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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Alan Kim Johnson, Baojian Xue
The causes of essential hypertension remain an enigma. Interactions between genetic and external factors are generally recognized to act as aetiological mechanisms that trigger the pathogenesis of high blood pressure. However, the questions of which genes and factors are involved, and when and where such interactions occur, remain unresolved. Emerging evidence indicates that the hypertensive response to pressor stimuli, like many other physiological and behavioural adaptations, can become sensitized to particular stimuli...
October 18, 2018: Nature Reviews. Nephrology
S Magder
Measurement of arterial pressure is one of the most basic elements of patient management. Arterial pressure is determined by the volume ejected by the heart into the arteries, the elastance of the walls of the arteries, and the rate at which the blood flows out of the arteries. This review will discuss the three forces that determine the pressure in a vessel: elastic, kinetic, and gravitational energy. Emphasis will be placed on the importance of the distribution of arterial resistances, the elastance of the walls of the large vessels, and critical closing pressures in small arteries and arterioles...
October 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
Ying Zheng, Li Tang, Weiguang Zhang, Delong Zhao, Dong Zhang, Li Zhang, Guangyan Cai, Xiangmei Chen
Background: The 2017 high blood pressure (BP) clinical practice guideline reported by the American College of Cardiology/American Heart Association put forward new categories of BP. This study aimed to assess the applicability of the new guideline in a nondialysis chronic kidney disease (CKD) population. Methods: This is a nationwide, multicenter, cross-sectional study with a large sample. A total of 8927 nondialysis CKD patients in 61 tertiary hospitals in all 31 provinces, municipalities and autonomous regions of China (except Hong Kong, Macao and Taiwan) were analyzed...
October 9, 2018: Nephrology, Dialysis, Transplantation
Mathieu Buonafine, Benjamin Bonnard, Frédéric Jaisser
Activation of the mineralocorticoid receptor (MR) in the distal nephron by its ligand, aldosterone, plays an important role in sodium reabsorption and blood pressure regulation. However, expression of the MR goes beyond the kidney. It is expressed in a variety of other tissues in which its activation could lead to tissue injury. Indeed, MR activation in the cardiovascular (CV) system has been shown to promote hypertension, fibrosis, and inflammation. Pharmacological blockade of the MR has protective effects in several animal models of CV disease...
October 15, 2018: American Journal of Hypertension
Xiaolei Chen, Yiling Cao, Zheng Wang, Dongmei Zhang, Wanxin Tang
AIM: Hypertensive nephropathy (HTN) is one of the leading causes of end-stage renal disease and is closely associated with inflammation and tubule-interstitial fibrosis. The molecular mechanism underlying HTN remains unclear. This study utilized bioinformatic analysis to identify the novel gene targets for HTN. METHODS: We downloaded the microarray data of GSE99325 and GSE32591 from Gene Expression Omnibus. The dataset comprised 20 HTN and 15 normal samples. The differentially expressed genes (DEGs) were identified, and then gene ontology (GO) enrichment was performed, and a GO tree was constructed by using clusterProfiler and ClueGO...
October 8, 2018: Nephrology
Qi Qian
Our knowledge on sodium and water homeostasis and regulation continues to evolve. A considerable amount of new information in this area has emerged in recent years. This review summarizes existing and new literature and discusses complex multi-organ effects of high-salt and low-water intake and role of arginine vasopressin in this process, as well as the potential clinical significance of non-osmotic sodium storage pool and rhythmicity of urine sodium excretion. It has become clear that sodium and water dysregulation can exert profound effects on kidney and vascular health, far greater than previously recognized...
October 2018: Nephrology
Jingru Lin, Rui Xu, Lin Yun, Yamin Hou, Chan Li, Ying Lian, Fei Zheng
Backgroud: While numerous risk factors for renal damage in the hypertensive population have been reported, there is no single prediction model. The purpose of this study was to develop a model to comprehensively evaluate renal damage risk among hypertensive patients. Methods: We analyzed the data of 582 Chinese hypertensive patients from 1 January 2013 to 30 June 2016. Basic patient information was collected along with laboratory test results. According to the albumin-to-creatinine ratio, the subjects were divided into a hypertension with renal damage group and a hypertension without renal damage group...
