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1

Electronic Resource

Vetter, H. ; Glänzer, K. ; Alasso, I. ; [et al.]

Springer

Journal of molecular medicine 57 (1979), S. 445-449

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ISSN: 1432-1440

Keywords: Aldosteron ; Renin-Angiotensin ; Essentielle Hypertonie ; Aldosterone ; Renin-angiotensin ; Essential hypertension

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Description / Table of Contents: Summary In essential hypertension mean basal (supine) and stimulated plasma renin activity (2 h upright posture +40 mg furosemide intraveneously) decreased progressively with age. No significant differences were observed in renin levels between male and female patients. With increasing age mean basal (supine) plasma aldosterone remained almost unchanged in females, whereas in males a slight increase was found. However, in the comparable age-groups no significant sexrelated differences were obtained. In female patients changes in mean stimulated plasma aldosterone with increasing age paralleled those of plasma renin activity, whereas in males this relationship was less obvious: only a slight age-related decline in stimulated aldosterone levels was observed and significantly lower plasma aldosterone concentrations in male than in female hypertensives of the younger age-groups (〈40 years) were found. The results indicate that in essential hypertension with increasing age dissociation between plasma aldosterone and plasma renin activity occurred. Furthermore, the described alterations in adrenal aldosterone release are more pronounced in male than in female patients.

Notes: Zusammenfassung Bei Patienten mit essentieller Hypertonie fiel sowohl die basale als auch die stimulierte Plasmareninaktivität (2 h aktive Orthostase +40 mg Furosemid intravenös) mit zunehmendem Lebensalter kontinuierlich ab. Signifikante Unterschiede zwischen Männern und Frauen fanden sich nicht. Die mittlere basale Plasmaaldosteronkonzentration zeigte bei weiblichen Patienten keine altersabhängigen Veränderungen, während bei männlichen Patienten ein leichter Anstieg festgestellt werden konnte. Allerdings ergaben sich hier keine signifikanten Geschlechtsunterschiede in den vergleichbaren Altersgruppen. Die mittlere stimulierte Plasmaaldosteronkonzentration zeigte bei Frauen mit zunehmendem Alter ein der Plasmareninaktivität paralleles Verhalten, während dies bei Männern weit weniger ausgeprägt war; so fand sich bei männlichen Patienten nur ein geringer Abfall der mittleren stimulierten Plasmaaldosteronkonzentration mit dem Alter und die Aldosteronspiegel waren in den jüngeren Altersgruppen (〈40 Jahre) signifikant niedriger als bei weiblichen Patienten. Die Ergebnisse zeigen, daß bei Patienten mit essentieller Hypertonie mit zunehmendem Lebensalter eine Dissoziation zwischen Plasmaaldosteron und Plasmareninaktivität auftritt, wobei dieser Befund bei Männern deutlicher ausgeprägt ist als bei Frauen.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF01477497

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2

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The effect of saralasin (1-Sar-8-Ala-Angiotensin II) on blood pressure in patients with cushing's syndrome (1976)

Vetter, W. ; Vetter, H. ; Beckerhoff, R. ; [et al.]

Springer

Journal of molecular medicine 54 (1976), S. 661-663

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ISSN: 1432-1440

Keywords: Cushing-Syndrom ; Hypertonie ; Renin-Aktivität ; Aldosteronismus ; Cushing's syndrome ; Hypertension ; Renin activity ; Aldosteronism

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Description / Table of Contents: Summary To investigate the role of the renin angiotensin system in the pathogenesis of hypertension in Cushing's syndrome two patients with hypercorticism were infused with 20 mg saralasin (1-sar-8-alaangiotensin II) over a period of 30 minutes under constant blood pressure control. In addition, one patient with primary aldosteronism, an established form of mineralocorticoid hypertension, served as control. Neither in the two patients with Cushing's syndrome nor in the patient with primary aldosteronism could a blood pressure lowering effect of saralasin be observed. In the two patients with hypercorticism both renin activity and plasma aldosterone increased during saralasin infusion. The patient with primary aldosteronism only showed a weak increase in plasma aldosterone concentration. These results seem to exclude an important role of the renin angiotensin system in the pathogenesis of hypertension in Cushing's syndrome. The unresponsiveness of elevated blood pressure to saralasin in the two patients with hypercorticism and in the patient with primary aldosteronism indirectly supports the assumption that in patients with Cushing's syndrome increased mineralocorticoid activity may be the main factor in the pathogenesis of hypertension.

