Abstract:
:Diagnosis of resistant hypertension (RH) is currently based upon awake-time office blood pressure (BP). An increasing number of studies have documented abnormally elevated sleep-time BP in most RH patients, indicating that diagnosis of true RH cannot be determined solely by comparison of office BP with either patient awake-time BP self-measurements or awake-BP mean from ambulatory monitoring (ABPM), as is customary in the published literature. Moreover, the ABPM-determined sleep-time BP mean is an independent and stronger predictor of cardiovascular and cerebrovascular disease (CVD) risk than either daytime office/ABPM-derived awake or 24-hour means. Results of the recently completed MAPEC (Monitorización Ambulatoria para Predicción de Eventos Cardiovasculares) prospective outcomes study, which included a large cohort of RH patients, established that time of treatment relative to circadian rhythms constituted a critically important yet often neglected variable with respect to BP control. The study found that bedtime versus morning ingestion of the full dose of ≥1 BP-lowering medications resulted in both better therapeutic normalization of sleep-time BP and reduced CVD morbidity and mortality, including in RH patients. Accordingly, ABPM is highly recommended to properly diagnose and manage true RH, with a bedtime hypertension medication regimen as the therapeutic scheme of choice.
journal_name
Curr Hypertens Repjournal_title
Current hypertension reportsauthors
Hermida RC,Ayala DE,Ríos MT,Fernández JR,Mojón A,Smolensky MHdoi
10.1007/s11906-014-0445-9subject
Has Abstractpub_date
2014-07-01 00:00:00pages
445issue
7eissn
1522-6417issn
1534-3111journal_volume
16pub_type
杂志文章,评审abstract::LCZ696 is a single molecule which combines the angiotensin receptor blocker valsartan with the neprilysn inhibitor sacubitril (AHU377). In the recently published PARADIGM-HF trial, LCZ696 proved superior to enalapril in reducing overall mortality, heart failure hospitalizations, and other endpoints in patients with sy...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-015-0548-y
更新日期:2015-05-01 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 RECENT FINDINGS:Outdated understanding of haemodynamics based on previous measurement systems can no longer be...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::The post-macula densa segments of the renal tubule--that is, the distal convoluted tubule, connecting tubule, and collecting duct--play a central role in determining final urine sodium excretion. The major regulated sodium transporters and channels in these cell types include the thiazide-sensitive (Na-Cl) cotransport...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-006-0013-z
更新日期:2006-05-01 00:00:00
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 v...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-013-0372-1
更新日期:2013-10-01 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::Endothelin receptor antagonists (ERAs) have the potential to be a new paradigm in the treatment of chronic kidney disease (CKD). ERAs inhibit the effects of endothelin-1 (ET-1), which is known to promote CKD by causing renal cellular injury, proteinuria, inflammation, fibrosis, and hypertrophy. ERAs have been extensiv...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-015-0568-7
更新日期:2015-07-01 00:00:00
abstract::Hypertension and high serum cholesterol levels are two of the most relevant risk factors for cardiovascular diseases. A combined increase in both risk factors has been reported in a significant proportion of patients with coronary artery disease. Statins are the most widely used drugs to treat hypercholesterolemia, an...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-001-0090-y
更新日期:2001-08-01 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::Obstructive sleep apnea is a common disorder that is often unrecognized and underappreciated. Emerging evidence suggests that there is a causal link between obstructive sleep apnea and hypertension. This relationship appears to be independent of other comorbidities that have been previously linked to hypertension, suc...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-003-0083-0
更新日期:2003-10-01 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: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 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::The discovery of angiotensin-converting enzyme (ACE) 2 adds a new level of complexity to the understanding of the renin-angiotensin system. The high catalytic efficiency of ACE2 for the generation of angiotensin (ANG)-1-7 from ANG II suggests an important role of ACE2 in preventing ANG II accumulation, while at the sa...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-008-0014-1
更新日期:2008-02-01 00:00:00
abstract::Hypertension and obesity are two closely related pathologies in clinical practice. Currently, about one billion adults worldwide are overweight, and it is estimated that, if no serious action is taken to effect profound change, that figure will continue to rise throughout this century. Hypertension is also a serious p...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-014-0438-8
更新日期:2014-07-01 00:00:00
abstract::Prorenin and renin bind to a 350-amino acid protein called the (pro)renin receptor, which is present on the surface and functions intracellularly. When the receptor's N terminus binds either prorenin or renin, intracellular signaling occurs via extracellular-regulated kinases, which can result in plasminogen activator...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-008-0075-1
更新日期:2008-10-01 00:00:00
abstract::In the quest for "evidence-based" medicine, an accepted hierarchy of evidence has been proposed. This hierarchy places in vitro studies and animal data at the base, and puts systematic reviews, meta-analyses, and randomized controlled trials at the pinnacle. However, when clinical medicine faces questions that have no...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-006-0054-3
更新日期:2006-06-01 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
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::Obstructive sleep apnea (OSA) is a prevalent sleep disorder which is characterized by recurrent upper closure with oxygen desaturation and sleep disruption. OSA increases the risk of vascular disorders in the form of stroke, myocardial infarction, congestive heart failure, and hypertension. The mechanisms underlying t...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-014-0482-4
更新日期:2014-10-01 00:00:00
abstract::The prevalence of the metabolic syndrome (MetS) has increased rapidly in North America in recent years. Presently, the MetS is found in 34.3% of the population, and the prevalence is likely to continue to increase in parallel with the obesity epidemic. Losing weight and long-term maintenance of the weight loss are pri...
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::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::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::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::This review is focused on the interplay between two major factors affecting the vascular tree in diabetes, insulin resistance, and hyperglycemia. The implications for vascular function, structure, and the interaction between vascular cells and other tissues by which they are affected under these conditions are reviewe...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-004-0082-9
更新日期:2004-04-01 00:00:00
abstract:PURPOSE OF REVIEW:This is a review of available data on the effects of blood pressure and statins on cognition. RECENT FINDINGS:Recent randomized clinical trials have shown that intensive control of systolic blood pressure in older adults prevented the development of mild cognitive impairment (MCI) and the combined ef...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-019-0973-4
更新日期:2019-07-26 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::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:PURPOSE OF REVIEW:This meta-analysis and systematic review was conducted to evaluate the effect of probiotics on blood pressure, body mass index (BMI), and blood glucose changes in patients with hypertension. RECENT FINDINGS:We searched the PubMed, Cochrane, Embase, and ProQuest databases using a combination of MeSH a...
journal_title:Current hypertension reports
pub_type: 杂志文章,meta分析
doi:10.1007/s11906-020-01042-4
更新日期:2020-03-21 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 adverse cardiovascular consequences of high blood pressure (BP) not only depend on absolute BP values, but also on BP variability (BPV). Evidence has been provided that independently of mean BP levels, BP variations in the short- and long-term are associated with the development, progression and severity of cardia...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-012-0290-7
更新日期:2012-10-01 00:00:00