Perioperative hypertension associated neurohumoral stress response in craniotomy patients: Effects of β-blocker and angiotensin converting enzyme inhibitor

Publication date: Available online 26 July 2019Source: Interdisciplinary NeurosurgeryAuthor(s): Parthiban Velayutham, Sanjib Das Adhikary, Victoria Job, Krothapalli Srinivasa Babu, Vedantam Rajshekhar, Ari George Chacko, Berend MetsAbstractBackgroundDevelopment of perioperative hypertension in craniotomy procedures is commonly associated with activation of sympathetic events through renin-angiotensin-aldosterone system (RAAS). Preemptive therapy with β-blockers or angiotensin converting enzyme (ACE) inhibitors may attenuate this hypertensive response. We conducted a randomized, double blind; placebo controlled study to compare the effect of β-blocker (atenolol) and an ACE inhibitor (Lisinopril) on perioperative hypertension in patients undergoing for the craniotomy and also studied biochemical markers of these two systems.MethodsEighty five patients undergoing craniotomy for supratentorial tumor removal were screened and randomized into three groups to receive either (atenolol; lisinopril or placebo). Blood analysis of renin, aldosterone, norepinephrine and sodium levels was drawn 12 h prior to surgery, at the time of dural opening, and at the time of extubation. Differences in mean arterial pressure (MAP), hear rate (HR) and biochemical markers between three groups were analyzed using one-way ANOVA.ResultsPerioperative hemodynamic changes were highly associated with biochemical markers in all the three groups. Specifically, HR was significantly attenuated by aten...
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research

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In this study, we investigated whether parental hypertension induces autonomic dysfunction in male adult offspring, and the H2S mechanism underlying this autonomic dysfunction. 2-kidney-1-clip method was employed to induce parental hypertension during pregnancy and lactation in rats. Basal blood pressure (BP) and autonomic function of male offspring in adulthood was evaluated. Additionally, either maternal hypertensive dams or their male offspring after weaning were treated with H2S to determine improving effects of H2S on autonomic dysfunction. The BP was significantly increased in male offspring of renovascular hypertens...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
ConclusionChronic metformin presented anti-inflammatory and antioxidant effects and, independently of alterations in glycaemia, it improved cardiac autonomic parameters that are impaired in hypertension, being related to end-organ damage and mortality. These findings open up perspectives for future innovative uses of metformin in cardiovascular diseases, especially in hypertension.Graphical abstract
Source: Nutrition, Metabolism and Cardiovascular Diseases - Category: Nutrition Source Type: research
manifests as severe, symptomatic paroxysmal hypertension without significant elevation in catecholamine and metanephrine levels and lack of evidence of tumor in the adrenal gland. The clinical manifestations are similar but not identical to those in excess circulating catecholamines. The underlying symptomatic mechanism includes augmented cardiovascular responsiveness to catecholamines alongside heightened sympathetic nervous stimulation. The psychological characteristics are probably attributed to the component of repressed emotions related to a past traumatic episode or repressive coping style. Successful management can...
Source: Endocrinology and Metabolism Clinics of North America - Category: Endocrinology Authors: Source Type: research
Publication date: Available online 12 September 2019Source: Journal of Critical CareAuthor(s): M.-H. Ho Anthony, Glenio B. MizubutiAbstractProphylactic administration of a vasopressor to mitigate the hypotensive effect of propofol (and/or other co-induction agents) during sedation/anesthesia immediately prior to tracheal intubation in frail patients in the intensive care unit and emergency and operating rooms appears to be not an uncommon practice. We submit that this practice is unnecessary and potentially harmful. Despite restoring the blood pressure, phenylephrine, for instance, may have an additive or synergistic effec...
Source: Journal of Critical Care - Category: Gastroenterology Source Type: research
Conclusion: Dietary capsaicin may alleviate 2K1C renovascular hypertension, probably via enhancing phosphorylation of Akt and eNOS. Abbreviations: 2K1C: 2-kidney, 1-clip hypertension model; Akt: protein kinase B; Ang II: angiotensin II; ANOVA: measures analysis of variance; BP: blood pressure; EC: endothelial cell; eNOS: endothelial nitric oxide synthase; GAPDH: glyceraldehyde-3-phosphate dehydrogenase; L-NAME, LN: Nω-Nitro-L-arginine methyl ester hydrochloride; MA: mesenteric arteries; MAP: mean arterial blood pressure; NO: nitric oxide; PKA: protein kinase A; PVDF: polyvinylidene difluoride; SBP: Systolic blood pre...
Source: Clinical and Experimental Hypertension - Category: Cardiology Authors: Tags: Clin Exp Hypertens Source Type: research
ub NL Abstract Perivascular adipocytes residing in the vascular adventitia are recognized as distinct endocrine cells capable of responding to inflammatory stimuli and communicating with the sympathetic nervous system and adjacent blood vessel cells, thereby releasing adipocytokines and other signaling mediators to maintain vascular homeostasis. Perivascular adipocytes exhibit phenotypic heterogeneity (both white and brown adipocytes) and become dysfunctional in conditions, such as diet-induced obesity, thus promoting vascular inflammation, vasoconstriction, and smooth muscle cell proliferation to potentially cont...
Source: Arteriosclerosis, Thrombosis and Vascular Biology - Category: Cardiology Authors: Tags: Arterioscler Thromb Vasc Biol Source Type: research
Conclusion: Masked hypertension is not uncommon in children born small for gestational age. After stress, urinary norepinephrine levels were increased in children born small for gestational age with masked hypertension.
Source: Blood Pressure Monitoring - Category: Cardiology Tags: Clinical Methods and Pathophysiology Source Type: research
AbstractPurpose of ReviewTo review the findings of trials evaluating pharmacological treatment approaches for hypertension in general, and resistant hypertension (RH) in particular, and propose future research and clinical directions.Recent FindingsRH is defined as blood pressure (BP) that remains above target levels despite adherence to at least three antihypertensive medications, including a diuretic. Thus far, clinical trials of pharmacological approaches in RH have focused on older molecules, with spironolactone being demonstrated as the most efficacious fourth-line agent. However, the use of spironolactone in clinical...
Source: Current Hypertension Reports - Category: Primary Care Source Type: research
Authors: Cornu E, Belmihoub I, Burnichon N, Grataloup C, Zinzindohoué F, Baron S, Billaud E, Azizi M, Gimenez-Roqueplo AP, Amar L Abstract Phaeochromocytomas and paragangliomas (PPGL) are rare neuroendocrine tumors that arise from the adrenal medulla or sympathetic and parasympathetic ganglia. These tumors produce most often catecholamines in excess, causing hypertension and sometimes severe acute cardiovascular complications. The diagnosis is based on plasma or urines metanephrines measurements and on conventional and nuclear medicine imaging. Catecholamines-producing PPGL is very unlikely if levels are nor...
Source: Revue de Medecine Interne - Category: Internal Medicine Tags: Rev Med Interne Source Type: research
AbstractPurpose of ReviewSympathetic overactivity plays an important role in the progression of pulmonary arterial hypertension (PAH). The purpose of this review is to illustrate localization of pulmonary arterial sympathetic nerves, the key steps of pulmonary artery denervation (PADN) procedure, and to highlight clinical outcomes.Recent FindingsSympathetic nerves mostly occurred in the posterior region of the bifurcation and pulmonary trunk. Emerging preclinical data provided the potential of PADN for PAH. PADN, produced at bifurcation area, improved a profound reduction of pulmonary arterial pressure and ameliorated clin...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
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