October 9, 2018: Clinical and Experimental Hypertension: CHE
Dimitrie Siriopol, Adrian Covic, Radu Iliescu, Mehmet Kanbay, Oana Tautu, Luminita Radulescu, Ovidiu Mitu, Delia Salaru, Maria Dorobantu
Accumulating evidence indicates that higher levels of salt intake are associated with higher blood pressure levels. The aim of our analysis was to test the hypothesis that the effect of urinary sodium excretion (UNaV) on systolic blood pressure (SBP) is mediated through estimated glomerular filtration rate (eGFR) and arterial stiffness and also to test the direction of the relationship between eGFR and arterial stiffness, in both hypertensive and normotensive patients. We assessed the potential for connection between UNaV and SBP and mediators (eGFR and pulse wave velocity [PWV]) of this relationship using structural equation models of data from 1599 adults ≥18 years of age and without chronic kidney disease who participated in the Third Epidemiologic Study concerning the Prevalence of Arterial Hypertension and Cardiovascular Risk in Romania (SEPHAR III)...
October 7, 2018: Journal of Clinical Hypertension
Sayumi Watanabe, Tsuneo Konta, Kazunobu Ichikawa, Masafumi Watanabe, Kenichi Ishizawa, Yoshiyuki Ueno, Hidetoshi Yamashita, Takamasa Kayama, Isao Kubota
BACKGROUND: The association between salt intake and blood pressure levels is still inconclusive, and may be influenced by patient characteristics. We thus conducted a community-based cross-sectional study. METHODS: This study included 2297 subjects aged ≥ 40 years not on antihypertensive medication at the time of a health check-up. We examined the association between blood pressure levels and the estimated amount of 24-h urinary sodium excretion (e24hUNa) stratified by background characteristics...
October 6, 2018: Clinical and Experimental Nephrology
Maria Dolores Sanchez-Niño, Alberto Ortiz
Drug-induced hypertension offers the opportunity to further understand pathways involved in the regulation of blood pressure. Posaconazole is an antifungal agent known to induce hypertension and hypokalaemia. In recent months, a flurry of reports has unravelled the metabolic processes involved. In this issue of CKJ , Barton K, Davis TK, Marshall B et al. Posaconazole-induced hypertension and hypokalemia due to inhibition of the 11β-hydroxylase enzyme. Clin Kidney J 2018; 11: 691-693 present convincing evidence of 11β-hydroxylase inhibition resulting in a biochemical syndrome resembling genetic congenital adrenal hyperplasia and characterized by high 11-deoxycorticosterone and 11-deoxycortisol levels as well as androgen levels...
October 2018: Clinical Kidney Journal
Rakesh Malhotra, Timothy Craven, Walter T Ambrosius, Anthony A Killeen, William E Haley, Alfred K Cheung, Michel Chonchol, Mark Sarnak, Chirag R Parikh, Michael G Shlipak, Joachim H Ix
BACKGROUND: Random assignment to the intensive systolic blood pressure (SBP) arm (<120mmHg) in the Systolic Blood Pressure Intervention Trial (SPRINT) resulted in more rapid declines in estimated glomerular filtration rates (eGFRs) than in the standard arm (SBP<140mmHg). Whether this change reflects hemodynamic effects or accelerated intrinsic kidney damage is unknown. STUDY DESIGN: Longitudinal subgroup analysis of clinical trial participants. SETTINGS & PARTICIPANTS: Random sample of SPRINT participants with prevalent chronic kidney disease (CKD) defined as eGFR<60mL/min/1...
September 28, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
George Howard, Mary Cushman, Claudia S Moy, Suzanne Oparil, Paul Muntner, Daniel T Lackland, Jennifer J Manly, Matthew L Flaherty, Suzanne E Judd, Virginia G Wadley, D Leann Long, Virginia J Howard
Importance: The high prevalence of hypertension among the US black population is a major contributor to disparities in life expectancy; however, the causes for higher incidence of hypertension among black adults are unknown. Objective: To evaluate potential factors associated with higher risk of incident hypertension among black adults. Design, Setting, and Participants: Prospective cohort study of black and white adults selected from a longitudinal cohort study of 30 239 participants as not having hypertension at baseline (2003-2007) and participating in a follow-up visit 9...
October 2, 2018: JAMA: the Journal of the American Medical Association
Geum Joon Cho, Ho Yeon Kim, Jong Heon Park, Ki-Hoon Ahn, Soon-Cheol Hong, Hai-Joong Kim, Sun Won Han, Min-Jeong Oh
BACKGROUND: The aim of our study was to investigate the prepregnancy characteristics that are risk factors for the development of hypertension (HTN) and identify prepregnancy factors for the development of HTN in women affected by pre-eclampsia in their first pregnancy. METHODS: We enrolled 1910 women who had undergone a National Health Screening Examination through the National Health Insurance Corporation between 2002 and 2003, and who had their first delivery affected by pre-eclampsia in 2004...
