Blood pressure and angiotensin converting enzyme inhibitor use in hypertensive patients with chronic renal insufficiency.


BACKGROUND:Hypertension treatment is important in managing chronic renal insufficiency (CRI). Little is known, however, about the blood pressure (BP) control achieved or the pattern of antihypertensive drug prescription among CRI patients. METHODS:Using computerized medical records, we studied 3,089 adult hypertensive subjects treated at Brigham and Women's Hospital (Boston, MA) from 1990 through 1998. All subjects had at least two serum creatinine measurements 2 years apart, at least two BP readings, and online weight (to estimate Cockcroft-Gault creatinine clearance [CrCl]). RESULTS:The average mean arterial pressure over time (mean MAP) was 103 +/- 9 mm Hg among those with CrCI >60 mL/min, 102 t 9 mm Hg among those with CrCl 41 to 60 mL/min. and 101 +/- 9 mm Hg among those with CrCl 21 to 40 mL/min. There were no significant differences in mean MAP among the different categories of renal function in the multivariate analysis (P = .26 for trend). The proportion of patients with final systolic BP < 160 mm Hg and diastolic BP <90 mm Hg was 68% and did not vary with renal function (P = .68 for trend). The proportion of subjects who were prescribed ACE inhibitors was 38% among those with CrCl >60 mL/min, 36% among those with CrCI 41 to 60 mL/min, and only 27% among those with CrCl 21 to 40 mL/min (P = .003 for trend). CONCLUSIONS:The BP control achieved among hypertensive CRI subjects, although no worse than that among those without CRI, was found to be suboptimal. Patients with CrCl 21 to 40 mL/min were less likely to be prescribed ACE inhibitors than were those with CrCl >60 mL/min. Improvement is needed in the clinical management of these factors that can influence the progression of CRI.


Am J Hypertens


Hsu CY,Bates DW,Kuperman GJ,Curhan GC




Has Abstract


2001-12-01 00:00:00














  • Factors associated with blood pressure response to the cold pressor test: the GenSalt Study.

    abstract:BACKGROUND:Blood pressure (BP) response to the cold pressor test (CPT) has been associated with increased risk of cardiovascular disease. We studied risk factors associated with BP response to CPT. METHODS:We conducted the CPT among 2,682 individuals in rural north China. BP was measured using a standard mercury sphyg...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Zhang M,Zhao Q,Mills KT,Chen J,Li J,Cao J,Gu D,He J

    更新日期:2013-09-01 00:00:00

  • R Wave in aVL Lead is a Robust Index of Left Ventricular Hypertrophy: A Cardiac MRI Study.

    abstract:BACKGROUND:In patients free from overt cardiac disease, R wave in aVL lead (RaVL) is strongly correlated with left ventricular mass index (LVMI) assessed by transthoracic echocardiography. The aim of the present study was to extend this finding to other settings (cardiomyopathy or conduction disorders), by comparing EC...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Courand PY,Grandjean A,Charles P,Paget V,Khettab F,Bricca G,Boussel L,Lantelme P,Harbaoui B

    更新日期:2015-08-01 00:00:00

  • Lung Ultrasound-Guided Dry-Weight Reduction in Hemodialysis Patients Does Not Affect Short-Term Blood Pressure Variability.

    abstract:BACKGROUND:Increased short-term blood pressure (BP) variability (BPV) in hemodialysis is associated with increased cardiovascular and all-cause mortality. Studies on the impact of BP-lowering interventions on BPV are scarce. This study examined the effect of dry-weight reduction with a lung ultrasound-guided strategy o...

    journal_title:American journal of hypertension

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Loutradis C,Sarafidis PA,Theodorakopoulou M,Ekart R,Alexandrou ME,Pyrgidis N,Angeloudi E,Tzanis G,Toumpourleka M,Papadopoulou D,Mallamaci F,Zoccali C,Papagianni A

