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Related Concept Videos

Hypertension I: Introduction01:28

Hypertension I: Introduction

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Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
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Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

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Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
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Hypertension V: Nursing Management01:23

Hypertension V: Nursing Management

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The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
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Hypertension and Regulation of Blood Pressure01:18

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Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
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Pulmonary Hypertension: Classification and Pathogenesis01:30

Pulmonary Hypertension: Classification and Pathogenesis

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Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
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Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

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Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
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Evaluation of Right Ventricular Function in Experimental Models of Pulmonary Arterial Hypertension
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Pheochromocytomas and Hypertension.

Joseph M Pappachan1, Nyo Nyo Tun2, Ganesan Arunagirinathan2

  • 1Department of Endocrinology and Metabolism, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, LA1 4RP, UK. drpappachan@yahoo.co.in.

Current Hypertension Reports
|January 23, 2018
PubMed
Summary

Pheochromocytomas and paragangliomas (PPGLs) are rare tumors causing hypertension. This review updates knowledge on their diagnosis, genetics, and treatment, emphasizing recent findings.

Keywords:
HypertensionParagangliomas (PGLs)Pheochromocytomas (PCCs)Plasma free metanephrinesUrine fractionated metanephrines

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Area of Science:

  • Endocrinology
  • Oncology
  • Genetics

Background:

  • Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors originating from the adrenal medulla or autonomic ganglia.
  • Catecholamine excess from PPGLs leads to hypertension, sweating, headaches, and palpitations, increasing cardiovascular risks.
  • Genetic mutations are found in 35-40% of cases, with 10-15% of pheochromocytomas and 20-50% of paragangliomas being malignant.

Purpose of the Study:

  • To provide an updated review of pheochromocytomas and paragangliomas (PPGLs).
  • To cover the pathophysiology, genetic aspects, and diagnostic and therapeutic algorithms for PPGLs.
  • To focus on scientific literature published within the past three years.

Main Methods:

  • Literature review focusing on recent scientific publications (past 3 years).
  • Analysis of diagnostic approaches including biochemical tests (plasma-free metanephrines, 24-h urine-fractionated metanephrines) and imaging (CT, MRI, 123I-MIBG, PET, SPECT).
  • Review of current therapeutic strategies for both curative and palliative management.

Main Results:

  • Biochemical diagnosis relies on highly sensitive and specific measurements of plasma or urinary metanephrines.
  • Anatomical localization is typically achieved with CT or MRI, followed by functional imaging for prognostication.
  • Management includes surgery, chemotherapy, radiotherapy, radionuclide therapy, and ablation procedures, with annual follow-up recommended.

Conclusions:

  • PPGLs are significant causes of endocrine hypertension with unique neuroendocrine tumor characteristics.
  • Updated diagnostic and therapeutic algorithms are crucial for managing these neoplasms.
  • Genetic testing and comprehensive follow-up are essential for optimal patient outcomes.