Abstract:
:Peak-systolic blood pressure (SBP) and end-diastolic blood pressure (DBP) have been considered the exclusive mechanical factors predicting cardiovascular (CV) risk in populations of normotensive and hypertensive subjects. The purpose of this review is to show that in addition to SBP and DBP, other hemodynamic indices that have particular relevance for coronary complications and originate from pulse pressure (PP) should be taken into account, namely brachial PP and, potentially, heart rate (HR). In normotensive and hypertensive populations, increased PP is an independent predictor for myocardial infarction, more powerful than SBP, even in hypertensive subjects under successful antihypertensive drug therapy. Increased HR is an additional CV risk factor, acting particularly through the presence of an enhanced PP x HR product. Such findings, observed during a period in which standard antihypertensive agents are known to reduce SBP and PP to a much lesser extent than DBP, require the development of intervention trials using drugs acting specifically on SBP, PP, and arterial stiffness.
journal_name
Curr Hypertens Repjournal_title
Current hypertension reportsauthors
Safar MEdoi
10.1007/s11906-004-0068-7keywords:
subject
Has Abstractpub_date
2004-06-01 00:00:00pages
190-4issue
3eissn
1522-6417issn
1534-3111journal_volume
6pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:The major health issue of being overweight or obese relates to the development of hypertension, insulin resistance and diabetic complications. One of the major underlying factors influencing the elevated blood pressure in obesity is increased activity of the sympathetic nerves to particular organs suc...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-017-0750-1
更新日期:2017-07-01 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::Diabetes mellitus is one of the leading causes of end-stage renal disease. The pathogenesis of diabetic nephropathy is still poorly understood, but glomerular injury has been ascribed, at least in part, to glomerular hyperfiltration, which occurs early in the course of diabetes mellitus. Therefore, a better understand...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-005-0089-x
更新日期:2005-04-01 00:00:00
abstract::Obesity is recognized as a major health problem throughout the world. Excess weight is a major cause of increased blood pressure in most patients with essential hypertension and greatly increases the risk for diabetes, cardiovascular diseases, and end-stage renal disease. Although the mechanisms by which obesity raise...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-009-0036-3
更新日期:2009-06-01 00:00:00
abstract::The seventeenth century London neuroanatomical school headed by Thomas Willis published the first images of the sympathetic nervous system. Nineteenth century European physiologists characterised these as the "pressor nerves". Von Euler's demonstration that the sympathetic transmitter was norepinephrine brought the fi...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-014-0519-8
更新日期:2015-02-01 00:00:00
abstract::It is widely accepted that the pathophysiology of hypertension involves autonomic nervous system dysfunction, as well as a multitude of immune responses. However, the close interplay of these systems in the development and establishment of high blood pressure and its associated pathophysiology remains elusive and is t...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-013-0361-4
更新日期:2013-08-01 00:00:00
abstract::Over the last few decades, there has been increasing emphasis on cardiovascular disease in women and study of female-specific cardiovascular risk factors. Hypertension in pregnancy, and specifically preeclampsia, has been identified as one such risk factor. In this review, we explore the epidemiological evidence for p...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-014-0472-6
更新日期:2014-09-01 00:00:00
abstract::Excess weight gain is a major cause of essential hypertension, and abnormal kidney function appears to be a cause as well as a consequence of obesity hypertension. Excess renal sodium reabsorption and a hypertensive shift of pressure natriuresis play a major role in mediating increased blood pressure associated with w...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-000-0073-4
更新日期:2000-04-01 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::The kidneys play a central role in the long-term regulation of blood pressure and in the pathogenesis of hypertension. A common defect that has been found in all forms of hypertension examined to date is a hypertensive shift in the pressure-natriuresis relationship. A major objective of this brief review is to highlig...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-006-0068-x
更新日期:2006-08-01 00:00:00
abstract::Atherosclerotic cardiovascular disease (CVD) is the most common cause of death worldwide. Usually atherosclerosis is caused by the combined effects of multiple risk factors. For this reason, most guidelines on the prevention of CVD stress the assessment of total CVD risk. The most intensive risk factor modification ca...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-010-0143-1
更新日期:2010-10-01 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::The metabolic syndrome leads to cardiovascular disease and type 2 diabetes mellitus, through multiple risks, such as insulin resistance, dyslipidemia, hyperinsulinemia, and hypertension. It also represents a disorder of partial genetic background as mutations of the peroxisome proliferator-activated receptor-gamma (PP...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-005-0019-y
更新日期:2005-08-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this meta-analysis was to compare the magnitude of systematic bias (mean difference) and random error (standard deviation of mean difference) between the cuff method of indirect blood pressure and directly measured intra-arterial pressure. RECENT FINDINGS:Blood pressure is almost exclu...
