Neurogenic Participation in Essential and Renovascular Hypertension Assessed by Acute Ganglionic Blockade: Correlation with Haemodynamic Indices and Intravascular Volume

1973 ◽  
Vol 44 (3) ◽  
pp. 197-212 ◽  
Author(s):  
R. C. Tarazi ◽  
Harriet P. Dustan
Keyword(s):  
Essential Hypertension ◽  
Renovascular Hypertension ◽  
Peripheral Resistance ◽  
Arterial Stenosis ◽  
Intravascular Volume ◽  
Physiological Factors ◽  
Depressor Response ◽  
Different Types ◽  
Normotensive Subjects ◽  
Pressure Resistance

1. Neurogenic activity at rest was estimated from the immediate depressor response to intravenously administered trimetaphan in two groups of untreated hypertensive patients (thirty with essential hypertension and twenty with renal arterial stenosis). Responses were correlated with simultaneously determined haemodynamic functions and intravascular volume. 2. The two groups did not differ significantly in degree of response but the pattern of its correlations was different. In essential hypertension, the depressor response correlated directly with control total peripheral resistance (P < 0.005) and diastolic arterial pressure (P < 0.025) and inversely with blood volume (P < 0.02); data from seven age-matched normotensive subjects fell along the same regression lines. In renovascular hypertension, on the other hand, the response did not correlate with either pressure, resistance or volume. The results suggest the interference in renovascular hypertension of a factor or factors not evident in essential hypertension. Further, this approach indicates that different types of hypertension may differ more by the pattern in which physiological factors interrelate than by a disturbance of a single factor alone.

Hypertension in the Elderly: Haemodynamic, Fluid Volume and Endocrine Findings

1981 ◽  
Vol 61 (s7) ◽  
pp. 393s-394s ◽  
Author(s):  
F. H. Messerli ◽  
L. B. Glade ◽  
G. R. Dreslinski ◽  
F. G. Dunn ◽  
E. Reisin ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Peripheral Resistance ◽  
Plasma Renin ◽  
The Elderly ◽  
Fluid Volume ◽  
Intravascular Volume ◽  
Pathophysiological Process ◽  
Normotensive Subjects ◽  
Lower Cardiac Output ◽  
Noradrenaline Levels

1. Systemic and renal haemodynamics, intravascular volume, circulating catecholamines and plasma renin activity were measured in 18 patients with established essential hypertension who were older than 60 years of age. Each patient was matched with respect to mean arterial pressure, body surface area, race and sex with a patient that was younger than 42 years of age. 2. When compared with the younger group, elderly patients had a lower cardiac output, impaired myocardial reserve, lesser aortic elasticity, higher total peripheral resistance, more contracted intravascular volume and higher circulating noradrenaline levels. 3. Similar effects of age, although less pronounced, have been reported in normotensive subjects. We conclude that essential hypertension is a pathophysiological process that seems to accelerate the natural physiological haemodynamic, fluid volume and endocrine processes of aging.

Effect of 1 Year's Therapy in Essential Hypertension on Systemic Haemodynamics Studied before and after ‘Total’ Autonomic Blockade

1979 ◽  
Vol 57 (s5) ◽  
pp. 11s-13s ◽  
Author(s):  
G. L. Jennings ◽  
P. I. Korner ◽  
M. D. Esler
Keyword(s):  
Essential Hypertension ◽  
Blood Pressure Reduction ◽  
Peripheral Resistance ◽  
Resistance Index ◽  
Antihypertensive Drug Therapy ◽  
Complete Restoration ◽  
Before And After ◽  
Autonomic Blockade ◽  
Normotensive Subjects ◽  
Total Peripheral Resistance Index

