Involvement of endogenous prostaglandins in salt-induced hypertension

Abstract. Insufficient production of prostaglandins, which are possible antihypertensive agents, may be a pathogenetic factor in hypertensive patients on salt loading. We compared the levels of plasma PGE2, plasma renin activity (PRA) and urinary 6-Keto-PGF1α (6-O-PGF1α), a major stable metabolite of PGI2, on day 5 of salt deprivation and also on day 5 of subsequent salt loading in 17 patients with essential hypertension. Salt loading decreased plasma PGE2, and slightly increased urinary 6-O-PGF1α. On salt loading, a positive correlation was found between the levels of plasma PGE2 and urinary sodium excretion. On salt deprivation, PRA was significantly correlated with plasma PGE2. The per cent change in mean blood pressure on changing from salt restriction to salt loading was inversely correlated with the per cent change in PGE2, and positively correlated with the per cent change in 6-O-PGF1α excretion. These findings suggest that on salt restriction, PGE2 is involved in the renin-angiotension system and that on salt loading, PGE2 is produced to compensate for the excessive sodium. The finding that PGE2 production was attenuated progressively as the mean blood pressure increased on salt loading in patients with essential hypertension suggests that insufficient compensatory PGE2 production is a pathogenetic factor in salt-induced hypertensive patients. In contrast, PGI2 may be produced adaptively to regulate blood pressure during changes in salt balance.

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Sodium-Accelerated Platelet Aggregation in Men Predisposed to Essential Hypertension

Clinical Science ◽

10.1042/cs063391s ◽

1982 ◽

Vol 63 (s8) ◽

pp. 391s-393s ◽

Cited By ~ 10

Author(s):

Y. Nara ◽

M. Kihara ◽

T. Kanbe ◽

R. Horie ◽

J. Endo ◽

...

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Platelet Aggregation ◽

Genetic Predisposition ◽

Sodium Intake ◽

Salt Loading ◽

Salt Restriction

1. Men with a genetic predisposition to essential hypertension had a significantly higher blood pressure during salt restriction and a greater elevation of blood pressure in response to salt loading than men without such a genetic predisposition. 2. The activity of platelet aggregation was significantly greater in men with a genetic predisposition to essential hypertension. 3. Platelet aggregation was activated directly or indirectly by an increased sodium intake. 4. This activation by an increased sodium intake was more pronounced in men predisposed to essential hypertension.

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Elevated Plasma and Urinary Endothelin-I Levels in Human Salt-Sensitive Hypertension

Clinical Science ◽

10.1042/cs0930035 ◽

1997 ◽

Vol 93 (1) ◽

pp. 35-41 ◽

Cited By ~ 37

Author(s):

Claudio Ferri ◽

Cesare Bellini ◽

Giovambattista Desideri ◽

Clarita Mazzocchi ◽

Luca De Siati ◽

...

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Mean Blood Pressure ◽

Pressure Sensitivity ◽

Elevated Plasma ◽

Hypertensive Patients ◽

Endothelin 1 ◽

Cardiovascular Damage ◽

Increased Risk ◽

Salt Sensitive Hypertension

1. The behaviour of the potent vasoconstrictive endothelium-derived peptide endothelin-1 was evaluated in salt-sensitive hypertension. 2. Circulating and urinary endothelin-1 levels were evaluated in 30 men (mean age 44.6 ± 3.1 years) with uncomplicated essential hypertension after three consecutive 2-week periods on an intermediate (120 mmol), low (20 mmol) and high (240 mmol) NaCl diet. On the same occasions, blood pressure was measured to identify salt-sensitive patients (n = 16), i.e. those patients showing a mean blood pressure increase > 10 mmHg when switching from a low to a high NaCl diet, and salt-resistant patients (n = 14), i.e. those who did not show such mean blood-pressure variations. 3. Plasma endothelin-1 levels were higher (P < 0.005) in salt-sensitive than in salt-resistant hypertensive patients after intermediate-, low- and high-NaCl diets. Urinary endothelin-1 excretion was similar in both groups after an intermediate-NaCl diet, whereas it was significantly higher in salt-sensitive than in salt-resistant hypertensive subjects after low (P < 0.002) and high (P < 0.007) NaCl diets. High NaCl intake induced a significant increase in plasma endothelin-1 levels (P < 0.002) as compared with intermediate and low NaCl diet levels in salt-sensitive patients, but did not in salt-resistant subjects. No significant NaCl intake-related variations of urinary endothelin-1 excretion were observed in either group. 4. Salt-sensitive hypertensives are characterized by increased levels of endothelin-1 in both plasma and urine. This fact suggests that blood-pressure sensitivity to NaCl intake could be associated with an increased risk of developing both renal and cardiovascular damage.

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The effectiveness of differentiated treatment of patients with essential hypertension

Kazan medical journal ◽

10.17816/kazmj60567 ◽

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.

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Change in Blood Pressure during Altered Sodium Intake is not Associated with Calciotropic Hormone Level

Clinical Science ◽

10.1042/cs0930153 ◽

1997 ◽

Vol 93 (2) ◽

pp. 153-157 ◽

Cited By ~ 2

Author(s):

Ryoji Ozono ◽

Tetsuya Oshima ◽

Hideo Matsuura ◽

Katsuhiko Ishibashi ◽

Mitsuaki Watanabe ◽

...

