave changes appeared early during the course of the hypertensive crisis and were attributed to subendocardial ischemia. The changes were transient and reverted to baseline in parallel with a fall in blood pressure. Conclusion Recognition of tall symmetrical T-waves in early phases of hypertensive crisis heralds commencement of myocardial damage. This calls for prompt medical intervention to avoid an impending irreversible myocardial injury. It is our belief that these findings will add new insight into the management of hypertensive crisis and will open avenues of further investigation.

  20. Neurological disorders in hypertensive patients

    Directory of Open Access Journals (Sweden)

    N. V. Vakhnina

    2015-01-01

    Full Text Available Hypertension is one of the most common vascular diseases. The brain as target organs in hypertension is damaged more often and earlier. Neurological complications due to hypertension are frequently hyperdiagnosed in Russian neurological practice. Thus, headache, dizziness, impaired recall of recent events, nocturnal sleep disorders, and many other complaints in a hypertensive patient are usually regarded as a manifestation of dyscirculatory encephalopathy. At the same time headaches (tension headache and migraine in hypertensive patients are predominantly primary; headache associated with dramatic marked elevations in blood pressure is encountered in only a small number of patients. The role of cerebrovascular diseases in the development of dizziness in hypertensive patients is also overestimated. The vast majority of cases, patients with this complaint are in fact identified to have benign paroxysmal postural vertigo, Mеniеre’s disease, vestibular neuronitis, or vestibular migraine. Psychogenic disorders or multisensory insufficiency are generally responsible for non-systemic vertigo in hypertensive patients. Chronic cerebral circulatory insufficiency may cause non-systemic vertigo as a subjective equivalent of postural instability.Cognitive impairments (CIs are the most common and earliest manifestation of cerebrovascular lesion in hypertension. In most cases, CIs in hypertension were vascular and associated with cerebrovascular lesion due to lacunar infarcts and leukoaraiosis. However, mixed CIs frequently occur when hypertensive patients are also found to have signs of a degenerative disease, most commonly in Alzheimer’s disease.

  1. Hypertension: issues in control and resistance.

    Science.gov (United States)

    Wofford, Marion R; Minor, Deborah S

    2009-10-01

    Hypertension remains uncontrolled in more than 50% of treated patients. Barriers to hypertension control include those that are patient-related, physician-related, and related to the health system. Identification of uncontrolled hypertension, pseudoresistant hyper-tension, and resistant hypertension require thoughtful attention to accurate blood pressure measurement, lifestyle factors, evaluation for secondary causes of hypertension, and proper treatment. Recent guidelines emphasize the importance of aggressive treatment and referral to hypertension specialists for patients with resistant hypertension, defined as blood pressure that remains above goal despite the use of three appropriate anti-hypertensive agents.

  2. [Hyperuricemia, diabetes and hypertension].

    Science.gov (United States)

    Viazzi, Francesca; Bonino, Barbara; Ratto, Elena; Desideri, Giovambattista; Pontremoli, Roberto

    2015-01-01

    Hyperuricemia is frequently found in association with several condition predisposing to cardiovascular events such as arterial hypertension and diabetes mellitus. This has led researchers to investigate possible pathogenetic mechanisms underlying this association. Several experimental studies and some indirect clinical evidence support a causal link between mild hyperuricemia and the developement of hypertension as well as new onset diabetes. At the tissue level, chronic exposure to increased uric acid has been shown to promote vascular changes leading to renal ischemia as well as stimulation of the renin angiotensin system. Furthermore, uric acid has been shown to promote the development of insulin resistance, hypertrglyceridemia and haepatic steatosis through pro-oxidative mechanisms. These experimental pathophysiological changes may be partly preventable by hypouricemic treatments. Whether clinical implications of these findings are confirmed by solid clinical intervention trials, mild hyperuricemia may soon change its status from risk predictor to treatment target for patients at high cardiovascular and renal risk.

  3. Emergency Neurological Life Support: Intracranial Hypertension and Herniation

    OpenAIRE

    Stevens, Robert D.; Shoykhet, Michael; Cadena, Rhonda

    2015-01-01

    Sustained intracranial hypertension and acute brain herniation are “brain codes,” signifying catastrophic neurological events that require immediate recognition and treatment to prevent irreversible injury and death. As in cardiac arrest, a brain code mandates the organized implementation of a stepwise management algorithm. The goal of this emergency neurological life support protocol is to implement an evidence-based, standardized approach to the evaluation and management of patients with in...

  4. 17-α-Hydroxylase deficiency: An unusual case with primary amenorrhea and hypertension

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Kota

    2011-01-01

    Full Text Available A 14-year-old girl presented with acute onset quadriparesis and newly detected hypertension. Parental consanguinity, delayed puberty with normal stature form the additional information. Hypokalemia with metabolic alkalosis, low cortisol, high ACTH and FSH pointed to the possibility of CAH with 17α hydroxylase deficiency. 46XX karyotype and high progesterone supported this. Normalization of hypokalemia and hypertension with glucocorticoid treatment confirmed the diagnosis. In summary, the possibility of 17 OHD should be suspected in patients with hypokalemic myopathy, Hypertension and hypogonadism so that appropriate therapy can be implemented.

  5. Treatment Resistant Hypertension.

    Science.gov (United States)

    Egan, Brent M

    2015-11-05

    Treatment resistant hypertension (TRH) is defined by office blood pressure (BP) uncontrolled on ≥ 3 or controlled on ≥ 4 antihypertensive medications, preferably at optimal doses and including a diuretic. Apparent (a)TRH is used when optimal therapy, adherence, and measurement artifacts are unknown. Among treated hypertensives, ~30% of uncontrolled and 10% of controlled individuals have aTRH, with a higher prevalence in Blacks than other race-ethnicity groups. In ≥ 50% of aTRH patients, BP measurement artifacts ('office' TRH), suboptimal regimens, or suboptimal adherence are present, ie, pseudo-resistance. While patients with 'office' TRH have fewer cardiovascular events than those with 'true' TRH, no evidence confirms that patients with suboptimal regimens or adherence are spared. Averaging several office BPs obtained with an automated monitor can reduce 'office' TRH. Home or ambulatory BP monitoring can identify office resistance. Prescribing ≥ 3 different antihypertensive medication classes, eg, thiazide-type diuretic, renin-angiotensin blocker and calcium antagonist at ≥ 50% of maximum recommended doses reasonably defines optimal therapy. Intensifying diuretic therapy, eg, adding an aldosterone antagonist, is effective for many TRH patients who are volume expanded. Clinical information, hemodynamic and renin-guided therapeutics can inform other treatment options. Attention to adverse effects, medication costs, and pill burden can improve adherence and control. Patients with aTRH and suspected secondary hypertension should be evaluated. Interfering substances or medications should be discontinued. These approaches will identify or correct the problem in ~80% of aTRH patients. Referral to a hypertension specialist and newer therapeutic approaches are options for TRH patients who cannot take or do not respond to optimal therapy.

  6. Effects of Phenibut and Citrocard on Non-Competitive and Competitive Behavior during Provoked Aggression in Animals.

    Science.gov (United States)

    Bagmetova, V V; Krivitskaya, A N; Tyurenkov, I N

    2015-05-01

    Anti-aggressive effects of phenibut (25 mg/kg) and its structural analogue citrocard (50 mg/kg) were revealed in rats under condition of provoked intraspecific aggression. These substances significantly decreased manifestations of aggression in animals: they increased the latency of attacks and reduced their number. Anti-aggressive effects of citrocard were more pronounced than effects of phenibut under conditions of non-competitive aggression induced by fear of inescapable painful exposure or under conditions of competitive aggression reflecting the ability of animals to reveal adaptive social communicative skills in aversive situation.

  7. Radioimmunologic analysis of the state of the renin-angiotensin-aldosterone-system in arterial hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Slavnov, V.N.; Yakovlev, A.A.; Gandzha, T.I.; Yugrinov, O.G. (AN Ukrainskoj SSR, Kiev)

    1985-01-01

    In 110 patients suffering from various forms of arterial hypertension (hypertension, aldosteronoma, phaeochromocytoma, corticosteroma) the parameters of the system renin-angiotensin-aldosterone were measured. Basal values of aldosterone, renin activity in blood as well as their concentration in blood taken from the vena cava inferior, renal and adrenal veins during selective renography were determined. The 24-hours rhythm of the hormones in the blood, the reaction of the glomerular zone of the adrenal cortex and the juxtaglomerular renal system under acute Lasix (furosemide) stress was evaluated. It was found, that the system renin-angiotensin-aldosterone is disturbed in all patients with arterial hypertension. This is indicated by changes of aldosterone concentration, renin activity in peripheral blood and in the blood from the vena cava inferior, renal and adrenal veins, the 24-hours rhythm of their concentrations in serum and the reaction to acute Lasix stress. The radioimmunoassays of quantitative parameters of the renin-angiotensin-aldosterone system are decisive for the differential diagnosis of hypertension and adrenal gland tumors connected with a hypertension syndrome. They facilitate a rational choice of the hypertension therapy and the daily distribution of the medications for patients with hypertension. The radioimmunoassays can be used for checking the efficiency of medications and surgery.

  8. Obesity and hypertension

    Science.gov (United States)

    Jiang, Shu-Zhong; Lu, Wen; Zong, Xue-Feng; Ruan, Hong-Yun; Liu, Yi

    2016-01-01

    The imbalance between energy intake and expenditure is the main cause of excessive overweight and obesity. Technically, obesity is defined as the abnormal accumulation of ≥20% of body fat, over the individual's ideal body weight. The latter constitutes the maximal healthful value for an individual that is calculated based chiefly on the height, age, build and degree of muscular development. However, obesity is diagnosed by measuring the weight in relation to the height of an individual, thereby determining or calculating the body mass index. The National Institutes of Health have defined 30 kg/m2 as the limit over which an individual is qualified as obese. Accordingly, the prevalence of obesity in on the increase in children and adults worldwide, despite World Health Organization warnings. The growth of obesity and the scale of associated health issues induce serious consequences for individuals and governmental health systems. Excessive overweight remains among the most neglected public health issues worldwide, while obesity is associated with increasing risks of disability, illness and death. Cardiovascular diseases, the leading cause of mortality worldwide, particularly hypertension and diabetes, are the main illnesses associated with obesity. Nevertheless, the mechanisms underlying obesity-associated hypertension or other associated metabolic diseases remains to be adequately investigated. In the present review, we addressed the association between obesity and cardiovascular disease, particularly the biological mechanisms linking obesity and hypertension. PMID:27703502

  9. Portal hypertensive enteropathy

    Institute of Scientific and Technical Information of China (English)

    Parit Mekaroonkamol; Robert Cohen; Saurabh Chawla

    2015-01-01

    Portal hypertensive enteropathy (PHE) is a conditionthat describes the pathologic changes and mucosalabnormalities observed in the small intestine of patientswith portal hypertension. This entity is being increasinglyrecognized and better understood over the past decadedue to increased accessibility of the small intestine madepossible by the introduction of video capsule endoscopyand deep enteroscopy. Though challenged by its diverseendoscopic appearance, multiple scoring systems havebeen proposed to classify the endoscopic presentationand grade its severity. Endoscopic findings can be broadlycategorized into vascular and non-vascular lesions withmany subtypes of both categories. Clinical manifestationsof PHE can range from asymptomatic incidental findingsto fatal gastrointestinal hemorrhage. Classic endoscopicfindings in the setting of portal hypertension may leadto a prompt diagnosis. Occasionally histopathologyand cross sectional imaging like computed tomographyor magnetic resonance imaging may be helpful inestablishing a diagnosis. Management of overt bleedingrequires multidisciplinary approach involving hepatologists,endoscopists, surgeons, and interventionalradiologists. Adequate resuscitation, reduction of portalpressure, and endoscopic therapeutic intervention remainthe main principles of the initial treatment. This articlereviews the existing evidence on PHE with emphasison its classification, diagnosis, clinical manifestations,endoscopic appearance, pathological findings, and clinicalmanagement. A new schematic management of ectopicvariceal bleed is also proposed.

  10. 索拉非尼致高血压并发急性心肌梗死死亡%Hypertension and death of acute myocardial infarction caused by oral sorafenib

    Institute of Scientific and Technical Information of China (English)

    司海燕; 王伟兰

    2011-01-01

    One 72-year-old woman with the history of hypertension had been treated for controlling blood pressure in the normal range. Because of suffering from renal carcinoma lung metastases, she was administered sorafenib tosylate tablets 0.4 g, twice a day. Two days later, the patient developed headaches and her blood pressure was 170/120 mm Hg. After the treatment with benazepril and indapamide, her blood pressure returned to normal. Then she continued to use sorafenib. Four days later, she unexpectedly developed inferior wall myocardial infarction, arrhythmias and ventricular fibrillation. Although the treatments of boosting pressure, fluid expansion, anticoagulation, intubation ventilator-assisted ventilation and defibrillation were used to rescue the patient, the patient still died of circle and respiratory failure.%1例72岁女性患者,既往有高血压史,经治疗血压控制在正常范围内.因肾癌肺转移,口服甲苯磺酸索拉非尼片0.4g,每天2次.用药2d后,患者出现头痛,BP 170/120mm Hg.给予贝那普利及吲达帕胺治疗,血压恢复正常,继续使用索拉非尼治疗,4 d后患者突发下壁心肌梗死,出现心律不齐,室颤.给予升压、扩容、抗凝、气管插管辅助呼吸、除颤等综合抢救治疗,终因病情危重,抢救无效死亡.

  11. An uncommon cause of acute pulmonary edema.

    Science.gov (United States)

    Nepal, Santosh; Giri, Smith; Bhusal, Mohan; Siwakoti, Krishmita; Pathak, Ranjan

    2016-09-01

    Acute cardiogenic pulmonary edema secondary to catecholamine-induced cardiomyopathy is a very uncommon and fatal initial presentation of pheochromocytoma. However, with early clinical suspicion and aggressive management, the condition is reversible. This case report describes a patient who presented with hypertension, dyspnea, and cough with bloody streaks, and who recovered within 48 hours after appropriate treatment.

  12. Taste and hypertension in humans

    DEFF Research Database (Denmark)

    Roura, Eugeni; Foster, Simon; Winklebach, Anja;

    2016-01-01

    The association between salty taste and NaCl intake with hypertension is well-established, although it is far from completely understood. Other taste types such as sweet, umami or bitter have also been related to alterations in blood pressure. Here, we review the mutual relationship between taste...... and hypertension to identify potential avenues to better control blood pressure. This review focuses on published data involving humans, with the exception of a section on molecular mechanisms. There is compelling evidence to suggest that changes in salty taste sensitivity can be used to predict the onset...... of hypertension. This goes hand in hand with the medical concept of sodium sensitivity, which also increases with age, particularly in hypertensive patients. The association of hypertension with the loss of taste acuity less definitive with some data/conclusions masked by the use of anti-hypertensive drugs...

  13. Calcium channel antagonists in hypertension.

    Science.gov (United States)

    Ambrosioni, E; Borghi, C

    1989-02-01

    The clinical usefulness of calcium entry-blockers for the treatment of high blood pressure is related to their capacity to act upon the primary hemodynamic derangement in hypertension: the increased peripheral vascular resistance. They can be used alone or in combination with other antihypertensive agents for the treatment of various forms of hypertensive disease. The calcium entry-blockers appear to be the most useful agents for the treatment of hypertension in the elderly and for the treatment of hypertension associated with ischemic heart disease, pulmonary obstructive disease, peripheral vascular disease, and supraventricular arrhythmias. They are effective in reducing blood pressure in pregnancy-associated hypertension and must be considered as first-line therapy for the treatment of hypertensive crisis.

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

    Science.gov (United States)

    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%; pnegative 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.

  15. Hypertension--forekomst og behandling

    DEFF Research Database (Denmark)

    Ibsen, Hans; Jørgensen, Torben; Jensen, Gorm B;

    2009-01-01

    Hypertension is the most important modifiable risk factor for cardiovascular disease. However, less than half of all hypertensives have their blood pressure reduced to relevant goals. The prevalence of hypertension in Denmark was found to be between 26% and 40% of the adult population. Just over ...... half were aware of the diagnosis, but less than half were in treatment. Blood pressure control in patients who are undergoing treatment has improved during recent years, but there is still a gap to achievable control rates....

  16. EFFECT OF CHRONIC ACE-INHIBITION ON THE DIAGNOSTIC-VALUE OF RENOGRAPHY FOR RENOVASCULAR HYPERTENSION - A PRELIMINARY-REPORT

    NARCIS (Netherlands)

    VISSCHER, CA; DEZEEUW, D; HUISMAN, RM

    1995-01-01

    We compared the effects of acute and chronic ACE inhibition (ACEi) on the I-123-hippurate in the stenotic kidney of two 2-kidney, 1-clip hypertensive dogs. In the period after clip implantation poststenotic renograms without ACEi of both dogs were normal. Acute ACEi always resulted in delayed hippur

  17. [An unusual case of transient ST-segment elevation during hypertensive crisis in a patient with left ventricular hypertrophy].

    Science.gov (United States)

    Cappelletti, Alberto; Maggio, Silvia; Maranta, Francesco; Mazzavillani, Monica; Margonato, Alberto; Camici, Paolo G

    2012-10-01

    We report the case of a 73-year-old patient with severe left ventricular hypertrophy presenting with acute ST-segment elevation mimicking acute myocardial infarction on ECG during a hypertensive crisis. Unexpectedly, emergency coronary angiography showed no evidence of coronary thrombosis or spasm. Electrocardiographic alterations gradually resolved after lowering blood pressure.

  18. Acute Bronchitis

    Science.gov (United States)

    ... Smoking also slows down the healing process. Acute bronchitis treatment Most cases of acute bronchitis can be treated at home.Drink fluids, but ... bronchial tree. Your doctor will decide if this treatment is right for you. Living with acute bronchitis Most cases of acute bronchitis go away on ...

  19. Relationship between serum retinol binding protein 4 and the heart rate variability in hypertension patients with acute cerebral infarction%高血压病合并急性脑梗死患者血清视黄醇结合蛋白4与心率变异性的关系

    Institute of Scientific and Technical Information of China (English)

    刘涛生; 张爱军; 周志鸿; 郑凤霞

    2012-01-01

    Objective To investigate the relationship between serum retinol binding protein 4 ( RBP4 ) and heart rate variability HRV )in hypertension patients with acute cerebral infarction. Methods 78 cases of hypertension patients with a-cute cerebral infarction were enrolled in the observation group, 50 cases of simple hypertension patients were enrolled in the control group. Enzyme linked immunosorbent assay of serum RBP4 levels of the subjects were measured, ambulatory blood pressure were used to monitor heart rate variability time domain parameters, included SDNN, SDANN, SDNN index, rMSSD and PNN50. Results The serum retinol binding protein 4 levels in control group and observation group were( 15. 5 ± 5.4 )mg/ L and( 24. 2 ±7. 6 )mg/L respectively, the difference between them was statistically significant( P <0. 01 ). The time domain HRV parameters in control group and observation group were as follows, SDNN ( 112. 3 ±21. 9 vs. 79. 7 ± 19. 1 )ms, SDANN (36.1 ±9.3 vs. 25. 8±7.2)ms,SDNN index(96.7±26. 8 vs. 81.3 ±25.0 )ms,rMSSD ( 23.2 ±7.9 vs. 19.4 ±5.7 )ms, PNN50 ( 8. 9 ±4. 1 vs. 5. 7 ±3. 2 )% ,these data in the observation group were lwoer than in the control group,the differences were statistically significant P <0.05 ). Pearson linear correlation analysis showed that serum RBP4 and SDNN( r = - 0. 483, P <0.01 ), SDANN( r = -0.452, P <0.01 ), SDNN index( r = -0.414, P <0.01 ),rMSSD( r = -0.293, P < 0. 05 ), PNN50( r = -0.286, P <0. 05 ) were negative correlated. Conclusion The serum retinol binding protein 4 was negative correlated with heart rate variability parameters. Serum retinol binding protein 4 might be part of autonomic imbalance in hypertension patients with acute cerebral infarction.%目的 探讨高血压病合并急性脑梗死患者血清视黄醇结合蛋白4(RBP4)与心率变异性(HRV)之间的关系.方法 选择78例高血压病合并急性脑梗死患者为观察组,以50例单纯高血压病为对照组.采用酶联免疫吸

  20. Vascular inflammatory cells in hypertension

    Directory of Open Access Journals (Sweden)

    David G. Harrison

    2012-05-01

    Full Text Available Hypertension is a common disorder with uncertain etiology. In the last several years, it has become evident that components of both the innate and adaptive immune system play an essential role in hypertension. Macrophages and T cells accumulate in the perivascular fat, the heart and the kidney of hypertensive patients and in animals with experimental hypertension. Various immunosuppressive agents lower blood pressure and prevent end-organ damage. Mice lacking lymphocytes are protected against hypertension, and adoptive transfer of T cells, but not B cells in the animals restores their blood pressure response to stimuli such as angiotensin II or high salt. Recent studies have shown that mice lacking macrophages have blunted hypertension in response to angiotensin II and that genetic deletion of macrophages markedly reduces experimental hypertension. Dendritic cells have also been implicated in this disease. Many hypertensive stimuli have triggering effects on the central nervous system and signals arising from the circumventricular organ seem to promote inflammation. Studies have suggested that central signals activate macrophages and T cells, which home to the kidney and vasculature and release cytokines, including IL-6 and IL-17, which in turn cause renal and vascular dysfunction and lead to blood pressure elevation. These recent discoveries provide a new understanding of hypertension and provide novel therapeutic opportunities for treatment of this serious disease.

