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.

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.

ESSENTIAL HYPERTENSION IN THE ELDERLY: HAEMODYNAMICS, INTRAVASCULAR VOLUME, PLASMA RENIN ACTIVITY, AND CIRCULATING CATECHOLAMINE LEVELS

The Lancet ◽  
1983 ◽  
Vol 322 (8357) ◽  
pp. 983-986 ◽  
Author(s):  
FranzH. Messerli ◽  
HectorO. Ventura ◽  
LouisB. Glade ◽  
Kirsten Sundgaard-Riise ◽  
FrancisG. Dunn ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Plasma Renin ◽  
The Elderly ◽  
Renin Activity ◽  
Intravascular Volume ◽  
Catecholamine Levels

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.

scholarly journals Correlation Between Blood Pressure Variability and Plasma Renin–Angiotensin–Aldosterone Levels in Patients With Essential Hypertension at Different Ages

2020 ◽  
Vol 33 (6) ◽  
pp. 581-581
Author(s):  
Cai-ni Fan ◽  
Hai-ying Zhao ◽  
Dan-dan Tian ◽  
Hao Wang
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Blood Pressure Variability ◽  
Plasma Renin ◽  
The Elderly ◽  
Young Group ◽  
Moderate Essential Hypertension ◽  
Elderly Group ◽  
Middle Aged ◽  
Aged Group

Abstract Background To study the correlation between blood pressure variability (BPV) and plasma renin activity (PRA), angiotensin II (AngII), aldosterone levels in patients with essential hypertension. Methods A total of 300 patients with mild to moderate essential hypertension were analyzed retrospectively. The subjects were divided into 3 age groups: 100 patients aged 18–44 years (young group), 110 patients aged 45–64 years (middle-aged group), and 90 patients aged over 65 years (elderly group). PRA, AngII, and aldosterone levels were assessed. Blood pressure (BP) was measured by 24-hour ambulatory BP monitoring. The relationships between BP variability and the PRA, AngII, aldosterone levels were compared among the 3 groups. Results Supine and upright PRA and aldosterone levels were significantly higher in the young group than those in the middle-aged and elderly groups. The coefficient of variation (CV) of 24-hour systolic (24hSBPCV), diastolic BP (24hDBPCV), CV of daytime systolic (dSBPCV), diastolic (dDBPCV), and nighttime systolic BP (nSBPCV) in the elderly group was higher than those in the young group and the middle-aged group (all P &lt; 0.05). Spearman correlation analysis showed that in the young and middle-aged groups, BPV was significantly correlated with the levels of PRA, AngII, and aldosterone (all P &lt; 0.05). In the elderly group however, only 24hDBPCV, nDBPCV, and nSBPCV were correlated with AngII and aldosterone levels (all P &lt; 0.05). Conclusions BPV is correlated with plasma renin–angiotensin–aldosterone levels in young and middle-aged patients with mild to moderate essential hypertension.

Plasma Renin Levels and Systemic Haemodynamics in Essential Hypertension

1977 ◽  
Vol 52 (6) ◽  
pp. 591-597 ◽  
Author(s):  
R. Fagard ◽  
A. Amery ◽  
T. Reybrouck ◽  
P. Lijnen ◽  
L. Billiet ◽  
...  
Keyword(s):  
Renal Function ◽  
Cardiac Output ◽  
Essential Hypertension ◽  
Arterial Pressure ◽  
Total Peripheral Resistance ◽  
Peripheral Resistance ◽  
Plasma Renin ◽  
Inverse Relation ◽  
Plasma Renin Concentration ◽  
Low Renin Hypertension

1. Plasma renin concentration, intra-arterial pressure, cardiac output and total peripheral resistance have been studied in 50 patients with essential hypertension and normal renal function. 2. Total peripheral resistance and plasma renin were negatively correlated (r = −0·45), indicating that ‘high-renin’ essential hypertension is not necessarily associated with arteriolar vasoconstriction. 3. The inverse relation between mean arterial pressure and plasma renin (r = −0·46) suggests a role for the renal baroreceptor mechanism in the suppression of renin in ‘low-renin’ hypertension. 4. Cardiac output was positively related to plasma renin concentration (r = +0·42). 5. Multiple regression analysis indicates that the described relationships were independent of age.

