Abstract:
:Diabetes mellitus (DM)-linked metabolic alterations and hypertension concomitantly accelerate or precipitate cerebrovascular and coronary heart disease, nephropathy, retinopathy and widespread macroangiopathy, thereby conferring to diabetic patients a very high risk of morbidity, disability and early death. Therefore, the long-term care for diabetic patients should be aimed at concomitant metabolic and blood pressure (BP) control. Dietary measures are indispensable; a high fibre, low fat, low salt diet is recommended, complemented with caloric restriction and physical exercise when body weight is above the ideal. Antidiabetic pharmacotherapy involves an unresolved dilemma. The desired achievement of euglycemia necessitates effective levels of insulin, but hyperinsulinemia (due to parenteral [over]treatment in insulin-dependent DM) is suspected to promote atherogenesis and represents a coronary risk factor and perhaps even facilitates hypertension. Considering antihypertensive pharmacotherapy, thiazide-type or loop diuretics are problematic drugs in DM because they can aggravate metabolic alterations. These agents also seem to exert only a limited preventive or regressive effect on left ventricular hypertrophy (LVH); beta-blockers are also not considered ideal, since they decrease the awareness of hypoglycemia and tend to promote glucose intolerance. Unselective beta-blockers in particular promote peripheral ischemia and insulin-induced hypoglycemia, while beta-blockers without intrinsic sympathomimetic activity lower serum HDL-cholesterol. Calcium antagonists and ACE inhibitors have equivalent antihypertensive efficacy, do not impair carbohydrate and lipid homeostasis or peripheral perfusion and can effectively improve LVH. Certain ACE inhibitors may even slightly ameliorate abnormal insulin sensitivity and plasma glucose levels. While alpha-blockers share most of these desirable properties, these agents are more prone to precipitate orthostatic hypotension in the diabetic patient. The non-thiazide diuretic indapamide and the serotonin2-antagonist ketanserin also combine antihypertensive efficacy with metabolic neutrality. The ultimate goal of therapy is to improve life prognosis. In essential hypertension, conventional drug treatment based on diuretics in high dosage satisfactorily reduced cerebrovascular but not coronary complications or sudden death. In diabetic patients, the influence of antihypertensive therapy on prognosis has not been assessed prospectively. Based on retrospective analyses, Warram et al reported a 3.8 times higher mortality in diabetics treated with diuretics alone, than in diabetics with untreated hypertension (Arch Intern Med. 1991;151:1350). H. H. Parving calculated that effective BP control in patients with diabetic nephropathy might reduce 10 year-mortality from about 65 to 20 percent (J Hypertension. 1990; 8[Suppl 7]:187).(ABSTRACT TRUNCATED AT 400 WORDS)
journal_name
J Hum Hypertensjournal_title
Journal of human hypertensionauthors
Weidmann P,Boehlen LM,de Courten M,Ferrari Psubject
Has Abstractpub_date
1992-12-01 00:00:00pages
S23-36eissn
0950-9240issn
1476-5527journal_volume
6 Suppl 2pub_type
杂志文章,评审abstract::High dietary salt is a major contributor to increased blood pressure, the leading risk for death worldwide. In several countries, national programmes to reduce dietary salt have been implemented with leadership and involvement of hypertension experts. Other hypertension experts may be interested in assisting or leadin...
journal_title:Journal of human hypertension
pub_type: 杂志文章,评审
doi:10.1038/jhh.2011.25
更新日期:2011-12-01 00:00:00
abstract::Haemorrhagic diathesis develops in chronic renal failure, in which calcium antagonists are used widely as antihypertensive agents. Although calcium antagonists are reported to impair platelet function, it has not been examined whether calcium antagonists alter bleeding time. The present study was conducted to clarify ...
journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1038/sj.jhh.1001327
更新日期:2002-03-01 00:00:00
abstract::A blood pressure recording is strictly speaking only relevant for the circumstances under which it is measured. There is increasing evidence that ambulatory recordings have more predictive power than casual BP recordings and are a better discriminator between high and low risk groups of patients, particularly within t...
journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1990-10-01 00:00:00
abstract::We compared haemodynamic and humoral responses to nifedipine and nilvadipine in 25 elderly hypertensives. The study had a single-blind crossover design. Doppler flowmetry and laboratory examinations were performed before and after nifedipine and nilvadipine. Both nifedipine and nilvadipine significantly reduced mean a...
journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract::The cholesterol:phospholipid ratio was measured in platelet plasma membrane, red blood cell (RBC) membranes, low density lipoprotein (LDL) and whole plasma in patients with primary hypertension and in matched normal controls. The cholesterol:phospholipid ratio was raised in the platelet membrane from hypertensive pati...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1990-06-01 00:00:00
abstract::To assess the suitability of therapy with an angiotensin-converting enzyme inhibitor for older hypertensives, a randomised double blind two group comparison of enalapril (10 to 40 mg daily) with hydrochlorothiazide (25 to 100 mg daily) was carried out in 32 untreated and independently living subjects aged 63 to 82 yea...
journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1989-04-01 00:00:00
abstract::Hypertension is an easily diagnosed and eminently modifiable risk factor for the development of all clinical manifestations of atherosclerosis. Despite the availability of a simple, non-invasive, and rather accurate method of measuring blood pressure (BP), and overwhelming evidence that reducing BP effectively prevent...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/sj.jhh.1001686
更新日期:2004-08-01 00:00:00
abstract::Footshocks increases mean arterial pressure and heart rate. Systemic or intracerebroventricular (IVT) administration of losartan, a specific angiotensin AT1 receptor antagonist, not only inhibited the pressor response to footshocks but resulted in vasodepression. Peripheral or IVT administration of PD 123319, a specif...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/sj.jhh.1000986
更新日期:2000-04-01 00:00:00
abstract::Mild to moderate hypertension is usually asymptomatic and therefore the impact on quality of life and side-effects of the antihypertensive treatment can have a negative effect on treatment compliance. A number of comparative studies have addressed quality of life issues with various antihypertensive agents, and the re...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract::Coronary heart disease (CHD) is still relatively uncommon in the black population of South Africa. We embarked on a study to determine the prevalence of risk factors leading to CHD in the black population of Durban. The study sample was selected from patients attending a dental clinic at a hospital. A total of 458 Zul...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract::Psychosocial work environments may adversely influence blood pressure, but the benefits of altering these factors and introducing coping resources is unclear. We examined whether changing work stressors and coping resources affect the risk of hypertension and elevated BP. A total of 13,145 workers from the Occupationa...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/jhh.2016.79
更新日期:2017-05-01 00:00:00
abstract::Hypertension (HTN) is an important cause for chronic kidney disease (CKD). There is a paucity of studies exploring the association of HTN with CKD from rural India. The objective of the study was to determine the prevalence and the determinants for HTN in a rural population in South India, focusing on the association ...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/jhh.2016.81
更新日期:2017-05-01 00:00:00
abstract::The use of heart rate in clinical practice is limited by its variability under measurement situations. The mean heart rate on ambulatory monitoring provides a more robust statistic for clinical use. We examined the relationship between mean heart rate on initial referral ambulatory blood pressure monitoring (ABPM) to ...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/sj.jhh.1000586
更新日期:1998-04-01 00:00:00
abstract::The interactions of intrarenal dopamine (DA) synthesis and natriuresis were studied in 11 healthy volunteers by giving a low and high sodium diet (LoSo, 50 mmol Na+; HiSo, 250 mmol Na+). On 2 days in both dietary phases an acute saline load was given, without or with an infusion of the DA precursor 3, 4-dihydroxypheny...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract::Early exercise engagement elicits meaningful changes in peripheral blood pressure in patients diagnosed with transient ischaemic attack (TIA) or minor stroke. However, central hemodynamic markers may provide clinicians with important diagnostic and prognostic information beyond that provided by peripheral blood pressu...
journal_title:Journal of human hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1038/jhh.2016.72
更新日期:2017-03-01 00:00:00
abstract::Disturbed sympathetic and also parasympathetic activity of the autonomic nervous system points to pathological alterations in the cardiovascular system. Untreated hypertensive subjects were examined with respect to the question of whether an increase in sympathetic activity necessarily goes along with a reduction in p...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/sj.jhh.1001671
更新日期:2004-05-01 00:00:00
abstract::The effects of propranolol and diltiazem on left ventricular systolic and diastolic function in hypertensive subjects (DBP 90-114 mmHg) were examined with M-mode and 2D echocardiograms in 21 patients in a double-blind fashion prior to and after 4 months of treatment. Systolic function was assessed by measurement of fr...
journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1990-12-01 00:00:00
abstract::Evidence from the medical literature is reviewed to indicate that ambulatory monitoring of blood pressure (ABPM) is a better predictor of target organ damage and clinical outcome in the hypertensive patient than clinic measurements of blood pressure (BP). A re-analysis of the documented BPs from the placebo limb of th...