  1. Pharmacologic Treatment of Pediatric Hypertension.

    Science.gov (United States)

    Dhull, Rachita S; Baracco, Rossana; Jain, Amrish; Mattoo, Tej K

    2016-04-01

    Prevalence of hypertension is increasing in children and adolescents. Uncontrolled hypertension in children not only causes end organ damage but also increases the risk of adult hypertension and cardiovascular disease. Clinical trials have proven efficacy of antihypertensive medications in children. These medications are well tolerated by children with acceptable safety profile. The choice of agent is usually driven by underlying etiology of hypertension, profile of its side effects, and clinician's preference. This article will review currently available pediatric data on mechanism of action, common adverse effects, pediatric indication, recent clinical trial, and newer drugs in the common classes of antihypertensive medications.

  2. Obesity: A Perspective from Hypertension.

    Science.gov (United States)

    Susic, Dinko; Varagic, Jasmina

    2017-01-01

    The prevalence of obesity-related hypertension is high worldwide and has become a major health issue. The mechanisms by which obesity relates to hypertensive disease are still under intense research scrutiny, and include altered hemodynamics, impaired sodium homeostasis, renal dysfunction, autonomic nervous system imbalance, endocrine alterations, oxidative stress and inflammation, and vascular injury. Most of these contributing factors interact with each other at multiple levels. Thus, as a multifactorial and complex disease, obesity-related hypertension should be recognized as a distinctive form of hypertension, and specific considerations should apply in planning therapeutic approaches to treat obese individuals with high blood pressure.

  3. In vivo PTH provokes apical NHE3 and NaPi2 redistribution and Na-K-ATPase inhibition

    DEFF Research Database (Denmark)

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

    1999-01-01

    The aim of this study was to test the hypothesis that in vivo administration of parathyroid hormone (PTH) provokes diuresis/natriuresis through redistribution of proximal tubule apical sodium cotransporters (NHE3 and NaPi2) to internal stores and inhibition of basolateral Na-K-ATPase activity....... With this diuresis/natriuresis, 25% of NHE3 and 18% of NaPi2 immunoreactivity redistributed from apical membranes to higher density fractions containing intracellular membrane markers, and basolateral Na-K-ATPase activity decreased 25%. [Nle8,18,Tyr34]PTH-(3-34) failed to increase V or CLi or to provoke...... redistribution of NHE3 or NaPi2, but it did inhibit Na-K-ATPase activity 25%. We conclude that in vivo PTH stimulates natriuresis/diuresis associated with internalization of apical NHE3 and NaPi2 and inhibition of Na-K-ATPase activity, that cAMP-protein kinase A stimulation is necessary for the natriuresis/diuresis...

  4. Cocaine, Marijuana, Hypertension and Cardiovascular Effects

    Directory of Open Access Journals (Sweden)

    Mohammad Hassan Ghadiani

    2015-07-01

    Full Text Available Cocaine is used by more than 14 million people worldwide, about 0.3 percent of the global population age is 15 to 64 years. After alcohol, cocaine is the most common cause of acute drug-related emergency department visits in the United States. Cocaine consumption is more frequently associated with acute cardiovascular illness.  Cocaine stimulates α1, α2, β1 and β2 adrenergic receptors through increased levels of norepinephrine and a lesser extent epinephrine. The cardiovascular effects of cocaine are thought to be similar and regardless to the route of consumption. An acute coronary syndrome is the most common cardiac problem including myocardial ischemia and infarction even in young persons without atherosclerosis, aortic dissection and rupture, arrhythmias, ventricular tachycardia and fibrillation, asystole and finally sudden death. Other cardiovascular effects that caused by cocaine include coronary artery aneurysm, palpitation, sinus tachycardia, increased systemic vascular resistance and hypertension crisis, left ventricular hypertrophy, myocarditis, cardiomyopathy, myocardial fibrosis, bundle branch block, heart block, supraventricular arrhythmia, accelerated atherosclerosis, hypotension, bradycardia and infective endocarditis  among intravenous users.Cocaine by three mechanisms cause ischemia: 1. increased myocardial oxygen demand, 2. decreased coronary blood flow due to coronary artery vasoconstriction and spasm and 3. Coronary artery thrombosis via activation of platelets, stimulation of platelet aggregation and potentiation of thromboxane production.

  5. Liquorice: a root cause of secondary hypertension

    Science.gov (United States)

    Ross, Calum N.

    2017-01-01

    We describe a patient presenting with hypertension and hypokalaemia who was ultimately diagnosed with liquorice- induced pseudohyperaldosteronism. This rare cause of secondary hypertension illustrates the importance of a methodical approach to the assessment of hypertension. PMID:28210494

  6. Genetics Home Reference: pulmonary arterial hypertension

    Science.gov (United States)

    ... Home Health Conditions pulmonary arterial hypertension pulmonary arterial hypertension Enable Javascript to view the expand/collapse boxes. ... PDF Open All Close All Description Pulmonary arterial hypertension is a progressive disorder characterized by abnormally high ...

  7. Hypertension and hypertensive heart disease in African women.

    Science.gov (United States)

    Sliwa, Karen; Ojji, Dike; Bachelier, Katrin; Böhm, Michael; Damasceno, Albertino; Stewart, Simon

    2014-07-01

    Hypertension and hypertensive heart disease is one of the main contributors to a growing burden of non-communicable forms of cardiovascular disease around the globe. The recently published global burden of disease series showed a 33 % increase of hypertensive disorders in pregnancy in the past two decades with long-term consequences. Africans, particularly younger African women, appear to be bearing the brunt of this increasing public health problem. Hypertensive heart disease is particularly problematic in pregnancy and is an important contributor to maternal case-fatality. European physicians increasingly need to attend to patients from African decent and need to know about unique aspects of disease presentation and pharmacological as well as non-pharmacological care. Reductions in salt consumption, as well as timely detection and treatment of hypertension and hypertensive heart disease remain a priority for effective primary and secondary prevention of CVD (particularly stroke and CHF) in African women. This article reviews the pattern, potential causes and consequences and treatment of hypertension and hypertensive heart disease in African women, identifying the key challenges for effective primary and secondary prevention in this regard.

  8. Prevalence and persistence of masked hypertension in treated hypertensive patients

    NARCIS (Netherlands)

    Verberk, Willem J.; Thien, Theo; Kroon, Abraham A.; Lenders, Jacques W. M.; van Montfrans, Gert A.; Smit, Andries J.; de Leeuw, Peter W.

    2007-01-01

    Background: Masked hypertension (MH) is defined as a normal blood pressure in the physician's office and an elevated blood pressure when measured out-of-office. The cause of MH may be termed the masked hypertension effect (MHE), and is not restricted to blood-pressure (BP) values around the threshol

  9. Psychological Factors in Essential Hypertension

    Directory of Open Access Journals (Sweden)

    Barbaros Özdemir

    2010-04-01

    Full Text Available Essential hypertension is one of the most emphasized psychosomatic disorders. Age, sexuality, excessive salt and alcohol consumption, lower activity level, fatigue, personality traits, emotional factors and stress are some of the risk factors for essential hypertension. The presence of emotional factors in the etiology of the essential hypertension and the emergence of psychiatric symptoms in the course of the illness has driven considerable attention from mental health workers on the disease for a long time. Some of the personality traits that make a person vulnerable to hypertension are being over controlled, being submissive, and hardworking. Hypertension is accepted to be a reaction against suppressed emotions and an adaptive and defense mechanism of the body. Among persons who are prone to hypertension, sympathetic nerve system is affected as a response to emotional stress and hypertension appears as a result of vasoconstriction and other autonomous responses. All at once, it was also shown that vasoconstrictor response continues much longer in hypertensive individuals than in normotensive patients. Autonomic response to stress almost always displays itself as hypertension in individuals who are prone to hypertension. Moreover, normotensive children of hypertensive parents also have elevation in blood pressures as a response to emotional stress almost without exception. The increase in sympathetic stimulus, re-modulation of bar receptors by structural and functional changes are the main features of the most commonly valid hypothesis in essential hypertension, currently. According to this hypothesis: as a result of emotional stress, inhibition over vasomotor center decreases and output of stimulus increases; epigenetic changes in endothelial structure of carotid sinus and/or aortic arch and/or vasomotor centers occurs; and finally stress increases sympathetic stimulus output. This situation leads to neurohormonal excitation; increases in

  10. Four faces of baroreflex failure: hypertensive crisis, volatile hypertension, orthostatic tachycardia, and malignant vagotonia

    Science.gov (United States)

    Ketch, Terry; Biaggioni, Italo; Robertson, RoseMarie; Robertson, David

    2002-01-01

    BACKGROUND: The baroreflex normally serves to buffer blood pressure against excessive rise or fall. Baroreflex failure occurs when afferent baroreceptive nerves or their central connections become impaired. In baroreflex failure, there is loss of buffering ability, and wide excursions of pressure and heart rate occur. Such excursions may derive from endogenous factors such as stress or drowsiness, which result in quite high and quite low pressures, respectively. They may also derive from exogenous factors such as drugs or environmental influences. METHODS AND RESULTS: Impairment of the baroreflex may produce an unusually broad spectrum of clinical presentations; with acute baroreflex failure, a hypertensive crisis is the most common presentation. Over succeeding days to weeks, or in the absence of an acute event, volatile hypertension with periods of hypotension occurs and may continue for many years, usually with some attenuation of pressor surges and greater prominence of depressor valleys during long-term follow-up. With incomplete loss of baroreflex afferents, a mild syndrome of orthostatic tachycardia or orthostatic intolerance may appear. Finally, if the baroreflex failure occurs without concomitant destruction of the parasympathetic efferent vagal fibers, a resting state may lead to malignant vagotonia with severe bradycardia and hypotension and episodes of sinus arrest. CONCLUSIONS: Although baroreflex failure is not the most common cause of the above conditions, correct differentiation from other cardiovascular disorders is important, because therapy of baroreflex failure requires specific strategies, which may lead to successful control.

  11. Nocturnal Hypertension: Neglected Issue in Comprehensive Hypertension Management

    Directory of Open Access Journals (Sweden)

    Andi Kristanto

    2016-09-01

    Full Text Available The body circardian rhythm affects blood pressure variability at day and night, therefore blood pressure at day and night might be different. Nocturnal hypertension is defined as increase of blood pressure >120/70mmHg at night, which is caused by disturbed circadian rhythm, and associated with higher cardiovascular and cerebrovascular events also mortality in hypertensive patients. Nocturnal hypertension and declining blood pressure pattern, can only be detected by continuous examination for 24 hours, also known as ambulatory blood pressure measurement (ABPM. Chronotherapy, has become a strategy for managing the hypertensive nocturnal patients, by taking hypertensive medication at night to obtain normal blood pressure decrease in accordance with the normal circadian rhythm and, improving blood pressure control.

  12. Intracranial Hypertension in Children without Papilledema

    OpenAIRE

    Chelse, Ana B.; Epstein, Leon G.

    2015-01-01

    Researchers at Nationwide Children's Memorial Hospital studied the frequency of intracranial hypertension without papilledema in children followed in a multispecialty pediatric intracranial hypertension clinic.

  13. Primary hyperparathyroidism presenting as acute gallstone pancreatitis

    Institute of Scientific and Technical Information of China (English)

    HE Jian-hong; ZHANG Quan-bao; LI Yu-min; ZHU You-quan; LI Xun; SHI Bin

    2010-01-01

    @@ Primary hyperparathyroidism (PHPT) is a generalized disorder of calcium metabolism resulting from an abnormally high level of serum calcium and an increased level of parathormone (PTH).1,2 Traditionally, symptomatic PHPT patients present with a variety of disorders including fatigue, amyotrophy, memory impairment, emotional instability, hallucination, irritation, loss of consciousness, abdominal distention, nausea, vomiting, constipation, acute pancreatitis, refractory peptic ulcer, osteopenia, hypertension, etc.3-5 Acute pancreatitis (AP) is an uncommon presentation of PHPT.6-8 We report a typical case of primary hyperparathyroidism with hypercalcemic crisis presenting as acute gallstone pancreatitis.

  14. Pharmacotherapy for mild hypertension

    Directory of Open Access Journals (Sweden)

    Diana Diao

    Full Text Available BACKGROUND: People with no previous cardiovascular events or cardiovascular disease represent a primary prevention population. The benefits and harms of treating mild hypertension in primary prevention patients are not known at present. This review examines the existing randomized controlled trial (RCT evidence. OBJECTIVE: Primary objective: To quantify the effects of antihypertensive drug therapy on mortality and morbidity in adults with mild hypertension (systolic blood pressure (BP 140-159 mmHg and/or diastolic BP 90-99 mmHg and without cardiovascular disease. METHODS: Search: We searched CENTRAL (2011, Issue 1, MEDLINE (1948 to May 2011, EMBASE (1980 to May 2011 and reference lists of articles. The Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effectiveness (DARE were searched for previous reviews and meta-analyses of anti-hypertensive drug treatment compared to placebo or no treatment trials up until the end of 2011. Selection criteria: RCTs of at least 1 year duration. Data collection and analysis: The outcomes assessed were mortality, stroke, coronary heart disease (CHD, total cardiovascular events (CVS, and withdrawals due to adverse effects. MAIN RESULTS: Of 11 RCTs identified 4 were included in this review, with 8,912 participants. Treatment for 4 to 5 years with antihypertensive drugs as compared to placebo did not reduce total mortality (RR 0.85, 95% CI 0.63, 1.15. In 7,080 participants treatment with antihypertensive drugs as compared to placebo did not reduce coronary heart disease (RR 1.12, 95% CI 0.80, 1.57, stroke (RR 0.51, 95% CI 0.24, 1.08, or total cardiovascular events (RR 0.97, 95% CI 0.72, 1.32. Withdrawals due to adverse effects were increased by drug therapy (RR 4.80, 95% CI 4.14, 5.57, ARR 9%. AUTHORS' CONCLUSIONS: Antihypertensive drugs used in the treatment of adults (primary prevention with mild hypertension (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg have not been

  15. Hypertension and renovascular disease

    DEFF Research Database (Denmark)

    Hasbak, P; Ibsen, H; Jensen, Lars Thorbjørn

    2002-01-01

    % of the patients before entering the diagnostic programme. We conclude that the RVRS demands a very restrictive referral pattern if it should be of prognostic value for the blood pressure outcome after intervention. No indices of lateralised renin concentrations proved high predictive value. However, a peripheral......The clinical value of renal vein renin sampling (RVRS) as a prognostic tool in the treatment of renovascular hypertension was evaluated. One hundred consecutive patients were included over a 4-year period of time. About half of the patients (49%) were treated interventionally by PTRA (21...

  16. Incranial hypertension management

    Directory of Open Access Journals (Sweden)

    David Gonçalves Nordon

    2009-09-01

    Full Text Available ABSTRACT Intracranial hypertension is a hazardous and common situation in the emergency room. Every effort must be made in order to avoid or reduce its secondary lesions. Advanced Trauma Life Support in the first evaluation is important, along with head computerized tomography, which is useful to identify surgical cases or anatomical lesions, and intracranial pressure monitoring. Mannitol is the mostly used drug to reduce intracranial pressure, but it must be used attentively, otherwise it may cause hypovolemic shock. Barbiturate coma and decompressive craniectomy are reserved to the refractory cases, as second tier procedures.

  17. Inflammation in hypertension: primary evidence

    Institute of Scientific and Technical Information of China (English)

    LI Jian-jun

    2006-01-01

    @@ Cardiovascular diseases are the most common cause of hospitalization and a major contributor to mortality in the western world. Since hypertension is a major risk factor for cardiovascular disease,kidney failure and stroke, control of hypertension is an important goal of cardiovascular therapies.

  18. HYPERTENSION IN RENAL ALLOGRAFT RECIPIENTS

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To further evaluate the effect of hypertension on renal graft function, and the relationship between hypertension, hyperlipoidemia and ischemic heart disease. Methods 102 renal transplant recipients with a functioning renal graft for more than 1 year were enrolled in this study. Renal function was followed for the further 24 months. Results The overall prevalence of hypertension was 89.2%(91/102) and 36.2%(33/91) hypertensive patients had uncontrolled blood pressure. After 24 months those with high blood pressure had significantly higher Scr levels than normotensive patients (P<0.05). The number of different antihypertensive classes required was related to Scr (P<0.05). Plasma cholesterol levels in hypertension patients especially in blood pressure uncontrolled group were significantly elevated (P<0.01). Ischemic heart disease was more common in hypertensive patients (P<0.05). Cyclosporine A was associated with hypertension more frequently than azathioprine and FK506, whereas low-dose prednisolone did not appear to influence blood pressure. Conclusion The data further confirmed that hypertension was associated with hyperlipidemia and ischemic heart disease, and emerged as a predictor of renal graft dysfunction. Whether cyclosporine A should be converted to new immunosuppressive agents and which class of antihypertensive medication is more effective in this population remain open questions.

  19. The Immune System in Hypertension

    Science.gov (United States)

    Trott, Daniel W.; Harrison, David G.

    2014-01-01

    While hypertension has predominantly been attributed to perturbations of the vasculature, kidney, and central nervous system, research for almost 50 yr has shown that the immune system also contributes to this disease. Inflammatory cells accumulate in the kidneys and vasculature of humans and experimental animals with hypertension and likely…

  20. Endocrine causes of secondary hypertension.

    Science.gov (United States)

    Sica, Domenic A

    2008-07-01

    Secondary hypertension is common in clinical practice if a broad definition is applied. Various patterns of hypertension exist in the patient with an endocrine source of their disease, including new-onset hypertension in a previously normotensive individual, a loss of blood pressure control in a patient with previously well-controlled blood pressure, and/or labile blood pressure in the setting of either of these 2 patterns. A thorough history and physical exam, which can rule out concomitant medications, alcohol intake, and over-the-counter medication use, is an important prerequisite to the workup for endocrine causes of hypertension. Endocrine forms of secondary hypertension, such as pheochromocytoma and Cushing's disease, are extremely uncommon. Conversely, primary aldosteronism now occurs with sufficient frequency so as to be considered "top of the list" for secondary endocrine causes in otherwise difficult-to-treat or resistant hypertension. Primary aldosteronism can be insidious in its presentation since a supposed hallmark finding, hypokalemia, may be variable in its presentation. It is important to identify secondary causes of hypertension that are endocrine in nature because surgical intervention may result in correction or substantial improvement of the hypertension.

  1. Current practice for pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    Toru Satoh

    2014-01-01

    Objective To investigate the current practice of pulmonary hypertension including current epidemiology,diagnosis and treatment.Data sources The review was based on data obtained from the published articles and guidelines.Study selection Articles with high level of evidence or current best evidence in each issue were selected to be reviewed.Results Overall prevalence of pulmonary hypertension was 0.3% to 6% with left heart disease occupying the most proportion,followed by pulmonary disease,pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension.In diagnosis,a flow diagram of diagnosis of pulmonary hypertension,differential diagnosis of pulmonary hypertension and how to determine the severity of pulmonary hypertension are explained including recent development of magnetic resonance imaging and gene abnormality study on bone morphogenetic protein receptor Ⅱ.In treatment,newlydeveloped pulmonary vasodilators and the way to use them are shown to treat pulmonary hypertension.Conclusion Safer and more effective treatment algorithm and basic researches and clinical trials are warranted to be explored.

  2. Pulmonary arterial hypertension : an update

    NARCIS (Netherlands)

    Hoendermis, E. S.

