Abstract:
BACKGROUND:New onset resistant hypertension in a previously stable patient with chronic hypertension should lead to consideration of secondary causes. Electrolyte abnormalities are useful clues for identifying some common causes, especially mineralocorticoid excess. CASE PRESENTATION:We report the case of a 69-year-old man who developed severe resistant hypertension despite the use of 6 antihypertensive medications, including diuretics. He had metabolic alkalosis and hypokalemia with suppressed plasma renin activity and serum aldosterone. Concurrently, he was diagnosed with small cell neuroendocrine carcinoma of the prostate gland, a rare form of prostate cancer. Despite absence of typical Cushingoid features, investigation confirmed the diagnosis of ectopic adrenocorticotropic hormone (ACTH) syndrome from neuroendocrine prostate cancer. Because of the severity of his hypercortisolism, he underwent urgent bilateral adrenalectomy for hormonal and symptomatic control. Blood pressure improved significantly and he was dismissed with a single antihypertensive agent. Unfortunately, the patient died from his cancer 1 month later. CONCLUSION:Primary and secondary hyperaldosteronism are usually diagnosed based on measurements of aldosterone and plasma renin activity. However, if plasma renin activity and aldosterone are both low, rare causes of mineralocorticoid excess such as ectopic ACTH syndrome should be entertained.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Klomjit N,Rowan DJ,Kattah AG,Bancos I,Taler SJdoi
10.1093/ajh/hpz125subject
Has Abstractpub_date
2019-11-15 00:00:00pages
1214-1217issue
12eissn
0895-7061issn
1941-7225pii
5540054journal_volume
32pub_type
abstract:BACKGROUND:We examined data from a cohort of Caucasian women for evidence of an association between serum vitamin D (25-hydroxyvitamin D (25(OH)D)) insufficiency and greater risk of systolic hypertension in the population-based longitudinal Michigan Bone Health and Metabolism Study (MBHMS). METHODS:The cohort includes...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.226
更新日期:2011-03-01 00:00:00
abstract::Intracellular free sodium levels ([Na+]i) were assessed with 23Na nuclear magnetic resonance (NMR) spectroscopy in isolated, Langendorff-perfused normal, compensated hypertrophied, and hypertrophied failing guinea pig hearts under several conditions. Baseline [Na+]i measured with a shift reagent was significantly grea...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(95)00219-F
更新日期:1995-09-01 00:00:00
abstract::Fenoldopam (Corlopam), a new dopaminergic agent in clinical development by SmithKline Beecham Pharmaceuticals, is a dopamine-1 (DA1) agonist at post-synaptic dopamine receptors. Preclinical and clinical studies have demonstrated that it is a potent renal vasodilator as well as a peripheral vasodilator. In both normal ...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/3.6.120s
更新日期:1990-06-01 00:00:00
abstract:BACKGROUND:Obesity is a risk factor for the development of cardiovascular diseases that are associated with impaired angiogenesis. Nifedipine, a calcium-channel blocker, has a number of blood pressure (BP)-independent effects as well, such as improving endothelial function and decreasing oxidative stress. Here, we inve...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2011.239
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:The X-linked angiotensin II type-2 receptor (AT2R) gene 1675G/A polymorphism is located in the short intron 1 of the AT2R gene within a sequence motif conforming to a splice branch site. AT2R is expressed in the human retina, but no previous study examined the association between retinal microvascular phenot...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2011.151
更新日期:2011-12-01 00:00:00
abstract::Hypertension is the most ubiquitous risk factor for developing cardiovascular disease, which is the leading cause of death in the United States. Results from clinical trials have established the benefit of antihypertensive therapy in preventing the morbidity and mortality associated with high blood pressure, including...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(97)00422-6
更新日期:1998-01-01 00:00:00
abstract::To evaluate the clinical importance of serum hepatocyte growth factor (HGF) concentration, we designed two clinical investigations. The first study analyzed the correlation between serum HGF concentration and clinical arterial stiffness or the vasodilator response to reactive hyperemia in hypertensive patients. The se...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(02)02274-4
更新日期:2002-06-01 00:00:00
