Relationship between Altered Na+–K+ Cotransport and Na+–Li+ Countertransport in the Erythrocytes of ‘essential’ Hypertensive Patients

1981 ◽  
Vol 61 (s7) ◽  
pp. 33s-36s ◽  
Author(s):  
D. Cusi ◽  
C. Barlassina ◽  
M. Ferrandi ◽  
P. Palazzi ◽  
E. Celega ◽  
...  

1. The maximal rate of activity of sodium extrusion by the sodium pump, Na+—K+ outward cotransport, passive permeability to sodium and potassium, Na+—Li+ countertransport, and passive permeability to lithium were measured in 45 essential hypertensive patients, 24 young normotensive subjects with at least one hypertensive parent and 24 normotensive subjects with both parents normotensive. 2. The maximal rate of activity of the sodium pump and the rate constants for passive permeability to sodium, potassium and lithium were similar in the three groups. 3. The mean value for Na+—K+ outward cotransport was significantly lower and that for Na+—Li+ countertransport significantly higher in the hypertensive patients than in the normotensive subjects without a family history of hypertension, but there was a great overlap between individual values. The offspring of hypertensive parents had intermediate values. 4. A highly significant positive correlation existed between Na+—K+ cotransport and Na+—Li+ countertransport both in the normotensive and in the hypertensive subjects, indicating that in the latter there were some with high Na+—Li+ countertransport and others with low Na+—K+ cotransport. 5. In nine hypertensive families studied, if an alteration of the transport system was detected in a hypertensive propositus, the same type of alteration was also found in his still normotensive offspring, thus indicating a familial tendency for the alteration to occur.

1982 ◽  
Vol 63 (s8) ◽  
pp. 41s-43s ◽  
Author(s):  
W. Zidek ◽  
H. Vetter ◽  
K.-G. Dorst ◽  
H. Zumkley ◽  
H. Losse

1. The intracellular Na+ and Ca2+ activity and Na+ concentration were measured in erythrocytes of normotensive subjects, with and without a familial disposition to hypertension, in essential hypertensive patients with and without a family history of hypertension, and in patients with secondary hypertension. 2. In normotensive subjects without a genetic trait of hypertension intracellular Na+ activity and concentration were 7.00 ± 1.38 mmol/l and 5.67 ± 0.95 mmol/l respectively. The intracellular Ca2+ activity was 4.82 ± 4.49 μmol/l. In normotensive subjects with a familial hypertensive disposition intracellular Na+ activity and concentration were 9.74 ± 1.43 mmol/l (P < 0.01) and 6.63 ± 0.88 mmol/l (P < 0.05). Intracellular Ca2+ was 9.59 ± 9.71 μmol/l (P < 0.05). 3. Essential hypertensive patients without a familial genetic trait had an elevated intracellular Na+ activity (8.35 ± 2.08 mmol/l, P < 0.05). Intracellular Na+ concentration was 6.64 ± 0.79 mmol/l (P < 0.05). The intracellular Ca2+ activity was markedly elevated to 25.33 ± 19.03 μmol/l (P < 0.01). The essential hypertensive patients with a familial disposition had an elevated intracellular Na+ activity (17.19 ± 4.37 mmol/l, P < 0.001) and Ca2+ activity (32.8 ± 32.51 μmol/l, P < 0.01). The intracellular Na+ concentration was 6.25 ± 1.23 mmol/l. 4. The results indicate that in essential hypertension intracellular Na+ activity is increased, particularly in patients with a familial disposition for hypertension. Intracellular Ca2+ is increased in essential hypertension whether or not there was a family disposition to hypertension.


