Diabète, hypertension artérielle et angiopathie: comparaison chez les patients diabétiques insulino-dépendants et non insulino-dépendants.

in Archives des Maladies du Coeur et des Vaisseaux (1991), 84(suppl 1), 35

Arguments en faveur de l'existence d'un inhibiteur endogène de la Na-K ATPase rénale, de nature stéroïdienne et a vertu natriuretique

in Archives des Maladies du Coeur et des Vaisseaux (1990), 83(8), 1229-1231

In order to explain the opposite effect of 6,7-dihydroxylated isomers of 6, 7 - dihydrocanrenone on the urinary sodium and potassium excretion, we have tested the effect of these substances isolated from ... [more ▼]

In order to explain the opposite effect of 6,7-dihydroxylated isomers of 6, 7 - dihydrocanrenone on the urinary sodium and potassium excretion, we have tested the effect of these substances isolated from human urine on the Na(+)-K+ pump from different tissue preparation: rabbit kidney slices as well as NA-K ATPase purified from the kidney. Our results show an inhibition of pump as well as enzyme activity by the 6 beta 7 alpha isomer while the 2 other isomers are either uneffective or slightly stimulating. The 6 beta 7 alpha dihydroxy-6, 7-dihydrocanrenone could be one of the plasma ouabain-like substance incriminated in the pathogenesis of volume-expanded hypertension. [less ▲]

Anomalie rénale de l'excrétion sodée, un marqueur de la prédisposition héréditaire à l'hypertension artérielle, rôle de la dopamine?

in Archives des Maladies du Coeur et des Vaisseaux (1989), 82(7), 1245-1248

Since Dahl's observation, a renal defect os sodium excretion is proposed as one of pathogenetic mechanism of hypertension (HTA). Our study has tried to verify this concept in 20 young normotensives with ... [more ▼]

Since Dahl's observation, a renal defect os sodium excretion is proposed as one of pathogenetic mechanism of hypertension (HTA). Our study has tried to verify this concept in 20 young normotensives with (n = 12) and without (n = 8) familial predisposition to HTA, allowing to test the genetic transmission of such potential renal abnormality of sodium balance. Each people was submitted to 3 different Na diet (20, 170 and 340 mM NaCl) each for 1 week. At each visit, blood pressure, vascular resistances, biological values were determined at rest (plasma renin activity, creatinine clearance, 24 hours before the test, catecholamines, aldosterone and ion urinary excretion). Then 1 liter of isotonic saline was perfused in 30 minutes with measures of blood pressure and 3 hours urinary dopamine and Na excretion. During the low and medium Na diets, but not during the high Na diet, the natriuresis and dopamine excretion were lower in the 3 hour urine collection in patients with a family history of HTA (p less than 0.02 and p less than 0.005, respectively). No other clinical or biological difference was noted between the 2 groups. Thus, genetic hypertensive predisposition seems to be characterized by a lower Na excretion during acute Na loading in normal or depleted Na diet, linked to an impaired urinary dopamine excretion. These findings suggest that the defect responsible for the susceptibility to sodium intake is at the kidney level. Some dopamine agonists would be of great therapeutical value in treating such patients when blood pressure begins to rise. [less ▲]

La mesure ambulatoire de la pression artérielle permet d'améliorer la définition de l'hypertension artérielle

in Archives des Maladies du Coeur et des Vaisseaux (1988), 81 Spec No

The lack of effect of treatment of mild hypertension on the coronary heart disease has motivated researches for a better diagnosis of hypertension. One of the approaches presently under study uses the ... [more ▼]

The lack of effect of treatment of mild hypertension on the coronary heart disease has motivated researches for a better diagnosis of hypertension. One of the approaches presently under study uses the recording of ambulatory blood pressure using semi-automatic devices. The usefulness of these apparatus is however restricted by the lack of reference values recorded in normotensive control patients. We have recorded ambulatory blood pressure (PAA) in 24 normotensives, 22 untreated hypertensives and 45 treated hypertensive patients, and compared the data obtained to the blood pressure recorded during medical examination (PAC). If a good correlation is usually observed between PAA and PAC, very large and unpredictable discordances are frequently observed. No correlation is found between the difference PAA-PAC and the variability of PAA. This variability does not fully explain the difference observed between PAA and PAC. This variability expressed in mmHg increases with age and the level of BP. Ambulatory BP appears to be a very reproducible value which may allow to improve the definition of hypertension and therefore the cardiovascular risk. [less ▲]