Hipertensión secundaria: ¿cuándo y cómo buscarla? / Secondary hypertension: when and how to look for it?

Resumen En la población hipertensa se detecta una causa subyacente en 5% a 10%. Identificar etiología y establecer un tratamiento específico reduce el riesgo de daño de órgano blanco y, en algunos casos, puede curar la enfermedad primaria y la hipertensión. Dada su baja prevalencia, no se recomienda realizar una búsqueda exhaustiva de causas secundarias en todos los pacientes hipertensos. En este artículo se analiza cuándo y cómo debe estudiarse una hipertensión secundaria.

Abstract In the hypertensive population, between 5-10%, an underlying cause is detected. Identifying the etiology and giving specific treatment reduces the risk of hypertension-mediated organ damage and, in some cases, can cure the disease and high blood pressure. Due to its low prevalence, an exhaustive search for secondary causes is not recommended in all patients with hypertension. This article will discuss when and how to study secondary hypertension.

Renal sympathetic denervation for resistant hypertension: where do we stand after more than a decade / Denervação simpática renal para hipertensão resistente: situação depois de mais de uma década

Abstract Despite the current availability of safe and efficient drugs for treating hypertension, a substantial number of patients are drug-resistant hypertensives. Aiming this condition, a relatively new approach named catheter-based renal denervation was developed. We have now a clinically relevant time window to review the efficacy of renal denervation for treating this form of hypertension. This short review addresses the physiological contribution of renal sympathetic nerves for blood pressure control and discusses the pros and cons of renal denervation procedure for the treatment of resistant hypertension.

Resumo Em que pese a atual disponibilidade de medicamentos seguros e eficientes para o tratamento da hipertensão, um número significativo de pacientes sofre de hipertensão arterial resistente a tratamento medicamentoso. Em vista dessa condição, foi desenvolvida uma abordagem relativamente nova, denominada denervação renal por cateter. Dispomos atualmente de uma janela de tempo clinicamente relevante para analisar a eficácia da denervação renal no tratamento dessa modalidade de hipertensão. A presente revisão aborda a contribuição fisiológica dos nervos renais simpáticos no controle da pressão arterial e discute os prós e contras do procedimento de denervação renal no tratamento da hipertensão resistente.

Clinical Efficacy of Modified Jingui Shenqitang in Treatment of Renal Hypertension with Spleen-kidney Yang Deficiency Syndrome / 中国实验方剂学杂志

Objective::To explore the efficacy of modified Jingui Shenqitang in the treatment of renal hypertension with spleen-kidney yang deficiency syndrome and its effect on blood lipids, renal function and vascular endothelial function. Method::Totally 110 patients were randomly divided into control group and observation group by random number table method, with 55 cases in each group. Control group was given levamlodipine (2.5-5 mg every time, once/day) and enalapril maleate (10 mg every time, once/day), and observation group was given modified Jingui Shenqitang in addition to the therapy of control group (1 dose/day). They were treated for 12 weeks. Blood pressure monitoring was performed, the systolic blood pressure (SBD) and diastolic blood pressure (DBP) were compared before and after treatment, and the blood pressure compliance was calculated. The 24 h urinary protein quantification (24 hUpr), serum creatinine (SCr), albumin (ALB) and urea nitrogen (BUN) were detected before and after treatment, the glomerular filtration rate (eGFR) was calculated, and the triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HLD-C) and low-density lipoprotein( LDL-C) were detected before and after treatment. The spleen-kidney Yang deficiency syndromes were scored before and after treatment. The levels of nitric oxide (NO), plasma endothelin (ET) and angiotensin Ⅱ (Ang Ⅱ) were detected before and after treatment. Result::The blood pressure efficacy in observation group was better than that in control group (Z=1.905, P<0.05). The efficacy of traditional Chinese medicine(TCM) syndromes in observation group was better than that in control group (Z=2.416, P<0.01). The compliance rate of causal blood pressure in observation group was higher than that in control group (88.89% vs 71.25%) (χ2=7.861, P<0.01). SBP and DBP in observation group were lower than those in control group (P<0.05). TC and LDL-C in observation group were lower than those in control group (P<0.01). The 24 hUpr, BUN and SCr in observation group were lower than those in control group (P<0.05), while the eGFR was higher than that in control group (P<0.05). The levels of ET-1 and Ang Ⅱ in observation group were lower than those in control group (P<0.05), whereas the NO level was higher than that in control group (P<0.01). Conclusion::In addition to the routine intervention with western medicine, modified Jingui Shenqitang for patients with spleen-kidney Yang deficiency syndrome can further control blood pressure level, improve blood pressure compliance rate, regulate lipid metabolism, protect kidney function, and regulate vascular endothelial function, with a better clinical efficacy than pure western medicine.