1. The haemodynamics of ten patients with essential hypertension were studied before treatment (study 1) and again 1 week after cessation of 1 year's antihypertensive drug therapy (study 2). On each occasion measurements of mean arterial pressure (MAP), cardiac index (CI) and total peripheral resistance index (TPRI) were made before and after ‘total’ pharmacological autonomic blockade (with intravenous propranolol, atropine, phentolamine and clonidine); measurements after ‘total’ autonomic blockade were used to assess the magnitude of the ‘non-autonomic’ component of TPRI, which reflects humoral or structural alterations in the vasculature. 2. The findings before ‘total’ autonomic blockade during study 2 showed that MAP was 18 ± 8 mmHg below the value (135 mmHg) observed during study 1 before treatment, and TPRI had fallen by 33% (P &lt; 0·05) and CI had increased by 23% (P &lt; 0·05). 3. After ‘total’ autonomic blockade the differences in the ‘non-autonomic’ components of the different variables were similar, with ‘non-autonomic’ MAP 14 ± 4 mmHg lower in study 2, TPRI 42% lower (P &lt; 0·005) and CI 28% higher. The value in ‘non-autonomic’ TPRI was now the same as values previously observed in normotensive subjects. 4. We conclude that after 1 year's successful treatment there is complete restoration of ‘non-autonomic’ TPRI as a secondary consequence of the blood pressure reduction.

Aging and Endothelial Function in Normotensive Subjects and Patients With Essential Hypertension

Circulation ◽  
1995 ◽  
Vol 91 (7) ◽  
pp. 1981-1987 ◽  
Author(s):  
Stefano Taddei ◽  
Agostino Virdis ◽  
Paola Mattei ◽  
Lorenzo Ghiadoni ◽  
Alessandra Gennari ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Endothelial Function ◽  
Normotensive Subjects

Role of sympathetic nerves during developing cardiac hypertrophy in Grollman hypertensive rats

1987 ◽  
Vol 253 (4) ◽  
pp. H818-H825
Author(s):  
R. J. Tomanek ◽  
D. W. Carlson ◽  
P. J. Palmer ◽  
R. K. Bhatnagar
Keyword(s):  
Cardiac Hypertrophy ◽  
Renovascular Hypertension ◽  
Volume Expansion ◽  
Peripheral Resistance ◽  
Sympathetic Nerves ◽  
Left Ventricular ◽  
Lv Function ◽  
Hypertensive Rats ◽  
Anterior Portion ◽  
Mitochondrial Volume

Peak left ventricular (LV) function, during rapid volume expansion, and cardiocyte structure were studied in rats with developing cardiac hypertrophy in response to Grollman hypertension (1 kidney, 1 figure 8) after chemical sympathectomy with 6-hydroxydopamine. This form of renovascular hypertension led to the same magnitude of hypertrophy in rats with or without sympathectomy. Indices of peak LV function, measured during acute volume expansion, tended to be normal or slightly higher in hypertensive rats than in controls. Sympathectomy in rats with hypertension significantly improved cardiac and stroke indices while decreasing total peripheral resistance at peak cardiac output. Despite similar magnitudes of LV hypertrophy (LVH) in the two hypertensive groups, cardiocytes in sympathectomized rats had higher mitochondrial volume densities and slightly lower myofibrillar volume densities. After regional sympathectomy of the anterior portion of the LV with phenol, mitochondrial volume density increased by 21% in hypertensive rats with LVH. These data indicate that, during the development of LVH in response to renovascular hypertension, sympathetic nerves do not contribute to the magnitude of LVH but may limit improvement in peak LV performance in response to increased preload. However, sympathetic nerves do play a role in the regulation of mitochondrial and myofibril growth.

Solitary Kidney and Ageing as Causes of Low Renin and Aldosterone Concentrations: Relevance to ‘Low-Renin’ Essential Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 177s-180s ◽  
Author(s):  
R. Gordon ◽  
Freda Doran ◽  
M. Thomas ◽  
Frances Thomas ◽  
P. Cheras
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Plasma Volume ◽  
Plasma Renin ◽  
Renin Activity ◽  
Dietary Sodium ◽  
Sodium Restriction ◽  
Normotensive Subjects ◽  
The Mean

