Abstract:
OBJECTIVES:Advanced diabetic nephropathy (DN) is characterized by a marked development of cardiovascular and renal disease. These patients are frequently managed by different health professionals with the consequence that the quality of care may differ substantially. To compare the management of cardiovascular risk factors in patients with type 2 DN and an estimated glomerular filtration rate (GFR) of 15-60 ml/min per 1.73 m2 followed in nephrology, diabetology and primary care. METHODS:This multicentre cross-sectional study verified the control of blood pressure (BP), total cholesterol, triglycerides, glycosylated haemoglobin A1c (HbA1c) and haemoglobin in patients exclusively followed in either nephrology (n = 266), diabetology (n = 246) or primary care (n = 195) of the same metropolitan area for at least 1 year. RESULTS:Primary care patients were older and had a greater prevalence of previous cardiovascular events. The GFR was lower in nephrology than in diabetology and primary care (33 +/- 13 versus 47 +/- 9 and 40 +/- 12 ml/min per 1.73 m2, P < 0.0001). The prevalence of BP target (< 130/80 mmHg) was similarly low in nephrology, diabetology and primary care (14, 13 and 10%, P = 0.421) probably because of insufficient prescription of diuretics and low-salt diet. Whereas the prevalence of the triglycerides target was similar, that of total cholesterol (< 200 mg/dl) was larger in diabetology (63%) than in nephrology and primary care (59 and 46%, P = 0.003) because of greater statin prescription in hypercholesterolemic individuals (70, 50 and 41%, respectively, P = 0.002). The attainment of HbA1c less than 7% was less frequent in diabetology (32%) than in nephrology and primary care (61 and 46%, P = 0.0003) despite a more frequent prescription of insulin/oral agents in diabetology. The control of anaemia was better in diabetology. Multivariate analysis adjusted for the patient case-mix and physician-level clustering confirmed these differences except for anaemia. CONCLUSION:Patients with advanced DN, despite the worst renal and cardiovascular prognosis, are at high risk of being under-treated independently of the type of clinical setting.
journal_name
J Hypertensjournal_title
Journal of hypertensionauthors
Minutolo R,Sasso FC,Chiodini P,Cianciaruso B,Carbonara O,Zamboli P,Tirino G,Pota A,Torella R,Conte G,De Nicola Ldoi
10.1097/01.hjh.0000239303.93872.31subject
Has Abstractpub_date
2006-08-01 00:00:00pages
1655-61issue
8eissn
0263-6352issn
1473-5598pii
00004872-200608000-00027journal_volume
24pub_type
杂志文章,多中心研究abstract:OBJECTIVE:The pteridine cofactor tetrahydrobiopterin (BH4) has emerged as a critical determinant of endothelial nitric oxide synthase (eNOS) activity. When BH4 availability is limited, eNOS does not produce nitric oxide (NO) but instead generates superoxide. BH4 may reverse endothelial dysfunction due to cardiovascular...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000173520.13976.7d
更新日期:2005-07-01 00:00:00
abstract::To establish the role of angiotensin converting enzyme inhibitors in the management of hypertension in the elderly, 16 patients were treated with captopril in a randomized double-blind placebo-controlled cross-over study. Clinic blood pressure, ambulatory blood pressure, renal function and mental performance, with emp...
