Abstract:
:How chlorthalidone (CTDN) reduces risk for cardiovascular events (CVEs) can be considered in light of its ability to lower blood pressure (BP) and its non-BP related, pleiotropic effects. The mechanism by which CTDN lowers BP is unclear but may include alterations in whole body regulation and vasodilatory actions on vasculature, possibly mediated via its inhibitory effects on carbonic anhydrase. Additionally, CTDN has potentially beneficial, non-BP related, pleiotropic effects that include improvements in endothelial function, anti-platelet activity, and oxidative status. CTDN reduces pulse wave velocity, predictor of CVEs and a measure of central aortic stiffness associated with endothelial dysfunction. On the other hand, CTDN fosters hypokalemia, hyperglycemia, sympathetic discharge, and the renin-angiotensin-aldosterone system, but these potentially harmful effects do not appear to materially reduce CTDN's ability to prevent CVEs. Further, CTDN reduces and regresses left ventricular hypertrophy (LVH), an important BP-dependent predictor of CVEs. Consistent with this finding, CTDN was more effective than amlodipine in reducing congestive heart failure (CHF) in the Anti-hypertensive and Lipid-lowering Treatment to Prevent Heart Attach Trial (ALLHAT). In reducing CVEs, CTDN was superior to lisinopril in ALLHAT and superior to hydrochlorthiazide in observational cohort analyses and in network analyses of randomized trials. A statistical synthesis of randomized trials suggests that the reduction in cardiovascular risk from CTDN can be explained primarily on the basis of its ability to lower blood pressure rather than its influence upon non-BP related, pleiotropic effects.
journal_name
Curr Hypertens Repjournal_title
Current hypertension reportsauthors
Roush GC,Buddharaju V,Ernst ME,Holford TRdoi
10.1007/s11906-013-0372-1subject
Has Abstractpub_date
2013-10-01 00:00:00pages
514-21issue
5eissn
1522-6417issn
1534-3111journal_volume
15pub_type
杂志文章,评审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:PURPOSE OF REVIEW:To review the current literature on use of telehealth at different stages of the hypertension control cascade in sub-Saharan Africa (SSA) and to discuss opportunities to harness technology infrastructure in SSA to improve population-level blood pressure control. RECENT FINDINGS:Despite the high burde...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-019-0983-2
更新日期:2019-08-26 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::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::Recent guidelines for the treatment of hypertension place great emphasis on tighter blood pressure control, especially in the presence of hypertensive target organ damage and diabetes. In order to achieve these treatment targets, more patients will require a combination of antihypertensive medications. However, resist...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-001-0039-1
更新日期:2001-06-01 00:00:00
abstract::The publication of the Antihypertensive and Lipid-lowering Treatment to Prevent Heart Attack Trial (ALLHAT) results, when used in conjunction with a new meta-analysis, provides hypertension research with a watershed. Data demonstrate clearly that lowering blood pressure is the most important aspect of hypertension man...
journal_title:Current hypertension reports
pub_type: 杂志文章,meta分析
doi:10.1007/s11906-003-0044-7
更新日期:2003-08-01 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:PURPOSE OF REVIEW:To review data supporting the use of home blood pressure monitoring (HBPM) and provide practical guidance to clinicians wishing to incorporate HBPM into their practice. RECENT FINDINGS:HBPM more accurately reflects the risk of cardiovascular events than office blood pressure measurement. In addition,...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-019-0916-0
更新日期:2019-02-12 00:00:00
abstract:PURPOSE OF REVIEW:To estimate the impact of the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines for high blood pressure (BP) on the next hypertension guidelines in Asia. RECENT FINDINGS:The 2017 ACC/AHA guidelines for high BP in adults changed the diagnostic threshold and the manage...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-019-0906-2
更新日期:2019-01-10 00:00:00
abstract::Renal sympathetic efferent and afferent nerves, which lie within and immediately adjacent to the wall of the renal arteries, contribute to the maintenance of hypertension. Because the causative factors of hypertension change over time, denervation of both efferent and afferent renal nerves should result in long-term a...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-010-0108-4
更新日期:2010-06-01 00:00:00
abstract::Essential hypertension is associated with impaired endothelium-dependent vasodilation and is caused mainly by production of oxygen free radicals that can destroy nitric oxide (NO), impairing its beneficial and protective effects on the vessel wall. Antihypertensive drugs can improve or restore endothelium-dependent va...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-000-0061-8
更新日期:2000-02-01 00:00:00
abstract:PURPOSE OF REVIEW:To review the most recent literature on current strategies for the treatment of hypertension associated with pediatric obesity. RECENT FINDINGS:Over the last three decades, childhood and adolescent overweight and obesity prevalence in the USA has continued to rise. Unsurprisingly but rather disturbin...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-019-0922-2
更新日期:2019-02-12 00:00:00
abstract:PURPOSE OF REVIEW:This study aims to systematically review existing evidence on the effectiveness of mobile health technology (mHealth) interventions in addressing medication adherence among people with hypertension. RECENT FINDINGS:Twenty-one studies of mHealth interventions were included in the final review after sy...