1. As experimental models of reduced nephron population in man, (a) twelve men aged 15–32 years who had one kidney removed 1–13 years previously and (b) fourteen normotensive men aged 70–90 years were studied. Results were compared with those in eighteen normotensive men aged 18–28 years and eleven men aged 19–33 years with essential hypertension. 2. While the subjects followed a routine of normal diet and daily activity, measurements were made, after overnight recumbency and in the fasting state, of plasma volume and renin activity on one occasion in hospital and of blood pressure on five to fourteen occasions in the home. Blood pressure was also measured after standing for 2 min and plasma renin activity after 1 h standing, sitting or walking. Twenty-four hour urinary aldosterone excretion was also measured. 3. The measurements were repeated in the normotensive subjects and subjects in (a) and (b) above after 10 days of sodium-restricted diet (40 mmol of sodium/day). 4. The mean plasma renin activity (recumbent) in essential hypertensive subjects was higher than in normotensive subjects. In subjects of (a) and (b) above, it was lower than normotensive subjects, and was not increased by dietary sodium restriction in subjects of (a). 5. The mean aldosterone excretion level was lower in old normotensive subjects than in the other groups, and increased in each group after dietary sodium restriction. 6. Mean plasma volume/surface area was not different between the four groups and in normotensive, essential hypertensive and nephrectomized subjects but not subjects aged 70–90 years was negatively correlated with standing diastolic blood pressure.

Successful transluminal angioplasty of renal arterial stenosis using the transcarotid approach

2002 ◽  
Vol 12 (6) ◽  
pp. 589-591 ◽  
Author(s):  
Kiyohiro Takigiku ◽  
Gengi Satomi ◽  
Satoshi Yasukochi
Keyword(s):  
Renal Artery ◽  
Renovascular Hypertension ◽  
Coronary Arteries ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Left Ventricular ◽  
Arterial Stenosis ◽  
Left Renal Artery ◽  
Ventricular Failure ◽  
Percutaneous Transluminal

We successfully performed percutaneous transluminal angioplasty to treat severe renovascular hypertension with left ventricular failure in a 5-month-old infant. Using the transcarotid approach, we dilated the stenotic left renal artery without any difficulties, using progressively larger balloons designed for dilation of coronary arteries.

Hemodynamic changes induced by reversal of early and late renovascular hypertension

1983 ◽  
Vol 245 (5) ◽  
pp. H734-H740
Author(s):  
G. I. Russell ◽  
R. F. Bing ◽  
J. D. Swales ◽  
H. Thurston
Keyword(s):  
Blood Pressure ◽  
Renovascular Hypertension ◽  
Early Phase ◽  
Peripheral Resistance ◽  
Chronic Phase ◽  
Plasma Renin ◽  
Chronic Hypertension ◽  
Radioactive Microspheres ◽  
Hemodynamic Changes ◽  
Rapid Reduction

The hemodynamic changes associated with reversal of Goldblatt two-kidney, one-clip hypertension in conscious rats were studied using radioactive microspheres. In both the early phase (less than 6 wk from clipping) when plasma renin was elevated and the chronic phase (greater than 4 mo) when plasma renin was normal, hypertension was maintained by elevated peripheral resistance. Unclipping or removal of the ischemic kidney normalized blood pressure within 24 h by reduction in peripheral resistance. In early-phase hypertension blood pressure remained normal at 60 days after nephrectomy or unclipping, but in chronic-phase hypertension blood pressure was significantly elevated at 60 days after nephrectomy despite a similar fall in peripheral resistance. Plasma renin fell to normal or subnormal values after reversal in both early and chronic hypertension. Thus reversal of hypertension is associated with a rapid reduction in peripheral resistance even in longstanding hypertension. Since removal of the ischemic kidney and unclipping were equally effective, reversal must depend on either inhibition of a pressor system derived from the ischemic kidney or activation of a peripheral vasodepressor system not dependent on a revascularized kidney.

Plasma levels of 6-keto-prostaglandin F1α in normotensive subjects and patients with essential hypertension

1983 ◽  
Vol 10 (4) ◽  
pp. 455-464 ◽  
Author(s):  
Yoshio Uehara ◽  
Masao Ishii ◽  
Toshio Ikeda ◽  
Keiichiro Atarashi ◽  
Tadanao Takeda ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Plasma Levels ◽  
Normotensive Subjects
Sign in / Sign up

Export Citation Format

Share Document