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Rayner B - - 2008
The field of primary aldosteronism (PA) and aldosterone-related hypertension has undergone rapid evolution. From a relatively rare curiosity PA has become a common problem particularly in selected hypertensive populations. Patients with PA and aldosterone-related hypertension appear to be at higher cardiovascular and renal risk than comparable patients with essential hypertension ...
Sica Domenic A - - 2008
Secondary hypertension is common in clinical practice if a broad definition is applied. Various patterns of hypertension exist in the patient with an endocrine source of their disease, including new-onset hypertension in a previously normotensive individual, a loss of blood pressure control in a patient with previously well-controlled blood pressure, ...
Médeau Virginie - - 2008
OBJECTIVE: It is unknown why some patients with biochemical evidence of primary aldosteronism (PA) do not develop hypertension. We aimed to compare clinical and biochemical characteristics of normotensive and hypertensive patients with PA. DESIGN AND PATIENTS: Retrospective comparison of 10 normotensive and 168 hypertensive patients with PA for office or ...
Forrest M J - - 2008
Inhibition of cholesteryl ester transfer protein (CETP) with torcetrapib in humans increases plasma high density lipoprotein (HDL) cholesterol levels but is associated with increased blood pressure. In a phase 3 clinical study, evaluating the effects of torcetrapib in atherosclerosis, there was an excess of deaths and adverse cardiovascular events in ...
Victor Ronald G - - 2008
Compared with substantial clinical research on the renin-angiotensin-aldosterone system (RAAS), much less is known about the importance of the sympathetic nervous system as a therapeutic target to slow the initiation and progression of human hypertension. Using microelectrode recordings of sympathetic activity and radiotracer measurements of regional norepinephrine spillover in hypertensive ...
Gonzalez-Pantaleon Adalberto D - - 2008
OBJECTIVE: To report an unusual presentation of pheochromocytoma along with challenges in diagnosis and management. METHODS: We report a clinical case history and describe diagnostic methods and pitfalls. The preoperative medical preparation in a normotensive patient is described. RESULTS: A 33-year-old man fell off a ladder, resulting in C6 paraplegia. ...
Meneton P - - 2008
Plasma aldosterone and renin levels have been associated with blood pressure increase and 3-4 year incidence of hypertension in a middle-aged North American community in Framingham. To confirm these findings in a different population, a nested case-control study was performed in a national sample of 1984 French non-hypertensive volunteers aged ...
Jansen P M PM Department of Internal Medicine, Division of Vascular Pharmacology and Metabolism, Erasmus Medical Centre, Rotterdam, The Netherlands. - - 2008
Since the introduction of the aldosterone-to-renin ratio (ARR ) as a screening tool for primary aldosteronism (PA), there has been a marked increase in the reported prevalence of this condition among hypertensive subjects. A meta-analysis from the literature shows a PA prevalence of almost 8% among hypertensive patients, with a ...
Funder John W JW Prince Henry's Institute of Medical Research, Clayton, Victoria, Australia. - - 2008
1. It is currently assumed that translational research goes from benchtop to bedside; that aldosterone elevates blood pressure via its effects on salt and water homeostasis; that mineralocorticoid receptors (MR) and glucocorticoid receptors (GR) share a common immediate ancestor; and that aldosterone plays a deleterious role in essential hypertension and ...
Swaminathan K - - 2008
AIMS/HYPOTHESIS: Aldosterone antagonism improves endothelial function (and reduces deaths) in chronic heart failure. It is not known whether similar effects occur in other high-risk groups such as patients with diabetes and hypertension. We therefore assessed the full effects of aldosterone blockade in poorly controlled hypertensive patients with type 2 diabetes, ...
Rossi Gian Paolo - - 2008
Remodeling of the resistance arteries is a hallmark of arterial hypertension and predicts cardiovascular events, but it was unknown whether it could also predict the blood pressure response to adrenalectomy of patients with an aldosterone-producing adenoma. Therefore, we investigated the outcome of adrenalectomy as a function of vascular remodeling in ...
Rossi Gian-Paolo - - 2008
For many years primary aldosteronism was considered a relatively benign form of hypertension. This assumption reflects the primacy accorded to elevated levels of angiotensin in terms of deleterious cardiovascular effects, and the fact that in primary aldosteronism renin and angiotensin levels are low. We now know that primary aldosteronism causes ...
Rafidah H M - - 2008
Normotensive subjects with family history of hypertension (FHT) have been reported to have increased left ventricular mass index and reduced ventricular compliance. Of interest is whether blood pressure variability (BPV), which has been associated with target organ damage, is then part of this complex inherited syndrome? The objectives of this ...