Notes: Zusammenfassung Um die Bedeutung des Renin-Angiotensin Systems in der Pathogenese der Hypertonie bei Cushing-Syndrom zu untersuchen, wurden bei 2 Patienten mit Hyperkortizismus 20 mg Saralasin (1-Sar-8-Ala-Angiotensin II) über einen Zeitraum von 30 min unter ständiger Blutdruckkontrolle infundiert. Zusätzlich diente ein Patient mit primärem Aldosteronismus, einer etablierten Form von Mineralokortikoidhochdruck, als Kontrolle. Weder bei den 2 Patienten mit Cushing-Syndrom noch bei dem Patienten mit primärem Aldosteronismus ließ sich ein blutdrucksenkender Effekt des Saralasins nachweisen. Die beiden Patienten mit Hyperkortizismus zeigten unter Saralasin sowohl einen Anstieg der Renin-Aktivität als auch des Plasmaaldosterons. Bei dem Patienten mit primärem Aldosteronismus ließ sich nur ein geringgradiger Anstieg der Plasmaaldosteronkonzentration nachweisen. Diese Ergebnisse sprechen gegen eine wichtige Rolle des Renin-Angiotensin Systems in der Pathogenese der Hypertonie bei Cushing-Syndrom. Die Unbeeinflußbarkeit des Hochdrucks durch Saralasin bei den beiden Patienten mit Hyperkortizismus und dem Patienten mit primärem Aldosteronismus stützen indirekt die Annahme, daß bei Patienten mit Cushing-Syndrom eine erhöhte Mineralokortikoidaktivität der Hauptfaktor in der Pathogenese der Hypertonie ist.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF01469145

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3

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Morning versus evening administration of nifedipine gastrointestinal therapeutic system in the management of essential hypertension (1994)

Greminger, P. ; Suter, P. M. ; Holm, D. ; [et al.]

Springer

Journal of molecular medicine 72 (1994), S. 864-869

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ISSN: 1432-1440

Keywords: Nifedipine gastrointestinal therapeutic system ; Essential hypertension ; Ambulatory blood pressure measurement

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Abstract The nifedipine gastrointestinal therapeutic system (GITS) is a recently developed controlled-release formulation for once-a-day dosing. We evaluated the influence of morning versus evening administration of the drug in a randomized double-blind cross-over study including 15 essential hypertensives. Five patients had to be excluded from blood pressure analysis because of noncompliance (three cases) or intolerable side effects (two cases). To assess the exact duration of the antihypertensive efficacy noninvasive automatic ambulatory blood pressure monitoring was performed. After a placebo period patients were given 30 mg nifedipine GITS either at 1000 or 2200 hours. Twenty-four-hour systolic and diastolic blood pressure profiles documented a sustained antihypertensive effect of both nifedipine regimens throughout the whole period without affecting the circadian rhythm. Statistical analysis revealed no significant difference between morning and evening administration. Two patients stopped their medication because of intolerable side effects (fatigue and muscle cramps, respectively). Two more cases suffered from mild reversible headache which provoked no discontinuation of the drug. In conclusion our results document a sustained antihypertensive efficacy of 30 mg nifedipine GITS in patients with moderate essential hypertension. Time of administration has no impact on day- and nighttime blood pressure control.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF00190742

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4

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Weight reduction and salt restriction in hypertension: Effects on blood pressure and intracellular electrolytes (1986)

Zidek, W. ; Karoff, Ch. ; Losse, H. ; [et al.]

