Abstract P039: The Endogenous Ouabain And Changes In Blood Pressure And Sodium Excretion Following An Acute Saline Load In Essential Hypertension

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Chiara Livia Lanzani ◽  
Clarence E Grim ◽  
Marco Simonini ◽  
Lorena Citterio ◽  
Elisabetta Messaggio ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Sodium Excretion ◽  
Large Cohort ◽  
Hypertensive Patients ◽  
Fractional Sodium Excretion ◽  
Potential Mediator ◽  
Endogenous Ouabain ◽  
Quartile Group

Among ~25% of patients with essential hypertension (EH), circulating endogenous ouabain (EO) and aldosterone (Aldo) are typically coelevated and their BP is especially salt-sensitive (SS). We probed for exaggerated natriuresis in a large cohort (712) of hypertensive patients that underwent an acute 2hr (T 120 ) load with saline (0.9%/2 L). Results: Using a quartiles analysis of sodium excretion, the 4th quartile subgroups showed higher SBP and DBP at T 120 , and at 2 hrs recovery (T 240 ). Fractional sodium excretion (FE Na) was significantly higher during loading and recovery in the 4 th quartile subgroup. Plasma Aldo was suppressed after saline in all subgroups as expected. SS patients showed an increased EO. In the 4 th quartiles EO was elevated at baseline and after saline (see figure), p Manova > 0.001 and the urinary Na/K ratio output was higher. Further, increases in plasma Na + were greater in the 4 th quartile group (1.91 ± 0.15 vs 0.83 ± 0.13 mM, p<0.001). These data suggest circulating EO is a potential mediator of the exaggerated natriuresis in SS EH, and that this phenomenon is reminiscent of an “aldosterone escape”.

The effectiveness of differentiated treatment of patients with essential hypertension

1982 ◽  
Vol 63 (2) ◽  
pp. 19-21
Author(s):  
Yu. A. Panfilov ◽  
N. N. Kryukov ◽  
E. D. Baibursyan
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Beta Blocker ◽  
Hypotensive Effect ◽  
Blood System ◽  
Differential Treatment ◽  
Hypertensive Patients ◽  
Bed Days

Abstract. Depending on the hemodynamic type and state of the kallikreinkinin 'blood system, differential treatment of 246 hypertensive patients was carried out using the beta-blocker anaprilin and the peripheral arteriolar vasodilator apressin. A pronounced hypotensive effect was observed in 82.5% of patients. In patients who underwent differential treatment, a decrease in blood pressure was observed 3.2 days earlier than in patients who were treated empirically; hospitalization terms were reduced by an average of 2.5 bed-days.

Essential hypertension: Diagnosis, assessment, and treatment

2020 ◽  
pp. 3753-3778
Author(s):  
Bryan Williams ◽  
John D. Firth
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Severe Hypertension ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Elevated Blood ◽  
Hypertensive Patients ◽  
Assessment And Treatment ◽  
Hypertension Diagnosis

Essential hypertension is invariably symptomless and usually detected by routine screening or opportunistic measurement of blood pressure. However, once a patient has been labelled as ‘hypertensive’ it is not uncommon for them to associate preceding symptoms to their elevated blood pressure. Some patients will claim that they can recognize when their blood pressure is elevated, usually on the basis of symptoms such as plethoric features, palpitations, dizziness, or a feeling of tension. Screening surveys have demonstrated that these symptoms occur no more commonly in untreated hypertensive patients than they do in the normotensive population. However, there are two important caveats to the symptomless nature of essential hypertension: (1) symptoms may develop as a consequence of target organ damage, (2) headache may be a feature of severe hypertension.

scholarly journals EVALUATION OF THE EFFECT OF YOGIC PRACTICES ON RAKTAGATA VATA (ESSENTIAL HYPERTENSION)

2018 ◽  
Vol 11 (9) ◽  
pp. 425
Author(s):  
Pradeep Kumar Pal ◽  
Neera Saini ◽  
Mishra Vn ◽  
Awasthi Hh
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Nervous System ◽  
Essential Hypertension ◽  
System Control ◽  
Energy Channel ◽  
Hypertensive Patients ◽  
First Order ◽  
Positive Effects