    2011-01-01

    Pulmonary arterial hypertension (PAH), defined as group 1 of the World Heart Organisation (WHO) classification of pulmonary hypertension, is an uncommon disorder of the pulmonary vascular system. It is characterised by an increased pulmonary artery pressure, increased pulmonary vascular resistance a

  3. Autonomic nervous system dysregulation in pediatric hypertension.

    Science.gov (United States)

    Feber, Janusz; Ruzicka, Marcel; Geier, Pavel; Litwin, Mieczyslaw

    2014-05-01

    Historically, primary hypertension (HTN) has been prevalent typically in adults. Recent data however, suggests an increasing number of children diagnosed with primary HTN, mainly in the setting of obesity. One of the factors considered in the etiology of HTN is the autonomous nervous system, namely its dysregulation. In the past, the sympathetic nervous system (SNS) was regarded as a system engaged mostly in buffering major acute changes in blood pressure (BP), in response to physical and emotional stressors. Recent evidence suggests that the SNS plays a much broader role in the regulation of BP, including the development and maintenance of sustained HTN by a chronically elevated central sympathetic tone in adults and children with central/visceral obesity. Consequently, attempts have been made to reduce the SNS hyperactivity, in order to intervene early in the course of the disease and prevent HTN-related complications later in life.

  4. 中老年高血压急症患者应用乌拉地尔和尼卡地平的疗效比较%Comparison of the Effects of Urapidil and Nicardipine Application Among Middle and Old Aged Acute Hypertension Patients

    Institute of Scientific and Technical Information of China (English)

    张蕾; 马涛; 李霞

    2016-01-01

    Objective To compare the effects of urapidil and nicardipine in middle and old aged acute hypertension patients.Methods 100 middle and old aged acute hypertension patients from emergency department of the fifth affiliated hospital f Xinjiang Medical University between Dec.2013 to Dec.2013 were divided into four groups. Group A included middle-aged patients with urapidil (n=25); Group B included middle-aged patients with nicardipine (n=25); Group C included elderly patients with urapidil (n=25); Group D included elderly patients with nicardipine (n=25). The 24h ambulatory blood pressure (PP), the pulse pressure index (PPI), the heart rate (HR),the smoothness index (SI) of the systolic and diastolic blood pressures (SISBP and SIDBP) after treatment were collected. And level of norepinephrine, epinephrine, serum brain natriuretic peptide and angiotensin II were tested before and after treatment. The remission time of symptoms of hypertension was also recorded.Results Comparing with group A, 24h PP, PPI, HR and SI of group B were reduced significantly (P0.05). Serum NA and Adr levels were elevated in both group B and D (P<0.05). After treatment, the concentrations of BNP and AngII decreased in all groups. In elderly patients with urapidil, the change was more significant (P<0.05). In middle-aged patients with nicardipine, the change was more significant (P<0.05). The remission time of symptoms of hypertension in elderly patients with urapidil and middle-aged patients with nicardipine was shorter.Conclusion For better effects, elderly patients may choose urapidil, and middle-aged patients may use nicardipine.%目的:比较乌拉地尔与尼卡地平在中老年急性高血压患者中的疗效。方法选取2013年12月~2014年12月在新疆医科大学第五附属医院急诊治疗的急性高血压患者100例,其中男性54例,女性46例。中年患者随机分为A组(n=25)和B组(n=25),老年患者随机分为C组(n=25)和D组(n=25)。所

  5. Dig1 protects against cell death provoked by glyphosate-based herbicides in human liver cell lines

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    Travert Carine

    2010-10-01

    Full Text Available Abstract Background Worldwide used pesticides containing different adjuvants like Roundup formulations, which are glyphosate-based herbicides, can provoke some in vivo toxicity and in human cells. These pesticides are commonly found in the environment, surface waters and as food residues of Roundup tolerant genetically modified plants. In order to know their effects on cells from liver, a major detoxification organ, we have studied their mechanism of action and possible protection by precise medicinal plant extracts called Dig1. Methods The cytotoxicity pathways of four formulations of glyphosate-based herbicides were studied using human hepatic cell lines HepG2 and Hep3B, known models to study xenobiotic effects. We monitored mitochondrial succinate dehydrogenase activity and caspases 3/7 for cell mortality and protection by Dig1, as well as cytochromes P450 1A1, 1A2, 3A4 and 2C9 and glutathione-S-transferase to approach the mechanism of actions. Results All the four Roundup formulations provoke liver cell death, with adjuvants having stronger effects than glyphosate alone. Hep3B are 3-5 times more sensitive over 48 h. Caspases 3/7 are greatly activated in HepG2 by Roundup at non-cytotoxic levels, and some apoptosis induction by Roundup is possible together with necrosis. CYP3A4 is specifically enhanced by Roundup at doses 400 times less than used in agriculture (2%. CYP1A2 is increased to a lesser extent together with glutathione-S-transferase (GST down-regulation. Dig 1, non cytotoxic and not inducing caspases by itself, is able to prevent Roundup-induced cell death in a time-dependant manner with an important efficiency of up to 89%, within 48 h. In addition, we evidenced that it prevents Caspases 3/7 activation and CYP3A4 enhancement, and not GST reduction, but in turn it slightly inhibited CYP2C9 when added before Roundup. Conclusion Roundup is able to provoke intracellular disruption in hepatic cell lines at different levels, but a

  6. PLACENTAL PATHOLOGY IN PREGNANCY INDUCED HYPERTENSION

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    Sreechithra

    2014-08-01

    Full Text Available BACKGROUND: Hypertensive disorders complicating pregnancy are common and form one of the deadly triad along with hemorrhage and infection, that results in a large number of maternal deaths and there of fetal deaths. Since all anabolites needed for foetal metabolism come from the mothers blood and foetal catabolites are passed back into the mothers circulation through the placenta, the examination of placenta gives a clear idea of what had happened with it, when it was in the mother, s womb and what is going to happen with the foetus in future. With this objective the present study was carried out. MATERIALS AND METHODS: Retrospective study was done for a period of 21 months from April1st 2008 to December 31st 2009..Fifty mothers with uncomplicated pregnancy (control group and 100 mothers (test group diagnosed as having pregnancy induced hypertension were selected from patients of our institution of the age range from 20-40 years, and parity –primi, para2 and 3.Placental morphometric parameters, gross and histopathological features were examined in both test and control groups. STATISTICAL ANALYSIS USED: Fishers exact test RESULTS: Placental morphometric parameters were significantly reduced in the control group. Acute atherosis, endothelial proliferation and fibrinoid necrosis were the significant histological findings noted in our study. CONCLUSION: Placental findings can be confirmatory of PIH, but its absence does not exclude the diseases. These findings will become more evident only when there is significant reduction in the uteroplacental bloodflow

  7. Exercise, the Brain, and Hypertension.

    Science.gov (United States)

    Peri-Okonny, Poghni; Fu, Qi; Zhang, Rong; Vongpatanasin, Wanpen

    2015-10-01

    Exercise training is the cornerstone in the prevention and management of hypertension and atherosclerotic cardiovascular disease. However, blood pressure (BP) response to exercise is exaggerated in hypertension often to the range that raises the safety concern, which may prohibit patients from regular exercise. This augmented pressor response is shown to be related to excessive sympathetic stimulation caused by overactive muscle reflex. Exaggerated sympathetic-mediated vasoconstriction further contributes to the rise in BP during exercise in hypertension. Exercise training has been shown to reduce both exercise pressor reflex and attenuate the abnormal vasoconstriction. Hypertension also contributes to cognitive impairment, and exercise training has been shown to improve cognitive function through both BP-dependent and BP-independent pathways. Additional studies are still needed to determine if newer modes of exercise training such as high-intensity interval training may offer advantages over traditional continuous moderate training in improving BP and brain health in hypertensive patients.

  8. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    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......Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems (renin-angiotensin-aldosterone system, sympathetic nervous system, release...

  9. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    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...... likely includes the combination of vasodilatation and vasoconstriction in parallel. Arterial compliance; Central vascular filling; Chyperdynamic circulation; Kidney function, Nitric oxide; Blood pressure regulation; Renin–angiotensin–aldosterone system; Sympathetic nervous system; Vasodilatation...

  10. A clinical classification of hypertension

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Hypertension is a common cardiovascular problem worldwide. As with any other disease it is important to assess the severity of the disease. However the present classification of hypertension by the Joint National Committee in its seventh report (JNC 7) with numerical values staging the severity of hypertension is theoretically correct but difficult to apply in practice (Table 1).1 Admittedly this is a step in the right direction with lesser number of stages compared to the sixth report.2 The World Health Organization- International Society of Hypertension (WHO-ISH)-1999 3 and the European Society of Hypertension - European Society of Cardiology (ESH-ESC)4 guidelines follow similar numerical classifications (Table 2). All these papers are referred to as 'guidelines' in this article.

  11. Hypertension og apopleksi

    DEFF Research Database (Denmark)

    Christensen, Hanne; Christensen, Kent Lodberg

    2007-01-01

    Blood pressure changes in the acute phase of stroke are common. High blood pressure is often found on admission as a psychological reaction to stress--a white coat effect. Both high and low blood pressure relate to poor outcome after stroke. At the moment there is no evidence for pharmacological...... modification of blood pressure in the acute phase of stroke based on randomized controlled trials. Antihypertensive treatment as a secondary preventive measure should at least be started if blood pressure is stable and higher than 140/90 mmHg a few days after stroke onset. Udgivelsesdato: 2007-Oct-1...

  12. Dopamine, hypertension and obesity.

    Science.gov (United States)

    Contreras, F; Fouillioux, C; Bolívar, A; Simonovis, N; Hernández-Hernández, R; Armas-Hernandez, M J; Velasco, M

    2002-03-01

    Dopamine, a neurotransmitter, precursor of noradrenaline, is responsible for cardiovascular and renal actions, such as increase in myocardial contractility and cardiac output, without changes in heart rate, producing passive and active vasodilatation, diuresis and natriuresis. These cardiovascular and renal actions take place through the interaction with dopamine receptors, D(1), D(2), D(3), D(4), and D(5). Recent findings point to the possibility of D(6) and D(7)receptors. Dopamine is known to influence the control of arterial pressure by influencing the central and peripheral nervous system and target organs such as kidneys and adrenal glands, in some types of hypertension. Although dopamine and its derivatives have been shown to have antihypertensive effects, these are still being studied; therefore it is important to explain some physiological and pharmacological aspects of dopamine, its receptors, and the clinical uses it could have in the treatment of arterial hypertension and more recently in obesity, based on evidence proving a clear association between obesity and the decrease in the expression of D(2) receptors in the brain of obese persons.

  13. Clinical research about the curative effect of hypertonic saline on acute intracranial hypertension caused by craniocerebral injury%高渗盐水抢救颅脑损伤所致急性颅内高压的临床研究

    Institute of Scientific and Technical Information of China (English)

    刘万宝; 刘剑; 乔着意; 赵庆波; 王梅

    2011-01-01

    目的 探讨高渗盐水(hypertonic saline,HS)在急诊科抢救颅脑损伤所致急性颅内高压患者首次降颅压治疗中的临床疗效.方法 颅脑损伤所致急性颅内高压患者60例,随机分为3%HS组(20例)、10%HS组(20例)和20%甘露醇(mannitol,MT)组(20例).3%HS组静脉给予3%HS 260 mL,10%HS组静脉给予10%HS 80 mL,MT组静脉给予20%MT 250 mL,并于用药前及用药后30、60、90 min和2、3、4、5 h监测颅内压(intracranial pressure,ICP)、平均动脉压(mean artery pressure,MAP),记录尿量,观察生命体征变化,监测血生化指标.结果 ①HS组于用药后30 min ICP达到最大降幅,显著早于MT组(P0.05).③静脉快速滴注3%HS、10%HS和20%MT后脑灌注压(CPP)均显著升高(P0.05),但3%HS作用持续时间较10%HS、20%MT显著延长(P<0.05).结论 ①与MT比较,HS抢救颅脑损伤所致急性颅内高压起效更快、更持久,维持ICP更平稳.②两种浓度HS都能显著升高MAP,具有显著扩容作用.③三组均能升高CPP,以3%HS持续时间较长.%Objective To investigate the curative effect of hypertonic saline (HS) on the patients with acute intracranial hypertension caused by craniocerebral injury in emergency department.Methods Patients with acute intracranial hypertension caused by craniocerebral injury were divided into three groups including 3% HS group, 10% HS group and 20% mannitol (MT) group randomly.The intracranial pressure(ICP), mean arterial pressure (MAP), blood pressure(BP), cerebral perfusion pressure( CPP), urine output and blood biochemical parameters were recorded before the treatment and at 30, 60, 90 min and 2, 3, 4, 5 h after 3% HS 260 mL, 10% HS 80 mL and 20% MT 250 mL treatment respectively.Results ①The ICP decreased greatly at 30 min after HS treatment, which was earlier than in MT group(P < 0.05).Moreover, decreased ICP of 3% HS group maintained for 4 h,which was better than other groups(P < 0.05).②The MAP increased after treatment in HS

  14. Potential renovascular hypertension, space missions, and the role of magnesium

    Directory of Open Access Journals (Sweden)

    William J Rowe

    2009-11-01

    Full Text Available William J RoweFormer Assistant Clinical Professor of Medicine, Medical University of Ohio at Toledo, Keswick, VA, USAAbstract: Space flight (SF and dust inhalation in habitats cause hypertension whereas in SF (alone there is no consistent hypertension but reduced diurnal blood pressure (BP variation instead. Current pharmaceutical subcutaneous delivery systems are inadequate and there is impairment in the absorption, metabolism, excretion, and deterioration of some pharmaceuticals. Data obtained from the National Aeronautics and Space Administration through the Freedom of Information Act shows that Irwin returned from his 12-day Apollo 15 mission in 1971 and was administered a bicycle stress test. With just three minutes of exercise, his BP was >275/125 mm Hg (heart rate of only 130 beats per minute. There was no acute renal insult. Irwin’s apparent spontaneous remission is suggested to be related to the increase of a protective vasodilator, and his atrial natriuretic peptide (ANP reduced with SF because of reduced plasma volume. With invariable malabsorption and loss of bone/muscle storage sites, there are significant (P < 0.0001 reductions of magnesium (Mg required for ANP synthesis and release. Reductions of Mg and ANP can trigger pronounced angiotensin (200%, endothelin, and catecholamine elevations (clearly shown in recent years and vicious cycles between the latter and Mg deficits. There is proteinuria, elevated creatinine, and reduced renal concentrating ability with the potential for progressive inflammatory and oxidative stress-induced renal disease and hypertension with vicious cycles. After SF, animals show myocardial endothelial injuries and increased vascular resistance of extremities in humans. Even without dust, hypertension might eventually develop from renovascular hypertension during very long missions. Without sufficient endothelial protection from pharmaceuticals, a comprehensive gene research program should begin now

  15. Risk of recurrent venous thrombosis related to past provoking risk situations: follow-up of a cohort study.

    Science.gov (United States)

    Ribeiro, Daniel D; Lijfering, Willem M; Barreto, Sandhi M; Lopes, Fabiane Dias; Pires, Giselli de Souza; Rosendaal, Frits R; Rezende, Suely M

    2013-07-01

    Strategies targeting at classifying the risk for recurrent venous thrombosis are needed. We previously hypothesized, by studying a cohort of patients, that those who had 'survived' risk situations for venous thrombosis without developing it would, after a first venous thrombosis, have a low recurrence risk. Therefore, we re-evaluated the same cohort, now with a longer follow-up. Patients, after a first confirmed venous thrombosis event, were followed for an average of 43 months after suspension of anticoagulation. Patients with indication for indefinite anticoagulation were not included. The primary endpoint was objective recurrent venous thrombosis. Recurrent venous thrombosis was recorded in 9% of 378 eligible patients. Patients with a provoked first event and positive past risk situations for venous thrombosis had an incidence rate of recurrence of 1.26 (95% CI, 0.60-2.31) per 100 patient-years. The incidence rate ratio (IRR) of this subgroup compared with patients with a provoked event without other past risk situations for venous thrombosis was 0.8 (95% CI 0.2-2.9). This IRR was 2.8 (95% CI, 1.2-6.5) in patients with an unprovoked event and positive past risk situations and 7.1 (95% CI, 3.0-17.1) in patients with an unprovoked event and no past risk situations. When only idiopathic first events were evaluated the IRR was 2.5 (95% CI, 1.1-5.9) for patients without past risk situation compared with those with these history. In this study, asking a patient about past exposure to risk factors for venous thrombosis long before the occurrence of a first venous thrombosis occurred, could be used to classify patients with a first unprovoked venous thrombosis at higher risk for recurrence of venous thrombosis.

  16. Vascular Remodeling in Experimental Hypertension

    Directory of Open Access Journals (Sweden)

    Norma R. Risler

    2005-01-01

    Full Text Available The basic hemodynamic abnormality in hypertension is an increased peripheral resistance that is due mainly to a decreased vascular lumen derived from structural changes in the small arteries wall, named (as a whole vascular remodeling. The vascular wall is an active, flexible, and integrated organ made up of cellular (endothelial cells, smooth muscle cells, adventitia cells, and fibroblasts and noncellular (extracellular matrix components, which in a dynamic way change shape or number, or reorganize in response to physiological and pathological stimuli, maintaining the integrity of the vessel wall in physiological conditions or participating in the vascular changes in cardiovascular diseases such as hypertension. Research focused on new signaling pathways and molecules that can participate in the mechanisms of vascular remodeling has provided evidence showing that vascular structure is not only affected by blood pressure, but also by mechanisms that are independent of the increased pressure. This review will provide an overview of the evidence, explaining some of the pathophysiologic mechanisms participating in the development of the vascular remodeling, in experimental models of hypertension, with special reference to the findings in spontaneously hypertensive rats as a model of essential hypertension, and in fructose-fed rats as a model of secondary hypertension, in the context of the metabolic syndrome. The understanding of the mechanisms producing the vascular alterations will allow the development of novel pharmacological tools for vascular protection in hypertensive disease.

  17. Paradoxical hypertension with cardiac tamponade.

    Science.gov (United States)

    Argulian, Edgar; Herzog, Eyal; Halpern, Dan G; Messerli, Franz H

    2012-10-01

    Subacute (medical) tamponade develops over a period of days or even weeks. Previous studies have shown that subacute tamponade is uncommonly associated with hypotension. On the contrary, many of those patients are indeed hypertensive at initial presentation. We sought to determine the prevalence and predictors of hypertensive cardiac tamponade and hemodynamic response to pericardial effusion drainage. We conducted a retrospective study of patients who underwent pericardial effusion drainage for subacute pericardial tamponade. Diagnosis of pericardial tamponade was established by the treating physician based on clinical data and supportive echocardiographic findings. Patients were defined as hypertensive if initial systolic blood pressure (BP) was ≥140 mm Hg. Thirty patients with subacute tamponade who underwent pericardial effusion drainage were included in the analysis. Eight patients (27%) were hypertensive with a mean systolic BP of 167 compared to 116 mm Hg in 22 nonhypertensive patients. Hypertensive patients with tamponade were more likely to have advanced renal disease (63% vs 14%, p tamponade after pericardial effusion drainage. Those results are consistent with previous studies with an estimated prevalence of hypertensive tamponade from 27% to 43%. In conclusion, a hypertensive response was observed in approximately 1/3 of patients with subacute pericardial tamponade. Relief of cardiac tamponade commonly resulted in a decrease in BP.

  18. Hypertension in Patients with Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Vinicius Barbosa de; Silva, Eduardo Nani; Ribeiro, Mario Luiz; Martins, Wolney de Andrade, E-mail: wolney@cardiol.br [Curso de Pós-Graduação em Ciências Cardiovasculares da Universidade Federal Fluminense, Niterói, RJ (Brazil)

    2015-03-15

    There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality.

  19. Dermatoglyphics in hypertension: a review.

    Science.gov (United States)

    Wijerathne, Buddhika T B; Meier, Robert J; Agampodi, Thilini C; Agampodi, Suneth B

    2015-08-12

    Hypertension is a major contributor to the global burden of disease and mortality. A major medical advancement would be a better means to ascertain which persons are at higher risk for becoming hypertensive beforehand. To that end, there have been a number of studies showing that certain dermatoglyphic markers are associated with hypertension. This association could be explained if the risk toward developing hypertension later on in life is somehow connected with fetal development of dermatoglyphics. It would be highly valuable from a clinical standpoint if this conjecture could be substantiated since dermatoglyphic markers could then be used for screening out individuals who might be at an elevated risk of becoming hypertensive. The aim of this review was to search for and appraise available studies that pertain to the association between hypertension and dermatoglyphics.A systematic literature search conducted using articles from MEDLINE (PubMed), Trip, Cochran, Google scholar, and gray literature until December 2014. Of the 37 relevant publications, 17 were included in the review. The review performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement.This review showed a fairly consistent finding of an increased frequency of whorl patterns along with a higher mean total ridge count in digital dermatoglyphic results in hypertensive samples compared to controls. However, it was imperative to discuss several limitations found in the studies that could make this association as yet unsettled.

