BACKGROUND: Levosimendan was hypothesized to attenuate hypoxic pulmonary vasoconstriction (HPV). METHODS: 14 anaesthetized pigs (30,9±1,0kg) were studied in normoxia (FiO2∼0,21) and hypoxia (FiO2∼0,10), before and 10-90 min after infusion of placebo (n=7) or Levosimendan (n=7). RESULTS: Compared to normoxia, hypoxia-baseline at FiO2∼0,10 (n=14) increased PVR by 1.9±0.4 WU (p<0,001), MPAP ...

Object Previous studies have shown that cervical and thoracic kyphotic deformity increases spinal cord intramedullary pressure (IMP). Using a cadaveric model, the authors investigated whether posterior decompression can adequately decrease elevated IMP in severe cervical and thoracic kyphotic deformities. Methods Using an established cadaveric model, a kyphotic deformity was created ...

OBJECTIVE: To investigate changes in tissue oxygenation in the arm and leg during the cold pressor test in humans with spinal cord injury (SCI). METHODS: Subjects with SCI at cervical 6 (n = 7) and subjects with SCI at thoracic 5 or thoracic 6 (n = 5) experienced 3-min cold water immersion of the ...

High-pressure injection injuries occur infrequently but are usually work-related and involve the non-dominant hand. The neck is a very rare site for such an injury. We describe the management of a 36-year-old man with a high-pressure grease-gun injection injury to his neck causing a cervical spinal cord injury. He developed ...

The facet joint contributes to the normal biomechanical function of the spine by transmitting loads and limiting motions via articular contact. However, little is known about the contact pressure response for this joint. Such information can provide a quantitative measure of the facet joint's local environment. The objective of this ...

Aims:  To study the association between childhood snoring and cardiovascular risk factors. Methods:  Cross-sectional analyses of a population-based birth cohort, who had been participants in a randomised controlled trial of interventions to prevent asthma and who were assessed at age 8 years. The presence and frequency of snoring were assessed by ...

The lungs are in a constant state of motion. The dynamic nature of tidal breathing, whereby cycles of pressure changes across the lungs cause the chest wall, lung tissue and airways to repeatedly expand and contract, ventilates the lung tissue and allows respiration to occur. However, these regular cycles of ...

N-acetylcysteine (NAC), a mucolytic and antioxidant, is speculated to cause bronchoconstriction in cats when delivered via aerosol. We hypothesized that in cats with experimental asthma, aerosol delivery of NAC (400mg cumulative dose) via an endotracheal tube would increase airflow limitation as measured by ventilator-acquired mechanics. After endotracheal drug delivery, airway ...

Currently there is no consensus regarding which add-on therapy to use in resistant hypertension. This study was designed to compare two treatment options, spironolactone (SPR) versus dual blockade of the renin-angiotensin-aldosterone system (RAAS). Forty-two patients with true resistant hypertension were included in the study. An open-label prospective crossover design was ...

The renin-angiotensin-aldosterone system (RAAS) plays an important role in blood pressure control and volume homeostasis. Inappropriate activation of the RAAS has been implicated in the pathogenesis of hypertension and related cardiovascular disease. Several classes of agents that block RAAS signaling have been shown to be effective antihypertensives and to have ...

To assess safety, technical success, complications, and hemodynamic changes associated with the adrenal cryoablation procedure. This retrospective review was approved by the institutional review board, with waiver of informed consent, and was compliant with the Health Insurance Portability and Accountability Act. Adult patients with adrenal metastasis who were treated with ...

BACKGROUND: Primary hyperaldosteronism is a recognised cause of secondary hypertension with its aetiology most commonly due to a secreting aldosterone adenoma of the adrenal gland. Laparoscopic resection of the adrenal tumour has now become the accepted form of intervention. The aim of this study was to assess the effectiveness of ...

Recent studies have reported a high prevalence of primary aldosteronism among patients with severe hypertension. However, the prevalence of this disease among normotensive and mildly hypertensive patients has not been determined. The aim of this study was to examine the prevalence of primary aldosteronism among prehypertensive and stage 1 hypertensive ...