Objective: Essential hypertension is the most frequent kind of hypertension and also known as primary hypertension or idiopathic, affecting 95% of hypertensive patients. This study was conducted to see the effect of Yogic practices as Nadi Shodhana Pranayama (NSP = cleaning of subtle energy channel along with regulation of rhythm of breathing) and Dhyana (meditation) on the symptoms of Raktagata Vata (essential hypertension), blood pressure, and Hamilton’s anxiety rating scale.Methods: This clinical study was conducted on 50 cases of Raktagata Vata, and these were randomly divided into two subgroups: (1) Control and (2) intervention consisting of 25 cases in each subgroup. Yogic practices were done regularly for 3 months by the registered cases in both subgroups. Light medication of first order initially was also prescribed to intervention subgroup.Result: In both subgroups, significant results (p<0.001) were observed and most of the symptoms of Raktagata Vata improved better in the intervention than control subgroup. Significant results (p<0.001) were also observed in blood pressure along with Hamilton’s anxiety scale scoring.Conclusion: Yogic practices impact positive effects on Agya Chakra (hypothalamus-cerebral system), control autonomic nervous system and improve the quality of life of Raktagata Vata patients by improving symptoms and regulating the blood pressure.

scholarly journals Effects of combined statin and ACE inhibitor therapy on endothelial function and blood pressure in essential hypertension - a randomised double-blind, placebo controlled crossover study

2019 ◽  
Vol 20 (3) ◽  
pp. 147032031986889 ◽  
Author(s):  
Piotr Ruszkowski ◽  
Anna Masajtis-Zagajewska ◽  
Michał Nowicki
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Angiotensin Converting Enzyme ◽  
Endothelial Function ◽  
Enzyme Inhibitor ◽  
Converting Enzyme ◽  
C Reactive Protein ◽  
Double Blind ◽  
Hypertensive Patients ◽  
Reactive Protein

Background: The aim of this study was to compare the influence of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors on endothelial function and blood pressure in patients with essential hypertension on long-term angiotensin-converting enzyme inhibitor therapy. Method: The study was designed as a prospective, double-blind, randomised, placebo controlled, crossover clinical trial. Twenty patients with essential hypertension were treated with an angiotensin-converting enzyme inhibitor; the control group included 10 healthy subjects. Hypertensive patients received in random order 80 mg of fluvastatin daily or placebo for 6 weeks. The following parameters were assessed at baseline and after each treatment period: serum lipids, flow-mediated vasodilation, activity of von Willebrand factor, concentration of vascular endothelial growth factor, C-reactive protein and 24-hour blood pressure profile. Results: Hypertensive patients did not differ from healthy subjects with respect to age, body mass and biochemical parameters, with the exception of C-reactive protein, which was higher in hypertensive patients ( P=0.02). After statin therapy, low-density lipoprotein cholesterol ( P<0.0001), C-reactive protein ( P=0.03), von Willebrand factor ( P=0.03) and vascular endothelial growth factor ( P<0.01) decreased and flow-mediated vasodilation improved ( P<0.001). Statins had no significant effect on blood pressure. Conclusions: Statins added to angiotensin-converting enzyme inhibitors may improve endothelial function and ameliorate inflammation independently of blood pressure.

Clinical Evaluation of Atenolol in Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 513s-515s
Author(s):  
L. Hansson ◽  
B. E. Karlberg ◽  
H. Åberg ◽  
A. Westerlund ◽  
N. C. Henningsen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Blocking Agent ◽  
Long Term Results ◽  
Double Blind ◽  
Hypertensive Patients ◽  
Arterial Blood ◽  
Obstructive Airways Disease ◽  
Blind Comparison