  20. Baroreflex control of sympathetic activity in experimental hypertension

    Directory of Open Access Journals (Sweden)

    M.C.C. Irigoyen

    1998-09-01

    Full Text Available The arterial baroreceptor reflex system is one of the most powerful and rapidly acting mechanisms for controlling arterial pressure. The purpose of the present review is to discuss data relating sympathetic activity to the baroreflex control of arterial pressure in two different experimental models: neurogenic hypertension by sinoaortic denervation (SAD and high-renin hypertension by total aortic ligation between the renal arteries in the rat. SAD depresses baroreflex regulation of renal sympathetic activity in both the acute and chronic phases. However, increased sympathetic activity (100% was found only in the acute phase of sinoaortic denervation. In the chronic phase of SAD average discharge normalized but the pattern of discharges was different from that found in controls. High-renin hypertensive rats showed overactivity of the renin angiotensin system and a great depression of the baroreflexes, comparable to the depression observed in chronic sinoaortic denervated rats. However, there were no differences in the average tonic sympathetic activity or changes in the pattern of discharges in high-renin rats. We suggest that the difference in the pattern of discharges may contribute to the increase in arterial pressure lability observed in chronic sinoaortic denervated rats.

  1. Masked Uncontrolled Hypertension in CKD.

    Science.gov (United States)

    Agarwal, Rajiv; Pappas, Maria K; Sinha, Arjun D

    2016-03-01

    Masked uncontrolled hypertension (MUCH) is diagnosed in patients treated for hypertension who are normotensive in the clinic but hypertensive outside. In this study of 333 veterans with CKD, we prospectively evaluated the prevalence of MUCH as determined by ambulatory BP monitoring using three definitions of hypertension (daytime hypertension ≥135/85 mmHg; either nighttime hypertension ≥120/70 mmHg or daytime hypertension; and 24-hour hypertension ≥130/80 mmHg) or by home BP monitoring (hypertension ≥135/85 mmHg). The prevalence of MUCH was 26.7% by daytime ambulatory BP, 32.8% by 24-hour ambulatory BP, 56.1% by daytime or night-time ambulatory BP, and 50.8% by home BP. To assess the reproducibility of the diagnosis, we repeated these measurements after 4 weeks. Agreement in MUCH diagnosis by ambulatory BP was 75-78% (κ coefficient for agreement, 0.44-0.51), depending on the definition used. In contrast, home BP showed an agreement of only 63% and a κ coefficient of 0.25. Prevalence of MUCH increased with increasing clinic systolic BP: 2% in the 90-110 mmHg group, 17% in the 110-119 mmHg group, 34% in the 120-129 mmHg group, and 66% in the 130-139 mmHg group. Clinic BP was a good determinant of MUCH (receiver operating characteristic area under the curve 0.82; 95% confidence interval 0.76-0.87). In diagnosing MUCH, home BP was not different from clinic BP. In conclusion, among people with CKD, MUCH is common and reproducible, and should be suspected when clinic BP is in the prehypertensive range. Confirmation of MUCH diagnosis should rely on ambulatory BP monitoring.

  2. COMPARATIVE MORPHOFUNCTIONAL CHARACTERISTIC OF ADRENAL GLANDS IN ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    S. Yu. Alyabyeva

    2015-01-01

    Full Text Available The article is devoted to the study of morphological changes of the adrenal glands in arterial hyperten-sion. Adrenals investigated persons who do not suffer in life and suffering from hypertension during the life of hypertension and died from various causes – is incompatible with the life of a mechanical trauma, cerebral hemorrhage, and acute left ventricular failure. In each case, each of the adrenal glands were assessed: the presence and severity of focal and diffuse mononuclear infiltration, the number of lympho-cytes, monocytes, plasma cells and fibroblasts arranged in the respective zones of the cortex and medulla, the severity of hyperemia and edema of various structural parts, the number of zones cortex and medulla endocrinocytes with pycnotic nuclei in the reticular zone evaluated the distribution of secretory cells with lipofuscin and the degree of saturation of the cytoplasm of the secretory cells, in secretory cells of medul-la evaluated nuclear-cytoplasmic ratio, the severity of vacuolization and basophils cytoplasm revealed a number of regularities of morphological changes depending from the various clinical manifestations of hypertension, defining the ultimate option of dying. At the heart tanatogenesis version are more pro-nounced morphological features hyperfunctions glomerular zone – namely delipidization left and right glands. The beam and netted areas contralateral glands embodiment of dying of a heart compared to the brain, is more pronounced hyperemia. When cardiac variant tanatogenesis more pronounced focal lym-phoid infiltration and vacuolization in secretory cells of left adrenal medulla.

  3. [Update arterial hypertension 2015].

    Science.gov (United States)

    Rickenbacher, Peter

    2015-04-22

    Hypertension, defined as office blood pressure of ≥140 mmHg systolic and/or ≥90 mmHg diastolic, is prevalent and one of the most important risk factors for disease and premature death. Diagnostic evaluation includes risk stratification regarding other cardiovascular risk factors, cardiovascular disease and asymptomatic organ damage. Currently, treatment is generally recommended with blood pressure ≥140/90 mmHg with the goal of reducing values below these limits also in high risk patients. Exceptions concern patients with advanced age or diabetes. Treatment involves lifestyle changes, anthypertensive drugs and in the future probably interventional techniques. This mini-review summarizes selected and practically relevant diagnostic and therapeutic aspects from recent international guidelines.

  4. Hypertension og hjertet

    DEFF Research Database (Denmark)

    Wachtell, Kristian; Svendsen, Tage Lysbo; Andersen, Niels Holmark

    2009-01-01

    Within the latest ten years research in left ventricular hypertrophy as cardiac target organ damage has uncovered its prognostic importance, and studies indicate that treatment with angiotensin II receptor blockade is most effective in reducing left ventricular hypertrophy. In addition, reduction...... of left ventricular mass is associated with substantial and significant reduction of cardiovascular morbidity and mortality. Hypertension is strongly associated with increased risk of subsequent heart failure. Meta analysis data suggests that reduction in blood pressure is also associated with very...... reduction of traditional cardiovascular risk factors as well as blood pressure reduction for blood pressures exceeding 130/185 mmHg. Reductions which should be achieved using angiotensin converting enzyme inhibitor or angiotensin receptor blockers in order to improve the hemodynamic status of the patient...

  5. The effects of perpetrator age and abuse disclosure on the relationship between feelings provoked by child sexual abuse and posttraumatic stress.

    Science.gov (United States)

    Cantón-Cortés, David; Cortés, María Rosario; Cantón, José; Justicia, Fernando

    2011-07-01

    The present study examined the relationship between feelings provoked by child sexual abuse (CSA) and posttraumatic stress disorder (PTSD) symptom scores in a sample of 163 female survivors of CSA. Finkelhor and Browne's traumagenic dynamics model was applied. The interactive effects of provoked feelings with perpetrator age and the existence of abuse disclosure were also studied. Results showed an overall relationship between feelings provoked by CSA and PTSD symptom scores. Feelings of stigma, betrayal, and powerlessness as a result of CSA were associated with PTSD symptom score when the entire group of CSA victims was analyzed. The role of traumatic sexualization was relevant only when analyzed in interaction with the age of the perpetrator and disclosure. The relationship between traumatic sexualization and PTSD symptom scores was only significant when the abuse was committed by an adult perpetrator and when a disclosure was made during the time of abuse, or a short time after the abuse had occurred.

  6. Animal models of portal hypertension

    Institute of Scientific and Technical Information of China (English)

    Juan G Abraldes; Marcos Pasarín; Juan Carlos; García-Pagán

    2006-01-01

    Animal models have allowed detailed study of hemodynamic alterations typical of portal hypertension and the molecular mechanisms involved in abnormalities in splanchnic and systemic circulation associated with this syndrome. Models of prehepatic portal hypertension can be used to study alterations in the splanchnic circulation and the pathophysiology of the hyperdynamic circulation. Models of cirrhosis allow study of the alterations in intrahepatic microcirculation that lead to increased resistance to portal flow. This review summarizes the currently available literature on animal models of portal hypertension and analyzes their relative utility. The criteria for choosing a particular model,depending on the specific objectives of the study, are also discussed.

  7. Hypertension--forekomst og behandling

    DEFF Research Database (Denmark)

    Ibsen, Hans; Jørgensen, Torben; Jensen, Gorm B;

    2009-01-01

    Hypertension is the most important modifiable risk factor for cardiovascular disease. However, less than half of all hypertensives have their blood pressure reduced to relevant goals. The prevalence of hypertension in Denmark was found to be between 26% and 40% of the adult population. Just over ...... half were aware of the diagnosis, but less than half were in treatment. Blood pressure control in patients who are undergoing treatment has improved during recent years, but there is still a gap to achievable control rates. Udgivelsesdato: 2009-Jun-8...

  8. Isolated agenesis of the right pulmonary artery with late manifestation of pulmonary hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Huebsch, P.; Pichler, W.; Lang, I.; Mlczoch, J.

    1987-01-01

    The case of a woman patient of 25 years of age with acute cardiac decompensation is presented. The chest X-ray as well as the lung scan showed the typical features of absence of the right pulmonary artery. The diagnosis was confirmed angiographically. The sudden and late onset of symptoms of pulmonary hypertension is a remarkable feature.

  9. Bilateral native nephrectomy for refractory hypertension in kidney transplant and kidney pancreas transplant patients

    Directory of Open Access Journals (Sweden)

    Mark J. Lerman

    2015-01-01

    We found laparoscopic bilateral native nephrectomy to be beneficial in renal and simultaneous kidney pancreas transplant patients with severe and refractory hypertension. Our patients with better baseline renal allograft function at time of nephrectomy received the most benefit. No decrease in allograft function could be attributed to acute rejection.

  10. The effect of bilateral adrenal demedullation on vascular reactivity and blood pressure in spontaneously hypertensive rats.

    Science.gov (United States)

    Borkowski, K. R.; Quinn, P.

    1983-01-01

    Bilateral adrenal demedullation of juvenile spontaneously hypertensive rats attenuated, but did not prevent, the development of hypertension. Neither did it affect the subsequent vascular reactivity to phenylephrine though it significantly reduced the vascular effects of sympathetic nerve stimulation. Demedullation of adult spontaneously hypertensive rats did not alter blood pressure, but did attenuate the pressor responses to both alpha-adrenoceptor agonists and sympathetic nerve stimulation. In acutely demedullated adult rats, vascular reactivity to sympathetic nerve stimulation, but not to exogenous amines, could be restored by slow i.v. infusion of adrenaline in a dose-dependent manner. The results support a possible facilitatory role for adrenaline in sympathetic neurotransmitter release, both during the development of genetic hypertension and in vascular responses to sympathetic nerve stimulation. PMID:6640199

  11. Acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Bo-Guang Fan

    2010-01-01

    Full Text Available Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions : Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  12. Acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Bo-Guang Fan

    2010-05-01

    Full Text Available Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions: Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  13. Pulmonary Hypertension in Pregnancy: Critical Care Management

    OpenAIRE

    Bassily-Marcus, Adel M.; Carol Yuan; John Oropello; Anthony Manasia; Roopa Kohli-Seth; Ernest Benjamin

    2012-01-01

    Pulmonary hypertension is common in critical care settings and in presence of right ventricular failure is challenging to manage. Pulmonary hypertension in pregnant patients carries a high mortality rates between 30–56%. In the past decade, new treatments for pulmonary hypertension have emerged. Their application in pregnant women with pulmonary hypertension may hold promise in reducing morbidity and mortality. Signs and symptoms of pulmonary hypertension are nonspecific in pregnant women. Im...

  14. Clinical overview of hypertensive crisis in children.

    Science.gov (United States)

    Yang, Wen-Chieh; Lin, Mao-Jen; Chen, Chun-Yu; Wu, Han-Ping

    2015-06-16

    Hypertensive emergencies and hypertensive urgencies in children are uncommonly encountered in the pediatric emergency department and intensive care units, but the diseases are potentially a life-threatening medical emergency. In comparison with adults, hypertension in children is mostly asymptomatic and most have no history of hypertension. Additionally, measuring accurate blood pressure values in younger children is not easy. This article reviews current concepts in pediatric patients with severe hypertension.

  15. RENAL ENDOGENOUS ET-1 AND URINARY SODIUM EXCRETION AND MICROALBUMINURIA IN HUMAN SALT-SENSITIVE HYPERTENSION

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To investigate the urinary endothelin-1 (ET-1) excretion and urinary sodium excretion,microalbuminuria and ambulatory blood pressure(ABP) in salt-sensitive(SS) hypertension patients. Methods Twenty-one cases of normotensive subjects and 32 cases of uncomplicated hypertensive patients were recruited in this study. Salt sensitivity was determined by acute venous saline loading test. Before saline loading, 24-hour ABP measurements were performed. Urine samples were collected to assay ET-1 ,urinary sodium excretion and urinary albumin excretion(UAF). Results Compared to slat-resistant(SR) subgroup, SS showed low urinary ET-1 excretion in normotensive group (P<0.05) or hypertensive group (P<0.01) ,regardless of saline loading or not. The nighttime MAP of SS was higher than SR subgroup in normotensive or hypertensive group. Urinary sodium excretion during 4h of saline loading was significantly lower in SS than that in SR hypertensive patients (P<0. 05). Twenty-four-hour UAE of SS patients was higher than SR group (P<0.01). Results of further correlation analysis indicated that the urinary ET-1 excretion was positively related to urinary sodium content and negatively to ABP and UAE. Conclusion Urinary ET-1 is low in SS normotensives or hypertension patients,which may play a role in renal sodium retention and renal impairment of SS hypertension patients.

  16. Biological response of spontaneously hypertensive rats to the streptozotocin administration

    Directory of Open Access Journals (Sweden)

    Virginia Alice Vieira da Costa

    2008-02-01

    Full Text Available The sensitivity of adult spontaneously hypertensive rats (SHR to the diabetogenic effect of streptozotocin (STZ was studied. The animals were subdivided into three groups: control (citrate buffer, streptozotocin 40 mg/kg or 50 mg/kg, and general biologic parameters were analyzed, in addition to systolic blood pressure, blood glucose and insulin levels determinations. Both doses were able to induce hyperglycemia above 300 mg/dl; however, 50 mg/kg provoked a more pronounced physiological alterations in body weight, diuresis, water and food intake. There was no change on systolic blood pressure with either dose. Results suggested that SHRs did not need doses of streptozotocin above 40mg/kg in order to produce diabetes probably because this strain was much more sensible than normotensive rats. In addition, streptozotocin might be a drug choice to induce diabetes without provoking alterations in the blood pressure which allowed the use of this experimental model in the studies of induced hypertension-diabetes.Foi estudada a sensibilidade de ratos espontaneamente hipertensos (SHR adultos ao efeito diabetogênico da estreptozotocina (STZ. Os animais foram subdivididos em grupos: controle (tampão citrato, 40 mg/kg ou 50 mg/kg de estreptozotocina, sendo analisados parâmetros biológicos gerais, pressão arterial sistólica, níveis sanguíneos de glicose e insulina. Ambas doses foram capazes de induzir hiperglicemia acima de 300 mg/dl, entretanto a dose de 50 mg/kg provocou efeitos fisiológicos mais pronunciados no peso corpóreo, diurese, ingestão hídrica e de ração. Não houve alteração da pressão arterial sistólica em qualquer dose. Nossos achados sugerem que SHRs não necessitam de doses de estreptozotocina acima de 40 mg/kg com para produzir diabetes, provavelmente porque essa cepa é muito mais sensível do que ratos normotensos. A estreptozotocina pode ser a droga de escolha para induzir diabetes sem provocar alterações na press

  17. 犬急性肺动脉高压模型上腔静脉多普勒血流速度频谱变化规律研究%Study of superior vena cava Doppler flow velocity spectrum in the canine model of acute pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    孙丹丹; 段云友; 陈洪茂; 袁丽君; 梁宁南; 尚福军; 侯娜

    2011-01-01

    Objective To explore the relationship between the pulmonary artery pressure and the changes of spectrum of superior vena cava( SVC )blood flow in the canine model of acute thromboembolic pulmonary hypertension ( ATEPH ). Methods A canine model of ATEPH was developed by infusing thrombus into the femoral vein. The pulmonary arterial pressure was simultaneously measured via the right heart catheter. The maximum systolic peak flow velocity( S ), diastolic peak flow velocityC D ), atrial reverse peak flow velocityC AR ), and ventricular reverse peak flow velocity( VR )of the SVC were measured by Doppler echocardiography in the right supraclavicular fossa view. Paired samples f-test was used to compare the parameters before and after ATEPH. Simple linear regression was used to analyze the relations of the Doppler spectral indexes with the PASP. Results The models were successfully established in 24 dogs with the peak value of pulmonary arterial systolic pressure ( PASP ) greater than 30 mm Hg. Compared with the pre-embolization: S significantly decreased in the moderate and severe pulmonary hypertension group [( 15. 37 ± 8.08 ),( 14.72 ±7.42 ),( 19.92 ±7.27 )cm/s,f =2. 055,2.265,aU P <0.05 ],AR was significantly higher in the moderate and severe hypertension group[ ( 14. 08 ± 5.30),(21.84±6.56),(l0.05±2.8l)cm/s,f = -3.155, -8. 892,all P <0.05 ], VR was significantly higher in the severe pulmonary hypertension group[ ( 13. 03 ± 6.67),(8.87±2. 88)cm/s,f = -2. 101,P<0. 05 ]. The ratios of AR/S and VR/S increased significantly with the increase of PASP, and was positively correlated with PASP( r = 0.693,0.646, all P < 0. 01 ). Conclusion The ratios of AR/S and VR/S have good correlations with the pulmonary artery systolic pressure, and may provide good indexes for the assessment of pulmonary artery pressure.%目的 探索犬血栓栓塞性肺动脉高压模型上腔静脉血流频谱的变化规律及意义.方法 通过股静脉注入血栓栓子建立犬血栓栓

  18. Successful Tricuspid Valve Replacement in a Patient with Severe Pulmonary Arterial Hypertension and Preserved Right Ventricular Systolic Function

    Directory of Open Access Journals (Sweden)

    Jamil A. Aboulhosn

    2009-01-01

    Full Text Available A 56-year-old patient with severe pulmonary hypertension developed severe tricuspid regurgitation, right-sided heart failure, and congestive hepatopathy. She was transferred for possible lung transplant and/or tricuspid valve surgery. Clinical and echocardiographic assessment provided confidence that acute tricuspid valve failure was responsible for the decompensation and that tricuspid valve replacement despite pulmonary hypertension could be performed.

  19. Evaluation of Patients Cooperation in Hypertension Control

    Science.gov (United States)

    Brankovic, Suada; Pilav, Aida; Cilovic-Lagarija, Seila; Segalo, Mersa

    2014-01-01

    Introduction: Hypertension (high blood pressure) is one of the most widely spread diseases of our time and one of the leading risk factors for heart and vascular diseases, particularly stroke and coronary heart disease. According to the World Health Organization (WHO) cardiovascular diseases are the leading cause of death in the world of who dies each year about 17 million persons, of which 5 million in Europe. The World Health Organization estimates based on monitoring of demographic trends, trends in mortality and morbidity as economic models, further growth of cardiovascular diseases, especially in developing countries. Goal: Correlate the success of antihypertensive therapy and provoking factors, and to determine the degree of satisfaction with the effect of antihypertensive therapy of the patient. Material and methods: The study was conducted at the Primary Health Care Center Stari Grad - Sarajevo. Conducted is study that included 80 patients. Data for this study were collected by a questionnaire. The questionnaire was completed by the examiner using interviews with patients and their relatives (parents, guardians).After sorting, control and grouping the data were imported into the statistical software package SPSS 20.0, where after defining variables was performed statistical analysis. Results: The average age of male respondents was 60.80±13.03 and 63.50 ± 7.48 years of female respondents. The average value of systolic blood pressure amounted to 148mmHg (130-180), while the average value of diastolic blood pressure was 88.75mmHg (70-120). Student's t test showed that the average value of systolic pressure was statistically significantly different from the reference value (t=2.387, DF=19, p=0.028), and also the average values of diastolic blood pressure were statistically significantly different compared to baseline (p=3.561, DF=19, p=0.002). Of the total number of subjects included in this study good blood pressure control had 58 participants, and the

  20. Exercise and Pulmonary Hypertension (PH)

    Science.gov (United States)

    ... exercise is very beneficial for healthy individuals, increasing cardiovascular and muscular fitness, improving mood, controlling weight and lowering the risk of systemic hypertension and heart disease. Exercise may help lower the risk of chronic illnesses ...