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.

Effect of age on plasma aldosterone response to exogenous angiotensin II in normotensive subjects

1980 ◽  
Vol 94 (4) ◽  
pp. 552-558 ◽  
Author(s):  
Ryoyu Takeda ◽  
Shinpei Morimoto ◽  
Kenzo Uchida ◽  
Isamu Miyamori ◽  
Tetsuji Hashiba
Keyword(s):  
Angiotensin Ii ◽  
Plasma Renin Activity ◽  
Sodium Intake ◽  
Plasma Renin ◽  
The Elderly ◽  
Plasma Aldosterone ◽  
Renin Activity ◽  
Middle Aged ◽  
Basal Plasma ◽  
Normotensive Subjects

Abstract. The plasma aldosterone response to angiotensin II (10 ng/kg/min for 30 min, iv) under conditions of varied sodium intake was studied in 10 young subjects (20 to 35 years), 9 middle-aged (41 to 56 years) and 11 elderly (66 to 73 years) normotensive subjects. Basal plasma renin activity, basal plasma level and urinary excretion of aldosterone were significantly lower in the elderly than in the young and middle-aged groups on both 130 and 25 mEq sodium intakes. When sodium intake was reduced to 25 mEq for 3 days, the weight loss was significantly greater in the elderly than in the young and middle-aged groups. No significant differences in blood pressure and serum electrolytes were found between the three groups. Angiotensin II infusion caused significant increases in the mean blood pressure in all the three groups, but to a greater extent in the elderly group. Plasma aldosterone level and its absolute increment, but not its per cent increment, after angiotensin II infusion were significantly lower in the elderly than in the young and middle-aged groups. In combined young, middleaged and elderly subjects, the absolute plasma aldosterone increment correlated positively with basal plasma aldosterone and plasma renin activity levels on a 25 mEq sodium intake, and with plasma renin response to sodium restriction. These results suggest that ageing may cause a lesser plasma aldosterone response to angiotensin II with a decrease in basal plasma aldosterone, in parallel with a decrease in plasma renin activity, under condition of low sodium diet.

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.

Plasma Noradrenaline Concentration in Hypertensive and Normotensive 40-Year-Old Individuals: Relationship to Plasma Renin Concentration

1979 ◽  
Vol 57 (s5) ◽  
pp. 181s-183s ◽  
Author(s):  
H. Ibsen ◽  
N. J. Christensen ◽  
H. Hollnagel ◽  
A. Leth ◽  
A. M. Kappelgaard ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Plasma Renin ◽  
Close Correlation ◽  
Plasma Noradrenaline ◽  
Control Group ◽  
Plasma Renin Concentration ◽  
Plasma Noradrenaline Concentration ◽  
Noradrenaline Concentration ◽  
Group A ◽  
Normotensive Subjects

1. Forty-year-old individuals with mild essential hypertension, identified during a survey of a population born in 1936, were investigated. Forty-year-old normotensive subjects, drawn from the same population, served as a control group. 2. Plasma noradrenaline concentration and plasma renin concentration at rest supine and after acute stimulation, as induced by frusemide intravenously and ambulation, did not differ from reference values in the 40-year-old normotensive controls. In the hypertensive group a close correlation (r = 0·77, P &lt; 0·001) was found between plasma noradrenaline and plasma renin concentration after acute stimulation. 3. Sympathetic nerve activity, as defined by measurements of plasma noradrenaline, is normal in mild essential hypertension. Discrepancies described in the literature are probably related to a lack of comparability between hypertensive and normotensive study populations.

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