Abstract:
:Lipodystrophy (LD) associated with HIV infection is a syndrome of abnormal fat distribution observed in HIV-infected patients treated with various antiretroviral agents. In addition, insulin resistance and dyslipidemia can occur in HIV-infected patients with or without LD. The demonstration of the latter metabolic disorders in normal subjects using protease inhibitors suggests that these agents could play a causative role in their development independently of HIV status. Possible mechanisms whereby protease inhibitors can hinder insulin actions include inhibition of glucose transporter isoform Glut 4, and altered expression of leptin and tumor necrosis factor-a in adipose tissue. The presence of insulin resistance and dyslipidemia can potentially increase the risk of diabetes, cardiovascular disease, and death. However, short-term data in this regard are inconsistent. Treatment of HIV-related LD with metformin may ameliorate insulin resistance, but its impact on fat redistribution requires additional studies. Temporary cessation of antiretroviral therapy does not appear to reverse body fat changes or insulin resistance, but may partially improve the lipid profile. Further investigations are urgently needed to define the mechanisms and cardiovascular consequences of insulin resistance in HIV-related LD, and to find an effective treatment for this complex syndrome.
journal_name
Curr Hypertens Repjournal_title
Current hypertension reportsauthors
Mikhail Ndoi
10.1007/s11906-003-0067-0keywords:
subject
Has Abstractpub_date
2003-04-01 00:00:00pages
117-21issue
2eissn
1522-6417issn
1534-3111journal_volume
5pub_type
杂志文章,评审abstract::Diabetes mellitus is well recognized as a potent and prevalent risk factor for accelerated atherosclerosis and ischemic heart disease. However, there is also evidence of cardiac dysfunction in diabetes in the absence of coronary atherosclerosis, termed diabetic cardiomyopathy. Changes in ventricular structure and left...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-007-0086-3
更新日期:2007-12-01 00:00:00
abstract:PURPOSE OF REVIEW:This review is intended to briefly describe the primary mechanistic pathways by which several common drugs can increase blood pressure. We also propose potential management strategies based on the underlying mechanisms responsible for the blood pressure elevation. RECENT FINDINGS:As hypertension is a...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-017-0736-z
更新日期:2017-05-01 00:00:00
abstract::Heart failure has emerged as one of the most important diseases of the past century. The understanding and treatment of heart failure has evolved significantly over the years. As we move further into the era of device therapy, attention has turned to the idea of sympathetic nervous system modulation through renal dene...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-014-0528-7
更新日期:2015-03-01 00:00:00
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journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-011-0221-z
更新日期:2011-12-01 00:00:00
abstract::The fact that cardiovascular risk factors cluster among individuals with the insulin resistance syndrome strongly suggests a common pathogenetic denominator. For many years, abnormalities of nonesterified fatty acid metabolism have been implicated in the disturbances of carbohydrate and lipid metabolism that character...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-001-0021-y
更新日期:2001-04-01 00:00:00
abstract::Diastolic pressure, systolic pressure, and pulse pressure have all been assigned the role of the best predictor of cardiovascular events during the 20th century. At the dawn of the new millennium, concepts that draw attention to vascular mechanics reconcile the seemingly conflicting results of epidemiologic studies, b...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-000-0010-6
更新日期:2000-06-01 00:00:00
abstract::The research on molecular genetics of human hypertension aims to identify the loci involved in the regulation of blood pressure, detect gene variants within the identified loci, associate them with intermediate phenotypes, and ultimately estimate their quantitative effects on blood pressure level and their interaction...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-999-0071-0
更新日期:1999-02-01 00:00:00
abstract::Hypertension is very common in patients with chronic renal failure and contributes to cardiovascular morbidity and mortality. Several mechanisms may contribute to hypertension in these patients, but recently a large body of evidence supports the notion that activation of the sympathetic nervous system (SNS) may play a...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-002-0016-3
更新日期:2002-06-01 00:00:00
abstract::Hypertension is a preventable condition, and the outcomes of clinical trials have established that its treatment reduces cardiovascular morbidity and mortality. Although awareness about the disease has improved in the past two decades, the reality is that many people remain untreated or not adequately controlled. The ...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-001-0007-9
更新日期:2001-12-01 00:00:00
abstract::Insulin resistance (IR) is present in pathologies such as diabetes, obesity, metabolic syndrome, impaired glucose tolerance, hypertension, inflammation, cardiac disease, and dyslipidemias. Population studies show that IR is multifactorial and has genetic components, such as defects in the insulin-signaling pathway (as...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-015-0615-4
更新日期:2016-01-01 00:00:00
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journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-006-0041-8
更新日期:2006-04-01 00:00:00
abstract::The treatment of hypertension is proven to reduce cardiovascular and renal risk. Combination drug therapy is becoming recognized as a necessity in most patients with hypertension and kidney disease. Allegations about the safe use of calcium antagonists in patients with kidney disease have led to questions and confusio...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-002-0006-5
更新日期:2002-06-01 00:00:00
abstract::The underlying pathophysiologic concept of diverse invasive devices to treat resistant hypertension (e.g., sympathetic denervation, carotid sinus nerve stimulation) is known for a long time. Since the pioneering work in the 1940s in humans, innovative techniques have been developed resulting in less invasive treatment...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-014-0488-y
更新日期:2014-11-01 00:00:00
abstract::High blood pressure in the setting of type 1 and type 2 diabetes is commonly associated with the earlier development of target-organ damage, including cardiovascular and cerebrovascular disease and progressive renal insufficiency. The major goal of treating high blood pressure in this population is to prevent or reduc...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-003-0020-2