  1. STROKE PREVENTION IN HYPERTENSIVE PATIENTS

    Directory of Open Access Journals (Sweden)

    S. Y. Martsevich

    2006-01-01

    Full Text Available Importance of the stroke as one of the main reason of population mortality and invalidity is considered. Stroke risk factors including arterial hypertension are described. The main pharmacotherapy ways of primary and secondary stroke prevention are discussed.

  2. Dopamine, the kidney, and hypertension.

    Science.gov (United States)

    Harris, Raymond C; Zhang, Ming-Zhi

    2012-04-01

    There is increasing evidence that the intrarenal dopaminergic system plays an important role in the regulation of blood pressure, and defects in dopamine signaling appear to be involved in the development of hypertension. Recent experimental models have definitively demonstrated that abnormalities in intrarenal dopamine production or receptor signaling can predispose to salt-sensitive hypertension and a dysregulated renin-angiotensin system. In addition, studies in both experimental animal models and in humans with salt-sensitive hypertension implicate abnormalities in dopamine receptor regulation due to receptor desensitization resulting from increased G-protein receptor kinase 4 (GRK4) activity. Functional polymorphisms that predispose to increased basal GRK4 activity both decrease dopamine receptor activity and increase angiotensin II type 1 (AT1) receptor activity and are associated with essential hypertension in a number of different human cohorts.

  3. A case of hypertensive urgency.

    Science.gov (United States)

    Baum, Laurence

    2016-08-01

    A 41-year-old male Nepalese soldier presented to the primary care medical centre with a 1-week history of fatigue and muscle aches following a trip to Nepal. His BP was 164/98 but was otherwise normal. Four days later he presented with new symptoms of sweating and palpitations and a BP of 200/127 whereupon he was admitted to hospital with the diagnosis of hypertensive crisis. Appropriate investigation and initial management were undertaken, and he was discharged after 12 h on antihypertensive treatment. This case highlights the risk of hypertensive crisis in both diagnosed and silent hypertensive disease, and the review highlights the presentations, initial investigation and different management of hypertensive crisis.

  4. Update in pulmonary arterial hypertension.

    Science.gov (United States)

    Mejía Chew, C R; Alcolea Batres, S; Ríos Blanco, J J

    2016-11-01

    Pulmonary arterial hypertension is a rare and progressive disease that mainly affects the pulmonary arterioles (precapillary), regardless of the triggering aetiology. The prevalence of pulmonary hypertension and pulmonary arterial hypertension in Spain is estimated at 19.2 and 16 cases per million inhabitants, respectively. The diagnosis of pulmonary arterial hypertension is based on haemodynamic criteria (mean pulmonary artery pressure ≥25mmHg, pulmonary capillary wedge pressure ≤15mmHg and pulmonary vascular resistance >3 Wood units) and therefore requires the implementation of right cardiac catheterisation. Sequential therapy with a single drug has been used in clinical practice. However, recent European guidelines recommend combined initial therapy in some situations. This review conducts a critical update of our knowledge of this disease according to the latest guidelines and recommendations.

  5. Dopamine, the Kidney, and Hypertension

    OpenAIRE

    Raymond C. Harris; Zhang, Ming-Zhi

    2012-01-01

    There is increasing evidence that the intrarenal dopaminergic system plays an important role in the regulation of blood pressure, and defects in dopamine signaling appear to be involved in the development of hypertension. Recent experimental models have definitively demonstrated that abnormalities in intrarenal dopamine production or receptor signaling can predispose to salt-sensitive hypertension and a dysregulated renin-angiotensin system. In addition, studies in both experimental animal mo...

  6. A focus on paediatric hypertension

    OpenAIRE

    Pier Paolo Bassareo; Giuseppe Mercuro

    2015-01-01

    Hypertension can begin early in childhood, as occasional increases in blood pressure or abnormal blood pressure responses to physical or emotional stress. High blood pressure in juvenile age is defined as a blood pressure repeatedly above the 95th percentile of specific nomograms. Its worldwide prevalence ranges from 1% to about 10%. The purpose of this paper is to perform an overview about characteristics, diagnosis, risk factors, therapy, and prognosis of paediatric hypertension.

  7. Correlative research between homocysteine,cystatin C and patients with essential hypertension and hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    孙屿

    2014-01-01

    Objective To investigate the correlation between homocysteine(Hcy),cystatin C(Cys C)and patients with essential hypertension and hypertensive intracerebral hemorrhage.Methods Subjects were divided into hypertensive intracerebral hemorrhage group(108 cases),essential hypertension group(100 cases)and control group(100 cases),and their cystatin C,homocysteine and total cholesterol(TC)and triglycerides(TG)were surveyed.Results The patients with hypertensive intracerebral hemorrhage and essential hypertension had higher

  8. Immune Mechanisms in Arterial Hypertension.

    Science.gov (United States)

    Wenzel, Ulrich; Turner, Jan Eric; Krebs, Christian; Kurts, Christian; Harrison, David G; Ehmke, Heimo

    2016-03-01

    Traditionally, arterial hypertension and subsequent end-organ damage have been attributed to hemodynamic factors, but increasing evidence indicates that inflammation also contributes to the deleterious consequences of this disease. The immune system has evolved to prevent invasion of foreign organisms and to promote tissue healing after injury. However, this beneficial activity comes at a cost of collateral damage when the immune system overreacts to internal injury, such as prehypertension. Renal inflammation results in injury and impaired urinary sodium excretion, and vascular inflammation leads to endothelial dysfunction, increased vascular resistance, and arterial remodeling and stiffening. Notably, modulation of the immune response can reduce the severity of BP elevation and hypertensive end-organ damage in several animal models. Indeed, recent studies have improved our understanding of how the immune response affects the pathogenesis of arterial hypertension, but the remarkable advances in basic immunology made during the last few years still await translation to the field of hypertension. This review briefly summarizes recent advances in immunity and hypertension as well as hypertensive end-organ damage.

  9. The hidden epidemic of hypertension.

    Science.gov (United States)

    Grenfell, Robert; Lee, Rebecca; Stavreski, Bill; Page, Karen

    2014-04-01

    The majority of cardiovascular disease (CVD) is caused by risk factors that can be controlled, treated or modified. In terms of attributable deaths, the leading cardiovascular disease risk factor is hypertension. The Australian Health Survey results showed some startling figures-4.6 million adult Australians are hypertensive (>140/90 mmHg). Further, a fifth of the adult population experience hypertension, with more than two out of three not attaining blood pressure target levels. This is despite an estimated cost of $1 billion per annum spent on managing hypertension. It is now well recognised that the level of risk for coronary heart disease is linked to an individual's risk profile. Results indicate that many Australians have multiple risk factors, including hypertension. It could be considered that these numbers provide a proxy indicator of secondary prevention failure. Considerable attention needs to be given to the assessment of the combined risk of those with hypertension enabling effective management of identified, modifiable risk factors. We look forward to presenting the absolute risk profiles when the Australian Health Survey biometric results are released.

  10. [Hypertension during pregnancy: Epidemiology, definition].

    Science.gov (United States)

    Fauvel, Jean-Pierre

    2016-01-01

    Hypertension in pregnancy has several forms that differ by their mechanisms and their consequences for mothers and fetus. Chronic hypertension is defined by SBP≥140mm Hg or DBP≥90mm Hg before pregnancy or before the 20th week of amenorrhea. Gestational hypertension is defined by SBP≥140mm Hg or DBP≥90mm Hg during or after the 20th week of amenorrhea. Preeclampsia is the occurrence of hypertension and proteinuria after 20weeks of amenorrhea. Severe preeclampsia is accompanied by clinical signs and symptoms indicating visceral pain. The HELLP syndrome is a severe preeclampsia accompanied by intravascular hemolysis and hepatic cytolysis. Eclampsia is characterized by seizures of the tonic-clonic type. A chronic hypertension is observed in 1-5% of pregnancies. Gestational hypertension without proteinuria appears in 5-6% of pregnancies. A preeclampsia develops in 1-2% of pregnancies, but much more frequently (up 34%) in the presence of risk factors. High blood pressure during pregnancy remains, by its complications, the leading cause of maternal morbidity and mortality.

  11. Portopulmonary hypertension: from diagnosis to treatment.

    Science.gov (United States)

    Giusca, Sorin; Jinga, Mariana; Jurcut, Ciprian; Jurcut, Ruxandra; Serban, Marinela; Ginghina, Carmen

    2011-10-01

    Portopulmonary hypertension is a form of pulmonary arterial hypertension that has gained interest in recent years with the development of liver transplantation techniques and new pulmonary vasodilator therapies. Portopulmonary hypertension is defined as pulmonary artery hypertension associated with portal hypertension with or without advanced hepatic disease. Echocardiography plays a major role in screening for portopulmonary hypertension but right heart catheterization remains the gold standard for diagnosis. The treatment of patients with portopulmonary hypertension consists of general measures that apply to all patients that carry the diagnosis of pulmonary hypertension and specific vasodilator therapies. These new therapies showed encouraging results in patients who would otherwise have a contraindication for liver transplantation. The review presents a summary of the current knowledge on the epidemiology, diagnosis, treatment and prognosis of patients with portopulmonary hypertension.

  12. Provoking, disturbing, hacking

    DEFF Research Database (Denmark)

    Groth, Sanne Krogh

    Among the artists on the contemporary Danish scene of computer music and sound art the musician and composer Goodiepal (Gæoudjiparl van den Dobbelsteen or Parl Kristian Bjørn Vester) is by no comparison the most controversial and provocative. This statement is applicable whether we meet him...

  13. Provoking, disturbing, hacking

    DEFF Research Database (Denmark)

    Groth, Sanne Krogh

    2013-01-01

    The article is a discussion of works by two Danish composers who both, with self-constructed instruments challenge computer music both as genre, the understanding and use of conventional technology and the relation to history. At first glance, the use of the homemade instruments appears as a common...

  14. Anti-hypertensive property of a nickel-piperazine/NO donor in spontaneously hypertensive rats.

    Science.gov (United States)

    Monti, Martina; Ciccone, Valerio; Pacini, Aurora; Roggeri, Riccardo; Monzani, Enrico; Casella, Luigi; Morbidelli, Lucia

    2016-05-01

    The nickel-piperazine/NO donor compound, Ni(PipNONO)Cl, belonging to the family of compounds labelled as "metal-nonoates", due to its promising vasodilating activity, has been considered as a potential drug candidate in anti-hypertensive therapy. Drug efficacy has been evaluated in spontaneously hypertensive rats (SHR) in comparison with normotensive animals (C57BL/6 mice and WKY rats). In normotensive animals the metal-nonoate maintained blood pressure at basal level both following acute administration and after 30 days of treatment. In SHR, Ni(PipNONO)Cl reduced blood pressure in the dose range of 3-10mg/kg. When compared with a commercial NONOate, DETA/NO, used at the same doses, Ni(PipNONO)Cl was more active in reducing blood pressure in SHR than DETA/NO in the first two weeks, while the effect of the two molecules was similar in the third and fourth week. The degradation and control compound Ni(Pip)Cl2 had no effect on blood pressure and heart rate in same animal models. Remarkably, the blood pressure reduction induced by the new NO-donor Ni(PipNONO)Cl does not evoke changes in the heart rate and tolerance. Considering the mechanisms of vascular protection, 30 days of administration of Ni(PipNONO)Cl improved endothelial function in SHR by upregulating endothelial NO synthase (eNOS) through increased eNOS protein levels and downregulated Caveolin-1 (Cav-1), and by increasing superoxide dismutase 1 (SOD1) protein level in aortae. In cultured endothelial cells Ni(PipNONO)Cl restored the cell functions (cytoskeletal protein expression, migration and proliferation) altered by the inflammatory mediator interleukin-1β (IL-1β), impairing the endothelial to mesenchimal transition. In conclusion, Ni(PipNONO)Cl maintained unaltered blood pressure in normotensive mice and rats, and it exerted anti-hypertensive effect in SHR through the restoration of vascular endothelial protective functions.

  15. Acute cholecystitis

    OpenAIRE

    Halpin, Valerie

    2014-01-01

    Acute cholecystitis causes unremitting right upper quadrant pain, anorexia, nausea, vomiting, and fever, and if untreated can lead to perforations, abscess formation, or fistulae. About 95% of people with acute cholecystitis have gallstones.It is thought that blockage of the cystic duct by a gallstone or local inflammation can lead to acute cholecystitis, but we don't know whether bacterial infection is also necessary.

  16. Vasorreactividad a adenosina en los pacientes con hipertensión pulmonar arterial: Prevalencia y respuesta clínica, funcional y hemodinámica al tratamiento con diltiazem Acute vasodilatador test using adenosine in patients with pulmonary arterial hypertension: Prevalence and clinical, functional and hemodynamic response after diltiazem treatment

    Directory of Open Access Journals (Sweden)

    MÓNICA ZAGOLÍN B

    2009-01-01

    Full Text Available La Hipertensión Pulmonar Arterial (HAP es una entidad grave y progresiva. El estudio hemodinámica (EH permite certificar el diagnóstico y evaluar la vasorreactividad mediante adenosina. Los pacientes vaso-reactivos podrían responder a terapia con diltiazem. No existe información nacional al respecto. En nuestro programa todo paciente con sospecha de HAP es sometido a EH diagnóstico y de vasorreactividad. Los positivos son tratados con diltiazem y seguidos semestralmente según capacidad funcional (CF y con test de caminata. Al 6º mes se efectúa un 2º EH. Entre 2003-2008, 6/54 (11% de los pacientes con HAP fueron vasorreactivos. Todas mujeres, 45 ± 14 años, 4 con HPA idiopática, 4 en CFIII y 2 en CFII. A los 2 años, todos mejoraron clínicamente. La distancia recorrida aumentó significativamente en los meses 12 y 24 en 83 y 87 m respectivamente. Todas las variables hemodinámicas mejoraron. La terapia con diltiazem es efectiva en los pacientes vaso-reactivos lo que justifica usar el test de vasorreactividad.Pulmonary arterial hypertension (PAH is a severe and progressive disease. Invasive hemodynamic study (HS is required to confirm the diagnosis of PAH and to perform the vasodilator test (VT with adenosine. Vasodilator acute responders (VAR may have a sustained benefit with diltiazem. There is not national information regarding these issues. All patients with probable PAH were evaluated with HS and VT. VAR were treated with diltiazem and followed up with functional class score (FC and 6 minute walk test. After 6 months, a second HS was performed. Results: Between 2003 and 2008, 6/54 (11% were VAR. All were women, 45 ± 14 years oíd, 4 with idiopathic PAH, 4 in FCIII and 2 in FCII. After two years of treatment, all patients clinically improved. Walked distance significantly increased by 83 and 87 m at month 12 and 24 respectively. Hemodynamic parameters also improved. Therapy with diltiazem is effective in VAR patients supporting

  17. Exogenous interleukin-6, interleukin-13, and interferon-gamma provoke pulmonary abnormality with mild edema in enterovirus 71-infected mice

    Directory of Open Access Journals (Sweden)

    Huang Szu-Wei

    2011-11-01

    Full Text Available Abstract Background Neonatal mice developed neurological disease and pulmonary dysfunction after an infection with a mouse-adapted human Enterovirus 71 (EV71 strain MP4. However, the hallmark of severe human EV71 infection, pulmonary edema (PE, was not evident. Methods To test whether EV71-induced PE required a proinflammatory cytokine response, exogenous pro-inflammatory cytokines were administered to EV71-infected mice during the late stage of infection. Results After intracranial infection of EV71/MP4, 7-day-old mice developed hind-limb paralysis, pulmonary dysfunction, and emphysema. A transient increase was observed in serum IL-6, IL-10, IL-13, and IFN-γ, but not noradrenaline. At day 3 post infection, treatment with IL-6, IL-13, and IFN-γ provoked mild PE and severe emphysema that were accompanied by pulmonary dysfunction in EV71-infected, but not herpes simplex virus-1 (HSV-1-infected control mice. Adult mice did not develop PE after an intracerebral microinjection of EV71 into the nucleus tractus solitarii (NTS. While viral antigen accumulated in the ventral medulla and the NTS of intracerebrally injected mice, neuronal loss was observed in the ventral medulla only. Conclusions Exogenous IL-6, IL-13, and IFN-γ treatment could induce mild PE and exacerbate pulmonary abnormality of EV71-infected mice. However, other factors such as over-activation of the sympathetic nervous system may also be required for the development of classic PE symptoms.

  18. Age-Related Disruption of Steady-State Thymic Medulla Provokes Autoimmune Phenotype via Perturbing Negative Selection.

    Science.gov (United States)

    Xia, Jiangyan; Wang, Hongjun; Guo, Jianfei; Zhang, Zhijie; Coder, Brandon; Su, Dong-Ming

    2012-06-01

    The hymic medulla plays an essential role in the generation of central tolerance by eliminating self-reactive T-cell clones through thymic negative selection and developing natural regulatory T cells. Age-related FoxN1 decline induces disruption of medullary thymic epithelial cells (mTECs). However, it is unknown whether this perturbs central tolerance to increase autoimmune predisposition in the elderly. Using a loxP-floxed-FoxN1 (FoxN1(flox)) mouse model, which exhibits a spontaneous ubiquitous deletion of FoxN1 with age to accelerate thymic aging, we investigated whether disruption of steady-state thymic medulla results in an increase of autoimmune-prone associated with age. We demonstrated age-associated ubiquitous loss of FoxN1(flox)-formed two-dimensional thymic epithelial cysts were primarily located in the medulla. This resulted in disruption of thymic medullary steady state, with evidence of perturbed negative selection, including reduced expression of the autoimmune regulator (Aire) gene and disrupted accumulation of thymic dendritic cells in the medulla, which are required for negative selection. These provoke autoimmune phenotypes, including increased inflammatory cell infiltration in multiple organs in these mice. This finding in an animal model provides a mechanistic explanation of increased susceptibility to autoimmunity in aged humans, although they may not show clinic manifestations without induction.

  19. Primary pulmonary hypertension.

    Science.gov (United States)

    Rashid, A; Lehrman, S; Romano, P; Frishman, W; Dobkin, J; Reichel, J

    2000-01-01

    Primary pulmonary hypertension (PPH) is a condition characterized by sustained elevation of pulmonary artery pressure (PAP) without demonstrable cause. The most common symptom at presentation is dyspnea. Other complaints include fatigue, chest pain, syncope, leg edema, and palpitations. Right heart catheterization is diagnostic, showing a mean PAP >25 mmHg at rest and >30 mmHg during exercise, with a normal pulmonary capillary wedge pressure. In the National Institutes of Health-PPH registry, the median survival period was 2.8 years. Treatment is aimed at lowering PAP, increasing cardiac output, and decreasing in situ thrombosis. Vasodilators have been used with some success in the treatment of PPH. They include prostacyclin, calcium-channel blockers, nitric oxide and adenosine. Anticoagulation has also been advised for the prevention of deep vein thrombosis, pulmonary embolism, and in situ thromboses of the lungs. New drug treatments under investigation include L-arginine, plasma endothelin-I, and bosentan. Use of oxygen, digoxin, and diuretics for symptomatic relief have also been recommended. Patients with severe PPH refractory to medical management should be considered for surgery.

  20. Inflammation and pulmonary hypertension.

    Science.gov (United States)

    Mathew, Rajamma

    2010-01-01

    Pulmonary hypertension (PH) is a serious disorder with high morbidity and mortality rate. Evidence is accumulating to suggest that inflammation plays a significant role in the pathogenesis of PH. Endothelial cells play an important role in inflammation and immune reactions, and inflammatory cytokines cause endothelial dysfunction. Endothelial dysfunction is a hallmark of PH, consisting of reduced availability of vasodilators and antiproliferative factors and increased production of vasoconstrictors and vascular proliferative factors. Up-regulation of inflammatory cytokines and perivascular inflammatory cell infiltration have been detected in the lungs of patients with idiopathic PH. Prevalence of PH in patients with systemic inflammatory diseases is well documented. Interestingly, a significant loss of endothelial caveolin-1, a potent immunomodulator and an inhibitor of cell proliferation, has been reported in human and experimental forms of PH. Reduction in the expression of caveolin-1 is known to result in the removal of antiproliferative activities, thus, leading to deregulated vascular cell proliferation. This article summarizes the roles of inflammation and endothelial caveolin-1 and their possible interrelationship in PH.

  1. [Hypertension and dementia].