Mackraj I - - 2008
Salt-sensitive hypertension can be caused through abnormalities related to sodium and body fluid homeostasis; renin-angiotensin-aldosterone (RAAS) plays a key role in this regard. The molecular basis of the purported antihypertensive benefits of some plant-derived compounds such as quercetin is still lacking. To this end, we investigated RAAS in the Dahl ...
Vasan Ramachandran S - - 2008
Leukocyte telomere length (LTL) chronicles the cumulative burden of oxidative stress and inflammation over a life course. Activation of the renin-angiotensin-aldosterone system is associated with increased oxidative stress and inflammation. Therefore, LTL may be related to circulating biomarkers of the renin-angiotensin-aldosterone system. We evaluated the cross-sectional relations of LTL (dependent ...
Catena Cristiana - - 2008
BACKGROUND: Experimental and human studies demonstrate that long-term exposure to elevated aldosterone levels results in cardiac and vascular damage. METHODS: We investigated long-term cardiovascular outcomes in patients with primary aldosteronism after surgical or medical treatment. Fifty-four patients with or without evidence of adrenal adenomas were prospectively followed up for a ...
Shapiro Y - - 2008
Aldosterone might affect arterial stiffening, in both the short- and long-term. We investigated a possible association between excess aldosterone, reflected by an increased aldosterone : renin ratio (ARR) and pulse wave velocity (PWV) in young healthy adults. In a single-centre study, 60 subjects were evaluated for lipid profile, glucose, hs-CRP, ...
Mirza Faryal S - - 2008
OBJECTIVE: Estradiol and angiotensin receptor blockers have prominent effects on the renin-angiotensin-aldosterone system. The purpose of this study was to determine whether irbesartan, an angiotensin receptor blocker, has a greater effect on vascular function when combined with estradiol, compared with irbesartan alone, in hypertensive postmenopausal women. DESIGN: Fifty-one women were ...
Kienitz Tina - - 2008
BACKGROUND: There is substantial evidence that androgens may play a role in determining sex-specific blood pressure. Men are at higher risk for developing coronary heart disease or hypertension compared to premenopausal women. However, effects of androgens on the renal and cardiovascular system are complex. This review provides a critical overview ...
Wenzel Ulrich - - 2008
PURPOSE OF REVIEW: The aim of this review is to look at the role of aldosterone in the progression of chronic kidney disease. The reduction of blood pressure and proteinuria in patients suffering from chronic kidney disease decreases the rate of disease progression. Suppression of angiotensin formation by angiotensin converting ...
Kobal Sergio L - - 2008
BACKGROUND: A 52-year-old woman was admitted to hospital with recurrent episodes of chest and abdominal pain, dyspnea, palpitations and diaphoresis. Continuous blood pressure recordings revealed rhythmic alternation between episodes of severe hypertension and episodes of hypotension. This cyclic hemodynamic crisis continued for 2 hours, with each cycle lasting around 15 ...
Young William F WF - - 2007
The clinical presentations of the patient with pheochromocytoma -- a rare endocrine neoplasm -- include adrenal incidentaloma, hypertensive paroxysms, sustained apparent polygenic hypertension, hypertension in pregnancy, and hypertensive crisis induced by anesthesia. Although when undiagnosed a pheochromocytoma can be lethal, it can usually be cured with surgery. Biochemical documentation with ...
Chiang Kuo-Hsuan - - 2007
A rare case of combined unilateral adrenal hyperplasia and paraganglioma is reported. A 27-year-old woman presented with hypertension, palpitation, dizziness, and headache for about 3 months. Elevated plasma aldosterone with low renin and a high level of urine vanillylmandelic acid (VMA) were found. Computed tomography showed a microadenoma of the ...
Satoh Fumitoshi - - 2007
Accurate localization of aldosterone-producing adenoma (APA) is essential for the treatment of primary aldosteronism (PA). In order to confirm the clinical usefulness of adrenal venous sampling (AVS), we retrospectively studied 87 cases of PA in whom AVS was conducted. We collected right and left adrenal venous effluents simultaneously before and ...
Sharabi Yehonatan - - 2007
OBJECTIVES: The causes of paroxysmal hypertension in patients in whom pheochromocytoma has been excluded ('pseudopheochromocytoma') usually remain unclear. Blood pressure disturbances and symptoms of catecholamine excess in these patients may reflect activation of the sympathetic nervous and adrenal medullary systems. We therefore examined sympathoadrenal function in patients with pseudopheochromocytoma compared ...
