Hypertension For Many Years Research Articles

A clinical case of SARS-CoV-2 infection complicated by viral interstitial pneumonia and pulmonary edema in a patient with dilated cardiomyopathy

COVID-19 is especially severe in patients with a premorbid background.Aim: To describe a clinical case of SARS-CoV-2 infection complicated by bilateral viral pneumonia, cardiogenic pulmonary edema, and dilated сardiomyopathy.Clinical case. Patient M.V., 76 years old, from 02.11.2022 to 03.11.2022 was hospitalized at the Republican Cardiological Dispensary with a diagnosis of Bilateral viral pneumonia, the percentage of damage was 75%. Acute respiratory distress syndrome, severe. Complaints at admission: lack of air in a horizontal position, fever up to 38,0 °С, dry cough. Computed tomography of the chest was performed; bilateral viral pneumonia was determined (75% of lesions). PCR smear for coronavirus infection was positive. Determination of troponin T from 02.11.2022: 0.022 ng/ml. History: hypertension for many years with maximum blood pressure of 190/100 mm Hg, acute myocardial infarction of the anterior wall of the left ventricle with ST segment elevation (November 20, 2021), percutaneous coronary intervention (November 20, 2021). The above complaints were noted within a week. On the second day of inpatient treatment, a lethal outcome occurred. She was sent for a post-mortem examination. In the lungs, histological examination revealed a violation of microcirculation in the form of erythrocyte sludge, stasis. Widespread atelectasis/dystelectasis. There was intraalveolar edema. On macroscopic examination, the cavities of the heart are enlarged.Histological examination revealed large-focal cardiosclerosis, areas of wave-like deformation of myocardial muscle fibers. Virological examination of sectional material in the lungs and heart revealed SARS-CoV-2 RNA.Conclusion. Viral infection with COVID-19 contributed to the development of decompensation of chronic heart failure in the form of arrhythmia and cardiogenic pulmonary edema in a patient with dilated cardiomyopathy.

Aortic Dissection as a Complication in Patients on Maintenance Haemodialysis: Two Cases Report

Aortic dissection (AD) is a rare disease that may result in a fatal outcome. Uremic patients are often associated with factors susceptible to AD. We herein report two cases of AD occurring in maintenance haemodialysis patients. The two male Chinese had history of smoking and poor uncontrolled hypertension for many years. One patient died of the aortic wall rupture with conservative treatment. The other patient had a history of myocardial infarction and long-term administration of anti-platelet drugs. The patient survives after prompt stenting and continuous maintenance haemodialysis. It is important to improve our understanding about aortic dissection (AD) in haemodialysis patients because of the high mortality and morbidity. Once a patient on maintenance haemodialysis is diagnosed with AD, surgery or endovascular graft exclusion should be considered according to the actual situation of individual patients, and the mode of dialysis should be converted in conservation treatment patients.

Yiqi Huaju formula, a Chinese herbal medicine, reduces arterial pressure in salt‑sensitive hypertension by inhibiting renin‑angiotensin system activation.

Hypertension is a chronic disease with a high prevalence, and is associated with a high risk of vascular disease and premature death. Traditional Chinese medicine has been administered to treat hypertension for many years. In the present study, the effects of Yiqi Huaju formula (YQ; a compound used in traditional Chinese herbal medicine) were observed in salt‑sensitive hypertension, which was induced by a high‑salt and high‑fat (HSF) diet and the potential mechanism was investigated. YQ was prepared from five plant extracts and was dissolved in normal sodium chloride prior to use. Male Sprague‑Dawley rats were randomly divided into three groups, and fed either a normal diet (control), an HSF diet or an HSF diet with YQ. At week eight, blood pressure was measured and 24‑h urine samples were collected from all of the rats. The rats were subsequently sacrificed, and their blood was collected for biochemical analyses and kidney tissue samples were dissected for the immunohistochemical assay. YQ was observed to decrease the high arterial pressure and serum total cholesterol level, which had been induced by the HSF diet. It also enhanced the excretion of urinary angiotensinogen, Na+, and decreased the loss of urinary aldosterone, K+ and microalbuminuria. In addition, YQ inhibited the high mRNA expression level of renal renin, angiotensin II (Ang II), and Ang II receptor, type 1 (AT1R), and inhibited the protein expression of renal AT1R and Ang II receptor type 2, which had been induced by the HSF diet. These results indicate that YQ may reduce the arterial pressure in salt‑sensitive hypertension via the inhibition of renin‑angiotensin system activation.

Acute pulmonary oedema with normal left ventricular function in a patient with resistant hypertension – what is the likely diagnosis?