    Science.gov (United States)

    Hanon, O

    2014-06-01

    Prevention and treatment of dementia has turned into a major public health challenge. Several epidemiological studies have indicated a significant association between the presence of hypertension and the onset of dementia (vascular or Alzheimer's type) several years later. Cognitive disorder may be related to focal cerebral lesions of vascular origin (infarctus, lacunae) and/or chronic ischemia of the white matter (white matter lesions) related to arteriosclerosis and/or lipohyalinosis of small perforating arteries high blood pressure in mid-life to later cognitive decline and dementia. Moreover, disorders of cerebral microcirculation and endothelial dysfunction may be associated to blood brain barrier dysfunction and amyloid plaques formation leading to Alzheimer's process. Few randomized clinical trials have included a cognitive assessment and dementia as outcome in their design. They all raise some major criticisms: cognitive assessment was never the main outcome, too short follow-up to study dementia; incomplete assessment of cognition, lost of follow-up and a small proportion of subjects at risk for dementia at inclusion. However, the results of therapeutic trials (SYST-EUR, PROGRESS) open the way to the prevention of dementia (vascular or Alzheimer's type) or cognitive decline by antihypertensive treatments. A meta-analysis including randomized controlled studies, suggests a significant decrease in the risk of dementia with antihypertensive treatment compared to placebo.

  2. Role of sympathetic nervous system and neuropeptides in obesity hypertension

    Directory of Open Access Journals (Sweden)

    J.E. Hall

    2000-06-01

    Full Text Available Obesity is the most common cause of human essential hypertension in most industrialized countries. Although the precise mechanisms of obesity hypertension are not fully understood, considerable evidence suggests that excess renal sodium reabsorption and a hypertensive shift of pressure natriuresis play a major role. Sympathetic activation appears to mediate at least part of the obesity-induced sodium retention and hypertension since adrenergic blockade or renal denervation markedly attenuates these changes. Recent observations suggest that leptin and its multiple interactions with neuropeptides in the hypothalamus may link excess weight gain with increased sympathetic activity. Leptin is produced mainly in adipocytes and is believed to regulate energy balance by acting on the hypothalamus to reduce food intake and to increase energy expenditure via sympathetic activation. Short-term administration of leptin into the cerebral ventricles increases renal sympathetic activity, and long-term leptin infusion at rates that mimic plasma concentrations found in obesity raises arterial pressure and heart rate via adrenergic activation in non-obese rodents. Transgenic mice overexpressing leptin also develop hypertension. Acute studies suggest that the renal sympathetic effects of leptin may depend on interactions with other neurochemical pathways in the hypothalamus, including the melanocortin-4 receptor (MC4-R. However, the role of this pathway in mediating the long-term effects of leptin on blood pressure is unclear. Also, it is uncertain whether there is resistance to the chronic renal sympathetic and blood pressure effects of leptin in obese subjects. In addition, leptin also has other cardiovascular and renal actions, such as stimulation of nitric oxide formation and improvement of insulin sensitivity, which may tend to reduce blood pressure in some conditions. Although the role of these mechanisms in human obesity has not been elucidated, this

  3. Central Systolic Hypertension in Patients with Well-Controlled Hypertension

    Science.gov (United States)

    Potočárová, Mária; Murín, Ján; Kozlíková, Katarína; Luha, Ján; Čaprnda, Martin

    2017-01-01

    Background. Central systolic blood pressure (CSBP) has prognostic significance and simplified devices for its estimation have been introduced recently. The aim of this study was to assess the achievement of the target CSBP in treated hypertensive patients. Subjects and Methods. One hundred patients with well-controlled hypertension were analysed. For CSBP estimation, we used the Arteriograph (TensioMed Ltd.), which uses one cuff for all measurements, the “single-point measurement” approach. Results. We found that 62% of patients had CSBP ≥ 130 mmHg, the suggested cut-off value for hypertension. When sex-specific classification was employed (CSBP ≥ 137 mmHg for female and CSBP ≥ 133 mmHg for male), only 13% of patients (mainly women) remained in the hypertensive range. We also found that 55% of patients had a CSBP higher than brachial pressure. Multiple analyses showed that CSBP was significantly associated with sex, height, and return time. Conclusions. A high proportion of treated hypertensive patients had CSBP levels that exceeded their brachial BP. CSBP positively correlated with lower height and shorter return time of the reflected pressure wave and was significantly higher in females compared to males. These findings suggest that, for CSBP classification, it is important to take height and sex-specific differences into account. PMID:28127560

  4. First-Line First? Trends in Thiazide Prescribing for Hypertensive Seniors

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    Morgan Steve

    2005-01-01

    Full Text Available Background Evidence of reduced cardiovascular morbidity and mortality as well as cost support thiazide diuretics as the first-line choice for treatment of hypertension. The purpose of this study was to determine the proportion of senior hypertensives that received thiazide diuretics as first-line treatment, and to determine if cardiovascular and other potentially relevant comorbidities predict the choice of first-line therapy. Methods and Findings British Columbia PharmaCare data were used to determine the cohort of seniors (residents aged 65 or older who received their first reimbursed hypertension drug during the period 1993 to 2000. These individual records were linked to medical and hospital claims data using the British Columbia Linked Health Database to find the subset that had diagnoses indicating the presence of hypertension as well as cardiovascular and other relevant comorbidities. Rates of first-line thiazide prescribing as proportion of all first-line treatment were analysed, accounting for patient age, sex, overall clinical complexity, and potentially relevant comorbidities. For the period 1993 to 2000, 82,824 seniors who had diagnoses of hypertension were identified as new users of hypertension drugs. The overall rate at which thiazides were used as first-line treatment varied from 38% among senior hypertensives without any potentially relevant comorbidity to 9% among hypertensives with previous acute myocardial infarction. The rate of first-line thiazide diuretic prescribing for patients with and without potentially relevant comorbidities increased over the study period. Women were more likely than men, and older patients were more likely than younger, to receive first-line thiazide therapy. Conclusions Findings indicate that first-line prescribing practices for hypertension are not consistent with the evidence from randomized control trials measuring morbidity and mortality. The health and financial cost of not selecting the most

  5. First-line first? Trends in thiazide prescribing for hypertensive seniors.

    Directory of Open Access Journals (Sweden)

    Steve Morgan

    2005-04-01

    Full Text Available BACKGROUND: Evidence of reduced cardiovascular morbidity and mortality as well as cost support thiazide diuretics as the first-line choice for treatment of hypertension. The purpose of this study was to determine the proportion of senior hypertensives that received thiazide diuretics as first-line treatment, and to determine if cardiovascular and other potentially relevant comorbidities predict the choice of first-line therapy. METHODS AND FINDINGS: British Columbia PharmaCare data were used to determine the cohort of seniors (residents aged 65 or older who received their first reimbursed hypertension drug during the period 1993 to 2000. These individual records were linked to medical and hospital claims data using the British Columbia Linked Health Database to find the subset that had diagnoses indicating the presence of hypertension as well as cardiovascular and other relevant comorbidities. Rates of first-line thiazide prescribing as proportion of all first-line treatment were analysed, accounting for patient age, sex, overall clinical complexity, and potentially relevant comorbidities. For the period 1993 to 2000, 82,824 seniors who had diagnoses of hypertension were identified as new users of hypertension drugs. The overall rate at which thiazides were used as first-line treatment varied from 38% among senior hypertensives without any potentially relevant comorbidity to 9% among hypertensives with previous acute myocardial infarction. The rate of first-line thiazide diuretic prescribing for patients with and without potentially relevant comorbidities increased over the study period. Women were more likely than men, and older patients were more likely than younger, to receive first-line thiazide therapy. CONCLUSIONS: Findings indicate that first-line prescribing practices for hypertension are not consistent with the evidence from randomized control trials measuring morbidity and mortality. The health and financial cost of not selecting the

  6. New therapies for arterial hypertension.

    Science.gov (United States)

    Pagliaro, Beniamino; Santolamazza, Caterina; Rubattu, Speranza; Volpe, Massimo

    2016-03-01

    Arterial hypertension is the most common chronic disease in developed countries and it is the leading risk factor for stroke, ischemic heart disease, congestive heart failure, chronic renal failure and peripheral artery disease. Its prevalence appears to be about 30-45% of the general population. Recent European guidelines estimate that up to 15-20% of the hypertensive patients are not controlled on a dual antihypertensive combination and they require three or more different antihypertensive drug classes to achieve adequate blood pressure control. The guidelines confirmed that diuretics, beta-blockers, calcium-channel blockers, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are suitable for the initiation and maintenance of antihypertensive treatment, either as monotherapy or in combination therapy. Very few antihypertensive agents have reached the market over the last few years, but no new therapeutic class has really emerged. The long-term adherence to cardiovascular drugs is still low in both primary and secondary prevention of cardiovascular diseases. In particular, the issue of compliance is persistently high in hypertension, despite the fixed-dose combination therapy. As a consequence, a cohort of high-risk hypertensive population, represented by patients affected by refractory and resistant hypertension, can be identified. Therefore, the need of controlling BP in high-risk patients may be addressed, in part, by the development of new drugs, devices and procedures that are designed to treat hypertension and comorbidities. In this review we will comprehensively discuss the current literature on recent therapeutic advances in hypertension, including both medical therapy and interventional procedures.

  7. Thiazide diuretics in the management of hypertension.

    Science.gov (United States)

    Khan, Nadia A; Campbell, Norman R C

    2004-01-01

    Hypertension is highly prevalent in Canada, affecting more than 20% of all adults. Thiazide diuretics have been shown in numerous studies to be effective agents for controlling blood pressure and reducing cardiovascular disease and death in hypertensive patients. Thiazide diuretics are recommended as initial first line therapy for uncomplicated hypertension in the 2003 Canadian Hypertension recommendations. However, these agents are underutilized and in Canada, the proportion of persons with hypertension treated with diuretics is declining. To improve understanding of thiazide diuretic use, this document outlines the clinical pharmacology of thiazide diuretics, evidence for effectiveness in treating hypertension, as well as the side effects and controversies surrounding their use.

  8. EVALUATION OF RISK FACTORS IN ACUTE STROKE

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    Putta

    2015-03-01

    Full Text Available Introduction: Cerebrovascular disease is the third most common cause of death in the developed world after cancer and ischemic heart disease. In India, community surveys have shown a crude prevalence rate of 200 per 100000 population for hemiplegia. Aims and objectives: Identification of risk factors for c erebrovascular disease. Materials and Methods: Inclusion Criteria: Cases of acute stroke admitted in S.V.R.R.G.G.H, Tirupati were taken for the study. Exclusion Criteria: Head injury cases, neoplasm cases producing cerebrovascular disease were excluded. Re sults: Stroke was more common in male, 54% patients were male 46% were female. It was more common in 6 th and 7 th decade. More common risk factors were hypertension followed by smoking, diabetes mellitus. More common pathology was infarction. Conclusion: Com mon risk factors for acute stroke are hypertension, smoking, diabetes mellitus, alcoholism, obesity, cardiac disease. Stroke was confirmed by CT scan of brain.

  9. Tom Pickering as a clinical scientist: masked hypertension.

    Science.gov (United States)

    Eguchi, Kazuo

    2010-04-01

    Masked hypertension has been 'unmasked' by the use of the out-of-office measurement of blood pressure, as home BP monitoring or ambulatory blood pressure monitoring has become available. The term masked hypertension could be used more widely than the original version of masked hypertension; morning hypertension, stress-induced hypertension, and nocturnal hypertension are all classified as subtypes of masked hypertension. Masked hypertension can also be seen in patients with diabetes, that could change clinical practice in diabetes. Masked hypertension is associated with cardiovascular events, but most of the outcome studies are on antihypertensive medications. Therefore, masked hypertension includes insufficient treatment of hypertension. In Dr Pickering's latest review of masked hypertension, prehypertension or high normal blood pressure was stressed as an associating factor with masked hypertension. The biggest theme in the field of hypertension is how we can detect masked hypertension. I present two interesting cases of possible masked hypertension in this commentary.

  10. The clinical effect of Ex-Press glaucoma drainage device implantation combined with phacoemulsification for primary acute angle-closure glaucoma with cataract and persistent ocular hypertension%持续高眼压下白内障青光眼联合手术中青光眼引流器的应用

    Institute of Scientific and Technical Information of China (English)

    刘杰

    2015-01-01

    目的 探讨Ex-Press青光眼引流器植入联合晶状体超声乳化吸出术治疗合并白内障的急性闭角型青光眼持续高眼压患者的临床效果和安全性.方法 回顾性分析26例(30只眼)行Ex-Press青光眼引流器植入联合超声乳化手术治疗的合并白内障的急性闭角型青光眼持续性高眼压患者术前及术后各时间段的视力、眼压及并发症发生情况.结果 所有患者均随访至1年,完全成功率为76.67%(23只眼),部分成功率23.33%(7只眼),总成功率100.00%.术前平均眼压为(32.19±9.12) mmHg(1 mmHg=0.133kPa).术后1周,1、2、3、6及12个月的平均眼压分别为(10.30±5.07) mmHg、(10.28±4.93) mmHg、(10.87±4.22) mmHg、(11.32±6.11) mmHg、(12.12 ±6.07)mmHg、(13.05±5.26)mmHg,手术后眼压均较术前低,差异有统计学意义(P<0.05).术后1周视力较术前提高,差异有统计学意义(Z=-4.19,P=0.000).30只眼中2只眼出现少量前房积血,分别于术后4~7d吸收;4只眼出现一过性低眼压,8~10 d后眼压>6 mmHg;1只眼出现渗出性脉络膜脱离,于术后14 d复位.所有患者均未出现其他并发症.结论 Ex-Press青光眼引流器植入联合晶状体超声乳化吸出术是治疗合并白内障的急性闭角型青光眼持续性高眼压的一种安全而有效的方法.%Objective To investigate the clinical effects and safety of Ex-Press glaucoma drainage device implantation combined with phacoemulsification (E-P P) for primary acute angle-closure glaucoma (PAACG) with cataract and persistent ocular hypertension.Methods The data of 30 eyes of 26 patients of PAACG with cataract and persistent ocular hypertension were retrospectively analyzed, who received E-P P surgery.The visual acuity,intraocular pressure (IOP) and complications were observed.Results All patients were followed up for 1 year.The complete success rate was 76.67% (23 eyes), the partial success rate was 23.33% (7 eyes), and the total success rate was 100

  11. Hypertension in the nursing home.

    Science.gov (United States)

    Aronow, Wilbert S

    2008-09-01

    Hypertension in a nursing home patient is a systolic blood pressure of 140 mm Hg or higher and 130 mm Hg or higher in a patient with diabetes mellitus or chronic renal insufficiency, or a diastolic blood pressure of 90 mm Hg or higher and 80 mm Hg or higher in a patient with diabetes mellitus or chronic renal insufficiency. Numerous prospective, double-blind, randomized, placebo-controlled studies have demonstrated that antihypertensive drug therapy reduces the development of new coronary events, stroke, and congestive heart failure in older persons. The goal of treatment of hypertension in elderly persons is to lower the blood pressure to less than 140/90 mm Hg and to less than 130/80 mm Hg in older persons with diabetes mellitus or chronic renal insufficiency. Elderly persons with diastolic hypertension should have their diastolic blood pressure reduced to 80 to 85 mm Hg. Diuretics should be used as initial drugs in the treatment of older persons with hypertension and no associated medical conditions. The selection of antihypertensive drug therapy in persons with associated medical conditions depends on their associated medical conditions. If the blood pressure is more than 20/10 mm Hg above the goal blood pressure, drug therapy should be initiated with 2 antihypertensive drugs, one of which should be a thiazide-type diuretic. Other coronary risk factors must be treated in patients with hypertension.

  12. Renal dopamine receptors and hypertension.

    Science.gov (United States)

    Hussain, Tahir; Lokhandwala, Mustafa F

    2003-02-01

    Dopamine has been recognized as an important modulator of central as well as peripheral physiologic functions in both humans and animals. Dopamine receptors have been identified in a number of organs and tissues, which include several regions within the central nervous system, sympathetic ganglia and postganglionic nerve terminals, various vascular beds, the heart, the gastrointestinal tract, and the kidney. The peripheral dopamine receptors influence cardiovascular and renal function by decreasing afterload and vascular resistance and promoting sodium excretion. Within the kidney, dopamine receptors are present along the nephron, with highest density on proximal tubule epithelial cells. It has been reported that there is a defective dopamine receptor, especially D(1) receptor function, in the proximal tubule of various animal models of hypertension as well as in humans with essential hypertension. Recent reports have revealed the site of and the molecular mechanisms responsible for the defect in D(1) receptors in hypertension. Moreover, recent studies have also demonstrated that the disruption of various dopamine receptor subtypes and their function produces hypertension in rodents. In this review, we present evidence that dopamine and dopamine receptors play an important role in regulating renal sodium excretion and that defective renal dopamine production and/or dopamine receptor function may contribute to the development of various forms of hypertension.

  13. Accelerated Hypertension after Venlafaxine Usage

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    Yüksel Kıvrak

    2014-01-01

    Full Text Available Venlafaxine is the first antidepressant that acts via inhibiting serotonin and noradrenaline reuptake. Hypertension is observed in doses exceeding 300 mg/day and is the most feared complication. We report a patient with accelerated hypertension after venlafaxine use observed at a dose of 150 mg/day. A 23-year-old patient with symptoms of insomnia, depression, anhedonia, fatigue admitted our clinic. Venlafaxine at a dose of 75 mg/day was initiated after he was diagnosed with major depressive disorder. After 5 months, venlafaxine dose was uptitrated to 150 mg/day due to inadequate response to drug. After using venlafaxine for ten months at the dose of 150 mg/day, he admitted our clinic with headache and epistaxis. He was hospitalized after his blood pressure was measured as 210/170 mmHg. No secondary causes for hypertension were found, and venlafaxine treatment was considered possible etiologic factor. After stopping venlafaxine treatment, his blood pressure was reverted back to normal limits. While mild elevation of blood pressure could be observed after venlafaxine treatment, this case shows that accelerated hypertension with a diastolic blood pressure rise above 120 mmHg could be observed at relatively low doses of venlafaxine. Close monitoring of blood pressure is necessary after initiation of treatment, as accelerated hypertension could cause endorgan damage with potentially catastrophic results.

  14. Liver cirrhosis and arterial hypertension

    Institute of Scientific and Technical Information of China (English)

    Jens H Henriksen; Soren Moller

    2006-01-01

    Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems (renin-angiotensin-aldosterone system,sympathetic nervous system, release of vasopressin),and resistance to vasopressors. The vasodilatory state is mediated through adrenomedullin, calcitonin generelated peptide, nitric oxide, and other vasodilators,and is most pronounced in the splanchnic area.This constitutes an effective (although relative)counterbalance to increased arterial 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 likely includes the combination of vasodilatation and vasoconstriction in parallel.

  15. Acute Necrotizing Esophagitis Followed by Duodenal Necrosis.

    Science.gov (United States)

    Del Hierro, Piedad Magdalena

    2011-12-01

    Acute Necrotizing Esophagitis is an uncommon pathology, characterized by endoscopic finding of diffuse black coloration in esophageal mucosa and histological presence of necrosis in patients with upper gastrointestinal bleeding. The first case of acute necrotizing esophagitis followed by duodenal necrosis, in 81 years old woman with a positive history of Type 2 Diabetes Mellitus, Hypertension, and usual intake of Nonsteroidal Anti-inflammatory drugs, is reported. Although its etiology remains unknown, the duodenal necrosis suggests that ischemia could be the main cause given that the branches off the celiac axis provide common blood supply to the distal esophageal and duodenal tissue. The massive gastroesophagic reflux and NSAID intake could be involved.

  16. Clinic application of serum low-density lipoprotein cholesterol level in predicting expansion hematoma in elderly male patients with acute hypertensive intracerebral hemorrhage%血清LDL-C水平对老年男性高血压性脑出血血肿扩大的预测作用

    Institute of Scientific and Technical Information of China (English)

    周红霞; 刘首峰; 李玉旺; 王欣; 徐小林

    2015-01-01

    Objective To investigate whether serum level of low-density lipoprotein cholesterol can predict the expan⁃sion of hemorrhage growth in elderly male patients with acute hypertensive intracerebral hemorrhage. Methods Patients (n=108) who visited our hospital with from June 2012 until May 2014 spontaneous hypertensive intracerebral hemorrhage with⁃in 6 hours of onset which is confirmed by initial computed tomography (CT) were sent to repeated CT within 24 hours of on⁃set. All selected patients were divided into the LDL-C≥2.49 mmol/L group and LDL-C<2.49 mmol/L group. Clinical data of these 2 groups were compared and the relationships of hematoma growth and its risk factors were analyzed. Results Baseline blood pressure, the level of blood glucose, PT, APTT, FIB, PLT and hemorrhage volume did not differ significantly between the LDL-C≥2.49 mmol/L group and LDL-C<2.49 mmol/L group. The ratio of hemorrhage growth in LDL-C<2.49 mmol/L group was significantly higher than that in LDL-C≥2.49 mmol/L group (34.21%vs 11.43%). Multiple logistic regres⁃sion analysis showed that LDL-C<2.49 mmol/L was the only risk factor contribute to hemorrhage growth. Conclusion Pa⁃tients with LDL-C<2.49 mmol/L in acute intracerebral hemorrhage are of high risk of hemorrhage growth so early attention and appropriate procedure are needed to prevent or slow its growth.%目的:探讨血清低密度脂蛋白胆固醇(LDL-C)水平对老年男性高血压性脑出血急性期血肿扩大有无预测作用。方法收集我院2012年6月—2014年5月发病6 h以内的老年男性高血压性脑出血患者108例,按发病时LDL-C水平分为LDL-C<2.49 mmol/L组和LDL-C≥2.49 mmol/L组,对2组患者入院时的收缩压(SBP)、舒张压(DBP)、血糖水平、凝血酶原时间(PT)、部分活化凝血酶时间(APTT)、纤维蛋白原(FIB)、血小板计数、血肿体积进行对比分析,并于发病24 h复查头CT了解2组血肿扩大情况并进

  17. Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis

    NARCIS (Netherlands)

    Smit, M.; Buddingh, K. T.; Bosma, B; Nieuwenhuijs, V B; Hofker, H.S.; Zijlstra, J.G.

