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Hypertension

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41 papers 25 to 100 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/27906749/sodium-and-potassium-in-the-pathogenesis-of-hypertension-focus-on-the-brain
#1
Horacio J Adrogué, Nicolaos E Madias
PURPOSE OF REVIEW: Primary hypertension is characterized by Na excess and K deficit in the body, which together are key to its pathogenesis. These derangements work jointly in the brain and the peripheral vascular wall to establish hypertension. In this review, we highlight recent evidence describing the central mechanisms through which Na surfeit and K deficit enhance sympathetic nerve activity, thereby raising peripheral vascular resistance and generating hypertension. RECENT FINDINGS: Animal studies point to a small increase in plasma and cerebrospinal fluid (CSF) [Na], a small decrease in CSF [K], and increased levels of circulating angiotensin II, aldosterone, and endogenous ouabain as the central signals evoking hypertension...
December 2, 2016: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27906836/visit-to-visit-blood-pressure-variability-is-a-risk-factor-for-all-cause-mortality-and-cardiovascular-disease-a-systematic-review-and-meta-analysis
#2
Jianqi Wang, Xubo Shi, Changsheng Ma, Hua Zheng, Jie Xiao, Hong Bian, Zhimin Ma, Ling Gong
OBJECTIVE: Clinical cohort studies have reported that visit-to-visit variability (VVV) of blood pressure (BP) is associated with cardiovascular disease (CVD) or mortality. However, the results were not consistent in all studies. The current study is, therefore, aimed to conduct a systematic review and meta-analysis to determine the association between VVV of BP and CVD and all-cause mortality. METHOD: PubMed and EMBASE were searched through 18 May 2014, using the following terms: VVV, BP, CVD, coronary heart disease (CHD), myocardial ischemia, stroke, and mortality...
January 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/27873228/hypertension-in-chronic-kidney-disease
#3
Seyed Mehrdad Hamrahian, Bonita Falkner
Hypertension, a global public health problem, is currently the leading factor in the global burden of disease. It is the major modifiable risk factor for heart disease, stroke and kidney failure. Chronic kidney disease (CKD) is both a common cause of hypertension and CKD is also a complication of uncontrolled hypertension. The interaction between hypertension and CKD is complex and increases the risk of adverse cardiovascular and cerebrovascular outcomes. This is particularly significant in the setting of resistant hypertension commonly seen in patient with CKD...
November 22, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27898523/role-of-corin-in-the-regulation-of-blood-pressure
#4
Hui Li, Yue Zhang, Qingyu Wu
PURPOSE OF REVIEW: Corin is a transmembrane protease that activates atrial natriuretic peptide (ANP), an important hormone in regulating salt-water balance and blood pressure. This review focuses on the regulation of corin function and potential roles of corin defects in hypertensive, heart, and renal diseases. RECENT FINDINGS: Proprotein convertase subtilisin/kexin-6 has been identified as a primary enzyme that converts zymogen corin to an active protease. Genetic variants that impair corin intracellular trafficking, cell surface expression, and zymogen activation have been found in patients with hypertension, cardiac hypertrophy, and pre-eclampsia...
November 24, 2016: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27884230/the-kidney-in-hypertension
#5
REVIEW
Hillel Sternlicht, George L Bakris
Hypertension is the second most common cause of chronic kidney disease (CKD) and is a potentiator of kidney failure when accompanying disease. CKD is a common cause of resistant hypertension. Nephropathy progression has dramatically slowed over the past 3 decades from an average of 8 to between 2-3 mL/min per year regardless of diabetes status. The incidence of very high albuminuria as well as progression from high albuminuria very high albuminuria has substantially decreased over the past 3 decades. This improvement relates to better blood pressure control using agents that slow nephropathy as well as better glycemic and cholesterol control...
January 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/27873231/atherosclerotic-renal-artery-stenosis
#6
Robert Schoepe, Stephen McQuillan, Debbie Valsan, Geoffrey Teehan
Atherosclerotic Renal Artery Stenosis is a form or peripheral arterial disease that tends to affect older subjects with hyperlipidemia, history of tobacco use, and who have other coexistent forms of vascular insufficiency. An abdominal bruit on physical exam can be a helpful clue. Slowly progressive, it can lead to critical narrowing of the renal arteries which creates a cascade of events such as renin-angiotensin-aldosterone activation (RAAS), hypertension, acute pulmonary edema, and renal fibrosis. The hypertension is considered a secondary form and can even be resistant to multiple antihypertensives...