1980 ◽  
Vol 58 (10) ◽  
pp. 1069-1074 ◽  
Author(s):  
Georges Dagher ◽  
Ricardo P. Garay

In erythrocytes from essential hypertensive patients and some of their normotensive offspring, the Na+,K+ co-transport system is unable to transport Na+ in an uphill direction against the electrochemical Na+ gradient. Recent studies of the kinetic properties of this system have permitted us to further characterize the abnormal co-transport in hypertension.Thirty-four essential hypertensive patients were characterized by a two-to three-fold decrease in the maximal rate of the outward Na+,K+ co-transport and a partial uncoupling of this system as compared with 22 normotensive controls. On the other hand, a normal co-transport was found in five secondary hypertensives with no family history of hypertension, thus indicating that the abnormal co-transport is not the consequence of high blood pressure per se. An abnormal co-transport was also found in around 50% of 19 young normotensives born of one hypertensive parent, suggesting genetic transmission.This study allows us to propose the use of a specific Na+,K+ co-transport assay for the differential diagnosis between essential and secondary hypertension and for the detection of those normotensives born of hypertensive parents with a potential risk to develop high blood pressure.


1981 ◽  
Vol 61 (s7) ◽  
pp. 367s-368s ◽  
Author(s):  
A. Fernandez-Cruz ◽  
M. Luque Otero ◽  
L. Llorente Perez ◽  
C. Fernandez Pinilla ◽  
N. Martell Claros

1. Human leucocyte AB antigens were determined by means of a lymphocyte toxicity test in 84 patients with essential hypertension and in 1000 blood donors. 2. The prevalence of HLA B8 was 16.4% in hypertensive patients and 8.9% in controls (P = 0.07). 3. The prevalence of HLA B12 was 34.5% in hypertensive patients and 26.9% in the control group (N.S.). In WHO stage III hypertension HLA B12 was found in six out of 10 patients. 4. The prevalence of HLA B15 was 1.2% in hypertensive patients and 6.4% in controls (P &lt; 0.05). 5. In view of a previous report of HLA antigens in a Spanish diabetic population, this study does not support the suggestion of a genetic and possibly HLA-linked connection between essential hypertension and diabetes mellitus among the Spanish population. 6. A positive family history of hypertension tended to be more common in those patients with essential hypertension associated with HLA B8.


2019 ◽  
Vol 2 (1) ◽  
pp. 53-59
Author(s):  
Tirtha Man Shrestha ◽  
Laxman Bhusal ◽  
Shankar Raut ◽  
Rajan Ghimire ◽  
Poonam Shrestha

Objective: Hypertension is one of the common non-communicable health problems. While pharmacologic intervention is the most efficient way to control hypertension; non-adherence to medication is accounted as a significant cause for complications. This study was to address and to determine the magnitude of non-adherence among hypertensive patients by summarizing the associated risks factors among patients in community level. Method: This is a cross sectional study conducted on hypertensive patients who visited the community health clinic at Dhading, Nepal on 9th and 10th June 2018 using a pre structured questionnaire. Patients were sampled by nonprobability purposive sampling method. Effect of age, gender, marital status, employment, education level, presence of diabetes, cerebrovascular disease, current smoker, and family history of hypertension were analyzed by compliance of antihypertensive drugs using frequency distribution, chi-square test, and logistic regression. For all of the analysis p value <0.5 was considered as significance. Results: 150 patients were included in the study, out of whom 48 patients were found adherent and 102 patients non-adherent to antihypertensive medication. Out of total population 46% (n=69) were male and 54% (n=81) were female with no significant difference between compliant and noncompliant groups (OR= 1.512, p-=0.292). Mean age of patients in complaint group was 57 years and in non-compliant group was 52 years with odds ratio of 0.959 (p= 0.004, 95% C.I =0.933-0.987). However, there was no significant effect of marital status, employment status, and family history of hypertension on adherence to anti-hypertensive medication. Presence of diabetes had significant effect on adherence to medication (OR= 8.494, p= 0.014). The most common reason for non-adherence was the fear of getting stuck with medication for lifetime (n=31, 30.3%) followed by the use of ayurvedic/home remedy (n=27, 26.5%), unaware of complications (n=16, 15.7%), life style modification (n=14, 13.7%), and financial weakness (n=9, 8.8%). Pearson’s correlation of these reasons was between -1 to 0 with p value <0.5. Conclusion: Fear of taking medication lifelong was the major reason for non-adherence; however, age and comorbid health conditions like diabetes have a significant effect on adherence to medication. Health care awareness and counseling can help these patients to overcome the fear of taking medication for lifetime, which can increase the medication compliance rate.


