Abstract:
BACKGROUND:Patients with type-2 diabetes have a high prevalence of hypertension and show an elevated incidence of cardiovascular events and nephropathy. OBJECTIVES:Recent randomized trials of antihypertensive therapy providing information about cardiovascular and renal risk in diabetes, blood pressure goals and best suitable drugs were reviewed. FINDINGS:Evidence that association of type-2 diabetes with hypertension markedly increases cardiovascular and renal risk is incontrovertible: even blood pressure values in the high-normal range represent a more relevant risk than in non-diabetics. More versus less intensive blood pressure lowering or active versus placebo treatment can significantly prevent cardiovascular and renal events, with a particularly consistent reduction of proteinuria and microalbuminuria. Although several of the trials showing significant reduction of cardiovascular or renal risk achieved diastolic blood pressure (DBP) between 75 and 82 mmHg, systolic blood pressure (SBP) 140 mmHg was never achieved in trials showing cardiovascular benefits and SBP 130 mmHg was only achieved in two trials in normotensive subjects showing proteinuria reduction. The recommendation given by all major guidelines to lower SBP 130 mmHg appears to be difficult to comply with. Evidence of the superiority or inferiority of different drug classes (angiotensin-converting enzyme inhibitors, calcium antagonists, diuretics and beta-blockers) is rather vague, especially for cardiovascular protection. As to angiotensin-receptor antagonists, losartan has shown significant cardiovascular protection over a beta-blocker, and irbesartan, although not showing cardiovascular benefits over a calcium antagonist, was significantly better in retarding renal dysfunction and failure. CONCLUSIONS:In most trials on hypertensive diabetics, the large majority of patients were on two, three and even four-drug therapy. Therefore, it appears reasonable that all effective and well tolerated antihypertensive agents can be used in association to achieve DBP 80 mmHg and, whenever possible, SBP 130 or 135 mmHg, with the regular inclusion of an angiotensin-receptor antagonist for its proven renoprotective action. Hopefully, better guidance will be provided by further trials.
journal_name
J Hypertensjournal_title
Journal of hypertensionauthors
Zanchetti A,Ruilope LMdoi
10.1097/00004872-200211000-00001subject
Has Abstractpub_date
2002-11-01 00:00:00pages
2099-110issue
11eissn
0263-6352issn
1473-5598journal_volume
20pub_type
杂志文章,评审abstract::Hypertension in children and adolescents has gained ground in cardiovascular medicine, thanks to the progress made in several areas of pathophysiological and clinical research. These guidelines represent a consensus among specialists involved in the detection and control of high blood pressure in children and adolesce...
journal_title:Journal of hypertension
pub_type: 杂志文章,实务指引
doi:10.1097/HJH.0b013e32832f4f6b
更新日期:2009-09-01 00:00:00
abstract::Adequate evaluation of automated sphygmomanometers, in terms of safety, accuracy, mechanical reliability, patient acceptability and ability to record ambulatory blood pressure is essential before these devices are used in clinical practice and in clinical trials. We have evaluated the accuracy and performance of the A...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199007000-00003
更新日期:1990-07-01 00:00:00
abstract::Noradrenergic activity was measured in the brainstem, hypothalamus and thoracic spinal cord of male and female spontaneously hypertensive (SHR) and Wistar-Kyoto (WKY) rats at 6 and 28-36 weeks of age. Two techniques were used, measurement of a major noradrenaline (NA) metabolite, free 3,4-dihydroxyphenylethyleneglycol...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198506000-00007
更新日期:1985-06-01 00:00:00
abstract:OBJECTIVE:The value of SBP during exercise and recovery period as a risk marker for sudden cardiac death (SCD) is not known. Thus, we assessed the association of SBP during recovery from exercise testing with the risk of SCD. METHODS:SBP was measured every 2 min during and at 2 min after a progressive cycle ergometer ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000066
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:Studies directly comparing the associations of intima-media thickness with blood pressure (BP) on manual sphygmomanometric blood pressure measurement (SBPM) and 24-h ambulatory blood pressure measurement (ABPM) are scarce and have a cross-sectional design. METHODS:At baseline, we measured systolic and diasto...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e328324ed6c
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVES:To review, on a genome-wide scale, a linkage result obtained in an earlier candidate gene analysis in this same study sample, and to look for other possible contributing genetic loci predisposing to hypertension in this population. DESIGN:An affected sibpair linkage study with highly polymorphic genetic mar...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200018110-00008
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE:We have previously reported that hearts from N-[omega]-nitro-L-arginine methyl ester (L-NAME)-induced hypertensive rats exhibited an enhanced expression of Gi proteins. Since, losartan, an AT1 receptor antagonist, has been shown to attenuate the L-NAME-induced increase in blood pressure, we undertook the pres...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200401000-00028
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Obstructive sleep apnea (OSA) may lead to the development of hypertension and therapy with continuous positive airway pressure (CPAP) can promote reduction in blood pressure. OBJECTIVE:The objective of this study is to review systematically the effects of CPAP on blood pressure in patients with OSA. METHOD...