Springer

Journal of molecular medicine 64 (1986), S. 1183-1185

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ISSN: 1432-1440

Keywords: Salt restriction ; Weight reduction ; Hypertension ; Intracellular electrolytes

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Summary In 16 essential hypertensives on a program of energy restriction (800 kcal/day) with and without simultaneous salt restriction, the effects on blood pressure and intracellular Na+ and Ca2+ in red blood cells were studied. A decrease in blood pressure and intracellular free Na+ and Ca2+ was only observed in the cases of simultaneous energy and salt restriction. The beneficial effect of weight reduction in hypertension thus depends on a diminished salt intake and is probably mediated by changes in intracellular free Ca2+.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF01728458

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5

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Platelet Na+/H+ antiport activity in patients with insulin-dependent diabetes mellitus with and without diabetic nephropathy (1993)

Düsing, R. ; Sorger, M. ; Mattes, L. ; [et al.]

Springer

Journal of molecular medicine 71 (1993), S. 119-125

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ISSN: 1432-1440

Keywords: Na+/H+ antiport ; Hypertension ; Diabetic nephropathy ; Hereditary factors

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Summary The incidence of diabetic nephropathy in patients with insulin-dependent diabetes mellitus (IDDM) may depend on factors other than the quality of diabetes control. Hypertension is an additional factor associated with a high degree of renal involvement in IDDM. One abnormality consistantly observed in various tissues of patients with essential hypertension is enhanced activity of the Na+/H+ antiport. In the present study we have therefore studied platelet antiport activity in 41 healthy subjects (control), in 22 patients with untreated essential hypertension (EH), and in 35 normotensive IDDM patients (type 1). Of these patients 17 exhibited signs of diabetic nephropathy (group 1) while 18 had no evidence for renal involvement of IDDM in spite of a duration of IDDM of at least 10 years (group 2). The two IDDM patient groups were undistinguishable with respect to age, body mass index, and arterial blood pressure (group 1, 117.9±2.4/78.4±1.5 mmHg; group 2, 113.9±3.6/76.1±1.8 mmHg). Antiporter activity was determined from the rate of cell volume changes induced by propionic acid. Platelet Na+/H+ exchange activity averaged 23.43±0.43 10−3·s−1 in control subjects and was markedly elevated in EH (28.38±0.62 10−3·s−1 P〈0.01). Antiport activity in group 2 patients without nephropathy averaged 24.54±0.57 10−3·s−1 and was undistinguishable from the control group. However, platelet Na+/H+ antiport activity was significantly stimulated in group 1 patients with nephropathy as compared to group 2(26.95±0.73 10−3. s−1 ; P〈0.025). Our results show that renal involvement in IDDM is associated with enhanced activity of the platelet Na+/H+ antiport.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF00179992

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6

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Cellular calcium metabolism in primary hypertension (1987)

Zidek, W. ; Vetter, H.

Springer

Journal of molecular medicine 65 (1987), S. 155-160

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ISSN: 1432-1440

Keywords: Hypertension ; Ca2+

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Summary Several disturbances of cellular Ca2+ metabolism have been described in essential hypertension and in the spontaneously hypertensive rat. Possibly the elevation of intracellular free Ca2+ concentration in arterial smooth muscle cells is one important step in the pathogenesis of primary hypertension. In most studies a decreased energy-dependent Ca2+ transport has been proposed as a mechanism. However, disturbances in cellular Ca2+ metabolism, which can be exclusively ascribed to essential hypertension, have not yet been found. The cause of altered cellular Ca2+ transport in primary hypertension may either be a genetically determined defect of membrane transport or a still-unidentified humoral factor.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF01728224

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7

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Plasma lipids and lipoproteins and essential hypertension (1994)

Flesch, M. ; Sachinidis, A. ; Ko, Y. D. ; [et al.]