1. Atenolol (ICI 66.082, Tenormin) is a new β-adrenoreceptor-blocking agent, devoid of intrinsic sympathomimetic and membrane-stabilizing properties. It does not cross the blood—brain barrier. 2. Atenolol given to hypertensive patients in initial open trials reduced arterial blood pressure significantly. 3. A double-blind comparison between atenolol and placebo in forty-five patients with essential hypertension demonstrated that atenolol gave a statistically significant reduction of blood pressure (Δ 28/15 mmHg, P < 0·005). 4. The optimum anti-hypertensive dose of atenolol in patients with mild to moderately severe essential hypertension was 200 mg daily. 5. Atenolol was compared with propranolol in thirty patients with essential hypertension. No statistically significant differences of anti-hypertensive effect were observed between the two drugs. 6. Long-term results (up to 2 years) in 117 hypertensive patients indicate that drug tolerance is good. No serious toxic effects were observed. 7. In four of twelve hypertensive patients with obstructive airways disease atenolol had to be withdrawn owing to deterioration of ventilatory function.

Renal and Cardiovascular Effects of Exogenous Insulin in Healthy Volunteers

1991 ◽  
Vol 80 (3) ◽  
pp. 219-225 ◽  
Author(s):  
R. O. B. Gans ◽  
L. v.d. Toorn ◽  
H. J. G. Bilo ◽  
J. J. P. Nauta ◽  
R. J. Heine ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Analysis Of Variance ◽  
Sodium Excretion ◽  
Circadian Variation ◽  
Cardiovascular Effects ◽  
Insulin Dosage ◽  
Angiotensin I ◽  
Blood Pressure Elevation ◽  
Fractional Sodium Excretion

1. Renal and cardiovascular effects of three dosages of insulin [50 (Ins I), 300 (Ins II) and 500 (Ins III) m-units h−1 kg−1] were investigated in healthy males by using a euglycaemic clamp technique. On separate days, control experiments were carried out to correct for any circadian variation in the variables studied. 2. All three insulin dosages resulted in a marked decline in fractional sodium excretion (actual experiments: basal, 0.95 ± 0.15%, Ins I, 0.79 ± 0.10%, Ins II, 0.80 ± 0.12%, Ins III, 0.84 ± 0.08%; control experiments: basal, 0.96 ± 0.10%, Ins I, 1.20 ± 0.12%, Ins II, 1.53 ± 0.15%, Ins III, 1.43 ± 0.10%; means ± sem, P < 0.005, analysis of variance). With the highest insulin dosage, the reduction in fractional sodium excretion tended to be less striking. This coincided with a rise in heart rate, pulse pressure and pulse rate-systolic blood pressure product (double product). Although blood pressure itself did not change, systolic blood pressure also tended to increase (actual experiments: basal, 133 ± 5 mmHg, Ins I, 132 ± 5 mmHg, Ins II, 139 ± 5 mmHg, Ins III, 143 ± 4 mmHg; control experiments: basal, 128 ± 3 mmHg, Ins I, 129 ± 3 mmHg, Ins II, 130 ± 3 mmHg, Ins III, 133 ± 3 mmHg; means ± sem, P = 0.09, analysis of variance). There was a positive correlation between the change in fractional sodium excretion and the change in systolic blood pressure over control values (r = 0.696, P < 0.028). At a rise in systolic blood pressure of 18 mmHg, the sodium-retaining effect of insulin appeared to be offset. A shift of the pressure-natriuresis relation to the right is suggested. 3. Plasma catecholamines did not change. Plasma renin activity increased from 1.11 ± 0.17 (basal) to 2.13 ± 0.31 (Ins III) pmol of angiotensin I h−1 ml−1; on the control day, a decline from 1.28 ± 0.24 (basal) to 0.81 ± 0.13 (Ins III) pmol of angiotensin I h−1 ml−1 was noted (P < 0.001). Despite this rise no concomitant rise in plasma aldosterone occurred. 4. Chronic hyperinsulinaemia may lead to blood pressure elevation in the long-term if it is postulated that resistance to the glucose-lowering effect of insulin is absent for the effects of insulin on the kidney and the cardiovascular system.