    2016-01-01

    INTRODUCTION: Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS

  18. Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis

    NARCIS (Netherlands)

    Smit, M.; Buddingh, K. T.; Bosma, B.; Nieuwenhuijs, V. B.; Hofker, H. S.; Zijlstra, J. G.

    2016-01-01

    Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS, in particula

  19. Pressure Points: Preventing and Controlling Hypertension

    Science.gov (United States)

    ... Issue Past Issues Pressure Points: Preventing and Controlling Hypertension Past Issues / Summer 2006 Table of Contents For ... diagnosed with high blood pressure." Aditional Information On Hypertension MedlinePlus: High blood pressure: http://www.nlm.nih. ...

  20. Hypertension: The Demographics of Management and Control.

    Science.gov (United States)

    Ames, Natalie

    1985-01-01

    The ultimate goal of any hypertension control program is reduction of excessive morbidity and mortality from cardiovascular disease. Factors affecting detection of hypertension and compliance with educational intervention are discussed and implications drawn. (MT)

  1. Hypercortisolism in obesity-associated hypertension.

    Science.gov (United States)

    Varughese, Amy G; Nimkevych, Oksana; Uwaifo, Gabriel I

    2014-07-01

    Obesity is prevalent worldwide and associated with co-morbidities that result in increased cardiovascular risk. Hypertension is the most prevalent obesity comorbidity associated with increased cardiovascular risk. Obesity hypertension is a distinct subtype of essential hypertension. While endogenous Cushing's syndrome is an uncommon cause of both obesity and hypertension, the recent recognition of other hypercortisolemic states has raised the profile of hypercortisolism as an important contributor in obesity hypertension. The high prevalence of exogenous, iatrogenic, pseudo, and subclinical Cushing's syndromes makes hypercortisolism an important diagnostic consideration in the evaluation and management of patients with obesity hypertension who are resistant to conventional management. Available data suggest that the renin-angiotensin-aldosterone system modulating antihypertensives have the best efficacy in hypercortisolism-mediated obesity hypertension. Strategies aimed at reducing cortisol production and action also have utility. This review provides a comprehensive overview of the epidemiology, etiopathogenesis and management options available for glucocorticoid-mediated obesity hypertension.

  2. The association of duration of hypertension and changes in cognitive function in hypertension patients

    Institute of Scientific and Technical Information of China (English)

    李拓

    2014-01-01

    Objective To investigate the relationship between duration of hypertension and cognitive function in adult hypertension patients.Methods A total of 224 subjects with normal blood pressure were enrolled in group A,and 1 296 patients with poorly controlled hypertension were further divided by the duration of hypertension into

  3. [Treatment of compression of the left main coronary artery in patients with pulmonary hypertension].

    Science.gov (United States)

    Talavera, María L; Diez, Mirta; Cáneva, Jorge O; Boughen, Roberto P; Valdivieso, León; Mendiz, Oscar

    2011-01-01

    Chest pain is a frequent symptom in patients with pulmonary hypertension of any etiology. Its pathophysiology has not been clearly established, the proposed causes are ischemia due to increased right ventricle wall stress, transient increased pulmonary hypertension resulting in acute pulmonary artery dilatation and external compression of the left main coronary artery (LMCA) by a dilated pulmonary artery. We report and discuss here three cases where the association between chest pain and compression of the LMCA by a dilated pulmonary artery could be shown, and they were treated with coronary stenting.

  4. Taste and hypertension in humans

    DEFF Research Database (Denmark)

    Roura, Eugeni; Foster, Simon; Winklebach, Anja

    2016-01-01

    approaches to mitigate cardiovascular disease (CVD) could well take a different spin in the future following the discovery of taste receptors (TAS1R and TAS2R) in the cardiovascular system. Finally, long-term dietary strategies to minimize the risk of development of hypertension and CVD are discussed......The association between salty taste and NaCl intake with hypertension is well-established, although it is far from completely understood. Other taste types such as sweet, umami or bitter have also been related to alterations in blood pressure. Here, we review the mutual relationship between taste...... and hypertension to identify potential avenues to better control blood pressure. This review focuses on published data involving humans, with the exception of a section on molecular mechanisms. There is compelling evidence to suggest that changes in salty taste sensitivity can be used to predict the onset...

  5. [Hypertension and the metabolic syndrome.

    DEFF Research Database (Denmark)

    Olsen, Michael; Jeppesen, Jørgen; Larsen, Mogens

    2009-01-01

    The metabolic syndrome is a relatively prevalent condition characterized by co-existence of several metabolic and cardiovascular risk factors including hypertension. Patients with hypertension have an increased risk of developing the metabolic syndrome which, in turn, increases the cardiovascular...... risk associated with increased blood pressure. As the definition of the metabolic syndrome is based on dichotomization of cardiovascular risk factors with a continuously increasing risk, it cannot match risk stratification tools like the HeartScore for calculation of prognosis. However, the metabolic...... syndrome is of clinical importance as it makes the treating physician test for other elements of the syndrome in patients with one of the elements, e.g. hypertension. Udgivelsesdato: 2009-Jun-15...

  6. Effects of One Resistance Exercise Session on Vascular Smooth Muscle of Hypertensive Rats

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Tharciano Luiz Teixeira Braga da; Mota, Marcelo Mendonça; Fontes, Milene Tavares; Araújo, João Eliakim dos Santos; Carvalho, Vitor Oliveira; Bonjardim, Leonardo Rigoldi; Santos, Márcio Roberto Viana, E-mail: marciorvsantos@bol.com.br [Universidade Federal de Sergipe, Universidade de São Paulo (Brazil)

    2015-08-15

    Hypertension is a public health problem and increases the incidence of cardiovascular diseases. To evaluate the effects of a resistance exercise session on the contractile and relaxing mechanisms of vascular smooth muscle in mesenteric arteries of N{sup G}-nitro L-arginine methyl ester (L-NAME)-induced hypertensive rats. Wistar rats were divided into three groups: control (C), hypertensive (H), and exercised hypertensive (EH). Hypertension was induced by administration of 20 mg/kg of L-NAME for 7 days prior to experimental protocols. The resistance exercise protocol consisted of 10 sets of 10 repetitions and intensity of 40% of one repetition maximum. The reactivity of vascular smooth muscle was evaluated by concentration‑response curves to phenylephrine (PHEN), potassium chloride (KCl) and sodium nitroprusside (SNP). Rats treated with L-NAME showed an increase (p < 0.001) in systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) compared to the initial period of induction. No difference in PHEN sensitivity was observed between groups H and EH. Acute resistance exercise reduced (p < 0.001) the contractile response induced by KCl at concentrations of 40 and 60 mM in group EH. Greater (p < 0.01) smooth muscle sensitivity to NPS was observed in group EH as compared to group H. One resistance exercise session reduces the contractile response induced by KCl in addition to increasing the sensitivity of smooth muscle to NO in mesenteric arteries of hypertensive rats.

  7. Refeeding hypertension in dietary obesity

    Energy Technology Data Exchange (ETDEWEB)

    Ernsberger, P.; Nelson, D.O. (Northwestern Univ. Medical School, Chicago, IL (USA))

    1988-01-01

    A novel model of nutritionally induced hypertension in the rat is described. Dietary obesity was produced by providing sweet milk in addition to regular chow, which elicited a 52% increase in caloric intake. Despite 54% greater body weight gain and 139% heavier retroperitoneal fat pads, 120 days of overfeeding failed to increase systolic pressure in the conscious state or mean arterial pressure under urethan anesthesia. In contrast, mild hypertension developed in intermittantly fasted obese animals. The first 4-day supplemented fast was initiated 4 wk after the introduction of sweet milk, when the animals were 47 g overweight relative to chow-fed controls. Thereafter, 4 days of starvation were alternated with 2 wk of refeeding for a total of 4 cycles. A rapid fall in systolic blood pressure accompanied the onset of supplemented fasting and was maintained thereafter. With refeeding, blood pressure rose precipitously, despite poststarvation anorexia. Blood pressure tended to rise slightly over the remainder of the realimentation period. After the 4th supplemented fast, hypertension was sustained during 30 days of refeeding. Cumulative caloric intake in starved-refed rats fell within 2% of that in chow-fed controls. Refeeding hypertension appeared to be due to increased sympathetic nervous activity, since (1) cardiac {beta}-adrenergic receptors were downregulated, as indicated by a 40% decrease in the maximum binding of ({sup 3}H)dihydroalpranolol; and (2) the decrease in heart rate as a result of {beta}-blockade was enhanced. Refeeding hypertension in the dietary obese rat may be a potential animal model for some forms of human obesity-related hypertension.

  8. The immune system and hypertension.

    Science.gov (United States)

    Singh, Madhu V; Chapleau, Mark W; Harwani, Sailesh C; Abboud, Francois M

    2014-08-01

    A powerful interaction between the autonomic and the immune systems plays a prominent role in the initiation and maintenance of hypertension and significantly contributes to cardiovascular pathology, end-organ damage and mortality. Studies have shown consistent association between hypertension, proinflammatory cytokines and the cells of the innate and adaptive immune systems. The sympathetic nervous system, a major determinant of hypertension, innervates the bone marrow, spleen and peripheral lymphatic system and is proinflammatory, whereas the parasympathetic nerve activity dampens the inflammatory response through α7-nicotinic acetylcholine receptors. The neuro-immune synapse is bidirectional as cytokines may enhance the sympathetic activity through their central nervous system action that in turn increases the mobilization, migration and infiltration of immune cells in the end organs. Kidneys may be infiltrated by immune cells and mesangial cells that may originate in the bone marrow and release inflammatory cytokines that cause renal damage. Hypertension is also accompanied by infiltration of the adventitia and perivascular adipose tissue by inflammatory immune cells including macrophages. Increased cytokine production induces myogenic and structural changes in the resistance vessels, causing elevated blood pressure. Cardiac hypertrophy in hypertension may result from the mechanical afterload and the inflammatory response to resident or migratory immune cells. Toll-like receptors on innate immune cells function as sterile injury detectors and initiate the inflammatory pathway. Finally, abnormalities of innate immune cells and the molecular determinants of their activation that include toll-like receptor, adrenergic, cholinergic and AT1 receptors can define the severity of inflammation in hypertension. These receptors are putative therapeutic targets.

  9. Current management approaches to portopulmonary hypertension.

    OpenAIRE

    2010-01-01

    Abstract Portopulmonary hypertension (PoPH) is a rare but life-threatening complication of portal hypertension that is characterised by proliferative changes in the pulmonary microvasculature indistinguishable from other forms of pulmonary arterial hypertension (PAH). Although PoPH is most commonly observed in the setting of cirrhosis, patients with noncirrhotic portal hypertension are also at risk of developing the disorder. A definitive diagnosis requires invasive hemodynamic co...

  10. Syphilis mimicking idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne; Wegener, Marianne; Jensen, Rigmor

    2011-01-01

    Idiopathic intracranial hypertension (IIH) is a condition of yet unknown aetiology affecting predominantly obese females of childbearing age. IIH is a diagnosis of exclusion as raised cerebrospinal fluid pressure may occur secondary to numerous other medical conditions. An atypical phenotype...... or an atypical disease course should alert the physician to reevaluate a presumed IIH-diagnosis. The authors report a case of a 32-year-old non-obese male with intracranial hypertension, secondary to a syphilitic central nervous system infection, initially misdiagnosed as being idiopathic. Upon relevant...

  11. Scorpion sting and hypertensive crisis

    Directory of Open Access Journals (Sweden)

    C. Ratti

    2013-05-01

    Full Text Available BACKGROUND Scorpion stings are very frequent in Centre-South America. The most frequently observed clinical symptoms are: local pain and redness, tachycardia, irritability, hypertensive crisis; but it differs with the scorpion species involved. CLINICAL CASE We describe a scorpion sting in a woman who came back from a holiday in Mexico. Consequently she had a hypertensive crisis treated with furosemide. DISCUSSION The scorpion sting can be very dangerous. There are many species which could be lethal; in these cases, identifying the exact species can be essential to save the patient’s life. The treatment consists of symptomatic measures, support of vital functions and i.v. antivenom.

  12. Syphilis mimicking idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne; Wegener, Marianne; Jensen, Rigmor

    2011-01-01

    or an atypical disease course should alert the physician to reevaluate a presumed IIH-diagnosis. The authors report a case of a 32-year-old non-obese male with intracranial hypertension, secondary to a syphilitic central nervous system infection, initially misdiagnosed as being idiopathic. Upon relevant......Idiopathic intracranial hypertension (IIH) is a condition of yet unknown aetiology affecting predominantly obese females of childbearing age. IIH is a diagnosis of exclusion as raised cerebrospinal fluid pressure may occur secondary to numerous other medical conditions. An atypical phenotype...

  13. Acute Kidney Failure

    Science.gov (United States)

    ... out of balance. Acute kidney failure — also called acute renal failure or acute kidney injury — develops rapidly over ... 2015. Palevsky PM. Definition of acute kidney injury (acute renal failure). http://www.uptodate.com/home. Accessed April ...

  14. Acute Pancreatitis and Pregnancy

    Science.gov (United States)

    ... Pancreatitis Acute Pancreatitis and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as ... pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for almost 1 ...

  15. The renal transcriptome in experimental hypertension

    NARCIS (Netherlands)

    Wesseling, S.

    2007-01-01

    The renal transcriptome in experimental hypertension The kidneys importantly determine blood pressure. Kidney dysfunction can result in hypertension, which in turn leads to renal damage. In primary hypertension the cause is unknown. The condition is polygenic, however, which genetic defects cause el

  16. Childhood hypertension: what does the radiologist contribute?

    Energy Technology Data Exchange (ETDEWEB)

    Roebuck, Derek [Great Ormond Street Hospital for Children NHS Trust, Radiology Department, London (United Kingdom)

    2008-06-15

    Hypertension may be essential (primary) or secondary to a variety of causes. The most important risk factors for essential hypertension are obesity and a family history of high BP, but there are also associations with sleep apnoea, low birth weight and prematurity. The most important cause of secondary hypertension in childhood is chronic renal disease. (orig.)

  17. Hypertension and renal disease : Role of microalbuminuria

    NARCIS (Netherlands)

    Janssen, WMT; deJong, PE; deZeeuw, D

    1996-01-01

    Risks associated with hypertension Hypertension is a risk factor for cardiovascular and possibly renal organ damage. Microalbuminuria is a newly recognized cardiovascular and renal risk factor in diabetic and non-diabetic subjects. The prevalence of microalbuminuria is enhanced in hypertensive subje

  18. Health utilities of hypertensive patients in Vietnam

    NARCIS (Netherlands)

    Nguyen, T.P.; Postma, M.J.; Veninga, Catharina

    2015-01-01

    Objectives: With a lack of an essential evidence on utilities to support cost-effectiveness analysis of hypertension management in Vietnam, we aimed to gather data on health utilities for hypertensive patients and identify predictors of utility. Methods: Hypertensive patients, from 40 to 80 years ol

  19. Pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: pathophysiology

    Directory of Open Access Journals (Sweden)

    M. Humbert

    2010-03-01

    Full Text Available Pulmonary arterial hypertension (PAH and chronic thromboembolic pulmonary hypertension (CTEPH are two of the key subgroups of pulmonary hypertension. They are characterised by different risk factors. PAH can be associated with mutations in the gene encoding bone morphogenetic protein receptor type II (BMPR2, HIV infection, congenital heart disease, connective tissue disease (such as systemic sclerosis, and exposure to particular drugs and toxins including fenfluramine derivatives. In contrast, CTEPH can be associated with anti-phospholipid antibodies, splenectomy and the presence of a ventriculo-atrial shunt or an infected pacemaker. The first-line therapies used to treat PAH and CTEPH also differ. While medical therapy tends to be used for patients with PAH, pulmonary endarterectomy is the treatment of choice for patients with CTEPH. However, there are possible common mechanisms behind the two diseases, including endothelial cell dysfunction and distal pulmonary artery remodelling. Further research into these similarities is needed to assist the development of targeted pharmacological therapies for patients with inoperable CTEPH and patients who have persistent pulmonary hypertension after endarterectomy.

  20. Dangerous versus useful hypertension (a holistic view of hypertension).

    Science.gov (United States)

    Hulin, I; Duris, I; Paulis, L; Sapakova, E; Mravec, B

    2009-03-01

    The authors aim to offer a holistic view on hypertension and its treatment. Their approach is fairly confrontational, particularly by suggesting that hypertension may play a role in optimizing the blood flow and enhancing oxygen delivery. An increase in blood pressure brings about a threat of catastrophes. Therefore hypertension might be considered as either a subsequent complication, or an inevitable adaptation. When changes of many complicated and complex mechanisms result in retention of sodium and water, then the treatment of this condition is so far the most logical conclusion, and possibly beneficial to the patient. This can be done by influencing the peripheral resistance or the load of vascular bed. However, in some cases a moderate overfilling of the system with no increase in heart rate could be interpreted as an optimal solution for organism that does not necessarily need to be medically treated. This may apply especially to young hypertensive patients, and in cases when no catastrophe is assumed to take place. Lowering the blood pressure to average population levels in each case, especially by means of aggressive therapy may not necessarily lead to improved tissue perfusion. A decrease in blood pressure reduces the risk of catastrophes. However, on the other hand, it can deteriorate the tissue perfusion and cause unfavorable long-term consequences.

  1. H-Type Hypertension and C Reactive Protein in Recurrence of Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Qing Zhang

    2016-05-01

    Full Text Available Hypertension with high homocysteine (HHcy (H-type hypertension and C reactive protein (CRP can increase the incidence of ischemic stroke. However, it is not clear whether recurrent ischemic stroke (RIS is related to H-type hypertension and CRP. The present study investigated the correlation of H-type hypertension and CRP level with RIS. Totally, 987 consecutive patients with acute ischemic stroke were recruited in a teaching hospital in Henan province, China during March 2014 to March 2015. The demographic and clinical characteristics and blood biochemical parameters of patients were analyzed. Elevated levels of CRP and homocysteine (Hcy were defined as >8.2 mg/L and 10 μmol/L, respectively. Among the 987 patients, 234 were RIS. Thirty-eight percent of RIS patients had elevated CRP level and 91.5% of RIS patients had HHcy. In multivariate analysis, adjusted odds ratio (OR of RIS in patients aged ≥60 years was 1.576 (95% CI: 1.125–2.207, in male patients 1.935 (95% CI: 1.385–2.704, in patients with diabetes 1.463 (95% CI: 1.037–2.064, CRP levels 1.013 (95% CI: 1.006–1.019, simple hypertension 3.370 (95% CI: 1.15–10.183, and H-type hypertension 2.990 (95% CI: 1.176–7.600. RIS was associated with older age, male, diabetes, H-type hypertension and CRP. Controlling H-type hypertension and CRP level may reduce the risk of RIS.