Springer

Journal of molecular medicine 72 (1994), S. 944-950

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ISSN: 1432-1440

Keywords: Hypertension ; Low density lipoprotein ; Apo B ; Cholesterol ; Very low density lipoprotein ; Triglycerides ; Lipoprotein (a)

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Abstract In recent years there have been many studies demonstrating a correlation between increased arterial blood pressure and altered lipid profiles, and there has been an especially positive correlation between high cholesterol levels and blood pressure. There are differences between the various reports that are important. In our study the lipid distribution in 105 hypertensive patients with mild or moderate arterial hypertension according to WHO criteria without clinically or ultrasonographically apparent atherosclerosis was compared to the lipid distribution in 65 age-matched healthy persons. On the epidemiological level a significant, positive association was found between LDL serum levels (P ≤ 0.001), Apo B serum levels (P ≤ 0.001), serum triglyceride levels (P ≤ 0.05) and VLDL serum levels (P ≤ 0.01) and arterial hypertension. However, in contrast to recent reports, no significant difference was found between total serum cholesterol levels in normotensives and hypertensives, and there was no difference in HDL serum levels. No evidence could be found for a significant increase in lipoprotein (a) serum levels in hypertensives.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF00577733

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8

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Treatment of resistant hypertension by phlebotomy (1985)

Zidek, W. ; Tenschert, W. ; Karoff, Ch. ; [et al.]

Springer

Journal of molecular medicine 63 (1985), S. 762-764

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ISSN: 1432-1440

Keywords: Phlebotomy ; Hypertension

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Summary In 15 essential hypertensives resistant against a standard triple combination of antihypertensive drugs phlebotomy was performed. Mean arterial pressure was lowered from 140.1±12.2 mm Hg to 123.8±14.9 mm Hg after 14 days. No serious side effects were observed. The duration of the hypoptensive effect of phlebotomy was about 4 weeks. Phlebotomy can be used in addition to drug treatment in resistant essential hypertension.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF01733828

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9

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Comparison of casual, ambulatory and self-measured blood pressure in a study of nitrendipine vs bisoprolol (1992)

Mengden, T. ; Bättig, B. ; Schubert, M. ; [et al.]

Springer

European journal of clinical pharmacology 42 (1992), S. 569-575

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ISSN: 1432-1041

Keywords: Nitrendipine ; Bisoprolol ; Hypertension ; self-measured blood pressure ; diurnal variation ; adverse effects

Source: Springer Online Journal Archives 1860-2000

Topics: Chemistry and Pharmacology , Medicine

Notes: Summary In a double-blind, placebo-controlled study the antihypertensive efficacy and tolerability of a single morning dose of either 10 mg bisoprolol (n=26) or 20 mg nitrendipine (n=27) were investigated. Blood pressure was measured by three techniques: (1) Casual blood pressure 24 h after the dose; (2) ambulatory 24-h whole-day monitoring; and (3) self-recorded blood pressure in the morning 24 h after the dose (6–8 a.m.) and in the evening (6–8 p.m.). After 4 weeks of therapy bisoprolol had produced a highly significant reduction in blood pressure as assessed by casual, ambulatory day- and night-time monitoring, and self-measured morning and evening readings. Bisoprolol was significantly more effective than nitrendipine, which did not induce a significant reduction in the ambulatory night-time recordings. Whole-day ambulatory blood pressure profiles showed an antihypertensive effect of bisoprolol throughout the entire 24-h period. 24-h blood pressure curves after nitrendipine demonstrated a markedly shorter duration of action, with no reduction in early morning blood pressure. Adverse effects and tolerability of the two drugs were comparable. The average changes in systolic and diastolic blood pressure after bisoprolol and nitrendipine in 2-h periods of ambulatory monitoring (6–8 a.m. and 6–8 p.m.) and self-measured blood pressure (6–8 a.m. and 6–8 p.m.) showed a good agreement between ambulatory and self-measured blood pressure determinations with no significant difference between the methods. The results show that 24 h antihypertensive efficacy was more pronounced for bisoprolol than for nitrendipine at the doses studied. Further, self-measured blood pressures at home were suitable for accurate estimation of the 12-h and 24-h antihypertensive efficacy of the two drugs. The methodological findings of this study have important implications for further pharmacological trials investigating the duration of action of antihypertensive drugs.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF00265917

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10

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Renin, aldosterone and arterial pressure responses to acute β-adrenergic receptor blockade in hypertensive patients (1976)

Stumpe, K. O. ; Kolloch, R. ; Gramann, W. ; [et al.]

