Some Different Types Of Essential Hypertension

Keith, Norman M.; Wagener, Henry P.; Barker, Nelson W.

doi:10.1097/00000441-193903000-00006

Cited by 607 publications

(41 citation statements)

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“…The severity of the hypertension in these patients, as assessed by the state of the ocular fundi (Keith et al 1939) and by the level of the patient's diastolic blood pressure when first seen, is compared in Fig 1 with The renal handling of uric acid by 6 hypertensive hyperuricemic patients has been compared with 5 hypertensive patients who have a normal serum uric acid (SUA) and with 6 subjects with a normal blood pressure (Table 1). Glomerular filtration rate (GFR) was measured by vitamin B12 clearance (Nelp et al 1964, Breckenridge & Metcalfe-Gibson 1965, and uric acid clearance over two twenty-four-hour clearance periods.…”

Section: Patients Methods and Resultsmentioning

confidence: 99%

Hypertension and Hyperuricæmia

Breckenridge

1966

The Lancet

189

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Section: Patients Methods and Resultsmentioning

confidence: 99%

Hypertension and Hyperuricæmia

Breckenridge

1966

The Lancet

189

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“…No hypertensive subject had a significant medical, neurological, or psychiatric illness, a secondary cause of hypertension, or a disorder that might cause or contribute to brain dysfunction. Specifically, potential subjects were excluded if they had diabetes mellitus, renal dysfunction (including proteinuria), grade 3 or 4 retinal changes by the Keith-Wagener-Barber classification system, 32 myocardial infarction, or cardiac dysrhythmias. One hypertensive subject had a right femoral artery bruit, but no other subject had evidence of peripheral atherosclerosis.…”

Section: Subjectsmentioning

confidence: 99%

Brain atrophy in hypertension. A volumetric magnetic resonance imaging study.

et al. 1992

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To determine whether hypertension, the predominant risk factor for stroke and vascular dementia, is associated with brain atrophy, magnetic resonance imaging (MRI) scans were performed to quantify brain volumes and cerebrospinal fluid spaces. Eighteen otherwise healthy, cognitively normal older hypertensive men (mean±SD age, 69±8 years, duration of hypertension 10-35 years) and 17 age-matched healthy, normotensive male control subjects were studied in a cross-sectional design. Axial proton-density image slices were analyzed using region-of-interest and segmentation analyses. The hypertensive subjects had significantly larger mean volumes of the right and left lateral ventricles (p<0.05, both absolute volume and volume normalized to intracranial volume) and a significantly smaller normalized mean left hemisphere brain volume (p<0.05) with a trend toward significance for a smaller normalized mean right hemisphere volume (p<0.Q9). Four hypertensive subjects and one healthy control subject were found to have severe peri ventricular hyperintensities on T2-weighted MRI images. When data for these subjects were removed from the analyses, the normalized lateral ventricle volumes remained significantly larger in the hypertensive group. Lateral ventricle enlargement was not related to age or use of diuretics in the hypertensive group nor to duration of hypertension between 10 and 24 years. Our findings suggest that long-standing hypertension results in structural changes in the brain. Longitudinal studies will determine whether MRI-associated changes are progressive and if such changes identify hypertensive subjects at increased risk for clinically apparent brain dysfunction. 1 " 3 Nevertheless, hypertension remains the dominant risk factor for stroke and vascular dementia.4 -6 Hypertension-associated changes in the cardiovascular and renal systems have been well described by clinical studies, using readily available, noninvasive techniques such as echocardiography 7 -8 or creatinine clearance calculated from 24-hour urine measurements. 9 In vivo changes in the brains of hypertensive subjects are less commonly described, most likely because of fewer available methods for noninvasrvery studying the brain. In particular, there has been little emphasis on characterizing brain structure and function in hypertensive subjects in the absence of stroke or dementia.With more widespread availability of structural imaging modalities such as computed x-ray tomography (CT) and magnetic resonance imaging (MRI), methods have been developed to not only describe, but also quantify structural changes in the brain 1011 associated with normal, healthy aging 12 -15 and with various pathological conditions such as Alzheimer's disease 16 and Down's syndrome. 17 However, there has been only one volumetric imaging study, using CT, that applied these techniques to hypertensive subjects. In that retrospective cross-sectional study, Hatazawa et al 18 reported greater brain atrophy in older hypertensive subjects, including those with left ventricular...

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“…Abnormality was graded 0, 1, 2, or 3 units depending as to whether it was absent, mild, moderate, or severe. For the retinal arteries the units corresponded with the grades of Keith, Wagener, and Barker (1939) except that their grades 3 and 4 were each allotted 3 units. Brachial diastolic blood pressure was graded as follows:-Less than 90 mm.…”

Section: The Present Studymentioning

confidence: 99%