Resistant hypertension (RHTN) includes patients whose blood pressure (BP) is controlled with the use of four or more antihypertensive medications, and is referred to as 'controlled resistant hypertension' (CRH). While specifically comparing patients with CRH and uncontrolled resistant hypertension (UCRH), we hoped to identify distinguishing characteristics that would provide insight ...

In essential hypertension, the regression of left ventricular hypertrophy is an important goal of treatment. In addition to treatment-associated changes in blood pressure (BP), the roles of other determinants of left ventricular hypertrophy regression, including dietary sodium intake, deserve investigation. In the present study, the change in echographic left ventricular ...

Primary aldosteronism (PA) is a common cause of arterial hypertension: in the PA Prevalence in Hypertensives (PAPY) Study, the prevalence of PA was 11.2% in consecutive referred hypertensive patients. When adrenal vein sampling (AVS) is available, two thirds of the cases can be attributed to a tumor and one third ...

Cognitive impairment leading to dementia is associated with high prevalence of hypertension, decreased quality of life and poor prognosis. Aldosterone is known as a risk factor for cardiovascular and cerebrovascular diseases. In addition, mineral corticoid receptors are abundantly expressed in the hippocampus, which plays a pivotal role in cognitive function; ...

Liddle syndrome (LS) is an autosomal dominant disorder due to a gain-of-function mutation in the epithelial Na(+) channel and is perceived to be a rare condition. A cross-sectional study of 149 hypertensive patients with hypokalemia (<4 mmol/dL) or elevated serum bicarbonate (>25 mmol/dL) was conducted at a Veterans' Administration Medical ...

Large, Ca-activated K channels (BK) are comprised of an α pore (BKα) and one of four β subunits (BKβ1-4). When the gene for BKβ1 is knocked out (BKβ1-KO), the result is increased myogenic tone of vascular smooth muscle and hypertension. We reexamined whether the hypertension is entirely due to increased ...

The cardiovascular system is under the control of the circadian clock, and disturbed circadian rhythms can induce cardiovascular pathologies. This cyclic regulation is probably brought about by the circadian expression of genes encoding enzymes and regulators involved in cardiovascular functions. We have previously shown that the rhythmic transcription of output ...

The age-related course of blood pressure and its gender-related difference, as well as the incidence of hypertension, have been the subject of multiple experimental, clinical and epidemiological studies over the past decades. The role of the sex hormones estradiol and testosterone within this gender dimorphism has been investigated without conclusive ...

Osteopontin (OPN) has recently emerged as a key factor in both vascular remodelling and development of atherosclerosis. It has been reported that OPN is regulated by the renin-angiotensin-aldosterone system (RAAS). The aim of this study was to clarify the effect of angiotensin II receptor blockade with valsartan on plasma OPN ...

Aldosterone has been shown to exert a central sympathoexcitatory action in multiple animal models, but evidence in humans is still lacking. Our objective was to determine whether hyperaldosteronism causes reversible sympathetic activation in humans. We performed a cross-sectional comparison of muscle sympathetic nerve activity (SNA, intraneural microelectrodes) in 14 hypertensive ...

Ventricular remodeling is an independent risk factor for many cardiovascular events. Inhibiting ventricular remodeling early may be an effective way to postpone heart failure for patients with cardiovascular illness. The study was designed to examine the effect of sodium houttuyfonate on ventricular remodeling induced by pressure overload in rats, as ...

Despite the existence of established, effective therapies for hypertension, new methods of blood pressure and cardiovascular risk reduction are still needed. Novel approaches are targeted towards treating resistant hypertension, improving blood-pressure control, and achieving further risk reduction beyond blood-pressure lowering. Modulation of the renin-angiotensin-aldosterone system (RAAS) provides the rationale for ...

Beta(2)-adrenergic receptor (beta2-AR) is a susceptibility locus for hypertension, and polymorphisms at this site relate to salt sensitivity and low plasma renin activity (PRA). The Dietary Approaches to Stop Hypertension (DASH) dietary pattern lowers blood pressure and appears to interact with the renin-angiotensin-aldosterone system (RAAS). We hypothesized that the DASH ...