Pimenta Eduardo - - 2007
Resistant hypertension is defined as blood pressure that remains uncontrolled despite using at least three antihypertensive medications in effective doses, ideally including a diuretic. Stricter blood pressure goals, higher obesity rates, older age, and increased use of certain exogenous substances are related to an increasing prevalence of resistant hypertension. The ...
Lamounier-Zepter Valeria - - 2008
The A-ZIP/F-1 transgenic mouse is a model of lipoatrophic diabetes with severe insulin resistance, hyperglycemia and hyperlipidemia. Recently, a regulatory role of adipose tissue on adrenal gland function and blood pressure has been suggested. To further explore the importance of adipose tissue in the regulation of adrenal function and blood ...
Catena Cristiana - - 2007
Exposure to excess aldosterone results in cardiac damage in hypertensive states. We evaluated the long-term cardiac structural and functional evolution in patients with primary aldosteronism after surgical or medical treatment. Fifty-four patients with primary aldosteronism were enrolled in a prospective study and were followed for a mean of 6.4 years ...
Muhtz Christoph - - 2008
BACKGROUND: Reports about alterations of hypothalamic-pituitary-adrenocortical (HPA) function in patients with chronic posttraumatic stress disorder (PTSD) are inconsistent and controversial. More refined laboratory tests and subgrouping of PTSD patients might help to decrease variance of findings. METHODS: 14 subjects with chronic PTSD and 14 healthy controls were examined between 13:00 ...
Tamimi Nihad A M - - 2007
Resistant hypertension affects approximately 10% of the hypertensive patient population. It should be differentiated from white-coat hypertension and pseudo-resistant hypertension. Non-compliance to anti-hypertensive therapy remains the most common cause of resistant hypertension. Primary hyperaldosteronism is not as uncommon as previously thought, but its prevalence depends on the selected population. Low-renin ...
Huang Yu-Chih - - 2007
Pheochromocytoma in children shows much worse complications than that in the adult patients. An 11-year-old girl was transferred to our emergency room after suffering from headache, dizziness, cold sweating and palpitation for 3 days. Severe hypertension, remarkable blood pressure fluctuation between 260/160 and 65/50 mmHg, decrease of cardiac contractility, as ...
Pang Tony C - - 2007
BACKGROUND: Primary hyperaldosteronism is a frequent cause of resistant hypertension and is amenable to surgical intervention when caused by a unilateral aldosterone-producing adenoma. The aim of this study was to investigate the long-term results of laparoscopic adrenalectomy in the control of hypertension caused by primary hyperaldosteronism. METHODS: A prospective case ...
Hood Susan J - - 2007
BACKGROUND: There is continuing variation in diagnosis and estimated prevalence of primary hyperaldosteronism. The higher estimates encourage search for adrenal adenomas in patients with elevated ratios of plasma aldosterone to renin. However, it is more likely that patients with normal plasma K+ and aldosterone belong to the polygenic spectrum of ...
Lebrasseur Nathan K - - 2007
Hypertension and cardiac remodeling are associated with myocardial fibrosis, left ventricular (LV) hypertrophy, and diastolic heart failure. Fenofibrate suppresses aldosterone-mediated increases in myocyte matrix metalloproteinase activity and extracellular signal-regulated kinase phosphorylation. It is unknown whether the peroxisome proliferator-activated receptor-alpha agonist, fenofibrate, improves cardiac remodeling in a model of aldosterone-induced hypertension ...
Holaj Robert - - 2007
BACKGROUND: Aldosterone contributes to the accumulation of collagen fibers and extracellular matrix in arterial wall. The aim of this study was to compare intima-media thickness (IMT) of the common carotid artery and carotid bifurcation in patients with primary aldosteronism, essential hypertension and healthy controls. METHODS: Carotid ultrasound studies were carried ...
Park Sungha - - 2007
OBJECTIVE: The aldosterone-renin ratio (ARR) is widely used to screen for primary aldosteronism, and may reflect a relative excess of aldosterone secretion compared with renin secretion. Excess aldosterone may have a detrimental effect on vascular stiffness. We therefore hypothesized that ARR and aldosterone are independently correlated with pulse wave velocity ...
Petramala L - - 2007
Cushing's Syndrome (CS) may sometimes lead to dilated cardiomyopathy, even though this condition can be partially or completely reversed after treatment. In this article we report the case of a 28-yr-old woman with CS secondary to adrenal adenoma who exhibited congestive heart failure as an initial symptom. Two weeks before ...