Reninoma: a rare cause of curable hypertension / 소아과

The most common type of refractory hypertension found in children is secondary hypertension, which is a potentially curable disease. Reninoma, a renin-secreting juxtaglomerular cell tumor, is a rare cause of severe hypertension that is usually diagnosed in adolescents and young adults. Surgical resection of the tumor completely cures the hypertension of patients with reninoma. The typical clinical presentation of reninoma includes hypokalemia, metabolic alkalosis, and features secondary to the increased activation of the renin-angiotensin system without renal artery stenosis. We report a case of reninoma in a female adolescent with a typical clinical presentation, in which surgical removal of the tumor completely cured hypertension. We discuss here the clinical features, imaging studies, and immunohistochemical examination of the tumor used to establish the diagnosis of reninoma and for the management of the condition.

Bilateral Obstructive Uropathy Caused by Congenital Bladder Diverticulum Presenting as Hypertensive Retinopathy

A congenital bladder diverticulum (CBD) is caused by inherent muscular weakness instead of obstruction of the bladder outlet. The major clinical conditions are recurrent urinary tract infection (UTI) and voiding dysfunction. This report describes a 15-year-old male adolescent who developed sudden visual disturbance resulting from hypertensive retinopathy. The cause of hypertension was bilateral obstructive uropathy caused by enlarged paraureteral bladder diverticula. After the non-functioning right kidney and ureter and the bilateral diverticula were removed, the left ureter was reimplanted in the bladder. Pathologic findings showed chronic pyelonephritis and partial loss of the bladder musculature in the diverticular wall. This observation indicates that dilated CBD can cause latent UTI, ureteral obstruction, hydronephrosis, and secondary hypertension.

Abordaje diagnóstico de la hipertensión arterial secundaria / Diagnostic Approach Of Secondary Hypertension

Introducción: La hipertensión arterial es una de las enfermedades más prevalentes en atención primaria y el principal factor de riesgo para enfermedad cardivoascular. La hipertensión arterial secundaria es frecuente entre los pacientes con diagnóstico de hipertensión arterial, con una prevalencia del 10 % que puede incrementar hasta 20 % o 40 % en pacientes con hipertensión refractaria al tratamiento. Su identificación temprana se asocia con mejores desenlaces. Objetivo: Evaluar en la literatura las principales causas de hipertensión arterial secundaria e identificar el abordaje diagnóstico inicial de las patologías asociadas. Métodos: Selección y lectura de artículos de bases de datos Pubmed y Google Scholar y de revisiones de UpToDate que trataran el tema de hipertensión arterial secundaria. Conclusiones: Es importante reconocer aquellos pacientes que puedan estar cursando con hipertensión arterial de causa secundaria, ya que esto modifica el enfoque terapéutico, facilita el tratamiento y mejora los desenlaces; incluso puede llegar a la cura y resolución.

Hypertension is one of the most common diseases encountered in primary care settings and a major risk. factor for cardiovascular disease. Secondary hypertension is common in patients with hypertension diagnosis; its prevalence is about 10% and can be as high as 40% in patients whom are resistant to treatment. Its early recognition and treatment allows for better outcomes. Objective: To evalúate and identify the main causes for secondary' hypertension and to identify the diagnosis and evaluation of related conditions. Nfethods: Selection and review of articles from Pubmed and Google scholar and Iiterature reviews from Uptodate. Conclusions: It is important to identify secondary hypertension since this will modify treatment, outcomes and in some scenarios might be curable.