We report the case of a 75-year old woman who presented with shortness of breath and haemoptysis. She had been treated for presumed essential hypertension for many years. On admission she was found to be severely hypertensive. Chest X-ray showed pulmonary oedema. However, an echocardiogram reported good systolic ventricular function. Her hypertension and pulmonary oedema did not respond to medical treatment necessitating intubation. A CT angiogram identified the cause – undiagnosed bilateral severe renal artery stenosis. We discuss this increasingly common condition that is difficult to manage and easily missed.

Interrupted aorta in mosaic Turner syndrome

) prompted karyotype testing which con-firmed mosaic Turner syndrome.Otherwise, she had had poorly controlled hyper-tension for many years and was currently being pre-scribed labetalol for presumed primary hypertension.Her blood pressure remained elevated at 158/104mm Hg, but attempts to add other antihypertensivemedications had not been tolerated due to trouble-some side effects. Echocardiography had previous-ly shown a bicuspid aortic valve, but no left ventricu-lar hypertrophy or other structural abnormality.Due to concerns about potential secondarycauses for hypertension, she proceeded to magneticresonance imaging of her aorta. This indeed de-monstrated a post-ductal interrupted aorta (Fig. 1)with extensive collateralization and enlargement ofthe internal mammary arteries (Fig. 2). Currently,she is awaiting surgical repair of the interruptedaorta with fertility treatment postponed until aftersurgery.Cardiovascular disease is the commonest causeof death in Turner syndrome, with life expectancyreduced by approximately ten years [1, 2]. Aorticvalve disease (particularly bicuspid valve morpho-logy) and aortic coarctation are the commonest car-diovascular anomalies. Aortic root dilatation, aor-tic dissection, hypertension, mitral valve prolapse,

A simple, fast, solvent-free method for the determination of volatile compounds in Magnolia grandiflora linn

Magnolia grandiflora Linn belonging to the Magnoliaceae family has been used to treat hypertension for many years in China. Based on microwave-assisted extraction (MAE) and headspace solid-phase microextraction (HS-SPME) followed by gas chromatography-mass spectrometry (GC-MS), the volatile compounds of Magnolia grandiflora L. were determined. Results indicated that the optimum conditions of the determination of the volatile compounds in Magnolia grandiflora L. were achieved with fiber coating of carboxen/polidimethylsiloxane, microwave power of 700 W and irradiation time of 4 min. Under the optimal conditions, for the first time, 48 volatile compounds were separated and identified from the fresh leaves of Magnolia grandiflora L. The highest content component of 48 compounds was γ-elemene (15.67%). Relative standard deviation (RSD) values less than 11% shows that the present method has good precision. The experimental results demonstrate that MAE-HS-SPME followed by GC-MS is a simple, time-saving solvent-free method, and it is a potential analytic tool for the determination of the volatile compounds in plant materials.

The Role of Beta Blockers in Treating Hypertensive Patients

Beta-blockers have been used to treat hypertension for many years. Although beta-blockers can lower blood pressure, current data concerning the efficacy of these drugs have been disappointing, and the value of these drugs for patients without a compelling indication has been questioned. The early beta-blockers had significant pharmacologic disadvantages; however, new-generation beta-blockers have better pharmacologic profiles. The efficacy and tolerability of the most recently developed vasodilating beta-blockers (carvedilol and nebivolol) are currently being evaluated. Further investigation of these new beta-blockers is needed.

Paraganglioma of the thoracic spine

A 49-year-old man was admitted to hospital for treatment of a T10–11 paraspinal lesion, which was detected incidentally. He had suffered from facial flushing and palpitations associated with hypertension for many years. MRI confirmed the presence of a large, well-demarcated tumour in the left paraspinal area of the T10–11 vertebral bodies. Grossly complete excision was achieved without neurological complications. Post-operatively, the patient was normotensive with no adrenergic symptoms.

Interview With Edward Frohlich, MD

Dr. Edward Frohlich has been involved in research and treatment activities in hypertension for many years. His career has included working with some of the most important researchers in the field of hypertension--Ed Freis, Harriet Dustan, Irving Page, and Raymond Gifford among many others. He served as Editor in Chief of the journal Hypertension and continues as an active, productive researcher. He is most worthy of the designation Hypertension Icon.