journal_title:Journal of hypertension
pub_type: 杂志文章,meta分析,评审
doi:10.1097/HJH.0000000000000250
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVES:Patients with chronic renal failure are restricted to mild physical activity and tend to a lack of exercise. However, there have been few reports regarding the influence of chronic exercise on the progression of renal disease. Similarly, there are few animal models concerned with the effect of exercise train...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200110000-00024
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:Daily exposure to air-jet stress (AJS) causes sustained elevations of blood pressure in borderline hypertensive rats (BHR). It is known that the renin-angiotensin system is activated during episodes of behavioral stress, and the purpose of this study was to assess the involvement of renin-angiotensin system i...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1995-12-01 00:00:00
abstract::Hypertension is associated with thickening of the wall of resistance vessels, but the cellular or genetic basis of this is unclear. Cell proliferation and intracellular alkalinization via increased Na+/H+ exchange are linked in the response of tissues to growth factors. To define a possible cellular basis for vascular...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198906000-00006
更新日期:1989-06-01 00:00:00
abstract::Genetic factors in essential hypertension: Studies of the epidemiology of blood pressure indicate that genetic factors are part of the pathogenesis of human essential hypertension, raising the possibility of identifying these genes. This may provide unique opportunities to elucidate the pathophysiology of hypertension...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/00004872-199303000-00002
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Small size at birth and greater BMI in childhood are associated with greater brachial blood pressure (BP) in later life. Aortic (central) BP differs from brachial BP and is more predictive of organ damage and cardiovascular events; the relationship between BMI in childhood and central BP is not known. METHO...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000269
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Cardiac angiotensin AT1 receptors have been found in several animal species. In-vitro studies performed on cardiac preparations have shown that angiotensin II (ANG II) exerts a positive inotropic effect; however, in-vivo results have allowed no definitive conclusion to be drawn. The reasons behind these cont...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199715090-00013
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:The catalytic alpha and smaller beta subunits of the plasma membrane Na,K-ATPase occur in various molecular forms (alpha1, alpha2, alpha3, beta1 and beta2). The alpha isoforms of the enzyme have varying affinities for ouabain and exist in different tissues with particular distribution patterns. OBJECTIVE:To...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199816020-00003
更新日期:1998-02-01 00:00:00
abstract::Experimental models of genetic hypertension are used to develop paradigms to study human essential hypertension while removing some of the complexity inherent in the study of human subjects. Since 1991 several quantitative trait loci responsible for blood pressure regulation have been identified in various rat crosses...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/00004872-199816121-00003
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess the role of transforming growth factor (TGF)-beta1 in the development of diabetes-associated mesenteric vascular hypertrophy and in the antitrophic effect of angiotensin converting enzyme inhibitors. DESIGN AND METHODS:Streptozotocin-induced diabetic and control Spragu...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199816110-00006
更新日期:1998-11-01 00:00:00
abstract::: Altered blood pressure (BP) is a common phenomenon in acute ischemic stroke (AIS), with high BP being the most frequent scenario. The pathophysiology of BP changes in AIS is complex and only partially understood. The available evidence indicates that extremely high BP during AIS is associated with a poor outcome. Im...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001704
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:Obstructive sleep apnea (OSA) and hypertension (HYP) frequently coexist and have additive harmful effects on the cardiovascular system. There is also growing evidence that short sleep duration may contribute independently to poor cardiovascular outcome. The aim of this study was to evaluate the potential infl...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3283462e8b