更新日期:2003-06-01 00:00:00
abstract::Hypertension that complicates preeclampsia in pregnancy is a disorder that requires special consideration in both prevention and pharmacologic treatment. In recent years, few advances have been made regarding the pathophysiology and prevention of preeclampsia; however, there have been some promising results from studi...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-006-0030-y
更新日期:2006-12-01 00:00:00
abstract::Levels of urinary albumin excretion that are below the usual limit of detection by qualitative testing, but are above normal levels (microalbuminuria; MA), can be readily identified by simple measures, such as the urinary albumin to creatinine ratio in untimed urine samples. Such measurements, particularly when combin...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-010-0133-3
更新日期:2010-10-01 00:00:00
abstract::Women with chronic hypertension and pregnancy-induced hypertension are at substantial risk for developing pre-eclampsia/eclampsia, a disease with high fetomaternal morbidity and mortality. However, the etiology of this disease is still unknown. In this article, recent concepts on the pathophysiology of pre-eclampsia, ...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-003-0057-2
更新日期:2003-12-01 00:00:00
abstract::Hypertension is present in three of four patients with coronary artery disease (CAD) but remains largely uncontrolled in most patients. Treating hypertension in these patients is complicated by the concern of precipitating coronary ischemia when diastolic blood pressure (DBP) is reduced excessively. However, an emergi...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-008-0066-2
更新日期:2008-10-01 00:00:00
abstract:PURPOSE OF REVIEW:This review summarizes the latest science on hypertensive encephalopathy and posterior reversible encephalopathy syndrome (PRES). We review the epidemiology and pathophysiology of these overlapping syndromes and discuss best practices for diagnosis and management. RECENT FINDINGS:Diagnosis of hyperte...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-018-0813-y
更新日期:2018-02-26 00:00:00
abstract::Masked hypertension refers to the phenomenon of having a non-elevated clinic blood pressure (BP) despite having an elevated out-of-clinic BP. Masked hypertension is a common phenotype with a cardiovascular risk profile similar to that of sustained hypertension, defined as elevated clinic and out-of-clinic BP. Current ...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-017-0792-4
更新日期:2017-10-25 00:00:00
abstract:PURPOSE OF REVIEW:The intrarenal renin-angiotensin-aldosterone system (RAS) is an independent paracrine hormonal system with an increasingly prominent role in hypertension and renal disease. Two enzyme components of this system are angiotensin-converting enzyme (ACE) and more recently discovered ACE2. The purpose of th...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-017-0778-2
更新日期:2017-09-19 00:00:00
abstract::The impaired capacity of the kidney to excrete sodium plays an essential role in the development of hypertension. Adrenal corticosteroids control renal handling of sodium by regulating tubular sodium reabsorption in the distal nephron where both mineralocorticoid receptors (MR) and glucocorticoid receptors are express...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-015-0552-2
更新日期:2015-06-01 00:00:00
abstract::Angiotensin II (Ang II) has actions on the sympathetic nervous system both as a circulating hormone acting on the circumventricular organs and also as a neurotransmitter/ neuromodulator acting within the brain. Administration of Ang II into the cerebral ventricles has diverse effects on sympathetic nerve activity (SNA...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-013-0355-2
更新日期:2013-08-01 00:00:00
abstract::Our understanding of Na(+) transport defects has exploded in the past several years, and has provided unique insights into epithelial transport processes, and unusual clinical syndromes resulting from mutations of specific ion transporters. These genetic disorders affect Na(+) balance, with both Na(+) retaining and Na...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-999-0013-x
更新日期:1999-04-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim of the study is to perform a critical assessment of in vitro models of pre-eclampsia using complementary human and cell line-based studies. Molecular mechanisms involved in spiral uterine artery (SUA) remodelling and trophoblast functionality will also be discussed. RECENT FINDINGS:A number o...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-017-0786-2
更新日期:2017-10-23 00:00:00
abstract::Diabetes and hypertension are common coexistent conditions, the combination of which results in an increased risk for cardiovascular and renal disease. Clinical trials have convincingly demonstrated the benefit of tight blood pressure control among patients with diabetes in reducing these risks. Furthermore, the choic...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-005-0039-7
更新日期:2005-12-01 00:00:00
abstract:PURPOSE OF REVIEW:This article introduces the haemodynamic principles that underpin the pathophysiology of hypertension and introduces a rational physiological approach to appropriate pharmacologic treatment. RECENT FINDINGS:Outdated understanding of haemodynamics based on previous measurement systems can no longer be...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-018-0832-8
更新日期:2018-04-10 00:00:00
abstract::Hypertension (especially systolic hypertension) is very common in older persons. Systolic hypertension occurs because large conduit arteries become stiffer with age. Strong evidence from randomized trials suggests that treating systolic blood pressures initially higher than 160 mm Hg is extremely beneficial, and a rec...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-009-0057-y
更新日期:2009-10-01 00:00:00
abstract::The central nervous system plays a key role in the regulation of cardiovascular function, and alterations in the central neural mechanisms that control blood pressure may underlie the vast majority of cases of primary hypertension. The well-studied baroreceptor reflex powerfully regulates arterial pressure, though its...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-003-0030-0
更新日期:2003-06-01 00:00:00
abstract:PURPOSE OF REVIEW:The renin-angiotensin system (RAS) plays an important role in modulating cardiovascular function and fluid homeostasis. While the systemic actions of the RAS are widely accepted, the role of the RAS in the brain, its regulation of cardiovascular function, and sympathetic outflow remain controversial. ...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-018-0810-1
更新日期:2018-02-26 00:00:00