Altered circadian blood pressure rhythm in endocrine diseases (part 2)

Patients were divided into the following groups: primary aldosteronism (PA, n=25, mean age 47±2 years, comprising 12 patients with aldosterone-producing adenoma, 12 with idiopathic aldosteronism and one with aldosterone-producing carcinoma); sympathoadrenal hypertension (SH, n=14, mean age 46+4 years, comprising 13 patients with pheochromocytoma and one with neuroblastoma; seven had noradrenaline, three had adrenaline, and four had noradrenaline and adrenaline overproduction); Cushing’s syndrome (CS, n=11, mean age 44+5 years, comprising seven patients with central subtype, three with peripheral subtype and one with ectopic form); actomegaly (A, n=10, mean age 44+5 years; all had hypophyseal adenoma); essential hypertension of second- to third-degree World Health Organization criteria (PH, n=11, mean age 42+5 years); and a control group composed of healthy subjects (n=10, mean age 43+7 years).
The diagnosis of hypertension was established by repeated office BP measurements greater than 160/95 mmHg in seated patients. Office BP was determined using conventional technique (mercury sphygmomanometer). Basic clinical data are shown in Table 1. Different types of endocrine diseases were diagnosed on the basis of repeated blood and urinary determinations of different hormones as follows: primary aldosteronism – plasma renin activity in the recumbent position 0.32+0.04 ng/mL/h, plasma aldosterone 463+65 pg/mL, plasma aldosterone :plasma renin activity ratio 193+37; sympathoadrenal hypertension- adrenaline in urine 497+190 nmol/g creatine, noradrenaline in urine 1271+312 nmol/g creatine, dopamine in urine 1095+210 nmol/g cre -atine; Cushing’s syndrome – plasma cortisol 1160+120 nmol/L, urinary excretion of free cortisol 582+42 |ag/24 h; acromegaly – growth hormone 148+82 ng/mL, insulin-dike growth factor-1 1250+111 |ag/L. In addition to humoral determinations, morphological techniques including computed tomography and adrenal flebography were used. In patients undergoing surgical treatment (patients with aldosterone-producing adenoma, pheochromocytoma, Cushing’s syndrome and actomegaly), the cor-ect diagnosis was later confirmed by histological examination. A pharmacy deserving your trust and giving you cialis professional sale only here along with other services.

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