October 3, 2018: Journal of Women's Health
Margaret Riley, Anita K Hernandez, Angela L Kuznia
High blood pressure in children and adolescents is a growing health problem that is often overlooked. Children should be screened for elevated blood pressure annually beginning at three years of age or at every visit if risk factors are present. In children younger than 13 years, elevated blood pressure is defined as blood pressure in the 90th percentile or higher for age, height, and sex, and hypertension is defined as blood pressure in the 95th percentile or higher. In adolescents 13 years and older, elevated blood pressure is defined as blood pressure of 120 to 129 mm Hg systolic and less than 80 mm Hg diastolic, and hypertension is defined as blood pressure of 130/80 mm Hg or higher...
October 15, 2018: American Family Physician
N P Bowles, S S Thosar, M X Herzig, S A Shea
PURPOSE OF REVIEW: Given the emerging knowledge that circadian rhythmicity exists in every cell and all organ systems, there is increasing interest in the possible benefits of chronotherapy for many diseases. There is a well-documented 24-h pattern of blood pressure with a morning surge that may contribute to the observed morning increase in adverse cardiovascular events. Historically, antihypertensive therapy involves morning doses, usually aimed at reducing daytime blood pressure surges, but an absence of nocturnal dipping blood pressure is also associated with increased cardiovascular risk...
September 28, 2018: Current Hypertension Reports
Francesca Viazzi, Giovanna Leoncini, Guido Grassi, Roberto Pontremoli
A bidirectional relationship between hypertension and kidney disease, with one exacerbating the effect of the other, is well established. Elevated blood pressure (BP) is a well-recognized, modifiable risk factor for cardiovascular (CV) disease as well as for development and progression of chronic kidney disease and, therefore, the identification of optimal BP target is a key issue in the management of renal patients. Recent large trials and real life cohort studies have indicated that below a definite BP value renal protection seems to plateau and too low levels may even be associated with a paradoxical increase in renal morbidity, thus reviving the debate about the so called BP -renal function J-curve relationship...
September 28, 2018: Journal of Clinical Hypertension
Robert D Toto
No abstract text is available yet for this article.
October 8, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Jong Hyun Jhee, Jimin Park, Hyoungnae Kim, Youn Kyung Kee, Jung Tak Park, Seung Hyeok Han, Chul Woo Yang, Nam-Ho Kim, Yon Su Kim, Shin-Wook Kang, Yong-Lim Kim, Tae-Hyun Yoo
Hypertension is common and contributes to adverse outcomes in patients undergoing dialysis. However, the proper blood pressure (BP) target remains controversial and several factors make this difficult. This study aimed to investigate the adequate BP target in patients undergoing prevalent dialysis. Data were retrieved from the Clinical Research Center for End-Stage Renal Disease (2009-2014). 2,299 patients undergoing dialysis were evaluated. Patients were assigned into eight groups according to predialysis systolic blood pressure (SBP)...
September 20, 2018: Scientific Reports
Nicolás Roberto Robles, Francesco Fici, Guido Grassi
Aggressive reduction of blood pressure (BP) may increase cardiovascular events (the J-curve phenomenon) in certain populations. There is a high number of available studies of antihypertensive treatment that provide strong evidence for J-shaped relationships between both diastolic and systolic BP and main cardiovascular outcomes. Nonetheless, most available studies were observational, and randomized trials might not have or lost their statistical power in post-hoc analysis. Contrariwise, most of prospective trial to demonstrate the benefits of intensive blood pressure control were inconclusive...
September 17, 2018: Journal of Nephrology
Jirar Topouchian, Zoya Hakobyan, Jennifer Asmar, Svetlana Gurgenian, Parounak Zelveian, Roland Asmar
Background: Electronic devices for blood pressure (BP) measurements need to go through independent clinical validation as recommended by different authorities, both in general and in special populations such as pregnancy. Objective: To evaluate the accuracy of the Omron Evolv® (HEM-7600T-E) and the Omron M3 Comfort® (HEM-7134-E) devices in pregnancy and pre-eclampsia according to the Universal Standard Validation Protocol. Methods: Both devices, the Evolv and the M3 Comfort, measure BP at the brachial level using the oscillometric method...
2018: Vascular Health and Risk Management
2018-09-16 07:52:31
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