Approximately 500,000 American premenopausal women have the postural orthostatic tachycardia syndrome (POTS). We tested the hypothesis that in POTS women during orthostasis, activation of the renin-angiotensin-aldosterone system is greater, leading to better compensated hemodynamics in the midluteal phase (MLP) than in the early follicular phase of the menstrual cycle. Ten ...

OBJECTIVES: With the present analysis we intended to investigate the magnitude of the effect of relative aldosterone excess in predicting peripheral as well as aortic blood pressure levels in a well-characterized cohort of patients undergoing coronary angiography. BACKGROUND: The discussion on the relationship between aldosterone concentration and blood pressure has ...

This minireview examines both the basic science and clinical observations over the past 20 years to show how and why overstimulation of the amiloride-sensitive epithelial Na(+) channel (ENaC) expressed by epithelial principal cells of the renal collecting duct may be responsible for a large portion of hypertension in modern society. ...

A 38-year-old man had Stanford type B chronic aortic dissection. Blood pressure was difficult to control, and further examination revealed primary aldosteronism. Magnetic resonance images showed a 1-cm nodule in the left adrenal gland. Graft replacement for aortic dissection under extracorporeal circulation and resection of the left adrenal gland were ...

Aldosterone receptor blockade and thiazide therapy effectively lower blood pressure in geriatric hypertension. Their impact on sympathetic nervous system function has not been evaluated. In a double-blind, randomized study, 36 patients with stage 1 hypertension underwent 6 months of therapy with either aldosterone receptor blockade (spironolactone, n=19; 68+/-1 years) or ...

Hypertensive urgency/emergency occurs frequently, yet no prospective data on common secondary causes, including sleep apnea (SA), renal artery stenosis (RAS), and hyperaldosteronism, are available. Patients presenting to the emergency room for over 1 year with systolic blood pressure > or =180 mmHg and/or diastolic blood pressure > or =100 mmHg ...

Aldosterone plays an important role in blood pressure homeostasis, the regulation of circulating volume, and the maintenance of the sodium-potassium balance by binding to the mineralocorticoid receptor (MR). Primary aldosteronism (PA) states are associated with an increased cardiovascular risk, mediated not only by hypertension but also by the action of ...

We have shown previously that patients with resistant hypertension and hyperaldosteronism have increased brain natriuretic peptide suggestive of increased intravascular volume. In the present study, we tested the hypothesis that hyperaldosteronism contributes to cardiac volume overload. Thirty-seven resistant hypertensive patients with hyperaldosteronism (urinary aldosterone > or = 12 microg/24 hours ...

Hypertension is common and occurs in a majority of autosomal dominant polycystic kidney disease (ADPKD) patients before the loss of kidney function. Hypertension relates to progressive kidney enlargement and is a significant independent risk factor for progression to ESRD. The pathogenesis of hypertension in ADPKD is complex and dependent on ...

Recent evidence indicates a greater frequency of primary aldosteronism (PA) among patients with hypertension than the previously accepted prevalence. PA was once considered a relatively benign form of hypertension associated with low incidence of organ complications. Recent views, however, suggest that long-term exposure to increased aldosterone levels might result in ...

Primary hyperaldosteronism (PHA) is potentially curable by laparoscopic unilateral adrenalectomy (LUA). Pre-operative assessment rarely differentiates adrenal adenoma from hyperplasia. This study aimed to evaluate the results of LUA for PHA according to pathologic findings when an adrenal mass was identified unequivocally on a CT scan. A retrospective analysis of LUA ...

Patients presenting with primary aldosteronism experience more cardiovascular events than patients with essential hypertension independent of blood pressure. Therefore, the presence of primary aldosteronism should be detected, not only to determine the cause of hypertension, but also to prevent such complications. This review focuses on human data regarding increased end-organ ...