journal_title:Journal of human hypertension
pub_type: 杂志文章,评审
doi:
更新日期:1995-06-01 00:00:00
abstract::Erythrocyte Na/K flux ratio was examined in relation to a family history of essential hypertension (FH-HT) and plasma and urine electrolytes in 84 normotensive children (13-15 yrs old), and in relation to sodium intake in six children with acute glomerulonephritis or IgA nephropathy who had normal renal function (6-13...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract::We examined the association between serum lipoprotein subclasses and the three measures of arterial stiffness, that is, (i) carotid-femoral pulse wave velocity (cfPWV), which is a gold standard measure of central arterial stiffness, (ii) brachial-ankle PWV (baPWV), which is emerging as a combined measure of central an...
journal_title:Journal of human hypertension
pub_type: 杂志文章,多中心研究
doi:10.1038/jhh.2013.60
更新日期:2014-02-01 00:00:00
abstract::A forty-two year old woman presented with hypertension, trembling, sweating, visual impairment, headache and weight loss. A right adrenal phaeochromocytoma was diagnosed. The tumour could not be resected because it encircled the inferior vena cava. She was treated at first with phenoxybenzamine and propranolol and lat...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1989-04-01 00:00:00
abstract::The aim of the present longitudinal study was to describe determinants of blood pressure (BP) and echocardiographically calculated left ventricular mass in adolescents with a variable risk of future hypertension. BP was measured and M-mode echocardiography was performed in 52 children, 29 male and 23 female, at a mean...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract::To identify the prevalence and magnitude of clinic changes in blood pressure and determine their effects on the diagnosis and treatment of hypertension, 268 patients with a BP greater than or equal to 160/95 mmHg on three consecutive occasions (twice in the general practitioner's surgery and once in the hospital clini...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1990-10-01 00:00:00
abstract::The Chinese Hypertension Intervention Efficacy Study (CHIEF) is a multi-centre randomized controlled clinical trial comparing the effects of amlodipine+angiotensin II receptor blocker and amlodipine+diuretics on the incidence of cardiovascular events, represented as a composite of non-fatal stroke, non-fatal myocardia...
journal_title:Journal of human hypertension
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1038/jhh.2010.45
更新日期:2011-04-01 00:00:00
abstract::The divergence in cardiovascular disease risk among Asian countries may be related to differences in economics, lifestyles, and cultural backgrounds. We examined the differential association of overweight and hypertension between the high- and middle-income Asian countries, namely Japan and Thailand and extended to co...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/s41371-018-0118-2
更新日期:2019-02-01 00:00:00
abstract::Since endothelin production is stimulated in vitro by insulin, we performed this study to evaluate in vivo the relationships between endothelin and insulin plasma levels during a glucose load. We studied 28 subjects; 17 with normal glucose tolerance (NGT) and 11 with impaired glucose tolerance (IGT). Ten of the subjec...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/sj.jhh.1000386
更新日期:1997-01-01 00:00:00
abstract::We have investigated 59 patients with mild-to-moderate uncomplicated essential hypertension in order to estimate whether salt sensitivity is associated with greater urinary albumin excretion. Patients whose average mean blood pressure (BP) value on day 5 of the high-sodium regimen (300 mmol/l NaCl) exceeded 10 mm Hg o...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
abstract::Consistent reports indicate that hypertension is a particularly common finding in black populations. Hypertension occurs at younger ages and is often more severe in terms of blood pressure levels and organ damage than in whites, resulting in a higher incidence of cardiovascular disease and mortality. This review provi...
journal_title:Journal of human hypertension
pub_type: 杂志文章,评审
doi:10.1038/jhh.2017.18
更新日期:2017-08-01 00:00:00
abstract::Calcium plays a central role in maintaining vascular tone. Recent studies indicate that there are continuous relationships between systemic calcium metabolism and BP, as over the whole range of normal and raised BPs there is an inverse correlation between plasma ionised calcium concentration and BP. Twenty-two subject...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1989-08-01 00:00:00
abstract::Microalbuminuria (urinary albumin excretion equal to 30-300 mg/24 h) is a reliable indicator of premature cardiovascular mortality in diabetic patients and in the general population. In insulin-dependent and non-insulin-dependent diabetes mellitus microalbuminuria is a marker of initial diabetic nephropathy and predic...
journal_title:Journal of human hypertension
pub_type: 杂志文章,评审
doi:10.1038/sj.jhh.1001348
更新日期:2002-03-01 00:00:00