    更新日期:2019-07-17 00:00:00

  • Nocturnal hypertension or nondipping: which is better associated with the cardiovascular risk profile?

    abstract:BACKGROUND:Both increased night blood pressure (BP) and nondipping are associated with worse cardiovascular risk and prognosis. However, as they are often related features, their relative importance has been difficult to assess separately. In this study we address separate associations of nocturnal hypertension and non...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: de la Sierra A,Gorostidi M,Banegas JR,Segura J,de la Cruz JJ,Ruilope LM

    更新日期:2014-05-01 00:00:00

  • Differences in effects of age and blood pressure on augmentation index.

    abstract:BACKGROUND:The effect of age on the augmentation index (AI) differs between young adults and the elderly, and the AI reaches a plateau after the age of 60 years. We examined whether the effects of age and an elevation in blood pressure on the AI differ between young adults and the elderly, between subjects with and wit...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Tomiyama H,Odaira M,Kimura K,Matsumoto C,Shiina K,Eguchi K,Miyashita H,Shimada K,Yamashina A

    更新日期:2014-12-01 00:00:00

  • Comparisons of the effects of different long-acting delivery systems on the pharmacokinetics and pharmacodynamics of diltiazem.

    abstract::The benzothiazepine calcium channel antagonist diltiazem is a short-acting drug. To achieve effective 24-h blood pressure control with once-daily dosing, it relies on various extended drug-delivery systems that have grown in importance as a result of the recent reports relating the use of short-acting calcium channel ...

    journal_title:American journal of hypertension

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Smith DH,Neutel JM,Weber MA

    更新日期:1999-10-01 00:00:00

  • Hydroxyhydroquinone interferes with the chlorogenic acid-induced restoration of endothelial function in spontaneously hypertensive rats.

    abstract:BACKGROUND:Coffee is a rich source of antioxidative polyphenols, but epidemiological studies and interventional trials have failed to demonstrate any clear beneficial effects of coffee consumption on hypertension. The interaction between hydroxyhydroquinone (HHQ) and 5-caffeoylquinic acid (CQA) was examined, in an atte...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Suzuki A,Fujii A,Jokura H,Tokimitsu I,Hase T,Saito I

    更新日期:2008-01-01 00:00:00

  • Caffeine attenuates early post-exercise hypotension in middle-aged subjects.

    abstract:BACKGROUND:Sustained hypotension after an acute dynamic exercise bout is due primarily to peripheral vasodilation. We tested the hypothesis that adenosine-mediated vasodilation contributes to hypotension after exercise, by determining the effect of blocking its actions with caffeine. METHODS:Fourteen healthy middle-ag...

    journal_title:American journal of hypertension

    pub_type: 杂志文章,随机对照试验


    authors: Notarius CF,Morris BL,Floras JS

    更新日期:2006-02-01 00:00:00

  • Impact of Visit-to-Visit Variability in Systolic Blood Pressure on Cardiovascular Outcomes in Korean National Health Insurance Service-National Sample Cohort.

    abstract:BACKGROUND:Despite an association between visit-to-visit blood pressure (BP) variability (VV-BPV) and cardiovascular (CV) outcomes, many studies performed during the past 4 years have shown conflicting results. This study investigated the impact of VV-BPV on CV outcomes in the Korean National Health Insurance Service (...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Choi S,Shin J,Choi SY,Sung KC,Ihm SH,Kim KI,Kim YM

    更新日期:2017-06-01 00:00:00

  • Twenty-Five-Year Changes in Office and Ambulatory Blood Pressure: Results from the Coronary Artery Risk Development in Young Adults (CARDIA) Study.

    abstract:BACKGROUND:Blood pressure (BP) measured in the office setting increases from early through later adulthood. However, it is unknown to what extent out-of-office BP derived via ambulatory BP monitoring (ABPM) increases over time, and which participant characteristics and risk factors might contribute to these increases. ...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Bundy JD,Jaeger BC,Huffman MD,Knox SS,Thomas SJ,Shimbo D,Booth Iii JN,Lewis CE,Edwards LJ,Schwartz JE,Muntner P