journal_title:Journal of 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:OBJECTIVE:Urinary excretion of angiotensinogen [urine angiotensinogen (UAGT)] has been proposed as a biomarker of intrarenal renin-angiotensin system activity. We investigated the association between UAGT and salt-sensitivity and potassium-sensitivity of blood pressure (BP) among Genetic Epidemiology Network of Salt Se...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000564
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:Traditional cardiovascular risk factors do not fully account for ethnic differences in cardiovascular disease. We tested if arterial function indices, particularly augmentation index (AIx), and their determinants from childhood could underlie such ethnic variability among young British adults in the 'DASH' lo...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001066
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Hypertension is a complex trait with an ill-defined genetic predisposition, in which adrenergic mechanisms seem to be involved even at the early stages. Chromogranin A is a pro-hormone stored and released with catecholamines by exocytosis; its fragment catestatin, formed in vivo, inhibits further catecholami...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1097/00004872-200207000-00020
更新日期:2002-07-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:Blood pressure variability (BPV) within 24 h or between visits has been found to represent an independent risk factor for cardiovascular disease. The present study was aimed at determining whether a clinical significance can be given also to the BP variations occurring within a single clinica...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000700
更新日期:2015-11-01 00:00:00
abstract::Arterial aging is associated with a progressive increase in aortic stiffening, which results in a rise in central aortic pressures. Traditionally, blood pressure (BP)-lowering therapy has been directed at brachial rather than central pressures. However, a key contemporary question is whether this strategy is optimal i...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/HJH.0b013e328353e523
更新日期:2012-06-01 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::To evaluate factors influencing hemodynamic responses to psychological and physical stress, 117 normotensive college students were studied. The standardized tests included arithmetic, Stroop word-color, mirror draw, isometric handgrip and cold pressor challenges. The responses of blood pressure and pulse during the te...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1097/00004872-199010000-00012
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:To examine the associations among hypertension, insulin secretion, glucose tolerance and insulin resistance in vivo. DESIGN:Glucose tolerance and insulin secretion during an intravenous glucose tolerance test and action of insulin on whole-body glucose kinetics in the post-absorptive state and during hyperin...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199816030-00014
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:We assessed hypertension prevalence, blood pressure (BP)-lowering treatment and control in obese adults compared with lean/normal-weight individuals in France. METHODS:Multistage stratified random sample of 2075 adults from the French Nutrition and Health Survey (ENNS), a cross-sectional national survey carr...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3283593010
更新日期:2012-12-01 00:00:00
abstract::The effects on serum ionized calcium (ICa) and pH of different storage conditions of blood or serum, and of physiological influences such as over-ventilation, food intake and dietary sodium intake have been investigated. Temperature and time-related changes in ICa occurred with storage and were minimized by immediate ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1987-08-01 00:00:00
abstract::To elucidate whether a difference exists in blood pressure (BP) elevation during isometric handgrip exercise (IHG) between essential hypertensives (EHT) and normotensives (NT), IHG was carried out in 12 NT and 46 EHT under constant sodium intake using a new instrument. The acute effects of propranolol and prazosin on ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198706000-00007
更新日期:1987-06-01 00:00:00
abstract::Blood pressure, plethysmographically determined muscle blood flow in the calf at rest and during maximal dilatation, plasma renin activity, angiotensin II and plasma and urinary aldosterone were determined in normotensive men with a positive family history of hypertension (n = 17) and in an age- and weight-matched con...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1984-06-01 00:00:00
abstract:OBJECTIVE:We hypothesized that downregulation of the antioxidant thioredoxin system contributes to oxidative stress in angiotensin II-induced hypertension. As oestrogen may protect against oxidative stress, we also evaluated whether the thioredoxin system, particularly in the heart, is differentially regulated between ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3280acac60
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVES:To examine a possible relationship between baseline albuminuria and effect of losartan versus atenolol on cardiovascular (CV) events in hypertensive patients with left ventricular hypertrophy, the effect of losartan versus atenolol on albuminuria, and whether the benefits of losartan versus atenolol could be...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004872-200409000-00026
更新日期:2004-09-01 00:00:00
abstract::Recently, there has been an explosion of knowledge on vasopressin, including its neuro-anatomy, biochemistry and physiology. Recent work demonstrates extensive extra-hypothalamic vasopressinergic projections from the SON and PVN. Of particular importance are projections to the cardiovascular medullary centres. Convers...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/00004872-198512000-00001