Hypertension awareness, control and treatment in rural Mississippi: Morton Have-A-Heart Project

Mississippi leads the nation in cardiovascular disease mortality rates as well as rates for several risk factors. One of the major modifiable risk factors associated with cardiovascular disease is high blood pressure. The prevalence of hypertension in the Morton Have-A-Heart Project, a community participatory cardiovascular risk reduction study, is much higher than nationally reported rates. In this population, hypertension rates approximate 40%, almost 10% higher than national rates. These results are even more significant considering all national data includes ages 20 and greater while the Morton Project includes ages 12 and greater. The purpose of this study is to analyze blood pressure data, medication histories, and reported health behaviors in the 1300 participants in the Morton Have-A-Heart Project and compare this to national data. Diuretics have been recommended first line treatment for hypertension for many years. Despite these recommendations and the socioeconomic barriers in rural Mississippi, diuretics are underutilized in this population and blood pressure is less than adequately treated and controlled.

The vasorelaxation of Antrodia camphorata mycelia: Involvement of endothelial Ca 2+-NO-cGMP pathway

Antrodia camphorata, a medicinal fungus, has been used to treat cardiovascular diseases such as hypertension for many years. The purpose of this study was to examine the effects of mycelia extracts, from five Antrodia camphorata strains, on vascular tension and underlying mechanisms were explored. In isolated rat aortic rings, accession B86 caused concentration-dependent vasorelaxation with maximal relaxation of 40.34 ± 7.53% whereas accessions 35398, 35396 and B71 had mild vasorelaxing effects. Strain B85 evoked potent vasorelaxation, partly through an endothelium-dependent mechanism that was inhibited by N ω-nitro-L-arginine and 1H-[1,2,4]oxadiazolo[4,3-a]quinoxaline-1-one (ODQ) but not by antagonist of K + channels, tetraethylammonium. In cultured endothelial cells, B85 stimulated nitric oxide (NO) release and augmented the level of the intracellular Ca 2+ concentration. HPLC and LC-MS-MS analysis revealed the presence of adenosine. Our results suggest that B85 produced strongest vasorelaxation in aortic preparations among five test strains. B85 acts in part on endothelial cells by activating the Ca 2+-NO-cGMP pathway to reduce smooth muscle tone. However, K + channels had no apparent roles. Adenosine could possibly be involved in the endothelium-dependent pathway of B85-induced vasorelaxation.

Cardiac Transplantation 40 Years After a Stab Wound to the Heart

Cardiac Transplantation 40 Years After a Stab Wound to the Heart

Antihypertensive therapy in diabetes mellitus

Approximately 150 million people worldwide have diabetes mellitus, of whom 90% are type II diabetics. It is therefore of no surprise that diabetic nephropathy has become the leading cause of end-stage renal disease. Opposite to what has been known previously, kidney disease is at least as common in type II as in type I diabetes. However, because the majority of type II diabetics has hypertension for many years before diabetes mellitus becomes clinically relevant, renal lesions are often heterogeneous with frequent exclusive presence of ischemic changes. For the treatment of hypertension in diabetics without nephropathy (no microalbuminuria), drugs that exert beneficial effects or are at least neutral with respect to lipid and glucose metabolism, such as ACE inhibitors, angiotensin II-receptor antagonists, non-dihydropyridine-calcium channel blockers and the thiazide-like indapamide, are to be preferred. Although metabolically neutral, dihydropyridine calcium channel blockers should be used with caution, since an increase in cardiovascular morbidity and mortality in type II diabetics treated with these compounds has most recently been described. Once that diabetic nephropathy is established, blood pressure should be lowered to 120/80 mmHg (measured in seated position). Antihypertensive treatment should primarily be based on ACE inhibitors; angiotensin II-receptor antagonists are a valuable alternative if ACE inhibitors are not tolerated. Both ACE inhibitors and angiotensin II-receptor antagonists should be used with high caution in elderly patients with severe atherosclerosis in whom acute renal failure could occur due to the presence of bilateral renal artery stenosis. Newer studies indicate that non-dihydropyridine calcium channel blockers such as verapamil and diltiazem may be as effective as ACE inhibitors in preserving renal function in diabetic nephropathy. A fix-dose combination of the ACE inhibitor trandolapril with verapamil is now available; it should be reserved for patients whose blood pressure and/or proteinuria can not be adequately controlled with ACE inhibitors. Finally, indapamide is the only antihypertensive diuretic with nephroprotective properties.

Vasculites associadas ao ANCA.

The authors present a case report of a 62-year old woman, with hypertension for many years. She suffered from weakness, anorexia and weight loss in the last 6 months. On admission, anemia, elevated ESR, haematuria, proteinuria and renal failure were present. Renal biopsy was compatible with chronic glomerulonephritis. The clinical picture and positivity for P-ANCA suggested systemic vasculitis. Later evidence of maxillary sinusitis and nasal mucosae ulcers as well as pneumonitis, although biopsy did not reveal granulomas, suggested the diagnosis of Wegener Vasculitis. Medicated with Cyclophosphamide and Prednisolone, for a year, with improvement. The authors make a brief discussion of the clinical criteria for classification of ANCA-associated systemic vasculitis.