OBJECTIVE: In hypertensive patients, primary aldosteronism (PA) is the most prevalent type of secondary hypertension, and screening for PA has become very important. Calcium channel blockers (CCB) are widely used to treat hypertension, but most CCBs stimulate plasma renin activity (PRA) and increase plasma aldosterone concentration (PAC), both of which ...

The role of angiotensin II in mediating hypertension and renal diseases is well documented, and inhibition of the renin-angiotensin-aldosterone system elicits antihypertensive and renoprotective effects. There is increasing evidence implicating aldosterone, in addition to angiotensin II, in the pathogenesis of hypertension and renal diseases. Beneficial effects of mineralocorticoid receptor (MR) ...

Hypertension is characterized by endothelial dysfunction and increased risk for adverse cardiovascular outcomes. In addition to lowering blood pressure, the calcium-channel blocker amlodipine and blockers of the renin-angiotensin-aldosterone system (angiotensin-converting enzyme inhibitors and angiotensin II type 1 receptor blockers) may further reduce cardiovascular risk by improving endothelial function when used ...

IMPORTANCE OF THE FIELD: Severe sepsis is characterized by relative hypotension associated with a high cardiac output, peripheral vasodilation, and organ dysfunction. The renin-angiotensin-aldosterone system (RAAS) is primarily activated to increase blood pressure, but recently potential pro-inflammatory effects of angiotensin II have attracted interest because of the reported association between ...

The critical role played by the renin-angiotensin-aldosterone system (RAAS) in the regulation of blood pressure and body fluid homeostasis has been well recognized. Angiotensin (Ang) II and aldosterone are the most powerful biologically active products of the RAAS, although there are also other bioactive Ang peptides involved in this system, ...

A 29-year-old woman with refractory hypertension who previously suffered from subarchnoid hemorrhage visited our facility. The diagnosis of renovascular hypertension due to fibromuscular dysplasia was made based on a high level of plasma renin activity (PRA) and aldosterone concentration (AC), and computed tomographic image of bilateral renal artery stenosis/obstruction. Angioplasty, ...

We hypothesized that the aldosterone: renin ratio (ARR) predicts the antihypertensive response to mineralocorticoid receptor antagonist, spironolactone (SPIRO), when compared with bendroflumethiazide (BFZ). We conducted a randomized, crossover, trial on hypertensive patients with either high ARR (HARR defined as >750 and plasma aldosterone >250 pmol/l) or low ARR (LARR defined ...

AIM: An increase in blood pressure after menopause has been documented. The renin-angiotensin-aldosterone system (RAAS) plays a central role in the regulation of blood pressure and in the pathophysiology of hypertension. This study investigated the effects of raloxifene, a selective estrogen receptor modulator, on components of the RAAS and blood ...

Aldosterone was in the past considered only as a prohypertensinogenic agent. It has recently become clear that apart from the classical endocrine action, i.e. causing blood pressure elevation as a result of salt retention, aldosterone has numerous blood-pressure-independent actions on nonepithelial tissue. Under conditions of high salt concentration, aldosterone is ...

Surgically correctable forms of primary aldosteronism are characterized by unilateral aldosterone hypersecretion and renin suppression, associated with varying degrees of hypertension and hypokalemia. Unilateral aldosterone hypersecretion is caused by an aldosterone-producing adenoma (also known as Conn's adenoma and aldosteronoma), primary unilateral adrenal hyperplasia and rare cases of aldosterone-producing adrenocortical carcinoma. ...

In the setting of primary aldosteronism, elevated aldosterone levels are associated with increased blood pressure. Aldosterone concentrations within the normal range, however, can also alter blood pressure. Furthermore, the aldosterone-to-renin ratio, an indicator of aldosterone excess, is associated with hypertension, even in patients without excessive absolute aldosterone levels. In this ...

Obstructive sleep apnoea (OSA) and hyperaldosteronism are very common in subjects with resistant hypertension. We hypothesized that aldosterone-mediated chronic fluid retention may influence OSA severity in patients with resistant hypertension. We tested this in an open-label evaluation by assessing the changes in the severity of OSA in patients with resistant ...