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVES:To explore the association of different types of blood pressure (BP) variability measures estimated from either short-term ambulatory reading-to-reading or long-term clinic visit-to-visit BP records with long-term survival in an elderly treated hypertensive population. METHODS:A subset of patients (n = 508)...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001652
更新日期:2018-05-01 00:00:00
abstract::Cardiovascular risk increases with chronological as well as biological aging, and one marker of this might be telomere length. The telomere cap is located at the end of the DNA helix and serves to protect its end. This is an evolutionary adaptation which has resulted in stabilization of the DNA strand within the chrom...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/HJH.0b013e328353e512
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVES:To compare noninvasive methods to assess pulse wave velocity (PWV) with the invasive gold standard in terms of absolute values, age-related changes, and relationship with subclinical organ damage. METHODS:Invasive aortic PWV (aoPWVinv) was measured in 915 patients undergoing cardiac catheterization (mean ag...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000518
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:To characterize the in vivo vascular properties of the spontaneously hypertensive rat (SHR) renal vascular bed by examining vascular conductance/resistance responsiveness to vasoactive agents in vivo and determining whether the filtration surface area of glomerular capillaries is reduced. DESIGN AND METHODS:...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200108000-00020
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVES:To assess the prevalence of episodes of ST-segment depression in a population of consecutive patients with mild-to-moderate essential hypertension who are free of clinical signs of coronary artery disease. METHODS:The study involved 28 Italian centers that enrolled 414 hypertensive patients (aged 50-70 year...
journal_title:Journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1097/00004872-199816050-00016
更新日期:1998-05-01 00:00:00
abstract::Carvedilol (BM 14190) is a new antihypertensive compound which combines beta-adrenoceptor blocking and precapillary vasodilating properties but is devoid of intrinsic sympathomimetic activity. The acute and long-term effects on blood pressure and regional haemodynamics (forearm plethysmography) were studied with carve...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004872-198410000-00013
更新日期:1984-10-01 00:00:00
abstract:OBJECTIVES:Genetically hypertensive rats provide an excellent model to investigate the genetic mechanisms of hypertension. We previously identified three differentially expressed genes, Acadsb (short/branched chain acyl-CoA dehydrogenase), Comt (catecholamine-O-methyltransferase), and Pnpo (pyridoxine 5'-phosphate oxid...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3280103a40
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVES:We assessed the prevalence and determinants of high blood pressure (BP), and barriers to diagnosis and treatment, in Dar es Salaam, Tanzania. METHODS:We surveyed and screened 2174 community-dwelling adults aged at least 40 years in 2014 and conducted a follow-up after 1 year. RESULTS:Median BP was 131/81 m...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001117
更新日期:2016-12-01 00:00:00
abstract::Interstrain restriction fragment length polymorphism was detected after Southern blot hybridization of spontaneously hypertensive (SHR) and control (WKY) rat DNA digested by Bam HI restrictase with a v-fos probe. The SHR genome was characterized by an additional minor band of 4.0 kb. Other restriction fragment length ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1988-10-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to investigate interarm differences of blood pressure (BP) and its determinants, and to clarify whether both arms are equally good in assessing BP and target organ damage in the general population. METHODS:We studied a representative sample of Finnish adult population with 484 ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000040
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Nitric oxide is involved in the regulation of vascular basal tone and blood pressure. Polymorphisms of NOS3, the gene that codes for endothelial nitric oxide synthase, have been associated with essential hypertension. OBJECTIVE:To look for linkage and association of three di-allelic polymorphisms (Glu298Asp...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000163144.74588.ad
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVES:The role of the baroreflex function in the pathogenesis of hemodialysis-associated hypotension is controversial. Complex demodulation technique (CDM), providing continuous assessment of the amplitude of cardiovascular oscillation over time, is particularly suitable to assess dynamic changes in autonomic nerv...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e328332b7af
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:The optimal time to initiate antihypertensive therapy among patients with acute ischemic stroke remains uncertain. We tested the effects of blood pressure reduction among patients with acute ischemic stroke according to time from onset to initiation of antihypertensive treatment. METHODS:We randomly assigned...
journal_title:Journal of hypertension
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/HJH.0000000000001288
更新日期:2017-06-01 00:00:00