2005 ◽  
Vol 109 (3) ◽  
pp. 311-317 ◽  
Author(s):  
Hans Herlitz ◽  
Eva Palmgren ◽  
Bengt Widgren ◽  
Mattias Aurell

The renin–angiotensin system is implicated in the pathophysiology of hypertension. Renin release is regulated by a number of factors, including circulating Ang II (angiotensin II), the so-called short feedback loop. The aim of the present study was to investigate the responsiveness of circulating Ang II on PRA (plasma renin activity) in normotensive subjects with a PFH or NFH (positive or negative family history of hypertension respectively). PRA, renal haemodynamics and urinary sodium excretion were measured during infusion of Ang II without and with pretreatment with the AT1 (Ang II type 1) receptor blocker irbesartan. Normotensive men with a PFH (n=13) and NFH (n=10), with a mean age of 38 years, were given on different occasions intravenous Ang II infusions of 0.1, 0.5 and 1.0 ng·kg−1 of body weight·min−1 before and after pretreatment with 150 mg of irbesartan once a day for 5 consecutive days. RPF (renal plasma flow) and GFR (glomerular filtration rate) were also measured. Before Ang II infusion, the PFH and NFH groups did not differ with respect to BP (blood pressure), body mass index, PRA, RBF (renal blood flow) or urinary sodium. There was no difference in BP or renal haemodynamic response to the highest Ang II dose between the groups. PRA declined with the highest Ang II dose (P<0.01) in subjects with a NFH, but not in subjects with a PFH. After treatment with irbesartan when Ang II had no effect on BP in either group, Ang II also suppressed PRA in subjects with a PFH (P<0.01), and the difference between the groups at baseline was thus eliminated. In conclusion, these findings indicate that subjects with a PFH have a defective Ang II suppression of PRA, which is corrected by AT1 receptor blockade.


1982 ◽  
Vol 63 (s8) ◽  
pp. 53s-55s ◽  
Author(s):  
F. V. Costa ◽  
L. Montebugnoli ◽  
M. F. Giordani ◽  
L. Vasconi ◽  
E. Ambrosioni

1. Lymphocytes from normotensive subjects with normal intralymphocytic sodium content were incubated for 1 h in plasma from subjects with essential hypertension, secondary hypertension or borderline hypertension, and from normotensive subjects with (genetic) and without (non-genetic) family history of hypertension. 2. Lymphocytes from non-genetic normotensive subjects greatly increase their intralymphocytic sodium content after incubation in plasma (diluted 1:4) of patients with essential hypertension (but not with secondary hypertension), of borderline subjects and of genetic normotensive subjects with abnormally high intralymphocytic sodium content (<26 mmol/kg). 3. When plasma is diluted 1:8, an increase in intralymphocytic sodium content is detectable only after incubation in plasma of borderline subjects and of genetic normotensive subjects with high intralymphocytic sodium content. 4. These data suggest that a plasma factor altering Na+ transport is detectable in all the subjects in whom intralymphocytic sodium content is high, independently of their blood pressure values. The concentration (or the activity) of this substance is greater in borderline and genetic normotensive subjects than in patients with sustained essential hypertension. This suggests that these subjects are in a dynamic phase of the development of hypertension.


1986 ◽  
Vol 4 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Ikuo Saito ◽  
Eiko Takeshita ◽  
Takao Saruta ◽  
Shiro Nagano ◽  
Toshio Sekihara

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