journal_title:Current hypertension reports
pub_type: 杂志文章
doi:10.1007/s11906-018-0886-7
更新日期:2018-08-07 00:00:00
abstract:PURPOSE OF REVIEW:There is an established association between hypertension and increased risk of poor cognitive performance and dementia including Alzheimer's disease; however, associations between antihypertensive medications (AHMs) and dementia risk are less consistent. An increased interest in AHM has resulted in ex...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-016-0674-1
更新日期:2016-08-01 00:00:00
abstract:PURPOSE OF REVIEW:To evaluate recent developments in the management of hypertension in obese pregnant women. RECENT FINDINGS:The mainstay of management targets prevention of hypertension with preconception counselling, entering pregnancy with a lower BMI, limiting weight gain, and taking low-dose aspirin to prevent pr...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-019-0927-x
更新日期:2019-03-26 00:00:00
abstract::Young hypertensive adults demonstrate decreased performance on neurocognitive testing compared with that of normotensive controls. There is emerging, preliminary evidence that children with hypertension also manifest cognitive differences when compared to normotensive controls. These preliminary studies consist mostly...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-014-0508-y
更新日期:2015-01-01 00:00:00
abstract::Cardiovascular disease is the leading cause of death in women and claims the lives of more than half a million women every year. Hypertension is one of the most prevalent and powerful contributors to atherosclerotic cardiovascular disease. Hypertension affects more men than women until 55 years of age, but after age 5...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-000-0083-2
更新日期:2000-04-01 00:00:00
abstract::Current national guidelines recommend aggressive lowering of blood pressure (< 130/80 mm Hg) in patients with chronic kidney disease (CKD). In this paper, we summarize recent clinical trial data evaluating the effect of lower blood pressure goals on renal outcomes. The epidemiologic data relating blood pressure to pro...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-005-0072-6
更新日期:2005-10-01 00:00:00
abstract:PURPOSE OF REVIEW:This review sought to evaluate the role of exercise in patients with obesity and comorbid hypertension, with a focus on contemporary literature (since January 2015). RECENT FINDINGS:No reviews have included patients classified with both obesity and hypertension and there is a paucity of randomised co...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-020-01087-5
更新日期:2020-09-03 00:00:00
abstract::Hypertension is the leading risk factor for the global burden of disease, yet more than 20% of adults with hypertension are unaware of their condition. Underlying hypertension affects over 25% emergency department attendees, and the condition is more commonly encountered in emergency departments than in primary care s...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-016-0647-4
更新日期:2016-04-01 00:00:00
abstract:PURPOSE OF REVIEW:The pathophysiology of preeclampsia is complex and not entirely understood. A key feature in preeclampsia development is an immunological imbalance that shifts the maternal immune response from one of tolerance towards one promoting chronic inflammation and endothelial dysfunction. As a key regulator ...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-018-0833-7
更新日期:2018-04-30 00:00:00
abstract::Resistant hypertension is a common and growing clinical problem characterized by failure to achieve target blood pressure levels despite adequate use of at least three antihypertensive agents. Although numerous safe and effective pharmacologic therapies are available to treat elevated blood pressure, novel therapeutic...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-010-0119-1
更新日期:2010-08-01 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::Sympathetic nerve activity is involved in the pathogenesis of salt-sensitive hypertension. The central nervous system, which regulates sympathetic nerve activity and blood pressure, plays a pivotal role. Central sympathoexcitation is deeply involved in the pathogenesis of salt-sensitive hypertension, although the prec...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-015-0620-7
更新日期:2016-02-01 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::Hypertension is an established risk factor for stroke, premature coronary artery disease and heart failure. Control of elevated blood pressure has been shown to result in significant reduction of cardiovascular risk. Aldosterone, the final product of the renin-angiotensin-aldosterone system (RAAS), not only causes sal...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-013-0379-7
更新日期:2013-10-01 00:00:00
abstract::Resistant hypertension is defined as blood pressure that remains uncontrolled despite using at least three antihypertensive medications in effective doses, ideally including a diuretic. Stricter blood pressure goals, higher obesity rates, older age, and increased use of certain exogenous substances are related to an i...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-007-0066-7
更新日期:2007-11-01 00:00:00
abstract::There is increasing concern that sugar consumption may be linked to the development of metabolic and cardiovascular diseases. There is indeed strong evidence that consumption of energy-dense sugary beverages and foods is associated with increased energy intake and body weight gain over time. It is further proposed tha...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-016-0652-7
更新日期:2016-06-01 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::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 ...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-004-0068-7
更新日期:2004-06-01 00:00:00