abstract::Endothelin-1 is a potent vasoconstrictor peptide produced in blood vessels and other tissues that may play an important role in the control of local blood flow and could be involved in the pathogenesis of hypertension. Our previous studies have documented increases in endothelin-1 peptide content and gene expression i...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(95)96213-4
更新日期:1995-03-01 00:00:00
abstract::Surveys taken of blood pressure in Greenland indicated prevailing levels similar to those in the USA. Morphometrically measured renovasculopathies in 88 autopsies confirmed blood pressure levels comparable to the survey findings. At clinic visits, the recorded blood pressures in 48 of the autopsies verified the morpho...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(95)00440-8
更新日期:1996-06-01 00:00:00
abstract::The increased red blood cell Li+/Na+ exchange found in a subgroup of patients with essential hypertension (EH) may reflect an increased activity of the Na+/H+ exchange. The maximal velocity of the red cells' Na+/H+ (Na+ influx promoted by an outward H+ gradient) and Li+/Na+ (Li+ efflux promoted by external Na+) exchan...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/2.12.903
更新日期:1989-12-01 00:00:00
abstract::There is controversy over whether endothelial function is impaired in human essential hypertension. All studies to date have used measurements of forearm blood flow by plethysmography to assess endothelium-dependent vasodilation and endothelial function. In contrast to these studies, which have focused on resistance v...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/s0895-7061(96)00414-1
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:We investigated the effects of percutaneous transluminal renal angioplasty on left ventricular (LV) mass, and the impact of LV mass reduction on outcomes. METHODS:A total of 144 hypertensive patients with renal artery stenosis (RAS) (mean age 69 years; 22.2% fibromuscular dysplasia (FMD)) who underwent angi...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa036
更新日期:2020-05-21 00:00:00
abstract::Inhibition of calcineurin-mediated signaling in T lymphocytes is a major mechanism of cyclosporine A (CsA)-induced immunosuppression, and previous rat studies have suggested that inhibition of calcineurin-mediated signaling in central neuronal pools involved in blood pressure regulation plays an important role in caus...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(00)00288-0
更新日期:2000-09-01 00:00:00
abstract::This article examines the results of the Joint National Committee's Fifth Report on the treatment of hypertension (JNC-V), especially regarding the economic arguments put forth therein. Economics are a poor basis for treatment decisions, as the cheapest therapies may not be the best for any given patient. Broad treatm...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/0895-7061(94)P1709-9
更新日期:1994-10-01 00:00:00
abstract::Responses of renin release and blood pressure to aspirin DL-lysine (ASP) were examined to find out if the responses could help in the differentiation between unilateral renovascular hypertension (RVH) and hyperreninemic essential hypertension (EHT). The two studies involved ten patients with unilateral RVH, eight with...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.9.761
更新日期:1991-09-01 00:00:00
abstract::Among the major mechanisms controlling the renal release of renin, renal nerves are known to exert a direct stimulating action on juxtaglomerular cells that is mediated by beta-adrenoceptors. Activation of the renal nerves also exerts an important permissive role in order to amplify and possibly accelerate responses t...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/2.2.7s
更新日期:1989-02-01 00:00:00
abstract::Resistant hypertension (RH) is a multifactorial disease associated with several target organ damage, such as microalbuminuria, left ventricular hypertrophy, and arterial stiffness. These subjects have high cardiovascular complications, especially when associated with diabetes condition. Sodium glucose cotransporter 2 ...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/hpx204
更新日期:2018-02-09 00:00:00
abstract:BACKGROUND:In the hypertensive heart, epicardial arteries are not enlarged, despite increased total coronary flow related to augmented cardiac workload, wall stress, and left ventricular (LV) mass. The aims of this study were to assess the impact of different hemodynamic factors and LV mass on baseline left main corona...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2006.07.003
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Patients often exhibit higher blood pressure (BP) readings in the doctor's office, a phenomenon known as the white coat effect. This study examines the presence of a physician in the examining room as a possible factor in provoking a white coat effect. METHODS:Blood pressure measurements taken by an automat...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/s0895-7061(03)00058-x