    更新日期:2020-11-17 00:00:00

  • Angiotensin II type 1 receptor polymorphisms in the cardiovascular health study: relation to blood pressure, ethnicity, and cardiovascular events.

    abstract:BACKGROUND:The angiotensin II type 1 receptor A1166C polymorphism has been associated with increased risks of hypertension and myocardial infarction in several small studies. We examined the association between this polymorphism and new-onset hypertension, blood pressure (BP) control, and incident cardiovascular events...

    journal_title:American journal of hypertension

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Hindorff LA,Heckbert SR,Tracy R,Tang Z,Psaty BM,Edwards KL,Siscovick DS,Kronmal RA,Nazar-Stewart V

    更新日期:2002-12-01 00:00:00

  • Reexamining the quality of life of hypertensive patients. A new self-structured measure.

    abstract::This study included the introduction of a new, qualitative, self-structured measure of quality of life (QOL) after meta-analysis had shown that prestructured quantitative measures yielded insignificant results. This study compared the pre- and post-treatment evaluations of 268 men with mild hypertension, aged 40 to 65...

    journal_title:American journal of hypertension

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Bar-On D,Amir M

    更新日期:1993-03-01 00:00:00

  • How should we treat hypertensive women with cardiac and renal impairment?

    abstract::Arterial hypertension is the most common chronic medical condition requiring office visits to physicians and is a major contributing factor to the development of myocardial infarction and stroke. Its importance as a cardiovascular risk factor is at least as significant in women as in men; however, the ever-growing lit...

    journal_title:American journal of hypertension

    pub_type: 杂志文章,评审


    authors: Ruilope LM,Suarez C

    更新日期:1997-10-01 00:00:00

  • Interdependence of blood pressure and heart period regulation in mild hypertension.

    abstract::Blood pressure and heart period variability have been measured directly in 142 subjects with mild hypertension over 24 h. The variabilities have been expressed as the standard deviation of 2 min averages of all beats over 24 h. Baroreflex sensitivity was assessed in 102 subjects by the phenylephrine method. Blood pres...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Coats AJ,Conway J,Sleight P,Meyer TE,Somers VK,Floras JS,Vann Jones J

    更新日期:1991-03-01 00:00:00

  • Lipoxygenase-derived metabolites are regulators of peroxisome proliferator-activated receptor gamma-2 expression in human vascular smooth muscle cells.

    abstract:BACKGROUND:Peroxisome proliferator-activated receptor-gamma (PPAR-gamma) is a member of the nuclear receptor family that has been implicated in cell differentiation and proliferation, glucose metabolism, macrophage development, and inflammatory responses. PPAR-gamma can be activated by a range of synthetic substances a...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Limor R,Sharon O,Knoll E,Many A,Weisinger G,Stern N

    更新日期:2008-02-01 00:00:00

  • Erythrocyte Na-K-Cl cotransport activity in low renin essential hypertensive patients. A 23Na nuclear magnetic resonance study.

    abstract::The Na-K-Cl cotransport activity in red blood cells from essential hypertensive men with low (n = 8, mean age 42 +/- 4 years) or normal renin activity (n = 4, mean age 43 +/- 3 years), and in normotensive men with normal renin activity (n = 7, mean age 38 +/- 4 years) has been evaluated by means of a recently develope...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Cacciafesta M,Ferri C,Carlomagno A,De Angelis C,Scuteri A,Guidoni L,Luciani AM,Rosi A,Viti V,Santucci A

    更新日期:1994-02-01 00:00:00

  • The association of nephrolithiasis with hypertension and obesity: a review.

    abstract::Kidney stones affect hypertensive patients disproportionately compared to normotensive individuals. On the other hand, some prospective data suggest that a history of nephrolithiasis was associated with a greater tendency to develop hypertension. Newer epidemiologic data also link obesity and diabetes, features of the...

