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Renal, Cardiovascular, and Pulmonary Functions of Dopamine
Published in Nira Ben-Jonathan, Dopamine, 2020
Long-term regulation of blood pressure rests on both renal and cardiovascular mechanisms. Essential hypertension, also called primary hypertension or idiopathic hypertension, is a form of high blood pressure without clearly identifiable causes. Essential hypertension affects ∼25% of the adult population, and is a common risk factor for stroke, myocardial infarction, heart failure, and kidney failure [8,9]. This is a heterogeneous disease, caused by interactions of genetic and environmental factors.
Identifying cases of disease: Clinimetrics and diagnosis
Published in Milos Jenicek, Foundations of Evidence-Based Medicine, 2019
For example, if occult blood in stools is suspected as a result of a single Greegor's test, the patient is not immediately scheduled for bowel resection. More testing is needed. Fecal occult blood testing is thus a screening procedure. A single blood pressure measurement giving elevated systolic and diastolic pressure requires repetitive measurements as well as clinical and paraclinical work-ups to exclude renal and/or endocrine causes of hypertension, etc., before the diagnosis of essential hypertension is made and appropriate treatment prescribed. A single random blood pressure measurement is a screening test for hypertension, just as an isolated finding of a low blood hemoglobin level is a screening test for iron deficiency anemia. Both diagnostic and screening tests must have their internal and external validities known and evaluated by the following methods.
Medicine
Published in Andrew Schofield, Paul Schofield, The Complete SAQ Study Guide, 2019
Andrew Schofield, Paul Schofield
A normally fit and well 72-year-old lady attends a health screening clinic at her GP surgery. Her blood pressure is found to be 172/88, her cholesterol is 5.9, random glucose is 5.0 and urinalysis is normal. An appointment is booked for her to see her GP, and her blood pressure is 168/92. She has no family history of cardiovascular disease and takes no regular medications. She is started on bendroflumethiazide for hypertension and simvastatin for hypercholesterolaemia. What class of drug is now considered first-line in this age group? (1)Give three complications of essential hypertension. (3)What is the mechanism of action of simvastatin? (2)Give two signs of hypercholesterolaemia you may find on examination. (2)The same patient returns 2 days later with severe pain in the big toe on her right foot. On examination, it is red, swollen and tender to palpation. What is the most likely diagnosis? (1)Name one drug you may use to treat the acute phase of this condition. (1)
A decision tree model of hypertension among college students in Yunnan Province, China
Published in Blood Pressure, 2023
Xu Honglv, Wang Wei, Wang Min, Chen Junyu, Yu Chunjie, Li Min, Liu Dehui, Wang Jiai, Jiang Yinghong
Essential hypertension is the most common cause of hypertension in adolescents [9]. Essential hypertension is increasingly recognized as a syndrome rather than a disease, which is affected by multiple factors [10–12]. A systematic review and meta-analysis showed that being aged 30–60, married, living in an urban area, high income, smoking, family history of hypertension, overweight, obesity, diabetes and emotional symptoms (anxiety, stress and anger) were positively associated with hypertension; education level, physical activity and low dietary salt are negatively associated with hypertension [13]. Reviewing the worldwide literature, lifestyle (smoking, drinking, dietary behavior, drug abuse, physical inactivity, mobile phone dependence, poor sleep quality, etc.), genetic factors (family history of hypertension, etc.), environmental factors (living environment, maternal growth hormone levels during pregnancy, etc.) and demographic variables (gender, age, etc.) and health status (obesity, basal metabolic rate, mental health status, etc.) are the main risk factors for hypertension [13–17].
Kidney microbiota dysbiosis contributes to the development of hypertension
Published in Gut Microbes, 2022
Xin-Yu Liu, Jing Li, Yamei Zhang, Luyun Fan, Yanli Xia, Yongyang Wu, Junru Chen, Xinyu Zhao, Qiannan Gao, Bing Xu, Chunlai Nie, Zhengyu Li, Aiping Tong, Wenjie Wang, Jun Cai
Our study has several limitations. First, we only examined samples from SHRs with essential hypertension and found IgA-coated bacteria or L-forms, which were confirmed in biopsy samples from patients with essential hypertension. In a rat model of secondary hypertension, deoxycorticosterone acetate (DOCA)-salt hypertensive rats and Dahl salt-sensitive (SS) rats (SSR) remain to be determined. SSR is a typical model of secondary hypertension caused by the interaction between a high-salt diet (environmental factor) and genetic factors. A high-salt diet inevitably leads to high osmolarity in the gastrointestinal tract, which is conducive to the translocation and colonization of L-forms. Similarly, essential hypertension is also characterized by a genetic component that interacts with environmental risk factors including diet. Possibly, genetic predisposition alone may not play as great a role as is currently believed. The kidney microbiome, could be a factor independent of host heredity, and is transmitted from parents. Second, the data based on live bacteria detected in the kidney from 4-week-old SHRs with normal BP and TBWF intervention reconstructing hypertensive renal flora to lower blood pressure suggest that kidney microbiota dysbiosis is the cause rather than the result of hypertension. However, we could not confirm the bacterial species that promote the occurrence and development of hypertension.
Left ventricular long-axis ultrasound strain (GLS) is an ideal indicator for patients with anti-hypertension treatment
Published in Clinical and Experimental Hypertension, 2022
Tingting Wu, Lulu Zheng, Saidan Zhang, Lan Duan, Jing Ma, Lihuang Zha, Lingfang Li
The Research Ethics Committee of the Xiangya Hospital of Central South University had approved this study. All participating members had carefully read and signed informed consent. All enrolled members were divided into three groups, including 1) hypertensive treatment experimental group: 56 patients with newly diagnosed essential hypertension were followed up. 3) Healthy control group: 37 normal volunteers from the physical examination center were collected. The inclusion criteria are as follows: 1) Newly diagnosed essential hypertension. The diagnostic criteria included not taking antihypertensive drugs, measuring blood pressure three times on a different day, systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg (14); 2) 2) Patients with the previous diagnosis of hypertension and poor blood pressure control. After taking antihypertensive drugs, blood pressure was measured three times on a different day. The systolic blood pressure ≥140 mmHg and/or diastolic blood pressure≥90 mmHg. Moreover, exclusion criteria were as follows: 1) Patients have diagnosed as coronary heart disease; 2) Patients with various types of valvular heart disease; 3) Patients with various types of cardiomyopathy; 4) Patients with atrial fibrillation and atrial flutter; 5) Patients were previously diagnosed with primary and secondary pulmonary hypertension; 6) Patients with secondary hypertension; 7) LVEF <50% of patients with hypertension; 8) Patients with diabetes; 9) Patients with atrioventricular block of