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:The GTPase Rac1 has been implicated in hypertension as a modulator of mineralocorticoid receptor activity. Our aim is to investigate the frequency of polymorphisms rs10951982 (intron 1, G>A) and rs836478 (intron 3, T>C) in the RAC1 gene and perform association studies with clinical and biochemical parameters...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpt277
更新日期:2014-03-01 00:00:00
abstract::Arterial hypertension is the most common chronic medical condition requiring office visits to physicians and is a major contributing factor to the development of myocardial infarction and stroke. Its importance as a cardiovascular risk factor is at least as significant in women as in men; however, the ever-growing lit...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(97)00330-0
更新日期:1997-10-01 00:00:00
abstract::To assess whether aerobic exercise training is an effective and an alternative method to control blood pressure (BP) in hypertension, 32 uncomplicated, never treated patients suffering from mild-to-moderate essential arterial hypertension (EAH) were included in an aerobic exercise training program using a regular stan...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00265-4
更新日期:2000-06-01 00:00:00
abstract::Neutral metalloendopeptidase (NEP) inhibitors delay atrial natriuretic factor (ANF) catabolism and potentiate biological responses to ANF. We describe biochemical and pharmacological profiles of a novel NEP inhibitor, SCH 42354 (N-[2(S)-(mercaptomethyl)-3-(2-methylphenyl)-4-oxopropyl]-L-methionine and its orally activ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/6.5.357
更新日期:1993-05-01 00:00:00
abstract::The process whereby a physician explains to the ill patient what has gone wrong and what can be done about it can be taught and evaluated by simulated patients (SPIs). This study was designed to determine whether a training experience in educating a diabetic SPI improves subsequent performance with a hypertensive SPI....
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(98)00034-x
更新日期:1998-05-01 00:00:00
abstract::A negative calcium balance has previously been described in human hypertension with low levels of plasma ionized calcium (Ca2+) and an increased urinary excretion of calcium. The cause of this disturbance in mineral metabolism is not known, nor is it known if this derangement could be abolished if blood pressure is re...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/7.4.302
更新日期:1994-04-01 00:00:00
abstract::The results of 19 antihypertensive treatment trials spanning some 20 years of research showed that treatment had significant benefits for pressure-related complications of hypertension but generally did not prevent coronary artery disease morbidity or mortality. As possible reasons for this relative failure were explo...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,多中心研究,评审
doi:10.1093/ajh/2.12.313s
更新日期:1989-12-01 00:00:00
abstract:OBJECTIVES:Nighttime blood pressure (BP) has been shown to be superior to daytime BP in predicting hypertension related target organ damage and cardiac mortality. In our Georgia Cardiovascular Twin Study, we showed that apart from the genes that also influence daytime BP, specific genetic determinants explained 44% and...
journal_title:American journal of hypertension
pub_type: 杂志文章,meta分析
doi:10.1093/ajh/hpu162
更新日期:2015-04-01 00:00:00
abstract::We have explored the effect of verapamil on renal hemodynamics and the renin-aldosterone system in ten patients with chronic renal disease and hypertension before and after 3 months of therapy. The mean +/- SEM glomerular filtration rates were 55 +/- 7 mL/min pre- and 55 +/- 8 mL/min posttherapy; the renal plasma flow...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.12.939
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND:Uncontrolled treatment-resistant hypertension (TRH), i.e., blood pressure (BP, mm Hg) ≥140/≥90mm Hg in and out of office on ≥3 different BP medications at optimal doses, is common and has a poor prognosis. Aldosterone antagonist (AA) and renin-guided therapy (RGT) are effective strategies for improving BP co...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpw016
更新日期:2016-08-01 00:00:00
abstract::Congenital protein C deficiency is now widely recognized as a genetic risk for venous thrombosis. However, it remains uncertain whether this condition also confers risk for arterial thrombosis. We evaluated the association of congenital protein C deficiency with hypertension and silent cerebrovascular disease using br...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)02046-5
更新日期:2001-08-01 00:00:00