Clinical Observation of Valsartan Combined with Hydrochlorothiazide in the Treatment of Chronic Renal Disease Complicated with Hypertension / 中国药房

OBJECTIVE:To observe clinical efficacy and safety of valsartan combined with hydrochlorothiazide in the treat-ment of chronic renal disease complicated with hypertension. METHODS:A total of 156 chronic kidney disease patients with renal hypertensive were randomly divided into control group and observation group with 78 cases in each group. Control group was given hydrochlorothiazide tablets 25 mg orally,once a day. Observation group was additionally given valsartan capsule 80 mg orally,once a day,on the basis of control group. Treatment course of 2 groups lasted for 4 weeks. Clinical efficacies of 2 groups were observed and compared,and the levels of SBP,DBP,GFR,24 h urine protein quantification,Scr and BUN were observed before and after treatment. The occurrence of ADR was recorded. RESULTS:After treatment,total response rate of observation group was signifi-cantly higher than that of control group,with statistical significance (85.90% vs. 64.10%,P<0.05). Before treatment,there was no statistical significance in SBP,DBP,GFR,24 h urine protein quantification,Scr and BUN between 2 groups(P>0.05). After treatment,SBP,DBP,24 h urine protein quantification,Scr and BUN of 2 groups were significantly lower than before treatment,the observation group was significantly lower than the control group,GFR was significantly higher than before treatment,the observa-tion group was significantly higher than that of control group,with statistical significance(P<0.05). There was no statistical signif-icance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Valsartan combined with hydrochlorothiazide show good therapeutic efficacy for chronic renal disease complicated with hypertension,and can significantly improve blood pressure and renal function with good safety.

Effect of electroacupuncture on the rat model of type 2 diabetes mellitus combined with renal hypertension / 中国实验动物学报

Objective To observe the therapeutic effect of acupuncture therapy for the rat model of type 2 diabetes mellitus (T2DM) combined with renal hypertension and try to explore its mechanism. Methods We randomly select 10 Wistar rats as the blank group and 40 rats were used to make the model groups, which were divided into simple diabetes group, simple renal hypertension group, the compound group with electroacupuncture and the compound group without elec?troacupuncture, with 10 rats in each group. After a high fat and sugar diet for 4 weeks, the Wistar rats were given strepto?zotocin i. p. injection to establish models of type 2 diabetes mellitus. Renal hypertension was developed by the“2K1C” im?proved method to make unilateral renal artery ligation?induced renal artery stenosis. Then, electroacupuncture treatment was performed on the rats for 2 weeks except the compound group without electroacupuncture. The changes of values of BP, FBG, Cr, BUN, glycated hemoglobin, renin and Ang II were recorded and analyzed. Results The values of BP, FBG, Cr, BUN, glycated hemoglobin, renin and Ang II in the compound group with electroacupuncture showed a significant re?duction compared with the compound group without electroacupuncture after 2 weeks (P0?05). Conclusions The blood glucose and blood pressure in the rat model of compound group can be reduced to a normal level with continuous electroacupuncture at bilateral acupoints Zusanli, and it can also be kept at a stable level after single electroacupuncture for 2-3 days. The acupuncture therapy is more suitable for early clinical treatment and can be used in basic research with advantages of economic, safe, no side effect and so on.