Keyword(s):

Blood Pressure ◽

Calcium Metabolism ◽

Sodium Intake ◽

Urinary Calcium ◽

Urinary Calcium Excretion ◽

Mean Blood Pressure ◽

Calcium Excretion ◽

Sodium Restriction ◽

Sodium Diet ◽

Change In Mean

1. We evaluated the effects of the dietary restriction of sodium chloride on blood pressure and systemic calcium metabolism in 19 in-patients with essential hypertension (11 men and 8 women, mean age 49.9 ± 12.1 years). 2. All patients received a high-sodium diet (250 mmol/day) for 1 week, followed by a low-sodium diet (10 mmol/day) for another week. Intake of potassium (100 mmol/day) and of calcium (15 mmol/day) were kept constant throughout the study. 3. Sodium restriction significantly reduced the mean blood pressure (from 114.0 ± 1.9 to 105.0 ± 13.7 mmHg, P < 0.01). Urinary calcium excretion was significantly reduced (from 5.1 ± 2.4 to 2.2 ± 1.0 mmol/day, P < 0.01). 4. The change in mean blood pressure after sodium restriction was not correlated with a change in any parameter of calcium metabolism [whole blood ionized calcium, plasma intact parathyroid hormone, or 1,25-(OH)2 vitamin D3]. 5. Plasma renin activity during a regular sodium diet, an index of renin status, was significantly and inversely correlated with the change in blood pressure during sodium restriction, but not with any change in the parameters of calcium metabolism. 6. We conclude that sodium restriction reduces blood pressure and decreases urinary calcium excretion. However, we observed no significant role of extracellular calcium concentration or of calciotropic hormone concentration in the mechanism of sodium sensitivity.

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An observational comparative study of different doses of azilsartan and with chlorthalidone combination in moderate hypertension

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20190144 ◽

2019 ◽

Vol 8 (2) ◽

pp. 259

Author(s):

Tamoghna Maiti ◽

Sonai Mandal ◽

Ratul Banerjee ◽

Sourav Chakrabarty ◽

Amrita Panda

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Antihypertensive Agents ◽

Fixed Dose ◽

High Dose ◽

Hypertensive Patients ◽

Medical College ◽

Fda Approval ◽

High Prevalence ◽

Dose Combination

Background: High blood pressure (BP) is one of the significant non-communicable diseases that are of high prevalence in our country. Hypertension (HTN) is responsible cause of 57% of stroke and 24% of coronary heart disease deaths in India. Eight classes of medications are currently used in the treatment of hypertension. Azilsartan medoxomil is a newly added FDA approved drug to the ARB class of antihypertensive agents. azilsartan and chlorthalidone combination is also got the FDA approval. There is limited study in between these two groups regarding efficacy especially in rural Bengal.Methods: A prospective observational study was done in medicine OPD of Bankura Sammilani Medical College for twelve weeks with two groups that are azilsartan (80mg) and fixed dose combination of azilsartan (40mg) plus chlorthalidone (12.5mg) in the age group of 18 to 55years of moderate hypertensive patients. Change of heart rate was assessed as safety parameter.Results: It was found that both the group of drugs are very much effective in lowering blood pressure constantly in respect of both systolic and diastolic BP but azilsartan monotherapy in high dose reduce systolic blood pressure slightly high. Significant change of heart rate was not seen with both the groups.Conclusions: Both the group was effective as well as safe in hypertensive patients.

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Invasive and Concomitant Noninvasive Intraoperative Blood Pressure Monitoring

Anesthesiology ◽

10.1097/aln.0b013e3182330286 ◽

2011 ◽

Vol 115 (5) ◽

pp. 973-978 ◽

Cited By ~ 70

Author(s):

David B. Wax ◽

Hung-Mo Lin ◽

Andrew B. Leibowitz

Keyword(s):

Blood Pressure ◽

Odds Ratio ◽

Blood Pressure Monitoring ◽

Antihypertensive Agents ◽

Blood Transfusions ◽

Blood Products ◽

Pressure Monitoring ◽

Antihypertensive Medications ◽

Hypertensive Patients ◽

Simultaneous Measurements

Background Noninvasive (NIBP) and intraarterial (ABP) blood pressure monitoring are used under different circumstances and may yield different values. The authors endeavored to characterize these differences and hypothesized that there could be differences in interventions associated with the use of ABP alone ([ABP]) versus ABP in combination with NIBP ([ABP+NIBP]). Methods Simultaneous measurements of ABP and NIBP made during noncardiac cases were extracted from electronic anesthesia records; the differences were subjected to regression analysis. Records of blood products, vasopressors, and antihypertensives administered were also extracted, and associations between the use of these therapies and monitoring strategy ([ABP] vs. [ABP+NIBP]) were tested using univariate, multivariate, and propensity score matched analyses. Results Among 24,225 cases, 63% and 37% used [ABP+NIBP] and [ABP], respectively. Systolic NIBP was likely to be higher than ABP when ABP was less than 111 mmHg and lower than ABP otherwise. Among patients with hypotension, transfusion occurred in 27% versus 43% of patients in the [ABP+NIBP] versus [ABP] group, respectively (odds ratio = 0.4; 95% CI 0.35-0.46), and 7% versus 18% of patients in the [ABP+NIBP] versus [ABP] group received vasopressor infusions, respectively (P < 0.01). Among hypertensive patients, 12% versus 44% of those in the [ABP+NIBP] versus [ABP] group received antihypertensive agents, respectively (P < 0.01). Conclusions NIBP was generally higher than ABP during periods of hypotension and lower than ABP during periods of hypertension. The use of NIBP measurements to supplement ABP measurements was associated with decreased use of blood transfusions, vasopressor infusions, and antihypertensive medications compared with the use of ABP alone.

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Essential hypertension: Diagnosis, assessment, and treatment

Oxford Textbook of Medicine ◽

10.1093/med/9780198746690.003.0378 ◽

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.

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

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i9.27734 ◽

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.

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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

Journal of the Renin-Angiotensin-Aldosterone System ◽

10.1177/1470320319868890 ◽

2019 ◽

Vol 20 (3) ◽

pp. 147032031986889 ◽

Cited By ~ 3

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.

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