  2. Hyperammonemia,brain edema and blood-brain barrier alterations in prehepatic portal hypertensive rats and paravrtamol intoxication

    Institute of Scientific and Technical Information of China (English)

    Camila Scorticati; Juan P. Prestifilippo; Francisco X. Eizayaga; José L. Castro; Salvador Romay; Maria A. Fernández; Abraham Lemberg; Juan C. Perazzo

    2004-01-01

    AIM: To study the blood-brain barrier integrity, brain edema,animal behavior and ammonia plasma levels in prehepatic portal hypertensive rats with and without acute liver intoxication.METHODS: Adults male Wistar rats were divided into four groups. Group Ⅰ: sham operation; Ⅱ: Prehepatic portal hypertension, produced by partial portal vein ligation; Ⅲ:Acetaminophen intoxication and Ⅳ: Prehepatic portal hypertension plus acetaminophen. Acetaminophen was administered to produce acute hepatic injury. Portal pressure, liver serum enzymes and ammonia plasma levels were determined. Brain cortex water content was registered and trypan blue was utilized to study blood brain barrier integrity. Reflexes and behavioral tests were recorded.RESULTS: Portal hypertension was significantly elevated in groups Ⅱ and Ⅳ. Liver enzymes and ammonia plasma levels were increased in groups Ⅱ, Ⅳ and Ⅳ. Prehepatic portal hypertension (group Ⅱ), acetaminophen intoxication (group Ⅲ) and both (group Ⅳ) had changes in the blood brain-barrier integrity (trypan blue) and hyperammonemia. Cortical edema was present in rats with acute hepatic injury in groups Ⅲ and Ⅳ. Behavioral test (rota rod) was altered in group Ⅳ.CONCLUSION: These results suggest the possibility of another pathway for cortical edema production because blood brain barrier was altered (vasogenic) and hyperammonemia was registered (cytotoxic). Group Ⅳ, with behavioral altered test, can be considered as a model for study at an early stage of portal-systemic encephalopathy.

  3. Acute wiiitis representing as thrombosis of the inferior vena cava and left pelvic veins.

    Science.gov (United States)

    Brodmann, M; Gary, T; Hafner, F; Eller, P; Deutschmann, H; Pilger, E; Seinost, G

    2015-08-01

    Deep venous thrombosis as a result of venous wall injury provoked by trauma is a common finding. It often occurs in patients with sportive overstraining, caused by over fatigue of the body structures. In 2007, the entity of "acute wiiitis" was first described in a letter to the New England Journal of Medicine. Acute wiiitis sums up all affections, mainly skeletal and muscle affections, provoked by playing Nintendo Wii, a very common and loved video-game system. Deep venous thrombosis as a consequence of Nintendo Wii has not been described so far. We present a patient with a massive free floating thrombus of the left pelvic veins originating from the gluteal veins and reaching into the inferior vena cava after playing Nintendo Wii.

  4. Unveiling the hidden eagle: Acute parotitis-induced eagle syndrome

    Directory of Open Access Journals (Sweden)

    Nitipong Permpalung

    2014-01-01

    Full Text Available Context: A cervicofacial pain and foreign body sensation in pharynx associated with styloid process elongation is called Eagle syndrome. Typically, this syndrome is provoked by tonsillectomy or trauma. We report the first case of acute parotitis-induced Eagle syndrome. Case Report: A 65-year-old woman presented with right facial pain. CT scan of neck revealed asymmetric enhancement of the right parotid gland compatible with acute parotitis. All inflammation was resolved with antibiotics. However, the patient complained of pain in right mandibular region out of proportion to inflammation. Review CT found to have an asymmetrically long right styloid process measures. The diagnosis of acute parotitis-induced Eagle syndrome was established. Conclusion: Physicians should have a high index of suspicion for Eagle syndrome in patients with atypical neck pain and elongated styloid process since another significant manifestation of Eagle syndrome is carotid artery compression leading to recurrent syncope or stroke.

  5. Hypertensive disorders in twin pregnancy

    NARCIS (Netherlands)

    J.G. Santema (Job); E. Koppelaar (Elin); H.C.S. Wallenburg (Henk)

    1995-01-01

    textabstractObjective: To compare the incidence and severity of pregnancy-induced hypertensive disorders in twin pregnancy and in singleton gestation. Study design: Case-control study in the setting of a University Hospital. Each pregnancy of a consecutive series of 187 twin pregnancies attending th

  6. Intraabdominal hypertension og abdominalt kompartmentsyndrom

    DEFF Research Database (Denmark)

    Sonne, Morten; Hillingsø, Jens

    2008-01-01

    Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare conditions with high mortality. IAH is an intraabdominal pressure (IAP) above 12 mmHg and ACS an IAP above 20 mmHg with evidence of organ dysfunction. IAP is measured indirectly via the bladder or stomach. Various...

  7. Methamphetamine Use and Pulmonary Hypertension

    Science.gov (United States)

    ... other problems, diagnosing a case of pulmonary hyper- tension can be difficult and may require a specialist. Once pulmonary hyperten- sion is diagnosed, however, treatment can begin immediately. One form of PH is called pulmonary arterial hypertension (PAH). In PAH, the blood vessels that ...

  8. Hypertension control in brazilian publications

    Energy Technology Data Exchange (ETDEWEB)

    Pinho, Natália de Alencar; Pierin, Angela Maria Geraldo, E-mail: pierin@usp.br [Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP (Brazil)

    2013-09-15

    Hypertension is a major public health problem due to its high prevalence and cardiovascular complications. Its treatment is aimed at reducing cardiovascular morbidity and mortality, its goal being to maintain blood pressure levels below 140/90 mm Hg. Hypertension control in Brazil is low, and nationwide rates are unknown. The objective of this review was to provide an overview on hypertension control in Brazil from publications in a database. We identified 45 publications. In population-based studies, the highest control rate (57.6%) was reported in a multicenter study in 100 municipalities and the city of São José do Rio Preto, São Paulo state (52.4%), while the lowest rates (around 10%) were identified in microregions of the Rio Grande do Sul state and in the city of Tubarão, Santa Catarina state. In conclusion, the studies assessed showed a wide variation in hypertension control rates. It is worth noting that the comparison between studies was a major limiting factor, because of the different methods used.

  9. Pulmonary hypertension complicating pulmonary sarcoidosis

    NARCIS (Netherlands)

    Huitema, M P; Grutters, J C; Rensing, B J W M; Reesink, H J; Post, M C

    2016-01-01

    Pulmonary hypertension (PH) is a severe complication of sarcoidosis, with an unknown prevalence. The aetiology is multifactorial, and the exact mechanism of PH in the individual patient is often difficult to establish. The diagnostic work-up and treatment of PH in sarcoidosis is complex, and should

  10. Masked hypertension in diabetes mellitus

    DEFF Research Database (Denmark)

    Franklin, Stanley S; Thijs, Lutgarde; Li, Yan

    2013-01-01

    Although distinguishing features of masked hypertension in diabetics are well known, the significance of antihypertensive treatment on clinical practice decisions has not been fully explored. We analyzed 9691 subjects from the population-based 11-country International Database on Ambulatory Blood...

  11. Management of pulmonary arterial hypertension.

    LENUS (Irish Health Repository)

    Judge, Eoin P

    2013-02-01

    Pulmonary arterial hypertension (PAH) is a complex disease with a high mortality. Management of this disease is underpinned by supportive and general therapies delivered by multidisciplinary teams in specialist centres. In recent years, a number of PAH-specific therapies have improved patient outcomes. This article will discuss the management of PAH in the context of relevant recently published studies in this area.

  12. RELEVANCIA DEL DIAGNÓSTICO DIFERENCIAL ENTRE EL SÍNDROME AÓRTICO AGUDO Y EL SÍNDROME CORONARIO AGUDO EN PACIENTES CON DOLOR TORÁCICO Y CRISIS HIPERTENSIVA: REVISIÓN A PROPÓSITO DE 2 CASOS / Relevance of the differential diagnosis between acute aortic syndrome and acute coronary syndrome in patients with thoracic pain and hypertensive crisis: review on 2 case reports

    Directory of Open Access Journals (Sweden)

    Borja Simó Sánchez

    2011-11-01

    Full Text Available Acute aortic syndrome is a pathological process with low incidence compared with acute coronary syndrome, although with a worse prognosis in the short term, which is why its early diagnosis and urgent treatment are essential to the favorable evolution of thepatient. Electrocardiographic changes suggestive of myocardial ischemia, with acute evolution, are rare in acute aortic syndrome. Even in the presence of a suggestive thoracic pain and high levels of blood pressure, an adequate differential diagnosis is of utmost importance, since the administration of anticoagulation and antiplatelet therapy in high doses can have a dramatic impact on patient outcome. Two cases are presented in which electrocardiographic changes determined the action to take in patients with acute aortic syndrome.

  13. Visceral hypersensitivity is provoked by 2,4,6-trinitrobenzene sulfonic acid-induced ileitis in rats

    Directory of Open Access Journals (Sweden)

    Manoj Kumar Shah

    2016-07-01

    Full Text Available Background and Aims: Crohn’s Disease (CD, a chronic Inflammatory Bowel Disease, can occur in any part of the gastrointestinal tract, but most frequently in the ileum. Visceral hypersensitivity contributes for development of chronic abdominal pain in this disease. Currently, the understanding of the mechanism underlying hypersensitivity of Crohn’s ileitis has been hindered by a lack of specific animal model. The present study is undertaken to investigate the visceral hypersensitivity provoked by 2,4,6-trinitrobenzene sulfonic (TNBS-induced ileitis rats.Methods: Male Sprague-Dawley rats were anaesthetized and laparotomized for intraileal injection of TNBS (0.6 ml, 80 mg/kg body weight in 30% ethanol, n = 48, an equal volume of 30% Ethanol (n = 24 and Saline (n = 24, respectively. Visceral hypersensitivity was assessed by visceromotor responses (VMR to 20, 40, 60, 80 and 100 mmHg colorectal distension pressure (CRD at day 1, 3, 7, 14, 21 and 28. Immediately after CRD test, the rats were euthanized for collecting the terminal ileal segment for histopathological examinations and ELISA of myleoperoxidase and cytokines (TNF-α, IL-1β, IL-6, and dorsal root ganglia (T11 for determination of calcitonin gene-related peptide by immunohistochemistry, respectively. Results: Among all groups, TNBS-treatment showed transmural inflammation initially at 3 days, reached maximum at 7 days and persisted up to 21 days. The rats with ileitis exhibited (P < 0.05 VMR to CRD at day 7 to day 21. The calcitonin gene-related peptide-immunoreactive positive cells increased (P < 0.05 in dorsal root ganglia at day 7 to 21, which was persistently consistent with visceral hypersensitivity in TNBS-treated rats.Conclusions: TNBS injection into the ileum induced transmural ileitis including granuloma and visceral hypersensitivity. As this model mimics clinical manifestations of CD, it may provide a road map to probe the pathogenesis of gut inflammation and visceral

  14. Cardiovascular magnetic resonance in systemic hypertension

    Directory of Open Access Journals (Sweden)

    Maceira Alicia M

    2012-06-01

    Full Text Available Abstract Systemic hypertension is a highly prevalent potentially modifiable cardiovascular risk factor. Imaging plays an important role in the diagnosis of underlying causes for hypertension, in assessing cardiovascular complications of hypertension, and in understanding the pathophysiology of the disease process. Cardiovascular magnetic resonance (CMR provides accurate and reproducible measures of ventricular volumes, mass, function and haemodynamics as well as uniquely allowing tissue characterization of diffuse and focal fibrosis. In addition, CMR is well suited for exclusion of common secondary causes for hypertension. We review the current and emerging clinical and research applications of CMR in hypertension.

  15. Hypertension in obesity: is leptin the culprit?

    Science.gov (United States)

    Simonds, Stephanie E; Cowley, Michael A

    2013-02-01

    The number of obese or overweight humans continues to increase worldwide. Hypertension is a serious disease that often develops in obesity, but it is not clear how obesity increases the risk of hypertension. However, both obesity and hypertension increase the risk of cardiovascular diseases (CVD). In this review, we examine how obesity may increase the risk of developing hypertension. Specifically, we discuss how the adipose-derived hormone leptin influences the sympathetic nervous system (SNS), through actions in the brain to elevate energy expenditure (EE) while also contributing to hypertension in obesity.

  16. Vasculopathy and pulmonary hypertension in sickle cell disease.

    Science.gov (United States)

    Potoka, Karin P; Gladwin, Mark T

    2015-02-15

    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. A major risk factor for developing chronic organ injury is hemolytic anemia, which releases red blood cell contents into the circulation. Cell free plasma hemoglobin, heme, and arginase 1 disrupt endothelial function, drive oxidative and inflammatory stress, and have recently been referred to as erythrocyte damage-associated molecular pattern molecules (eDAMPs). Studies suggest that in addition to effects of cell free plasma hemoglobin on scavenging nitric oxide (NO) and generating reactive oxygen species (ROS), heme released from plasma hemoglobin can bind to the toll-like receptor 4 to activate the innate immune system. Persistent intravascular hemolysis over decades leads to chronic vasculopathy, with ∼10% of patients developing pulmonary hypertension. Progressive obstruction of small pulmonary arterioles, increase in pulmonary vascular resistance, decreased cardiac output, and eventual right heart failure causes death in many patients with this complication. This review provides an overview of the pathobiology of hemolysis-mediated endothelial dysfunction and eDAMPs and a summary of our present understanding of diagnosis and management of pulmonary hypertension in sickle cell disease, including a review of recent American Thoracic Society (ATS) consensus guidelines for risk stratification and management.

  17. Acute Myocardial Infarction: The First Manifestation of Ischemic Heart Disease and Relation to Risk Factors

    Directory of Open Access Journals (Sweden)

    Manfroi Waldomiro Carlos

    2002-01-01

    Full Text Available OBJECTIVE: To assess the association between cardiovascular risk factors and acute myocardial infarction as the first manifestation of ischemic heart disease, correlating them with coronary angiographic findings. METHODS: We carried out a cross-sectional study of 104 patients with previous acute myocardial infarction, who were divided into 2 groups according to the presence or absence of angina prior to acute myocardial infarction. We assessed the presence of angina preceding acute myocardial infarction and risk factors, such as age >55 years, male sex, smoking, systemic arterial hypertension, lipid profile, diabetes mellitus, obesity, sedentary lifestyle, and familial history of ischemic heart disease. On coronary angiography, the severity of coronary heart disease and presence of left ventricular hypertrophy were assessed. RESULTS: Of the 104 patients studied, 72.1% were males, 90.4% were white, 73.1% were older than 55 years, and 53.8% were hypertensive. Acute myocardial infarction was the first manifestation of ischemic heart disease in 49% of the patients. The associated risk factors were systemic arterial hypertension (RR=0.19; 95% CI=0.06-0.59; P=0.04 and left ventricular hypertrophy (RR=0.27; 95% CI=0,.8-0.88; P=0.03. The remaining risk factors were not statistically significant. CONCLUSION: Prevalence of acute myocardial infarction as the first manifestation of ischemic heart disease is high, approximately 50%. Hypertensive individuals more frequently have symptoms preceding acute myocardial infarction, probably due to ventricular hypertrophy associated with high blood pressure levels.

  18. Age, hypertension and arterial function.

    Science.gov (United States)

    McEniery, Carmel M; Wilkinson, Ian B; Avolio, Albert P

    2007-07-01

    1. Ageing exerts a marked effect on the cardiovascular system and, in particular, the large arteries. Using a variety of techniques to assess arterial stiffness, many cross-sectional studies have demonstrated a significant relationship between age and aortic stiffness, although the age-related changes observed in peripheral arteries appear to be less marked. 2. The relationship between arterial stiffness and hypertension is more complex. The distending, or mean arterial, pressure is an important confounder of measurements of arterial stiffness and, therefore, must be taken into consideration when assessing arterial stiffness in hypertensive subjects or investigating the effect of antihypertensive agents. Current methods for correcting for differences in distending pressure involve pharmacological manipulation, statistical correction or mathematical manipulation of stiffness indices. 3. Many studies have provided evidence that both peripheral (muscular) and central (elastic) arteries are stiffer in subjects with mixed (systolic/diastolic) hypertension compared with normotensive subjects. However, it is unclear to what extent differences in mean arterial pressure explain the observed differences in hypertensive subjects. In contrast, isolated systolic hypertension is associated with increased aortic, but not peripheral artery, stiffness, although the underlying mechanisms are somewhat unclear. 4. Traditional antihypertensive agents appear to reduce arterial stiffness, but mostly via an indirect effect of lowering mean pressure. Therefore, therapies that target the large arteries to reduce stiffness directly are urgently required. Agents such as nitric oxide donors and phosphodiesterase inhibitors may be useful in reducing stiffness via functional mechanisms. In addition, inhibitors or breakers of advanced glycation end-product cross-links between proteins, such as collagen and elastin, hold substantial promise.

  19. Changes and clinical value of heart-type fatty acid binding protein in patients with acute hypertensive cerebral hemorrhage%急性高血压脑出血患者血清h-FABP水平变化及其临床应用价值

    Institute of Scientific and Technical Information of China (English)

    杨文东

    2012-01-01

    目的 通过观察急性高血压脑出血患者血清心脏型脂肪酸结合蛋白(h-FABP)水平变化,探讨其临床检测价值.方法 血清h-FABP采用双抗体夹心酶联免疫一步法定量检测;cTnI采用固相酶联免疫吸附实验(ELISA);CK-MB采用免疫抑制法测定HT5"H〗结果 急性高血压脑出血患者组血清h-FABP水平显著高于对照组(P<0.01),大量出血者及意识不清者血清h-FABP水平分别显著高于小量出血者及意识清醒者(P<0.01);血清h-FABP阳性率显著高于血清cTnI、CK-MB及心电图的阳性率(P<0.01);死亡率为25.5%(28/110),血清h-FABP、cTnI、CK-MB及心电图异常组的死亡率显著高于正常组(P<0.01);血清h-FABP预测发生死亡具有高的敏感性和阴性预测值,特异性和准确度较低,但心电图具有较高的特异性(64.5%)和准确度(69.1%).结论 血清h-FABP定量测定可作为判断急性高血压脑出血病情轻重及评价发生意外的1项客观指标,联合心电图监测临床价值更高.%Objective To understand the clinical value of heart-type fatty acid binding protein (h-FABP) in patients with acute hypertensive cerebral hemorrhage(AHCE) through the variation analysis of its serum level. Methods Serum level of h-FABP was determined by enzyme-linked immunosorbent one-step quantitative detection, cardiac troponin I(cTnl) was detected by solid-phase enzyme-linked immunosorbent assay (ELISA) and isoenzyme MB of creatine kinase(CK-MB) was assayed by immunosuppression assay. Results The h-FABP level in(AHCE) group was significantly higher than healthy control group(P<0. 01) and that in AHCE patients with massive haemorrhage and unconsciousness was significantly higher than in patients with small heamorrhage and consciousness. The positive rate of h-FABP was significantly higher than cTnI,CK-MB and electrocardiogram(P<0. 01). The mortality rate in patients, with abnormality of serum level of h-FABP,cTnl and CK-MB and ECG, was higher than patients

  20. Clinical Value of Serum Biomarkers Levels on Essential Hypertension Found out Acute Myocardial Infarction%原发性高血压患者向急性心肌梗死转化时生物标志物水平的临床价值

    Institute of Scientific and Technical Information of China (English)

    王婷婷; 范建国; 范婷婷

    2016-01-01

    Objective To explore the clinical value of serum biomarkers levels on essential hypertension (EH) found out AMI.MethodsThe serum HCY, cTnI, CRP and D-D levels were determined in 276 patients with EH(including 35 cases normal pressure EH, 77 cases stageⅠ EH, 86 cases stageⅡ EH and 78 cases stageⅢ EH), 51 cases AMI and 60 normal controls by CLIA and immunoturbidimetry and compared study was done. The ROC curve was plotted to analyze HCY, cTnI, CRP and D-D as a prognostic clinical value indicator of EH found out AMI.ResultsThe biomarkers levels increased in EH patients with EH severity and signiifcantly higher than those of control group, but the biomarkers were obviously higher in AMI patients than those of control group (P all<0.001). The ROC curve analysis showed that AUC for EH found out AMI were HCY, cTnI, CRP and D-D respectively; cut off values were 73.35μmoL/L, 0.138 mg/L, 16.38 mg/L and 1.87 mg/L respectively, the sensitivity, speciifcity, positive predictive value and negative predictive value were HCY, cTnI, CRP and D-D also. They had a clinical value of EH found out AMI, the best were HCY and cTnI.Conclusion The serum HCY, cTnI,CRP and D-D levels increased with EH severity and were valuable index of EH found out AMI, the best were HCY and cTnI.%目的:探讨原发性高血压(essential hypertension, EH)患者向急性心肌梗死(acute myocardial infarction, AMI)转化时生物标志物[同型半胱氨酸(homocysteine, HCY),心肌肌钙蛋白I(cardiac troponin I, cTnI),C-反应蛋白(C-reactive protein, CRP),D-二聚体(D-dimer, D-D)]水平的临床价值。方法采用化学发光免疫分析和免疫比浊法分别测定276例EH患者(35例血压控制达标组,77例EHⅠ级组,86例EHⅡ级组和78例EHⅢ级组),51例AMI组和60名对照组血清生物标志物水平,并进行比较性研究。受试者工作特征曲线(receiver operating characteristic curve,ROC curve)评估EH向AMI转化