Humans ; Hypertension ; complications ; Metabolic Syndrome ; complications ; physiopathology

Humans ; Hypertension, Pulmonary ; complications ; physiopathology ; Ventricular Dysfunction, Right ; etiology

Hemodynamics ; Humans ; Hypertension, Portal ; etiology ; physiopathology ; surgery ; Liver Cirrhosis ; complications ; physiopathology ; surgery ; Liver Transplantation ; Postoperative Period

OBJECTIVETo examine the effect of different infusion volume on hemodynamics of portal hypertension (PHT) canines after hemorrhagic shock (HS).

METHODSPHT canine models were made by coarctating a half main portal vein with silk line chronic embolization. Two weeks later, the canine models were assigned to hemorrhagic shock by femoral artery venesection quickly. They were divided into two groups: large volume infusion group (n=6) and small volume infusion group (n=6). Hemodynamics indexes of PHT canines after HS were monitored continuously. We also examined the effect of different infusion volume on hemodynamics.

RESULTSPHT canines showed a series of hemodynamics changes in hemorrhagic shock stage, which aggravated hemodynamics disorder in PHT. After quick infusion, MAP, IVCP, PVP, PVPG, PVBF, HABF, and HBF increased significantly. These indexes in large volume infusion group were higher than those in small volume infusion group. PVR, SVR, HAR decreased significantly. PVP, PVPG, PVBF, HABF, and HBF showed a rebound increase above baseline values in large volume infusion group. The changes of PVP, PVPG, PVBF, HABF, and HBF were parallel with MAP and IVCP and without rebound increase in small volume infusion group. In large volume infusion group PVPG increased earlier and more significant than PVP and exceeded baseline by 13% (2.58 0.37) kPa, so the danger of rebleeding rose greatly. In small volume infusion group PVPG was over 22% (1.67 0.27) kPa lower than baseline, which infers that the danger of rebleeding reduced greatly. SVR and HAR were lower in large volume infusion group. PVP, PVPG, PVBF, HABF, and HBF showed a positive correlation with accumulated vein infusion volume. PVR showed a positive correlation with accumulated vein infusion volume in small volume infusion group. HAR showed a negative correlation with accumulated vein infusion volume in large volume infusion group.

CONCLUSIONSPHT canines after HS show a rebound increase of PVP, PVPG, PVBF, HABF, and HBF above baseline values in large volume infusion group. In small volume infusion group, however, no rebound increase is noticed. Large volume infusion may cause PVP, PVPG, PVBF, HABF, and HBF increase higher than small volume infusion.

Animals ; Dogs ; Hemodynamics ; Hypertension, Portal ; etiology ; physiopathology ; Portal Vein ; physiopathology ; Shock, Hemorrhagic ; complications

Humans ; Hypertension, Portal ; physiopathology ; surgery ; Liver ; physiopathology ; Liver Cirrhosis ; complications ; Liver Transplantation ; Portasystemic Shunt, Transjugular Intrahepatic

Preeclampsia is represented by hypertension and proteinuria in pregnancy. It usually occurs after 20 gestational weeks. There are few reports on preeclampsia before 20 gestational weeks. In this case, we report a patient with chronic hypertension superimposed with preeclampsia at 13 gestational weeks.
Adult ; Female ; Gestational Age ; Humans ; Hypertension ; physiopathology ; Pre-Eclampsia ; physiopathology ; Pregnancy ; Pregnancy Complications

OBJECTIVETo explore the alterations in pulmonary arterial reactivity during pulmonary arterial hypertension at the early-stage of pulmonary fibrosis in rats.

METHODSSixty-six male Sprague-Dawley rats were randomly divided into 2 groups: bleomycin (BLM) group and sham group. The rats in BLM group were received single intratracheal instillation of BLM (5 mg/kg), and the rats in sham group received equal volume of 0.9% normal saline (NS). The alterations in pulmonary arterial reactivity were measured by vascular tension detected technique, the pathomorphological changes in the wall of pulmonary arteries were displayed with Hematoxylin-Eosin (HE) staining, the degree of fibrosis in lung was revealed with Masson staining, and the mean pulmonary arterial pressure was detected via a catheter in the pulmonary artery.

RESULTS(1) The contractile response to a- adrenoceptor agonist phenylephrine (PE), of pulmonary arteries both with remaining endothelium and with removing endothelium, from BLM-treated rats , was reduced significantly, compared with sham rats (P both < 0.05). (2) The relaxant response to the endothelially dependent vasodilator acetylcholine (Ach), of pulmonary arteries with remaining endothelium, from BLM-treated rats, was also reduced, compared with sham rats (P < 0.01). (3) In sham rats, the contractile response to (omega) -nitro-L-arginine methyl ester (L-NAME) plus PE, of pulmonary arteries with remaining endothelium, was enhanced, compared with that to PE alone (P < 0.01), while in BLM group, the contractile responses to L-NAME plus PE, of pulmonary arteries with remaining endothelium, was not different from that to PE alone (P > 0.05). (4) In BLM group, vascular endothelial cells lost. (5) In BLM group, the initial stage of fibrogenesis was observed in lungs, and the mean pulmonary arterial pressure increased, compared with that in sham group (P < 0.05).