journal_title:Current hypertension reports
pub_type: 杂志文章,meta分析
doi:10.1007/s11906-019-0929-8
更新日期:2019-02-07 00:00:00
abstract::With current immunosuppression, elevated blood pressure is found in almost 90% of renal graft recipients. Major causes of this are impairment of renal function (secondary to chronic allograft nephropathy or less frequently recurrence of primary renal disease), the use of calcineurin inhibitors as immunosuppressants, u...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-001-0063-1
更新日期:2001-10-01 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:PURPOSE OF REVIEW:The overactive renin-angiotensin-aldosterone system (RAAS) plays an important part in many pathologic conditions including hypertension, heart failure, and renal disease. Hyperkalemia, a potentially life-threatening side effect of RAAS inhibitors, limits their use. The recent introduction of new hyper...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-016-0663-4
更新日期:2016-07-01 00:00:00
abstract::Aldosterone antagonists have been highly successful in treating congestive heart failure and resistant hypertension. Until recently, therapies targeting the mineralocorticoid receptor in chronic kidney disease (CKD) have received little attention, largely because of the risk of hyperkalemia and the incorrect assumptio...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-011-0202-2
更新日期:2011-08-01 00:00:00
abstract::With the cut-off point between "normal" and "high" blood pressure (BP) being pushed increasingly downward, especially for patients with multiple cardiovascular risk factors, most hypertensives need more than one antihypertensive agent to reach their target BP. In this article, we examine the rationale for combining dr...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-004-0020-x
更新日期:2004-08-01 00:00:00
abstract::The various antihypertensive regimens have varying effects on glucose metabolism and the development of diabetes mellitus. Recent large hypertension trials have shown great differences in the development of new-onset diabetes among antihypertensive drug therapies. The incidence of diabetes is unchanged or increased by...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-005-0029-9
更新日期:2005-08-01 00:00:00
abstract::Antiplatelet agents represent a cornerstone in the management of patients at increased cardiovascular risk. Essential hypertension is considered a major public health problem leading to increased cardiovascular morbidity and mortality. The majority of patients with essential hypertension exhibit also additional cardio...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-015-0536-2
更新日期:2015-04-01 00:00:00
abstract::Elevation of blood pressure (BP) and the risk for progression to hypertension (HTN) is of increasing concern in children and adolescents. Indeed, it is increasingly recognized that target organ injury may begin with even low levels of BP elevation. Sodium intake has long been recognized as a modifiable risk factor for...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-013-0382-z
更新日期:2013-10-01 00:00:00
abstract::Na+,K+-ATPase distributes ions between the intracellular and extracellular space and is responsible for total-body sodium homeostasis. The activity of this ion pump is regulated by catecholamines and peptide hormones; by the ligand of Na+,K+-ATPase, ouabain; and by direct interaction with cytoskeleton proteins. This r...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-001-0032-8
更新日期:2001-04-01 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 presence of renin production by the principal cells of the collecting duct has opened new perspectives for the regulation of intrarenal angiotensin II (Ang II). Angiotensinogen (AGT) and angiotensin-converting enzyme (ACE) are present in the tubular fluid coming from the proximal tubule and collecting duct. All th...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-017-0763-9
更新日期:2017-08-01 00:00:00
abstract::Inflammation plays an important role in the pathogenesis of hypertension. Innate and adaptive immune response may contribute to this process. The mechanisms implicating immune response in hypertension are still elusive. To date, the evidence originates in three major areas of data: cytokine production, central nervous...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-011-0224-9
更新日期:2011-12-01 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
abstract::Important new advances have occurred in our understanding and approach to management of high blood pressure in the elderly. New clinical trials have re-emphasized the risk of development of cardiovascular and cerebrovascular complications associated with isolated elevations in systolic blood pressure as well as the sa...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-996-0039-2
更新日期:2000-12-01 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