Springer

Journal of molecular medicine 54 (1976), S. 775-782

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ISSN: 1432-1440

Keywords: Akute β-Rezeptorenblockade ; Hypertension ; Renin ; Aldosteron ; Tag-Nacht-Rhythmus ; Acute β-receptor blockade ; Hypertension ; Renin ; Aldosterone ; Day-night rhythm

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Description / Table of Contents: Summary The effect of acute (intravenous) β-adrenergic blockade with propranolol or pindolol on arterial pressure (BP), plasma renin activity (PRA), and plasma concentration of aldosterone (PA) was evaluated in 20 essential hypertensive men. BP, PRA and PA were determined during continuous recumbency overnight (8 p.m. to 6 a.m.) every 30 min. Two groups of patients were observed. Patients of group I exhibited a characteristic day-night rhythm of PRA with low values before midnight and large increases early in the morning. Conversely, no rhythm and very low PRA values were observed in patients of group II. BP was higher in group II than in group I. In group I following intravenous propranolol or pindolol, BP fell within minutes and levels as well as rhythms of PRA were converted to those of group II without treatment. In group II day-night profiles of PRA and BP remained unchanged. Rhythm and concentration of PA in the two groups were not influenced by either drug. In 4 patients of group I infusion of angiotensin II inhibitor did not lower BP. The observations suggest that in the two groups dissimilarities in rhythms of PRA as well as in BP responses to β-blockade may reflect differences in neuro-adrenergic tone.

Notes: Zusammenfassung Der Einfluß einer akuten (intravenösen) β-Rezeptorenblockade mit Propranolol oder Pindololauf den Blutdruck (RR), die Plasma-Reninaktivität (PRA) und die Plasma-Aldosteronkonzentration (PA) wurde bei 20 Männern mit essentieller Hypertension untersucht. RR, PRA und PA wurden am liegenden Patienten nachts (20.00–6.00 Uhr) alle 30 min bestimmt. Zwei Gruppen von Patienten konnten unterschieden werden: Patienten der Gruppe I wiesen einen charakteristischen Tag-Nacht-Rhythmus in der Plasma-Reninaktivität auf, mit niedrigen Werten vor Mitternacht und hohen Werten am frühen Morgen. Im Gegensatz hierzu hatten die Patienten der Gruppe II sehr niedrige PRA-Werte; ein Rhythmus für PRA ließ sich nicht nachweisen. RR war höher in der Gruppe II als in Gruppe I. Nach Infusion von Propranolol oder Pindolol kam es in der Gruppe I zu einem schnellen RR-Abfall. Das Verhalten des Tag-Nacht-Profils für PRA war nach der β-Blockade vergleichbar mit demjenigen der Gruppe II vor der β-Blockade. In der Gruppe II blieben RR und Tag-Nacht-Profil von PRA unter β-Blockade unverändert. Rhythmus und Konzentration von PA wurden in beiden Gruppen nicht beeinflußt. Bei 4 Patienten der Gruppe I führte Angiotensin II-Blockade zu keiner RR-Senkung. Die Ergebnisse sind mit der Annahme vereinbar, daß die Unterschiede im Renin-Rhythmus und im Blutdruckverhalten nach akuter β-Rezeptorenblockade durch eine unterschiedliche neuroadrenerge Aktivität der beiden Gruppen bedingt sind.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF01614294

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