Direct vascular actions of quercetin in aorta from renal hypertensive rats

BACKGROUND: Chronic treatment with the dietary flavonoid quercetin is known to lower blood pressure and restore endothelial dysfunction in animal models of hypertension. This study investigated the direct effects of quercetin on vascular response in chronic 2-kidney, 1-clip (2K1C) renal hypertensive rats. The effects of antioxidant vitamin ascorbic acid on the vasoreactivity were also examined. METHODS: 2K1C renal hypertension was induced by clipping the left renal artery; age-matched rats that received sham treatment served as controls. Thoracic aortae were mounted in tissue baths for the measurement of isometric tension. RESULTS: Relaxant responses to acetylcholine were significantly attenuated in 2K1C rats in comparison with sham rats. Quercetin or ascorbic acid augmented acetylcholine-induced relaxation in 2K1C rats, whereas no significant differences were noted in sham rats. The relaxation response to sodium nitroprusside was comparable between 2K1C and sham rats, and sodium nitroprusside-induced relaxation was not altered by quercetin or ascorbic acid in either group. The contractile response to phenylephrine was significantly enhanced in 2K1C rats compared with sham rats. Phenylephrine-induced contraction was inhibited by pretreatment with quercetin or ascorbic acid in 2K1C rats, whereas neither chemical affected responses in sham rats. N(w)-nitro-L-arginine methyl ester markedly augmented the contractile response to phenylephrine in sham rats, whereas no significant differences were observed in 2K1C rats. Quercetin or ascorbic acid did not affect phenylephrine-induced contraction in the presence of N(w)-nitro-L-arginine methyl ester in either 2K1C or sham rats. CONCLUSION: Acute exposure to quercetin appears to improve endothelium-dependent relaxation and inhibit the contractile response, similar to the effect of ascorbic acid in 2K1C hypertension. These results partially explain the vascular beneficial effects of quercetin in renal hypertension.

Effects of oxidative stress on endothelial modulation of contractions in aorta from renal hypertensive rats

BACKGROUND: Endothelial dysfunction is linked to exaggerated production of superoxide anions. This study was conducted to examine the effects of oxidative stress on endothelial modulation of contractions in chronic two-kidney, one-clip (2K1C) renal hypertensive rats. METHODS: The 2K1C hypertension was induced by clipping the left renal artery; age-matched rats receiving sham treatment served as controls. Thoracic aortae were isolated and mounted in tissue baths for measurement of isometric tension. RESULTS: Norepinephrine-induced contraction was augmented by the removal of the endothelium, which was more pronounced in sham rats than in 2K1C rats. Nomega-nitro-L-arginine methyl ester, an inhibitor of nitric oxide production, had a similar augmenting effect. Vitamin C inhibited the contraction in aortic rings with intact endothelium from 2K1C rats but not from sham rats. The contraction was also suppressed by treatment with diphenyleneiodonium or apocynin, inhibitors of nicotinamide adenine dinucleotide/nicotinamide adenine dinucleotide phosphate (NADH/NADPH) oxidase, in the aortae with intact endothelium from 2K1C rats but not in those from sham rats. Superoxide anions generated by xanthine oxidase/hypoxanthine enhanced the contraction in the aortae with intact endothelium from sham rats, but had no effect in 2K1C rats. Enhanced contractile responses to norepinephrine by xanthine oxidase/hypoxanthine in sham rats were reversed by vitamin C. CONCLUSION: These results suggest that the effect on endothelial modulation of endothelium-derived nitric oxide is impaired in 2K1C hypertension. The impairment is, at least in part, related to increased production of superoxide anions by NADH/NADPH oxidase.

Correlation study on angiotensin Ⅱ type 2 receptor gene single nucleotide polymorphisms in essential and renal hypertension / 中国综合临床

Objective To study the relationship between angiotensin Ⅱ type 2 receptor (AGTR2) gene single nucleotide polymorphisms and hypertension in patients with essential hypertension and renal hypertension.Methods Direct DNA sequencing was performed to detect the single nucleotide polymorphisms (SNP) in eighty patients with essential hypertension,eighty patients with renal hypertension and forty normal blood pressure controls.Results There was significant difference on A allele frequencies between essential hypertension group and control group ( 56.88％ [ 91/160 ] vs 30.00％ [ 24/80 ],x2 =15.44,P ＜ 0.001 ).A allele frequency had no correlation with renal hypertension (42.50％ [ 68/160 ] vs 30.00％ [ 24/80 ],x2 =3.52,P ＞0.05).There was no significant difference on SNP between essential hypertension group and renal hypertension group ( P ＞ 0.05 ).Conclusion A1675G signal nucleotide polymorphisms of AGTR2 may be associated with the development of essential hypertension,but has nothing to do with renal hypertension.

