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 RECENT FINDINGS:Outdated understanding of haemodynamics based on previous measurement systems can no longer be applied to our understanding of the circulation. We question the current view of hypertension as defined by a predominantly systolic blood pressure and introduce the concept of vasogenic, cardiogenic and mixed-origin hypertension. We postulate that failure to identify the individual's haemodynamic pattern may lead to the use of inappropriate medication, which in turn may be a major factor in patient non-compliance with therapeutic strategies. A population-based approach to treatment of hypertension may lead to suboptimal functional dynamics in the individual patient. Finally, we question the validity of current guidelines and published evidence relating morbidity and mortality to the future treatment of hypertension. The importance of individual haemodynamic profiles may be pivotal in the understanding, diagnosis and treatment of hypertension if optimal control with minimal adverse effects is to be achieved. Research based on individual haemodynamic patterns is overdue.
journal_name
Curr Hypertens Repjournal_title
Current hypertension reportsauthors
Smith BE,Madigan VMdoi
10.1007/s11906-018-0832-8subject
Has Abstractpub_date
2018-04-10 00:00:00pages
29issue
4eissn
1522-6417issn
1534-3111pii
10.1007/s11906-018-0832-8journal_volume
20pub_type
杂志文章,评审abstract::This review attempts to highlight the potential of calcium-channel blockers in the prevention of sequelae of diabetes mellitus and hypertension in patients who have both disorders. Evidence-based medicine is driven by the results of randomized, clinical trials. Major contributions were therefore derived from post hoc ...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-999-0025-6
更新日期:1999-06-01 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::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::High-quality medical care requires implementing evidence-based best practices, with continued monitoring to improve performance. Implementation science is beginning to identify approaches to developing, implementing, and evaluating quality improvement strategies across health care systems that lead to good outcomes fo...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-008-0038-6
更新日期:2008-06-01 00:00:00
abstract::The nitric oxide (NO)-cyclic guanosine monophosphate (cGMP) signaling system is a well-characterized modulator of cardiovascular function, in general, and blood pressure, in particular. The availability of mice mutant for key enzymes in the NO-cGMP signaling system facilitated the identification of interactions with o...
journal_title:Current hypertension reports
pub_type: 杂志文章
doi:10.1007/s11906-012-0320-5
更新日期:2013-02-01 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::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::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
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::Decreased endothelial nitric oxide (NO) bioavailability as it relates to endothelial dysfunction plays an important role in various cardiovascular disorders, including athero-sclerosis. Recent research has provided evidence that endothelial dysfunction in atherosclerosis is not primarily caused by decreased endothelia...
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 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::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::The ubiquitin-proteasome system (UPS) is a major proteolytic system that regulates the degradation of intracellular proteins in the heart. The UPS regulates the turnover of misfolded and damaged proteins, in addition to numerous cellular processes, by affecting the stability of short-lived proteins such as transcripti...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-009-0069-7
更新日期:2009-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this meta-analysis is to compare the effects of moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) on blood pressure of hypertensive individuals. RECENT FINDINGS:Continuous aerobic training programs are successful in health promotion and are effec...
journal_title:Current hypertension reports
pub_type: 杂志文章,meta分析
doi:10.1007/s11906-020-1030-z
更新日期:2020-03-03 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::Primary aldosteronism (PA) is a common cause of arterial hypertension: in the PA Prevalence in Hypertensives (PAPY) Study, the prevalence of PA was 11.2% in consecutive referred hypertensive patients. When adrenal vein sampling (AVS) is available, two thirds of the cases can be attributed to a tumor and one third of c...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-010-0134-2
更新日期:2010-10-01 00:00:00
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 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::Diabetic nephropathy and hypertension are the major causes of chronic kidney disease. The renin system plays a key role in the control of blood pressure (BP), as well as in the regulation of renal and adrenal function. Chronic activation of the renin system can lead to organ damage, particularly renal damage; increasi...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-007-0076-5
更新日期:2007-11-01 00:00:00
abstract::We are used to thinking of angiotensin (Ang) II as a regulatory hormone that stimulates constriction of vascular smooth muscle cells, aldosterone release from the adrenal gland, and sodium reabsorption in the renal tubule. We have also become accustomed to understanding that Ang II may be formed and may act locally as...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-001-0082-y
更新日期:2001-02-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide insight into the mechanisms underlying cerebral pathophysiology and to highlight possible methods for evaluation, screening, and surveillance of cerebral complications in preeclampsia. RECENT FINDINGS:The pathophysiology of eclampsia remains enigmatic. Animal studies show that the cerebral...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-019-0977-0
更新日期:2019-08-02 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::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: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::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::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:PURPOSE OF REVIEW:Renal sympathetic denervation (RDN) as treatment option for hypertension has a strong rationale; however, variable effects on blood pressure (BP) have been reported ranging from non-response to marked reductions in BP. The absence of a procedural end point for RDN is one of the potential factors assoc...
journal_title:Current hypertension reports
pub_type: 杂志文章,评审
doi:10.1007/s11906-018-0821-y
更新日期:2018-03-19 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::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::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