    journal_title:American journal of hypertension

    pub_type: 杂志文章,评审


    authors: Obligado SH,Goldfarb DS

    更新日期:2008-03-01 00:00:00

  • Higher cholesterol and insulin levels in pregnancy are associated with increased risk for pregnancy-induced hypertension.

    abstract::Hyperinsulinemia and dyslipidemia are known to be associated with essential hypertension but their role in pregnancy-induced hypertension remains unclear. We performed a case-control study comparing cholesterol, insulin, and glucose levels in the early third trimester of pregnancy among 31 women who developed pregnanc...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Solomon CG,Carroll JS,Okamura K,Graves SW,Seely EW

    更新日期:1999-03-01 00:00:00

  • Chronic adrenergic receptor blockade does not prevent hyperinsulinemia-induced hypertension in rats.

    abstract::Increased adrenergic activity has been suggested to mediate the hypertension associated with hyperinsulinemia. This study tested whether combined alpha1- and beta-adrenergic receptor blockade would prevent insulin-induced hypertension when euglycemia was maintained by continuous intravenous glucose infusion. Sprague-D...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Keen HL,Brands MW,Alonso-Galicia M,Hall JE

    更新日期:1996-12-01 00:00:00

  • Atrial Dilatation Development in Hypertensive Treated Patients: The Campania-Salute Network.

    abstract:BACKGROUND:Left atrial (LA) dilatation is associated with unfavorable outcome in hypertension. However, there are few data on clinical, demographic, and echocardiographic findings correlated with LA dilatation development. METHODS:From the Campania-Salute Network registry, we identified 5,375 hypertensive patients (52...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Losi MA,Izzo R,Canciello G,Giamundo A,Manzi MV,Strisciuglio T,Stabile E,De Luca N,de Simone G,Trimarco B

    更新日期:2016-09-01 00:00:00

  • Unsweetening the Heart: Possible Pleiotropic Effects of SGLT2 Inhibitors on Cardio and Cerebrovascular Alterations in Resistant Hypertensive Subjects.

    abstract::Resistant hypertension (RH) is a multifactorial disease associated with several target organ damage, such as microalbuminuria, left ventricular hypertrophy, and arterial stiffness. These subjects have high cardiovascular complications, especially when associated with diabetes condition. Sodium glucose cotransporter 2 ...

    journal_title:American journal of hypertension

    pub_type: 杂志文章,评审


    authors: Pioli MR,Ritter AMV,Modolo R

    更新日期:2018-02-09 00:00:00

  • Immunosuppression improves blood pressure and endothelial function in a rat model of pregnancy-induced hypertension.

    abstract:BACKGROUND:Hypertensive disorders of pregnancy, including preeclampsia (PE), affect approximately 7-10% of pregnancies in the US. Clinical and experimental studies strongly suggest that the maternal immune system plays a role in the development of these disorders; however, few therapeutic options exist aside from deliv...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Tinsley JH,Chiasson VL,South S,Mahajan A,Mitchell BM

    更新日期:2009-10-01 00:00:00

  • Altered stores of atrial natriuretic peptide in specific brain nuclei of NaCl-sensitive spontaneously hypertensive rats.

    abstract::Previous studies from our laboratories have demonstrated a selective increase in stores of atrial natriuretic peptide (ANP) in the anterior hypothalamus of NaCl-sensitive spontaneously hypertensive rats (SHR-S) compared to NaCl-resistant Wistar-Kyoto (WKY) controls and have suggested that anterior hypothalamic ANP con...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Jin HK,Yang RH,Chen YF,Wyss JM,Oparil S

    更新日期:1991-05-01 00:00:00

  • Effects of aging and hypertension on plasma angiotensin II and platelet angiotensin II receptor density.

