ABSTRACT
BACKGROUND: The kidney's role in the pathogenesis of salt-induced hypertension remains unclear. However, it has been suggested that inherited morphological renal abnormalities may cause hypertension. We hypothesized that functional, not morphological, derangements in Dahl salt-sensitive rats' kidneys cause NaCl retention that leads to hypertension accompanied by renal pathologic changes and proteinuria. METHOD: We studied hemodynamic, renal morphologic, and biochemical differences in Dahl salt-resistant and Dahl salt-sensitive rats fed low (0.05-0.23% NaCl) or elevated (1% NaCl) salt diets. RESULTS: We found similar hemodynamics, equal numbers of glomeruli, normal renal medullary interstitial cells and their osmiophilic granules, and cortical morphology in normotensive Dahl salt-resistant and Dahl salt-sensitive rats fed low dietary salt. Furthermore, aldosterone secretion, caused by angiotensin II infusion in normotensive rats fed 0.23% NaCl, was significantly less in Dahl salt-sensitive than Dahl salt-resistant rats. Increasing NaCl to 1% caused renal vasoconstriction without changing cyclic GMP excretion in Dahl salt-sensitive rats; in Dahl salt-resistant rats, cyclic GMP increased markedly and renal vascular resistance remained unchanged. On 1% NaCl for 9 months, Dahl salt-sensitive rats developed marked hypertension, severe renal vasoconstriction, glomerulosclerosis, tubulointerstitial abnormalities, and marked proteinuria; hypertension resulted from increased total peripheral resistance, as occurs in essential hypertensive humans. No hemodynamic or renal pathologic changes occurred in Dahl salt-resistant rats, and proteinuria was minimal. CONCLUSION: We conclude that renal functional, not morphological, abnormalities cause salt sensitivity in Dahl rats.
Subject(s)
Hypertension/etiology , Kidney/metabolism , Sodium Chloride, Dietary/adverse effects , Aldosterone/metabolism , Angiotensin II/adverse effects , Animals , Blood Pressure/drug effects , Cyclic GMP/metabolism , Diastole/drug effects , Dose-Response Relationship, Drug , Fibrosis/chemically induced , Fibrosis/pathology , Glomerulosclerosis, Focal Segmental/chemically induced , Glomerulosclerosis, Focal Segmental/metabolism , Glomerulosclerosis, Focal Segmental/pathology , Hemodynamics , Hypertension/physiopathology , Kidney/pathology , Kidney Glomerulus/pathology , Kidney Glomerulus/ultrastructure , Kidney Medulla/cytology , Kidney Medulla/ultrastructure , Organ Size/drug effects , Proteinuria/chemically induced , Proteinuria/metabolism , Proteinuria/physiopathology , Rats , Rats, Inbred Dahl , Sodium/blood , Sodium/metabolism , Sodium Chloride, Dietary/metabolism , Systole/drug effects , Time Factors , Vascular Resistance/drug effects , Vasoconstriction/drug effectsABSTRACT
Our objective was to investigate sexual activity, behavior, dysfunction, and satisfaction in hypertensive women. Sixty-seven patients with a mean age of 60.4 years completed a detailed questionnaire. Of these women, 81.3% had a sex partner; 42.6% had untreated sexual dysfunction with a duration of more than 5 years in 70.9% and a duration of more than 10 years in 41.7%; 5.3% initiated sexual activity; 36.6% reported less sexual activity than desired; and 54.8% reported sexual activity as important. Our study revealed highly prevalent untreated sexual dysfunction of long duration. It also showed low frequency of sexual activity in spite of the high availability of partners. There was low frequency of initiation of sexual activity. In spite of the high prevalence of sexual dysfunction, more than a third of patients reported sexual activity to be less than desired, and more than half of patients reported sexual activity as important.