November 22, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27537098/getting-to-lower-systolic-blood-pressure-beyond-antihypertensive-therapy
#7
Nadia A Khan
No abstract text is available yet for this article.
August 16, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27536808/comparative-effectiveness-of-management-strategies-for-renal-artery-stenosis-an-updated-systematic-review
#8
Gowri Raman, Gaelen P Adam, Christopher W Halladay, Valerie N Langberg, Ijeoma A Azodo, Ethan M Balk
Background: Atherosclerotic renal artery stenosis (ARAS) is associated with high blood pressure (BP), decreased kidney function, renal replacement therapy (RRT), and death. Purpose: To compare benefits and harms of percutaneous transluminal renal angioplasty with stent placement (PTRAS) versus medical therapy alone in adults with ARAS. Data Sources: MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from 1993 to 16 March 2016; gray literature; and prior systematic reviews...
November 1, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27747454/non-invasive-imaging-cannot-replace-formal-angiography-in-the-diagnosis-of-renovascular-hypertension
#9
Agnes Trautmann, Derek J Roebuck, Clare A McLaren, Eileen Brennan, Stephen D Marks, Kjell Tullus
OBJECTIVES: Renovascular disease (RVD) is found in about 10 % of secondary childhood hypertension. Digital subtraction angiography (DSA) is the gold standard to diagnose RVD. Non-invasive imaging methods like Doppler ultrasound (US), magnetic resonance angiography (MRA), and computed tomography angiography (CTA) are increasingly used. Our aim was to evaluate the role and accuracy of US, MRA, and CTA compared to DSA in diagnosing RVD in children. PATIENTS AND METHODS: A retrospective review of 127 children with suspected renovascular hypertension was performed in children referred to Great Ormond Street Hospital between 2006 and 2014 due to clinical suspicion of renovascular hypertension and/or findings on US and/or MRA or CTA...
October 17, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27642926/br-04-1management-of-treatment-resistant-hypertension
#10
David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27573731/epidemiology-diagnosis-and-management-of-hypertension-among-patients-on-chronic-dialysis
#11
REVIEW
Panagiotis I Georgianos, Rajiv Agarwal
The diagnosis and management of hypertension among patients on chronic dialysis is challenging. Routine peridialytic blood pressure recordings are unable to accurately diagnose hypertension and stratify cardiovascular risk. By contrast, blood pressure recordings taken outside the dialysis setting exhibit clear prognostic associations with survival and might facilitate the diagnosis and long-term management of hypertension. Once accurately diagnosed, management of hypertension in individuals on chronic dialysis should initially involve non-pharmacological strategies to control volume overload...
October 2016: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/27406184/interventional-procedures-and-future-drug-therapy-for-hypertension
#12
Melvin D Lobo, Paul A Sobotka, Atul Pathak
Hypertension management poses a major challenge to clinicians globally once non-drug (lifestyle) measures have failed to control blood pressure (BP). Although drug treatment strategies to lower BP are well described, poor control rates of hypertension, even in the first world, suggest that more needs to be done to surmount the problem. A major issue is non-adherence to antihypertensive drugs, which is caused in part by drug intolerance due to side effects. More effective antihypertensive drugs are therefore required which have excellent tolerability and safety profiles in addition to being efficacious...
July 11, 2016: European Heart Journal
https://www.readbyqxmd.com/read/26912544/visit-to-visit-variability-of-bp-and-ckd-outcomes-results-from-the-allhat
#13
Jeff Whittle, Amy I Lynch, Rikki M Tanner, Lara M Simpson, Barry R Davis, Mahboob Rahman, Paul K Whelton, Suzanne Oparil, Paul Muntner
BACKGROUND AND OBJECTIVES: Increased visit-to-visit variability of BP is associated with cardiovascular disease risk. We examined the association of visit-to-visit variability of BP with renal outcomes among 21,245 participants in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We measured mean BP and visit-to-visit variability of BP, defined as SD, across five to seven visits occurring 6-28 months after participants were randomized to chlorthalidone, amlodipine, or lisinopril...