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVES:Endothelial dysfunction is established in aged individuals; however, the mechanism(s) are not fully elucidated. We have previously identified l-arginine transport as a potential rate-limiting factor in nitric oxide (NO) production in heart-failure patients, characterized with endothelial dysfunction. We ther...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1097/00004872-200402000-00016
更新日期:2004-02-01 00:00:00
abstract:RATIONALE:Cicletanine (CIC), an anti-hypertensive compound with direct vascular and natriuretic actions, is especially effective in salt-sensitive hypertension, in which dysregulation of the sodium pump plays an important pathogenic role, and digitalis-like cardiotonic steroids contribute to increased vascular tone. Th...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200018020-00012
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Hypertension-induced renal injury is characterized by inflammation, fibrosis and proteinuria. Previous studies have demonstrated that N-acetyl-Ser-Asp-Lys-Pro (Ac-SDKP) inhibits renal damage following diabetes mellitus and antiglomerular basement membrane nephritis. However, its effects on low-renin hyperten...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32834103ee
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVES:Remodeling of small resistance arteries is an early sign of target organ damage in hypertension. Peripheral capillary morphology abnormalities in hypertension are not well studied. The study objective was to determine whether altered capillary morphology is associated with SBP, DBP, or both in individuals wi...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32833e113b
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that sleep-related breathing disorder (SRBD) is associated with increasing severity of cardiovascular risk markers. DESIGN:A cross-sectional study of sleep laboratory patients. SETTING:University Hospital Sleep Disorders Centre. PATIENTS:We studied 591 patients referred for a sleep s...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200104000-00004
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:In hypertensive patients, exaggerated increases in vascular resistance and arterial blood pressure have been reported on changing posture from supine to upright. In this study we tested the hypothesis that in hypertensive subjects, upright posture induces an increase in the vasoconstrictor and pressor respons...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199917010-00015
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:There is a need for an easily accessible biomarker of sympathetic nervous activation in essential hypertension, but none exists. Heart rate (HR) has been suggested, but requires validation, now doubly important as an elevated HR in hypertension has emerged as an independent cardiovascular risk factor. METHO...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002407
更新日期:2020-08-01 00:00:00
abstract::: The hypertension paradigm has contributed to a dramatic reduction in CVD mortality. This has been achieved by applying average results of population studies to identify a target population and design a common intervention to achieve a BP goal. Progressive lowering of the BP threshold has expanded the fraction of per...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002375
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:To determine whether the decision to treat uncomplicated mild hypertension with drugs, in accordance with the World Health Organization - International Society of Hypertension (WHO/ISH) guidelines based on a series of blood pressure (BP) measurements over 6 months, resulted in the treatment of patients at hig...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199917060-00014
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:The effect of brief, prehypertensive therapy by angiotensin-converting enzyme inhibition (ACEi) with perindopril on the structure and function of large arteries was studied in rats. METHODS:Spontaneously hypertensive rats (SHR) received perindopril (3 mg/kg per day) between the ages of either 6 and 10 weeks ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3283562e35
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:We report the prevalence, awareness, treatment, and control of hypertension across four Middle Eastern countries (Iran, Occupied Palestinian Territory, Saudi Arabia, and United Arab Emirates), using a standardized and uniform method. METHODS:The Prospective Urban Rural Epidemiology study enrolled participant...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001326
更新日期:2017-07-01 00:00:00