Endothelium-dependent vasodilation by ferulic acid in aorta from chronic renal hypertensive rats

BACKGROUND: Ferulic acid (FA) is a naturally occurring nutritional compound. Although it has been shown to have antihypertensive effects, its effects on vascular function have not been intensively established. The aim of this study was to assess the vasoreactivity of FA in chronic two-kidney, one-clip (2K1C) renal hypertensive rats. METHODS: Hypertension was induced in 2K1C rats by clipping the left renal artery and age-matched rats that received a sham treatment served as a control. Thoracic aortas were mounted in tissue baths to measure isometric tension. The effects of FA on vasodilatory responses were evaluated based on contractile responses induced by phenylephrine in the aortic rings obtained from both 2K1C and sham rats. Basal nitric oxide (NO) bioavailability in the aorta was determined by the contractile response induced by NO synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME). RESULTS: FA induced concentration-dependent relaxation responses which were greater in 2K1C hypertensive rats than in sham-clipped control rats. This relaxation induced by FA was partially blocked by the removal of endothelium or by pretreating with L-NAME. L-NAME-induced contractile responses were augmented by FA in 2K1C rats, while no significant differences were noted in sham rats. FA improved acetylcholine-induced endothelium-dependent vasodilation in 2K1C rats, but not in sham rats. The simultaneous addition of hydroxyhydroquinone significantly inhibited the increase in acetylcholine-induced vasodilation by FA. CONCLUSION: These results suggest that FA restores endothelial function by altering the bioavailability of NO in 2K1C hypertensive rats. The results explain, in part, the mechanism underlying the vascular effects of FA in chronic renal hypertension.

Direct Vascular Actions of Indapamide in Aorta from Renal Hypertensive Rats / 대한신장학회지

PURPOSE: Thiazide diuretics exert their hypotensive efficacy through a combined vasodilator and diuretic effect. The present study was conducted to assess the inhibitory effect of thiazide diuretic, hydrochlorothiazide, and the thiazide-like diuretics, indapamide and chlorthalidone on contractile responses to norepinephrine and arginine vasopressin in aortic rings from 2K1C renal hypertensive and sham-clipped normotensive rats. METHODS: 2K1C hypertension was made by clipping the left renal artery and age-matched control rats received a sham treatment. Changes in the tension of aortic ring preparations were measured isometrically. RESULTS: Indapamide inhibits the contractile responses to norepinephrine and vasopressin in aortic rings from 2K1C rats, while it did not modify in control rats. The inhibitory effect of indapamide was abolished by endothelium removal. Hydrochlorothiazide or chlorthalidone did not affect the vasoconstriction induced by norepinephrine and vasopressin either in sham or in 2K1C hypertensive rats. CONCLUSION: These results suggest that indapamide inhibits the contractile responses to norepinephrine and vasopressin via an endothelium-dependent mechanism in 2K1C renal hypertension.

The Role of Oxygen-Derived Free Radicals in Vascular Relaxations to Pinacidil in Renal Hypertensive Rats / 대한신장학회지

PURPOSE: Evidence has emerged that oxygen-derived free radicals may induce vascular relaxations via ATP-sensitive K+ (K(ATP)) channels and the level of free radicals is increased in animal models of hypertension. The present study was conducted to determine whether relaxations to an K(ATP) channel opener, pinacidil, are increased in the aorta from two-kidney, one clip (2K1C) hypertensive rats and whether free radial scavengers reduce these relaxations. METHODS: 2K1C hypertension was induced by clipping the left renal artery and age-matched control rats received a sham treatment. Rings of aortae without endothelium were suspended for isometric force recording. RESULTS: Relaxations to pinacidil (10(-8) to 10(-5) M), which are abolished by glibenclamide (10(-5) M), were augmented in the aorta from 2K1C rats, compared to those from control rats. In the aorta from 2K1C rats, catalase (1,200 U/mL), but neither superoxide dismutase (150 U/mL) nor deferoxamine (10(-4) M), reduced relaxations to pinacidil, whereas in the aorta from control rats, the free radical scavengers did not affect these relaxations. CONCLUSION: These results suggest that in 2K1C hypertension, vasorelaxation to an KATP channel opener is augmented and that hydrogen peroxide in smooth muscle cells may partly contribute to these relaxations.

