Department of Internal Medicine D houses the Hypertension Research Unit and specializes in treating patients with high blood pressure and infectious diseases. Our staff is trained and experienced in treating patients with Pheochromocytoma, Hyperaldosteronism and Renal Artery Stenosis.

Hypertension Research Unit
Our Hypertension Research Unit runs clinical and basic science research and is currently doing collaborative research with the Ochsner Clinic in New Orleans, Louisiana (US) and the National Institutes of Health, (US).

Outpatient Clinics
We house two outpatient clinics: one servicing the general Sheba Medical Center population and one devoted to Hypertension.

General Outpatient Clinic
Our general outpatient clinic services patients after hospitalization and our clinic acts as a referral clinic for patients with general internal medicine problems.

Hypertension Clinic
We operate a Hypertension Outpatient Clinic for new Hypertensive patients to evaluate and control resistant Hypertension. Our clinic serves as a referral center for complicated Hypertension and follows many Hypertensive patients with other cardiovascular risk factors. Our therapeutic approach is unique because it deals with the global cardiovascular risk (treatment of Diabetes Mellitus, Hyperlipidemia, Obesity, Ischemic Heart Disease, etc.).  We offer 24-hour blood pressure monitors and have our own laboratory to measure blood and urine catecholamines levels. Our clinic also has the facility to do suppression and stimulations tests to diagnose Pheochromocytoma.
 

Hypertension Unit

Director : Dr. Yehonatan Sharabi

Chief of Laboratory:  Dr. Edna Peleg

Physicians: Prof Ehud Grossman, Dr Yehonatan Sharabi, Dr Naomi Nussinovitch, Dr. Yehuda Kamari, Dr. Amitay Elkayam

Vet Technician: Zehava Shabtay

Research Nurse: Zehava Gal-El

Secretary: Ella Yegudayev

We would be happy to be available to you and provide additional information that you may need: 
Tel: + 972 3 5302624
Fax: + 972 3 5355428
E mail: sharabiy@sheba.health.gov.il

Overview of the activities of the Institute:
Hypertension or high blood pressure is one of the most common diseases of western culture.  Also known as, "the silent killer", hypertension, is responsible for a considerable morbidity and mortality in Israel.  The main organs damaged by this condition are the heart, the brain and the kidneys.  However, early diagnosis and proper treatment can largely prevent most complications of the disease.  In the Hypertension Institute, we work on many aspects in the fight against this illness and its complications in the following sections:

Clinical section-
• The Hypertension clinic with two evaluation-rooms, operates three days a week.  The clinic, which evaluates over 3000 patients each year, is a referral center for patients with resistant hypertension, secondary hypertension and patients with other high-risk cardiovascular conditions.
• A referral center for evaluation of pheochromocytoma with dynamic testing (with the use of glucagon and clonidine).
• Consultation services for other departments, clinics, and institutes in the Chaim Sheba Medical Center.
• Neurocardiology service - a new clinical-laboratory for hemodynamic monitoring of autonomic function.
• A 24-hour blood pressure monitoring service

Research section-
• Laboratory for analysis of catecholamines, such as adrenaline, in blood and urine.
• Analysis of renin and angiotensin and the angiotensin converting enzyme (chemicals that regulate blood pressure and sodium balance)

Academic section-
• Clinical research:
o Relationship between overweight and obesity, high blood pressure and neuroendocrinologic systems; the relationship between melatonin and decreases in nocturnal blood pressure.
• Basic research at all levels: 
o a molecular laboratory,  cell culture and an animal facility.
• Mentoring and supervision is provided to medical residents in basic research, doctoral students, and physicians completing subspecialties in the field of hypertension.

The department is affiliated with the faculty of the Sackler School of medicine of Tel Aviv University.

The professional staff, the laboratory and the services provided by us are among the highest level available in Israel.  The department and its physicians lead the field  in an active academic and scientific frameworks whose goals are to improve the care of patients with and advance the research of hypertension in Israel.

Neurocardiology service:

At the Chaim Sheba Medical Center, a new service is now available the diagnostic evaluation of the autonomic nervous system.  The service is available in the clinical laboratory, where we non-invasively and with utmost accuracy evaluate, hemodynamic parameters such as, beat -to-beat blood pressure and heart rate and forearm blood flow in patients experiencing difficulties with blood pressure control.  This population of patients includes those suffering from autonomic dysfunction, postural hypotension, when standing or sitting up causes a sudden drop in blood pressure, recurrent syncope or fainting episodes.  It also includes patients suffering from other diseases where there is a component of autonomic dysfunction such as, diabetes mellitus, pheochromocytoma, and neurological conditions such as Parkinson disease and Multiple System atrophy,   among others.  This type of evaluation is recommended and performed after the standard work-up and after standard  medical drug therapy has failed.

The evaluation characterizes and localizes and in physiologic manner, the autonomic defect that leads to the clinical problem.  Identification of the flaw also helps guide optimal treatment for the patient.

Evaluation process: 
• Medical history and physical examination
• Insertion of an intravenous catheter : resting supine (on one's back) for 20 minutes
• Attachment of the patient to hemodynamic monitoring equipment.
• Monitoring of hemodynamic parameters (blood pressure and heart rate) at rest and with specific maneuvers (blowing against resistance, deep breathing, postural changes.)
• Measurement of plasma catecholamines (norepinephrine, epinephrine, the metabolite DHPG) when laying flat and after standing for 5 minutes.

After the evaluation, and analysis of the hemodynamic parameters in conjunction with the results of the blood tests, a diagnosis is established.  A summary is given to the patients containing details of the results, the diagnosis and recommendations for treatment.

Please feel free to contact us for additional details us or to set up an appointment.

Department at a Glance
Number of Patients per Year - 3,650
Number of Beds - 38 including 5 Beds of Intensive Care Shared with Department of Medicine E
Number of Visits in Hypertension Clinic - 3600 Visits per Year
Number of General Outpatient Clinic Visits per Year - Approximately 600
Director - Prof. Ehud Grossman
Address - Charles Clore Hospitalization Tower, East Wing
E-mail - Ehud.Grossman@sheba.health.gov.il
Tel - 973-2-530-2438