CEREBRAL, CENTRAL, AND CARDIAC HEMODYNAMI CS IN PATIENTS WITH PROGRESSIVE ARTERIAL-HYPERTENSION AFTER SURGICAL SUPPRESSION OF ADRENAL HYPERFUNCTION

Forty-eight patients with progressive (malignant) arterial hypertensio n resistant to conservative therapy were subjected to surgical portali zation of the adrenal blood stream in order to metabolize excessively produced aldosterone in the liver of the patients. Cerebral hemodynami cs was studied before by tetra- and bipolar rheoencephalography, centr al hemodynamics was studied by tetrapolar transthoracal rheography, an d intracardiac hemodynamics by echocardiography before and after surge ry; blood plasma aldosterone and hydrocortisone concentrations and pla sma renin activity were measured. A significant reduction of arterial pressure, elimination or alleviation of subjective and objective manif estations of chronic hypertensive encephalopathy were seen in the majo rity of patients after surgery. Cerebral blood flow improved, blood pl asma aldosterone and renin activity reduced, myocardial hypertrophy de creased, and a trend to normalization of intracardiac hemodynamics was observed.