Abstract:
:Young and middle-aged adults (ages ≤50 years) are increasingly prone to stroke, kidney disease, and worsening cardiovascular disease (CVD) mortality. An alarming increase in the prevalence of high blood pressure (BP) may underlie the adverse trend. However, there is often uncertainty in BP management for young and middle-aged adults. Isolated systolic hypertension (ISH) is one such example. Whether ISH in young and middle-aged adults represents "pseudo" or "spurious" hypertension is still being debated. ISH in young and middle-aged adults is a heterogeneous entity; some individuals appear to have increased stroke volume, whereas others have stiffened aortae, or both. One size does not seem to fit all in the clinical management of ISH in young and middle-aged adults. Rather than treating ISH as a monolithic condition, detailed phenotyping of ISH based on (patho)physiology and in the context of individual global cardiovascular risks would seem to be most useful to assess an individual expected net benefit from therapy. This review provides an overview of the current understanding of ISH in young and middle-aged adults, including the prevalence, pathophysiology, and treatment.
journal_name
Curr Hypertens Repjournal_title
Current hypertension reportsauthors
Yano Y,Lloyd-Jones DMdoi
10.1007/s11906-016-0686-xsubject
Has Abstractpub_date
2016-11-01 00:00:00pages
78issue
11eissn
1522-6417issn
1534-3111pii
10.1007/s11906-016-0686-xjournal_volume
18pub_type
杂志文章,评审abstract::Vascular changes associated with elevated blood pressure may precede the clinical diagnosis of hypertension. Even after the diagnosis is made, associated coronary heart disease and renal disease continue to progress, despite adequate blood pressure control. Early treatment of blood pressure may reduce the incidence of...
journal_title:Current hypertension reports
pub_type: 临床试验,杂志文章,评审
doi:10.1007/s11906-000-0038-7
更新日期:2000-08-01 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:PURPOSE OF REVIEW:Use of antihypertensives in older adults can be complicated by the potential for undesired effects on comorbidities, adverse effects of the drugs, and overall medication burden. The purpose of this two-part review is to discuss contemporary issues encountered in the management of hypertension in aged ...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-019-0988-x
更新日期:2019-10-10 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::There are many drug studies for the treatment of hypertension. Most studies compare one drug with another to determine if a drug or class of drugs have unique benefits. In evaluating drug trials, separation of hypertension as compared with atherosclerotic events is important. Trials that focus on prevention of hyperte...
journal_title:Current hypertension reports
pub_type: 杂志文章
doi:10.1007/s11906-999-0046-1
更新日期:1999-08-01 00:00:00
abstract::Recent studies have identified key gender differences in cardiovascular function, renal hemodynamics, and the renin-angiotensin system. Extensive epidemiologic evidence has shown a clear gender difference in cardiovascular and renal disease progression, whereby female sex appears to be protective. The mechanisms under...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-002-0039-9
更新日期:2002-04-01 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: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::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 ...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-014-0445-9
更新日期:2014-07-01 00:00:00
abstract:PURPOSE OF REVIEW:To review the latest reports of the contributions of the endothelial mineralocorticoid receptor to endothelial dysfunction and hypertension to begin to determine the clinical potential for this pathway for hypertension treatment. RECENT FINDINGS:Endothelial mineralocorticoid receptor expression is se...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-019-0981-4
更新日期:2019-09-04 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::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::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: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: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 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
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::The sodium pump, an ancestral enzyme with conserved ability to bind ouabain, plays a key role in salt conservation and is regulated by aldosterone and endogenous ouabain (EO). Plasma EO is elevated in about 45% of patients with essential hypertension and correlates with blood pressure. The relationship of EO with Na(+...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-010-0161-z
更新日期:2011-02-01 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::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: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::Epinephrine is the prototypical stress hormone. Its stimulation of all α and β adrenergic receptors elicits short-term systolic hypertension, hyperglycemia, and other aspects of the metabolic syndrome. Acute epinephrine infusion increases cardiac output and induces insulin resistance, but removal of the adrenal medull...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-011-0243-6
更新日期:2012-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Mechanisms facilitating progression of hypertension via cross stimulation of the renin-angiotensin system (RAS) and inflammation have been proposed. Accordingly, we review and update evidence for regulation of RAS components by pro-inflammatory factors. RECENT FINDINGS:Angiotensin II (Ang II), which ...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-018-0900-0
更新日期:2018-10-05 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: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::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::Blood pressure is typically lower in premenopausal women than in men. However, after menopause, the prevalence of hypertension in women is higher than it is in men. Hypertension is a major risk factor for cardiovascular disease in women and men, but cardiovascular disease is the leading cause of death in women. Furthe...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-012-0260-0
更新日期:2012-06-01 00:00:00
abstract::The renal pressure-natriuresis mechanism is the dominant controller of body fluid balance and long-term arterial pressure. In recent years, it has become clear that the balance of reactive oxygen and nitrogen species within the renal medullary region is a key determinant of the set point of the renal pressure-natriure...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-010-0094-6
更新日期:2010-04-01 00:00:00
abstract::Individuals with hypertension need to stay on therapy with antihypertensive medication to obtain the full benefits of blood pressure reduction. There are important differences in tolerability across antihypertensive drug classes, and these differences influence the extent to which patients are willing to continue taki...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-002-0021-6
更新日期:2002-12-01 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