CONCLUSIONThe abnormal responsibility of pulmonary arteries occurred during pulmonary arterial hypertension at the early-stage of pulmonary fibrosis in rats.

Animals ; Familial Primary Pulmonary Hypertension ; Hypertension, Pulmonary ; complications ; physiopathology ; Male ; Pulmonary Artery ; physiopathology ; Pulmonary Fibrosis ; complications ; physiopathology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Vasomotor System ; physiology

OBJECTIVETo explore the relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and hypertension.

METHODSThere were 1149 middle aged patients who were suspected to have OSAHS underwent polysomnography (PSG) from Jan, 1999 to June, 2011. The age of the patients ranged from 45 to 65 years. The patients were divided into 10 groups according to sleep apnea hypopnea index (AHI), group 1: AHI < 5; group 2: 5 ≤ AHI < 15; group 3: 15 ≤ AHI < 30; group 4: 30 ≤ AHI < 40; group 5: 40 ≤ AHI < 50; group 6: 50 ≤ AHI < 60; group 7: 60 ≤ AHI < 70; group 8: 70 ≤ AHI < 80; group 9: 80 ≤ AHI < 90; group 10: AHI ≥ 90. The incidence of hypertension in each group was tested using crosstabs method. The correlation between AHI, lowest oxygen saturation (LSaO2), age, body mass index (BMI) and hypertension were analyzed.

RESULTSAmong 1149 suspected OSAHS patients, 1004 were diagnosed as OSAHS by PSG. There were positive correlation between AHI and diastolic, systolic blood pressure (r were 0.239 and 0.305, respectively, P < 0.01). AHI was independent risk factor of hypertension (P < 0.001). No statistically significant difference in the incidence of hypertension was found among group 1 and group 2, 3, group 4 and group 5, group 6 to group 10 (χ(2) were 3.821, 0.005 and 1.325, P > 0.05, respectively). There was significant difference in the incidence of hypertension among group 4 and group 1, 2, 3, group 5 and group 6 (χ(2) were 2.615 and 4.300, P < 0.05, respectively). There were two cutoff points at the AHI of 30 and 50.

CONCLUSIONWith OSAHS exacerbations, the incidence of hypertension was significantly increased.

Aged ; Female ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Risk Factors ; Sleep Apnea, Obstructive ; complications ; physiopathology

OBJECTIVETo investigate the relationship between the carotid stenosis (CS) and the pulse pressure (PP) in elderly men with essential hypertension.

METHODSAccording to the Color Doppler Flow Imaging (CDFI), 157 elderly men with essential hypertension and carotid atherosclerosis were divided into five classifications and two groups: CS < 50% group (n = 66) and CS > or = 50% group (n = 91). The blood pressures were measured within one year before the CDFI was taken and clinical data were recorded.

RESULTS(1) The systolic blood pressure (SBP) and the PP in CS > or = 50% group were significantly increased than those in CS < 50% group, while the diastolic blood pressure (DBP) was converse. The independent risk factors of CS > or = 50% were peripheral arterial disease (OR: 4.543, 95%CI: 1.415-14.590) and PP (OR: 1.096, 95% CI: 1.038-1.157). (2) CS classifications positively correlated with PP (r = 0.402, P < 0.01) and fibrinogen (FIB) (r = 0.200, P < 0.05). After adjusting for age, body mass index (BMI), SBP, DBP, total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-c), high density lipoprotein cholesterol (HDL-c), fasting serum glucose (FBG), blood uric acid (UA), D-dimer, amino-terminal pro-brain natriuretic peptide (NT-proBNP), total bilirubin (TBIL) and direct bilirubin (DBIL), multiple regression analysis showed that PP and FIB remained as predisposing risk factors for CS classifications.

CONCLUSIONThe pulse pressure was correlated with carotid stenosis in elderly men with essential hypertension and it was justified for concurrent inhibition of PP in the treatment of high blood pressure.

Aged ; Aged, 80 and over ; Blood Pressure ; Carotid Stenosis ; complications ; diagnostic imaging ; physiopathology ; Humans ; Hypertension ; complications ; physiopathology ; Male ; Middle Aged ; Ultrasonography

Blood Pressure ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypertension ; complications ; drug therapy ; physiopathology ; Hypotension, Orthostatic ; complications ; drug therapy ; physiopathology ; Male ; Middle Aged ; Syncope ; complications ; drug therapy ; physiopathology