    abstract::Plasma renin activity (PRA) declines with age in normal individuals, but the effect of age on plasma angiotensin II (ANG II) is less clear. A decline in plasma ANG II with age could result in altered platelet ANG II receptor density since plasma hormone levels influence their target organ receptors. To investigate thi...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Duggan J,Kilfeather S,O'Brien E,O'Malley K,Nussberger J

    更新日期:1992-10-01 00:00:00

  • Dietary Sodium Modifies Serum Uric Acid Concentrations in Humans.

    abstract:BACKGROUND:Subjects with hypertension are frequently obese or insulin resistant, both conditions in which hyperuricemia is common. Obese and insulin-resistant subjects are also known to have blood pressure that is more sensitive to changes in dietary sodium intake. Whether hyperuricemia is a resulting consequence, mode...

    journal_title:American journal of hypertension

    pub_type: 杂志文章,随机对照试验


    authors: Todd AS,Walker RJ,MacGinley RJ,Kelly J,Merriman TR,Major TJ,Johnson RJ

    更新日期:2017-11-06 00:00:00

  • Patient Barriers and Facilitators to Ambulatory and Home Blood Pressure Monitoring: A Qualitative Study.

    abstract:BACKGROUND:Guidelines recommend that patients with newly elevated office blood pressure undergo ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM) to rule-out white coat hypertension before being diagnosed with hypertension. We explored patients' perspectives of the barriers and facili...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Carter EJ,Moise N,Alcántara C,Sullivan AM,Kronish IM

    更新日期:2018-07-16 00:00:00

  • Moderate waist circumference and hypertension prevalence: the REGARDS Study.

    abstract:BACKGROUND:High waist circumference (WC) (women: >88 cm; men: >102 cm) increases cardiovascular risk. Less is known about moderate WC (women: 80-88 cm; men: 94-102 cm). Therefore, we examined the association between moderate WC and hypertension prevalence, independent of body mass index (BMI). METHODS:Among 24,247 eli...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Levine DA,Calhoun DA,Prineas RJ,Cushman M,Howard VJ,Howard G

    更新日期:2011-04-01 00:00:00

  • Diurnal blood pressure variation in kidney-pancreas transplant recipients.

    abstract::Blood pressure normally follows a characteristic pattern throughout the 24 h cycle with daytime pressures higher than nighttime pressures. Patients lacking a nocturnal decrease in pressure have a higher incidence of end organ damage. This investigation was designed to characterize the diurnal pattern of blood pressure...

    journal_title:American journal of hypertension

    pub_type: 临床试验,杂志文章


    authors: Marx MA,Gardner SF,Ketel BL

    更新日期:1996-08-01 00:00:00

  • Impact of spironolactone on vascular, myocardial, and functional parameters in untreated patients with a hypertensive response to exercise.

    abstract:BACKGROUND:Although a hypertensive response to exercise (HRE) is associated with cardiac risk and masked hypertension (MHT), its mechanisms and appropriate treatment remain unclear. We investigated spironolactone as a treatment for abnormal vascular and myocardial stiffness in HRE. METHODS:In this randomized, double-b...

    journal_title:American journal of hypertension

    pub_type: 杂志文章,随机对照试验


    authors: Hare JL,Sharman JE,Leano R,Jenkins C,Wright L,Marwick TH

    更新日期:2013-05-01 00:00:00

  • Prevention of high salt diet-induced cardiac hypertrophy and fibrosis by spironolactone.

    abstract:BACKGROUND:High salt diet causes cardiac hypertrophy and fibrosis and increases cardiac aldosterone, while decreasing plasma aldosterone. The present study assessed, in Wistar rats, the effect of high salt diet on left and right ventricle (LV and RV, respectively) weight and fibrosis both with and without the aldostero...

    journal_title:American journal of hypertension

    pub_type: 杂志文章


    authors: Lal A,Veinot JP,Leenen FH

    更新日期:2003-04-01 00:00:00