Plasma Noradrenaline Concentration and α-Adrenoceptor-Mediated Vasoconstriction in Normotensive and Hypertensive Man

1981 ◽  
Vol 60 (5) ◽  
pp. 483-489 ◽  
Author(s):  
W. Kiowski ◽  
F. R. Bühler ◽  
P. Vanbrummelen ◽  
F. W. Amann
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Vascular Resistance ◽  
Sympathetic Activity ◽  
Plasma Noradrenaline ◽  
Arterial Infusion ◽  
Hypertensive Patients ◽  
Noradrenaline Concentration ◽  
Normotensive Subjects ◽  
Control Plasma

1. Plasma noradrenaline concentrations and blood pressure were measured in 45 patients with essential hypertension and 34 matched normotensive subjects. Plasma noradrenaline was similar in both groups, but in the hypertensive patients plasma noradrenaline correlated with blood pressure. 2. The increase in forearm flow in response to an intra-arterial infusion of phentolamine was determined in 12 of the hypertensive and 14 of the normotensive subjects to assess the α-adrenoceptor-mediated component of vascular resistance. Although the dilator response to phentolamine was similar in both groups, in the hypertensive patients it was correlated with the control plasma noradrenaline (r = 0.83, P<0.01) as well as the height of mean blood pressure (r = 0.73, P<0.01). 3. These results suggest that in hypertensive patients plasma noradrenaline can be a marker for both sympathetic activity and the α-adrenoceptor-mediated component of vascular resistance.

The Urinary Excretion of Catecholamines and Their Derivatives in Primary Hypertension in Man

1977 ◽  
Vol 52 (3) ◽  
pp. 319-323 ◽  
Author(s):  
R. F. Bing ◽  
J. Harlow ◽  
A. J. Smith ◽  
M. M. Townshend
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Urinary Excretion ◽  
High Plasma ◽  
Plasma Catecholamine ◽  
Elevated Blood ◽  
Hypertensive Patients ◽  
Catecholamine Excretion ◽  
Normotensive Subjects ◽  
Plasma Catecholamine Concentrations

1. The 24 h urinary excretion of adrenaline, noradrenaline, normetadrenaline, metadrenaline and vanilloylmandelic acid has been compared in 17 male normotensive subjects and 25 age-matched male hypertensive patients studied under similar in-patient conditions. 2. 24 h urinary metadrenaline was significantly lower in the hypertensive patients. With this exception, no significant differences were found between the two groups when the total 24 h excretion of free catecholamines and their metabolites was analysed. 3. Diurnal variation in free catecholamine excretion was found in both normotensive and hypertensive subjects. There was no corresponding variation in metabolite excretion. 4. No correlation could be established between systolic or diastolic blood pressure and the amounts of the catecholamines or their metabolites in the urine of either group. 5. The results are considered in the light of recent work demonstrating high plasma catecholamine concentrations in hypertension. They lend no support to the concept that excessive circulating catecholamines are responsible for the elevated blood pressure in essential hypertension.

Significance of Increase in Labelled Albumin Disappearance Rate in Arterial Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 211s-213s
Author(s):  
M. Ulrych ◽  
Z. Ulrych
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Blood Volume ◽  
Plasma Renin ◽  
Disappearance Rate ◽  
Reference Standard ◽  
Hypertensive Patients ◽  
Volume Blood ◽  
Normotensive Subjects ◽  
Normotensive Control

1. Relationships between labelled albumin disappearance rate (LADR), plasma volume, blood volume, plasma renin activity (PRA) and blood pressure (BP) were studied in normotensive control subjects and patients with hypertension of different aetiology and severity. In essential hypertensive patients without complications an inverse linear relationship was found between blood pressure and plasma or blood volume. 2. Very close inverse correlations were found between LADR and PRA in both normotensive subjects and patients with uncomplicated essential hypertension. LADR appears to be an excellent reference standard for PRA. 3. It is postulated that LADR mainly reflects the relation between circulating fluid and vascular capacitance tone. LADR is increased in hypertension and blood volume may still be inappropriately high.

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