March 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/26912547/masked-hypertension-and-elevated-nighttime-blood-pressure-in-ckd-prevalence-and-association-with-target-organ-damage
#14
Paul E Drawz, Arnold B Alper, Amanda H Anderson, Carolyn S Brecklin, Jeanne Charleston, Jing Chen, Rajat Deo, Michael J Fischer, Jiang He, Chi-Yuan Hsu, Yonghong Huan, Martin G Keane, John W Kusek, Gail K Makos, Edgar R Miller, Elsayed Z Soliman, Susan P Steigerwalt, Jonathan J Taliercio, Raymond R Townsend, Matthew R Weir, Jackson T Wright, Dawei Xie, Mahboob Rahman
BACKGROUND AND OBJECTIVES: Masked hypertension and elevated nighttime BP are associated with increased risk of hypertensive target organ damage and adverse cardiovascular and renal outcomes in patients with normal kidney function. The significance of masked hypertension for these risks in patients with CKD is less well defined. The objective of this study was to evaluate the association between masked hypertension and kidney function and markers of cardiovascular target organ damage, and to determine whether this relationship was consistent among those with and without elevated nighttime BP...
April 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/26806824/salt-and-health-time-to-revisit-the-recommendations
#15
Tilman B Drüeke
The relationship between salt and human health has been the subject of controversy over the past century. The largest study in the field demonstrates a J-curve relationship between sodium intake and adverse clinical outcomes, suggesting a need to reevaluate current recommendations to restrict sodium intake to less than 2 g/d in the general population.
February 2016: Kidney International
https://www.readbyqxmd.com/read/26806825/a-sprint-to-the-finish-or-just-the-beginning-implications-of-the-sprint-results-for-nephrologists
#16
Michael V Rocco, Alfred K Cheung
The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated a significant reduction in major cardiovascular events and all-cause mortality with intensive blood pressure control in older individuals at high cardiovascular risk, including patients with chronic kidney disease and mild proteinuria. Nephrologists should consider the SPRINT results when determining the optimal blood pressure target for patients with chronic kidney disease.
February 2016: Kidney International
https://www.readbyqxmd.com/read/26784837/interactive-effects-of-physical-fitness-and-body-mass-index-on-the-risk-of-hypertension
#17
Casey Crump, Jan Sundquist, Marilyn A Winkleby, Kristina Sundquist
IMPORTANCE: High body mass index (BMI) and low physical fitness are risk factors for hypertension, but their interactive effects are unknown. Elucidation of interactions between these modifiable risk factors may help inform more effective interventions in susceptible subgroups. OBJECTIVE: To determine the interactive effects of BMI and physical fitness on the risk of hypertension in a large national cohort. DESIGN, SETTING, AND PARTICIPANTS: This cohort study included all 1,547,189 military conscripts in Sweden from January 1, 1969, through December 31, 1997 (97%-98% of all 18-year-old men nationwide each year), who were followed up through December 31, 2012 (maximum age, 62 years)...
February 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/26765793/mineralocorticoid-receptor-antagonists-in-end-stage-renal-disease-efficacy-and-safety
#18
Andrew S Bomback
Mineralocorticoid receptor antagonists (MRAs) that block aldosterone's effects on both epithelial and non-epithelial receptors have become a mainstay of therapy for chronic heart failure. Given that cardiovascular events remain the leading cause of death for patients with end-stage renal disease (ESRD), the question of whether these MRAs can be employed in dialysis patients arises. This review summarizes the rationale for blocking aldosterone in patients with chronic and end-stage kidney disease and surveys the data on both the efficacy and safety of using MRAs in the ESRD population...
2016: Blood Purification
https://www.readbyqxmd.com/read/26551394/redefining-blood-pressure-targets-sprint-starts-the-marathon
#19
EDITORIAL
Vlado Perkovic, Anthony Rodgers
Blood pressure is a potent determinant of cardiovascular risk, but the most appropriate targets for blood-pressure lowering have long been debated. Observational studies with a low risk of confounding have shown a linear relationship between blood pressure and cardiovascular risk down to 115/75 mm..
November 26, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/26530623/the-double-challenge-of-resistant-hypertension-and-chronic-kidney-disease
#20
REVIEW
Patrick Rossignol, Ziad A Massy, Michel Azizi, George Bakris, Eberhard Ritz, Adrian Covic, David Goldsmith, Gunnar H Heine, Kitty J Jager, Mehmet Kanbay, Francesca Mallamaci, Alberto Ortiz, Raymond Vanholder, Andrzej Wiecek, Carmine Zoccali, Gérard Michel London, Bénédicte Stengel, Denis Fouque
Resistant hypertension is defined as blood pressure above goal despite adherence to a combination of at least three optimally dosed antihypertensive medications, one of which is a diuretic. Chronic kidney disease is the most frequent of several patient factors or comorbidities associated with resistant hypertension. The prevalence of resistant hypertension is increased in patients with chronic kidney disease, while chronic kidney disease is associated with an impaired prognosis in patients with resistant hypertension...
October 17, 2015: Lancet
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