Evidence that blood pressure remains under the control of arterial baroreceptors in renal hypertensive rats

The purpose of the present study was to determine the range of the influence of the baroreflex on blood pressure in chronic renal hypertensive rats. Supramaximal electrical stimulation of the aortic depressor nerve and section of the baroreceptor nerves (sinoaortic denervation) were used to obtain a global analysis of the baroreceptor-sympathetic reflex in normotensive control and in chronic (2 months) 1-kidney, 1-clip hypertensive rats. The fall in blood pressure produced by electrical baroreceptor stimulation was greater in renal hypertensive rats than in normotensive controls (right nerve: -47 ± 8 vs -23 ± 4 mmHg; left nerve: -51 ± 7 vs -30 ± 4 mmHg; and both right and left nerves: -50 ± 8 vs -30 ± 4 mmHg; P < 0.05). Furthermore, the increase in blood pressure level produced by baroreceptor denervation in chronic renal hypertensive rats was similar to that observed in control animals 2-5 h (control: 163 ± 5 vs 121 ± 1 mmHg; 1K-1C: 203 ± 7 vs 170 ± 5 mmHg; P < 0.05) and 24 h (control: 149 ± 3 vs 121 ± 1 mmHg; 1K-1C: 198 ± 8 vs 170 ± 5 mmHg; P < 0.05) after sinoaortic denervation. Taken together, these data indicate that the central and peripheral components of the baroreflex are acting efficiently at higher arterial pressure in renal hypertensive rats when the aortic nerve is maximally stimulated or the activity is abolished.

The Effects of Recombinant Adeno-Associated Virus Vector Delivery of Angiotensin Ⅱ Type 1 Receptor shRNA on Blood Pressure and Angiotensin Ⅱ Type 1 Receptor mRNA Expression in Renal Hypertensive Rats / 中华高血压杂志

Background Hypertension is a multigenetic inheritable disease.Gene therapy by regulating gene expression showed long term effects and less side effects,and has been emerged to be a potential and prospective treatment.Objective To investigate the effects of retroviraladeno-associated virus vector containing shRNA targeted on the AT1R gene (rAAV-AT1R-shRNA) on blood preesure(BP) in renal hypertensive rats,and the inhibitory effect of RNA interference (RNAi) on AT1R mRNA expression in renal hypertensive rats.Methods Two-kideny one-clip (2K1C) renal hypertension (RH) were established in SD rats and randomly to receive rAAV-AT1R-shRNA,1.5?109 particles/mL(n=12,ip),as treated group or retroviral vector (rAAV-EGFP),2.9?109 particles/mL,ip,as vehicle group,normal SD rats served as controls (n=12).SBP was measured before and after treatment.Animals were euthanized and blood,brain,heart,liver,kidney,aorta and adrenal gland were collected to identify the sites of rAAV-AT1R-shRNA expression by fluorescence microscope.Angiotensin Ⅱwas assessed by radioimmunology.Results 24 hours after single injection of rAAV-AT1R-shRNA,SBP was reduced by (22.3?5.5)mmHg compared to before intervention (P

Effects of Valsartan on Ventricular Hypertrophy and Expression of Proline-rich Tyrosine Kinase 2 in Myocardium of Renovascular Hypertensive Rats / 中华高血压杂志

