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Hypertension/High Blood Pressure
Published in Charles Theisler, Adjuvant Medical Care, 2023
Hypertension, or elevated blood pressure, is the most common cardiovascular disease. It is a serious medical condition that significantly increases the risks of irreversible heart, brain, eye, and kidney damage, as well as other diseases. Hypertension may result from a specific cause (secondary hypertension <10% of cases) such as obstructive sleep apnea, renal artery stenosis, medications, or endocrine disorders, or from an unknown etiology (primary or essential hypertension >90% of cases). Blood pressure is the force of blood against the interior arterial walls. Blood pressure is determined both by the amount of blood the heart pumps and the amount of resistance to blood flow in the arteries.
Diabetic Nephropathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
When the kidneys receive less blood flow than is needed, they respond as if the body is dehydrated and release aldosterone that stimulates the retention of sodium and water. The blood vessels fill with extra fluid and pressure increases. Usually, there are no symptoms, but when there is also severely elevated systemic blood pressure, there may be headache, blurry or double vision, bloody urine, confusion, and nosebleeds. The eventual outcome is chronic kidney disease. Often, systemic hypertension is more difficult to control with multiple medications when glomerular hypertension is also present. Some patients have stable systemic hypertension that suddenly worsens. Kidney abnormalities may develop suddenly, and there can sometimes be a fast development of pulmonary edema.
Fetal and neonatal medicine
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
4.3 Which of the following statements is/are true of a normal full-term infant on the first day of life?Fluid requirements are 100ml/kg on the first day.The average head circumference is 29 cm.The urinary output is 1-3 ml/kg.A true blood glucose of 2mmol/l is within the normal range.The average blood pressure is 50-60 mmHg.
Rituximab treatment for refractory nephrotic syndrome in adults: a multicenter retrospective study
Published in Renal Failure, 2023
Xiaoyan Ma, Lu Fang, Lili Sheng, Xun Zhou, Shoujun Bai, Xiujuan Zang, Yakun Wang, Mengke Li, Zexin Lv, Qin Zhong, Xinyu Yang, Yishu Wang, Yan Hu, Danying Yan, Yingfeng Shi, Hui Chen, Jinqing Li, Min Tao, Shougang Zhuang, Yi Wang, Na Liu
A total of 75 patients were identified with RTX therapy for RNS. After a median follow-up period of 18.5 (12.5, 29.25) months, 48 patients entered the final analysis according to the inclusion and exclusion criteria (Figure 1). The baseline demographic and clinical characteristics were shown in Table 1. Of a total of 48 eligible patients with an average age of 47.88 ± 16.93 years old, 33 were males and 8 were smokers. Nine patients had diabetes, and 22 had hypertension. The average blood pressure was 135.08 ± 17.34/82.75 ± 10.74 mmHg. Median disease duration of 48 patients was 29.5 (IQR 1260) months. All the patients were with biopsy-proven INS, 15 (31.3%) with MCD, 5 (10.4%) with FSGS, 26 (54.2%) with MN, and 2 (4.2%) with MPGN. The immunosuppressive therapies of patients before RTX treatment were steroid only (12, 25%), cyclosporine or tacrolimus (24, 50%), cyclophosphamide (10, 20.8%), mycophenolate (1, 2.1%), and others (1, 2.1%). One patient with other immunosuppressive agents was a male with MCD who received steroid and leflunomide therapy. All patients had received at least one course of immunosuppression therapy, with a median of 2 (IQR 1–3) courses. The reasons of refractory for patients enrolled included steroid dependent (4, 8.3%), steroid-resistant (3, 6.3%), frequent relapsing (11, 22.9%), steroid intolerant (5, 10.4%), and resistance to immunosuppression (25, 52.1%).
Rebound sign: a case report and review of literature
Published in Clinical and Experimental Hypertension, 2022
Yuehai Wang, Changpeng Zhai, Yuqiang Zhang, Guangyong Huang, Shengjun Ma
A 60-year-old male complained of paroxysmal chest pain for 1 day. He had a five-year history of hypertension and hyperlipidemia, and had no history of allergy. The blood pressure is 165/108 mmHg. and the heart rate is 74 beats/min. No ST-T changes were found in electrocardiogram (ECG). There was a rise in troponin I of 0.066 ng/ml. The initial diagnosis is acute coronary syndrome and the patient underwent a transradial selective coronary angiography (CAG). Right coronary artery (RCA) was normal (Figure 1(a)), and then left coronary artery (LCA) angiography was performed with JL3.5 tube. After the first injection of contrast agent, we found that the proximal segment of LAD was blocked (Figure 1(b), Figure 2(o,u) and Video S1), while the blood perfusion in the distal segment of left circumflex artery (LCX) was slow (TIMI class II blood flow) (Video 1). At the same time, the patient presented with sudden chest tightness and sweating. The heart rate dropped rapidly to 40 beats per minute, and blood pressure dropped to 80/40 mmHg. The dry or wet rales were not heard in lung auscultation. There was no murmur in cardiac auscultation. ECG monitoring showed 0.3 mV of ST segment elevation.
The association between serum ferritin and blood pressure in adult women: a large cross-sectional study
Published in Clinical and Experimental Hypertension, 2022
Andong He, Xiaofeng Yang, Yuzhen Ding, Lu Sun, Meiting Shi, Ruiman Li
High blood pressure often acts as a predisposing factor of some diseases, such as hypertensive heart disease, stroke, and kidney failure (1). Recently, hypertension has been one of the most-often diagnosed diseases whose incidence and prevalence are rising worldwide. According to a systematic analysis published in 2018 in Lancet, hypertension accounts for 10.4 million deaths and 218 million disability-adjusted life-years (2). Moreover, it also brings much economic burden since the healthcare costs related to this disease is close to $131 billion and the annual healthcare expenditure of patients with hypertension is approximately $2000 higher compared with the individuals without hypertensive (3). Therefore, more studies on the risk factors for hypertension are of major public health importance.