Obesity and hypertension in a longitudinal study of black physicians: The Meharry Cohort Study

Obesity has been considered a risk factor among the precursors of essential hypertension for many years. Most related studies were general population surveys or predominantly white, male cohorts. This paper reports results of a longitudinal study of former black medical students, now practicing physicians for an average of 22.5 years. A remarkably high 43.8% were found to have developed hypertension. Fifty nine per cent of those who became obese during the study were hypertensive compared with 40% of the non-obese, 36% of those initially obese only, and 45% of those obese on both examinations. The risk ratio was 1.7 for the most obese (⩾ 130% relative body weight) compared with 1.0 for the leanest group Dynamic weight change together with baseline diastolic blood pressure, were more prominent precursors than the other variables studied. Weight control would appear to be a potentially important nonpharmacologic hypertension risk reduction measure.

Hypoplastic Anemia Associated With Metolazone

To the Editor.— Recently we followed up a patient who had transient hypoplastic anemia associated with metolazone. Report of a Case.— A 74-year-old woman had had mild hypertension for many years. In June 1977, 5 mg/day of metolazone was prescribed. There was resultant fair control of blood pressure. In August 1977, notable weakness developed. Moderate anemia was diagnosed, and the patient was given folic acid preparations in addition to other hematinies, including iron. Her condition worsened, and when referred to us in October, her hematocrit reading was 27.4%, with a reticulocyte count of 1.0%. The WBC, differential, and platelet counts were normal. Morphological examination of RBCs showed normochromia and normocytic pictures. Bone marrow aspiration showed hypoplastic marrow without suggestion of myeloproliferative disorders. Drug-induced marrow suppression was suspected, and metolazone therapy was stopped. The patient was given an anabolic agent (methandrostenolone) orally through mid-January 1978. Because of fluid retention, hypertension, and

Ectopic thoracic kidney.

To the Editor.— Some types of renal ectopia are not uncommon, but thoracic kidney on the right side is rare. Campbell speaks of 23 known thoracic kidneys. 1 In a recent article, Hertz and Shanin 2 bring to 37 the number of reported cases diagnosed during the life of the patient. Most of these patients had kidney ectopia on the left side. Because of the rarity of site, and the ease with which an intrathoracic kidney can be confused with another intrathoracic-space-occupying lesion, this case deserves attention. Report of a Case.— An obese, hypertensive 48-year-old woman was admitted to the Worcester (Mass) City Hospital with repeated episodes of substernal pain and tightness, headache, dizziness, and nausea. Several hours before the patient's admission, dizziness was followed by unconsciousness for a few minutes. She was known to have had untreated hypertension for many years, and the blood pressure of 190/130 mm Hg

Detection and treatment of patients with renovascular hypertension

I n the past decade there has been a resurgence of clinical interest in surgically correctable lesions of the kidney which cause hypertension. The widespread interest in this form of hypertension initiated in 1933 by Goldblatt and associates’6 ingenious experiments and enhanced by work of Page and CorcoranX6 and others led clinicians to search enthusiastically for naturally occurring “Goldblatt kidneys”-unilateral renal causes of hypertension which could be cured by nephrectomy. In 1956, Homer Smithzo reviewed a series of 575 hypertensive patients treated by nephrectomy; only 26 percent of the patients were free of hypertension after one year. Smith concluded that nephrectomy should be reserved for strict urologic indications and not with any hope of relieving hypertension. This influential pronouncement might have dampened interest in surgically correctable renal hypertension for many years if it had not come at the time when vascular surgery was gaining prominence and aortography was receiving widespread application. Abdominal aortography frequently revealed stenosis of one or both renal arteries and the patients were usually hypertensive. Using

Lymphangioma of the Thoracic Duct

To the Editor:— In 1956, Maurer 1 reported the successful removal of a lymphangioma of the thoracic duct which, as far as we have determined, is the only previous report of this tumor. Our purpose is to report another surgically proven lymphangioma of the thoracic duct presenting, as did Maurer's case, with spontaneous right chylothorax. A brief summary of the pertinent details follows: A 47-year-old obese woman, well, except for hypertension for many years, developed the gradual onset of shortness of breath in mid December, 1961. She was found to have a sterile chylous pleural effusion on the right. No malignant cells could be found. After thoracentesis she remained asymptomatic for 3 weeks with no reaccumulation of the fluid. However, a month after the initial onset of symptoms, she had a rapid reaccumulation of chylous effusion and was readmitted to the hospital for further evaluation and treatment. She was found