Nyirenda Moffat J MJ Endocrinology Unit, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, - - 2007
Evidence from clinical trials suggests that refractory hypertension is increasingly common. The underlying mechanisms are largely unknown but recent data have implicated increased aldosterone activity as an important mediator of resistance to routinely used antihypertensive agents. Epidemiological studies have suggested a significant rise in the prevalence of primary aldosteronism among ...
Takei Yoshio - - 2007
Vertebrates expanded their habitats from aquatic to terrestrial environments during the course of evolution. In parallel, osmoregulatory and cardiovascular systems evolved to counter the problems of desiccation and gravity on land. In our physiological studies on body fluid and blood pressure regulation in various vertebrate species, we found that osmoregulatory ...
Stas Sameer - - 2007
The renin-angiotensin-aldosterone system contributes to cardiac remodeling, hypertrophy, and left ventricular dysfunction. Angiotensin II and aldosterone (corticosterone in rodents) together generate reactive oxygen species (ROS) via reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, which likely facilitate this hypertrophy and remodeling. This investigation sought to determine whether cardiac oxidative stress and ...
Young William F - - 2007
Great strides have been made in our understanding of the pathophysiology of primary aldosteronism syndrome since Conn's description of the clinical presentation of a patient with an aldosterone-producing adenoma (APA) more than 50 years ago. It is now recognized that the APA is just one of the seven subtypes of ...
Epstein Murray - - 2007
Resistant hypertension constitutes an increasingly common medical disorder. Although the exact incidence is not precisely known, estimates derived from recent outcome studies emphasize that resistant hypertension is much more common than previously thought. A major advance in our understanding of its pathogenesis and management is the recent recognition of the ...
Tubek SÅ‚awomir - - 2007
In the present study, differences between selected zinc parameters in healthy women and arterial hypotension patients were compared. The patients had baseline systolic blood pressure that did not surpass 100 mm Hg. During the orthostatic test, a decrease of over 20 mm Hg was seen and the patients reported dizziness, ...
Dubourg Olivier - - 2008
CONTEXT: The epidemic of heart failure (HF) in France has not been fully investigated and data on both the systolic and diastolic forms are limited. OBJECTIVES: To determine the prevalence, aetiology and treatments of both forms in French patients over 65 with HF (NYHA grade II-IV). PARTICIPANTS: Cross-sectional study of ...
Messerli Franz H - - 2007
President Eisenhower experienced an acute heart attack in September 1955 and died of ischemic cardiomyopathy 14 years later. The autopsy revealed, unexpectedly, a 1.5-cm pheochromocytoma in the left adrenal gland. In view of these hitherto unreported findings, the investigators analyzed the blood pressure pattern of the president throughout his life. ...
Christiansen Jens Juel - - 2007
BACKGROUND: Female adrenal insufficiency implicates reduced production of the adrenal androgen precursor dehydroepiandrosterone (DHEA) and low androgen levels. Oral DHEA restores androgen deficit but the clinical implications and safety of substitution therapy is uncertain. A putative DHEA receptor in vascular endothelium has been described and in vitro studies have shown ...
Pratt-Ubunama Monique N - - 2007
OBJECTIVE: Obstructive sleep apnea (OSA) and primary aldosteronism are common in subjects with resistant hypertension; it is unknown, however, if the two disorders are causally related. This study relates plasma aldosterone and renin levels to OSA severity in subjects with resistant hypertension, and in those with equally severe OSA but ...
Genazzani A R - - 2007
Drospirenone is a unique progestogen derived from 17alpha-spirolactone, with a pharmacologic profile very similar to that of endogenous progesterone. In contrast with other available progestins, drospirenone is a progestogen with aldosterone receptor antagonism (PARA) through its affinity for the mineralocorticoid receptor. It is thus able to act on the renin-angiotensin-aldosterone ...
White W B - - 2007
Hypertension is one of the most important risk factors for the development of cardiovascular disease. The prevalence of hypertension increases with age and also after the menopause; therefore, blood pressure monitoring and effective control of elevated blood pressure are very important in postmenopausal women. The knowledge that aldosterone is a ...
Zolk Oliver - - 2007
OBJECTIVE: Aldosterone plays a major role in the development of both hypertension and heart failure. As aldosterone is a substrate of the ABCB1 (P-glycoprotein) efflux transporter, whose expression and activity has been shown to be linked to the ABCB1 3435C-->T polymorphism, we tested the impact of the ABCB1 3435C-->T polymorphism ...
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