Backgroud and Objective Proline-rich tyrosine kinase2(Pyk2) is a Ca~(2+) sensitive,non-receptor tyrosine protein kinase.Previous reports showed Pyk2 involved in development of left ventrieular hypertrophy. The present paper aimed to study the effects of valsartan on ventricular hypertrophy and its effect on the expression of Pyk2 in myocardium in renovascular hypertensive rats(RHR).Methods Two-kidney and one-clip(2K1C) renal hypertensive model was established in Sprague-Dawley rats by chronic partial occlusion of left renal artery,and ran- domized to receive valsartan (30 mg/kg?d) or without treatment for 4 or 8 weeks.Left ventricular mass to body mass ratio was measured.Pyk2 protein expression and phosphorylation was detected by Western blotting.Results Blood pressure,left ventricular mass to body mass ratio,Pyk2 activity in myocardium of RHR were increased gradu- ally.Valsartan reduced BP and prevent myocardial hypertrophy(P

Role of KCa Channels in SNAP-Induced Relaxation of Aorta from Renal Hypertensive Rats / 대한신장학회지

PURPOSE: S-nitroso-N-acetylpenicillamine (SNAP), a nitric oxide (NO) donor, is thought to relax vascular smooth muscle by stimulation of soluble guanylate cyclase, accumulation of its product cyclic GMP (cGMP) level. Evidence has emerged that NO-induced vasodilatation is also mediated by stimulating Ca2+-activated K+ (KCa) channels directly or indirectly through cGMP. The aim of the present study was to investigate possible involvement or alteration of KCa channels in the mechanism of vasodilation induced by SNAP in two-kidney, one-clip (2K1C) hypertensive rats. METHODS: 2K1C hypertension was made by clipping the left renal artery and age-matched control rats received a sham treatment. Using rings prepared from thoracic aortae, we studied changes in isometric tension of the rings in response to SNAP to evaluate effects of a soluble guanylate cyclase inhibitor methylene blue (MB), and a specific blocker of KCa channel iberiotoxin (ITX). RESULTS: Aortic rings from 2K1C hypertensive and sham-clipped control rats precontracted with phenylephrine showed similar relaxation to SNAP. MB markedly suppressed the SNAP-induced relaxation in both groups, leaving about 30% of MB-resistant relaxation. ITX nearly completely eliminated the MB-resistant relaxation in control rats, but it did not affect 2K1C rats. CONCLUSION: These results suggest that SNAP-induced vasorelaxation is mediated through cGMP- dependent and cGMP-independent KCa channel involving mechanisms, the latter may be altered in 2K1C renal hypertension.

Observation of Effect of Nicardipine Combined with Metoprolol in the Treatment of Renal Hypertension / 药物流行病学杂志

Objective:To observe the curative effect and security of nicardipine combined with metoprolol succinate sustained-release tablet on renal hypertension.Method:65 renal hypertension patients were randomly divided into two groups.The patients in the nicardipine group were treated with nicardipine 80 mg q8h,while the patients in the therapy group were treated with nicardipine 40mg qd and metoprolol succinate sustained-release tablet 47.5-95mg qd for 8 weeks.Their blood pressure,heart rate,hepatic function,renal function,blood glucose and lipid were observed and recorded before and after the treatment.Result:The total efficiency was 74.4%in the controlled group and 88.5%in the therapy group,respectively. There were no obvious changes or obvious adverse reactions in their heart rate,hepatic function,renal function,blood glucose and lipid after the treatment.Conclusion:Nicardipine combined with metoprolol succinate sustained-release tablet is efficient and safe but more efficient than nicardipine alone in the treatment of renal hypertension.

Effect of Shouwujiangya Capsule on Renal Function of Renal Hypertension Rats / 中国中医药信息杂志

Objective To observe the effect of Shouwujiangya (SWJY) capsule on blood pressure, urinary content of immune globulin G (IgG), ?1-microglobulin (?1-MG) and ?2-microglobulin (?2-MG) of the renal hypertension rats (RHR). Methods To prepare RHR model by 2K1C and observe the urinary content of IgG, ?1-MG and ?2-MG. Results The blood pressure of high dose SWJY capsule group, low dose SWJY capsule group and captoril group was significantly lower than the model group (P