Abstract:
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.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Hsu CY,Bates DW,Kuperman GJ,Curhan GCdoi
10.1016/s0895-7061(01)02202-6subject
Has Abstractpub_date
2001-12-01 00:00:00pages
1219-25issue
12eissn
0895-7061issn
1941-7225pii
S0895706101022026journal_volume
14pub_type
杂志文章abstract:BACKGROUND:Hypertension is the leading global preventable risk factor for premature death. While hypertension prevalence has been declining in high-income countries, it has increased continuously in low- and middle-income countries. METHODS:We conducted a cross-sectional survey in 7,524 women and men aged 35-74 years ...
journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1093/ajh/hpw092
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Endothelial progenitor cells (EPCs) provide paracrine support to the vascular endothelium and may also replace damaged or senescent endothelial cells. Low numbers of endothelial progenitor colony-forming units (CFU-ECs) in culture are a predictive biomarker of vascular disease. We hypothesized that the numbe...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.101
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:The renal resistive index (RI) measured using Doppler ultrasonography has been used as a diagnostic tool in the daily work-up of kidney diseases. A better understanding of its relationship with preclinical organ damage may help in determining overall cardiovascular risk in hypertensive patients. METHODS:We ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2012.113
更新日期:2012-12-01 00:00:00
abstract::This double-blind placebo controlled study investigated the antihypertensive and humoral effects of nifedipine capsules in patients with essential hypertension inadequately controlled (seated diastolic blood pressure greater than or equal to 95 mm Hg) by hydrochlorothiazide (HCTZ) alone. Nifedipine acutely (first dose...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1093/ajh/2.11.828
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:Hypertension is the most prevalent chronic disease worldwide. Lifestyle behaviors for its prevention and control are recommended within worldwide guidelines. Nevertheless, their combined relationship with blood pressure (BP) level, particularly in the general population, would need more investigations. Our a...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpu164
更新日期:2015-03-01 00:00:00
abstract::To examine the effects of hypertension on renal graft function, we studied the clinical course of 144 kidney transplant recipients who had functioning grafts for three to 13 years. The patients were divided into three groups: normotensive (n = 32), controlled hypertensive (n = 49) and uncontrolled hypertensive group (...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/2.5.341
更新日期:1989-05-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(02)02967-9
更新日期:2002-09-01 00:00:00
abstract::Antihypertensive drugs are often initiated and adjusted over a period of weeks to months. It is not clear whether the time and inconvenience of this approach is necessary. We studied whether or not drug adjustment over several days in the context of a physician-nurse team could produce a durable blood pressure benefit...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(00)01273-5
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Essential hypertension ranks among the strongest cardiovascular risk factors. Cytokine production by monocytes plays a key role in atherosclerosis development and acute coronary syndromes. We investigated whether stimulated monocyte cytokine release and its inhibition by glucocorticoids would differ between ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2004.01.010
更新日期:2004-06-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2004.08.008
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Ionized magnesium levels are elevated in fetal blood compared with maternal blood, suggesting that the placenta may possess an active transport mechanism for magnesium. In the present study, we sought to determine the existence of an active transport mechanism for magnesium in the placenta using cultured tro...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(02)02272-0
更新日期:2002-06-01 00:00:00
abstract::Hypertensive renal injury is a major identifiable cause of end-stage renal disease in African-Americans. A complex nexus of sociologic, biologic, environmental, and sociocultural variables are involved in mediating this risk and interrelate with dietary salt consumption and salt sensitivity. It is likely that dietary ...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/0895-7061(95)00048-T
更新日期:1995-06-01 00:00:00
abstract::Sodium ions markedly decreased in vitro renal alpha 2-adrenoceptor affinity for epinephrine in Sabra hypertensive (SBH) but not in normotensive (SBN) rats. Under these conditions, affinity of alpha 1-adrenoceptor for epinephrine was unchanged in SBH and SBN rats. If these data could be confirmed in vivo, the sodium io...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.3.267
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:The GTPase Rac1 has been implicated in hypertension as a modulator of mineralocorticoid receptor activity. Our aim is to investigate the frequency of polymorphisms rs10951982 (intron 1, G>A) and rs836478 (intron 3, T>C) in the RAC1 gene and perform association studies with clinical and biochemical parameters...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpt277
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Determinants of exercise capacity have not been clearly defined in hypertensive patients. Doppler tissue imaging (DTI), a recently developed echocardiographic modality, is useful for evaluating left ventricular (LV) function regardless of loading conditions. The present study was performed to identify the de...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(03)00842-2
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:The relationship between regular physical activity, measured objectively and by self-report, and the circadian pattern of 24-hour ambulatory arterial blood pressure (BP) has not been clarified. METHODS:We performed a cross-sectional study in a cohort of healthy patients. We included 1,345 patients from the ...
journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1093/ajh/hpt159
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers (CCBs) increase arterial compliance and decrease left ventricular mass in hypertensive patients. This study examined whether combined therapy has greater arterial and cardiac effects than doubled doses of the individual drugs. METHO...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.amjhyper.2003.08.002
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Recent studies have shown that tamoxifen, which belongs to a group called selective estrogen receptor modulators (SERM), may exert protective effects against cardiovascular diseases and stroke in postmenopausal women. On the other hand, abnormalities in physical properties of the cell membranes may underlie ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.02.009
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Feeding stroke-prone spontaneously hypertensive rats (SHRSP) a diet rich in fructose results in a profound glucose intolerance not observed in the normotensive Wistar Kyoto (WKY) strain. The aim of this study was to investigate the role of the liver in the underlying mechanisms in the SHRSP. METHODS:SHRSP a...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2008.41
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Matrix Gla protein (MGP) is a vascular calcification inhibitor dependent upon vitamin K for activation. Evidence suggests that elevated plasma inactive MGP levels (desphospho-uncarboxylated MGP, dp-ucMGP; indicating poorer vascular vitamin K status) are associated with greater cardiovascular disease (CVD) ri...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpy049
更新日期:2018-05-07 00:00:00
abstract::The goal of this study was to investigate the activity of the Na+/H+ exchanger in erythrocytes of patients with essential hypertension and its relation with urinary Na+ excretion. The study was performed in cells from 27 untreated hypertensive patients and 30 normotensive controls with similar age and sex distribution...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(94)00172-8
更新日期:1995-02-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/6.4.302
更新日期:1993-04-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa011
更新日期:2020-04-29 00:00:00
abstract:BACKGROUND:Carvedilol is known to be an adrenoreceptor blocker and free radical scavenger, used in hypertension and cardiac failure. However, its therapeutic actions cannot be fully explained by these mechanisms. In these studies, we tested the hypothesis that carvedilol action is associated with the synthesis/release ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.11.011
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Aldosterone acts to restrain the extracellular potassium (K+) concentration. Blacks have on average lower plasma aldosterone concentrations (PACs) than Whites. Whether this ethnic difference is associated with similar changes in the concentration of K+ is unclear. METHODS:Subjects were Blacks and Whites fro...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpx006
更新日期:2017-05-01 00:00:00
abstract::Evidence is presented that bradykinin inhibits norepinephrine efflux from sympathetic nerves innervating canine mesenteric and pulmonary arteries, in part, by releasing endothelium-derived relaxing factor (EDRF) from the vascular endothelium. Moreover, in the absence of vascular endothelium, bradykinin also inhibits n...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.5.464
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:Angiotensin-converting enzyme inhibitors are the drugs of choice in renal hypertension. The efficacy and safety of ramipril in adults has been proved; however, data on effectiveness of ramipril in children are few. The aim of the present study was to investigate the effect of ramipril on blood pressure (BP) ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2004.01.008
更新日期:2004-05-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/1.1.91
更新日期:1988-01-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.211
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:The "nondipping" pattern (NDP) of blood pressure, characterized by the absence of the reduction in blood pressure (BP) that typically takes place during the night time, has been associated with elevated cardiovascular morbidity, including stroke, myocardial infarction, and sudden cardiac-related death. In va...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.252
更新日期:2010-03-01 00:00:00