Abstract:
:Body sodium works together with the plasma renin-angiotensin system to ensure adequate blood flow to the tissues. Body sodium content determines the extracellular fluid (ECF) volume ensuring that, with each heart beat, a sufficient volume of fluid is delivered into the arterial space. At the same time the kidneys monitor ECF volume and blood pressure (BP), so that the juxtaglomerular cells can adjust their net secretion rate of renin to maintain an appropriate plasma renin activity (PRA) level. Plasma renin produces angiotensin II (Ang II) to constrict the arterioles and thereby ensure sufficient BP to deliver an appropriate rate of flow for cardiovascular homeostasis. The low renin, sodium-volume dependent (V) form of essential hypertension occurs whenever body sodium content increases beyond the point where plasma renin-angiotensin vasoconstrictor activity is turned off. In contrast, medium to high renin (R) hypertension occurs when too much renin is secreted relative to the body sodium content. Thus, BP = V × R. This volume-vasoconstriction dual support of long-term hypertension is validated by the fact that all effective long-term antihypertensive drug types are either (i) natriuretic to reduce body salt and volume content (anti-V), or (ii) antirenin to reduce or block the activity of the circulating renin-angiotensin system (anti-R). The PRA test defines the relative participation of the concurrent volume and vasoconstrictor factors. In the hypertensive patient PRA testing can guide initiation, addition or subtraction of anti-V or anti-R antihypertensive drug types to thereby improve BP control and prognosis while reducing drug type usage and cost.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Laragh JH,Sealey JEdoi
10.1038/ajh.2011.171subject
Has Abstractpub_date
2011-11-01 00:00:00pages
1164-80issue
11eissn
0895-7061issn
1941-7225pii
ajh2011171journal_volume
24pub_type
杂志文章,评审abstract::Stroke (brain attack) is currently the third leading cause of death in Western societies. Recent advances in molecular genetics have finally demonstrated what has long been suggested by the clinical observation, that is, stroke is not only the complication of major pathologic conditions such as atherosclerosis, hypert...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(00)01249-8
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:Subjects with renovascular hypertension (RVH) often manifest with metabolic syndrome (MetS) as well. Coexisting MetS and hypertension increases cardiovascular morbidity and mortality, but the mechanisms underlying cardiac injury remain unknown. We hypothesized that superimposition of MetS induces myocardial ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa202
更新日期:2020-12-05 00:00:00
abstract::Hypertension is a common finding among obstructive sleep apnea (OSA) patients, and is thought to be caused by sympathetic hyperactivity. The present study compares the contributions of the respiratory disturbance index (RDI) as a reflection of sleep fragmentation, and the magnitude of oxygen desaturation, to sympathet...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(98)00159-9
更新日期:1998-11-01 00:00:00
abstract::Calcitonin gene-related peptide (CGRP), a highly potent vasodilator, is expressed from the calcitonin-gene and has been localized to nerve fibers of the cardiovascular system, suggesting involvement in the physiologic regulation of vascular tone. In this investigation serum concentrations of CGRP were measured in pati...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/4.7.565
更新日期:1991-07-01 00:00:00
abstract::The aim of this study was to compare sexual activity and plasma testosterone levels of hypertensive men with those of healthy normotensive controls. We investigated 110 newly diagnosed, never treated hypertensive (blood pressure [BP] > or = 140/95 mm Hg) men and 110 healthy normotensive (diastolic BP <90 mm Hg) men. A...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)02280-4
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:We evaluated the relationship of the severity of hyperuricemia and the flow-mediated vasodilatation of the brachial artery (FMD) in patients with and without the metabolic syndrome (MetS). METHODS:In a cross-sectional study, FMD was obtained in 2,732 Japanese healthy men (49 ± 8 years) who had no cardiovasc...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2011.55
更新日期:2011-07-01 00:00:00
abstract::Arterial stiffness has been known as a sign of cardiovascular risk since the 19th century. Despite this, accurate measurement and clinical utility have only emerged in recent times. Arterial stiffness and its hemodynamic consequences are now established as predictors of adverse cardiovascular outcome. They are easily ...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1038/ajh.2010.192
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Hypertension is a significant global public health challenge. Low-grade inflammation is known to facilitate the development of essential hypertension and target-organ hypertensive damage. Neutrophil to lymphocyte ratio (NLR) is a simple and reliable indicator of inflammation that may also be useful in the pr...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpv034
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:The direct renin inhibitor aliskiren is known to exhibit a strong antihypertensive effect. However, the organoprotective potential of aliskiren beyond its antihypertensive properties is less clear. This study investigates the antifibrotic nephroprotective effects of aliskiren in a nonhypertensive mouse model...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.231
更新日期:2011-03-01 00:00:00
abstract::This article examines the results of the Joint National Committee's Fifth Report on the treatment of hypertension (JNC-V), especially regarding the economic arguments put forth therein. Economics are a poor basis for treatment decisions, as the cheapest therapies may not be the best for any given patient. Broad treatm...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/0895-7061(94)P1709-9
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:Debate exists about the relationship between hypovitaminosis D and cardiovascular (CVD) risk. METHODS:This study investigated baseline (n=2,271) 25-hydroxyvitamin D (25(OH)D) and baseline and 4 year (n=1,957) CVD risk in a cohort of Finnish middle-aged male smokers. RESULTS:The prevalences of measured hype...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpt051
更新日期:2013-08-01 00:00:00
abstract::Stroke-prone spontaneously hypertensive rats (SHRSP), subjected to high NaCl, show severe hypertension, organ damage, and early death. Preventive treatment with angiotensin II type 1 (AT1) receptor antagonists is known to be effective. Previously, we found that angiotensin converting enzyme (ACE) inhibition could redu...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(00)01231-0
更新日期:2001-01-01 00:00:00
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
doi:10.1016/s0895-7061(98)00258-1
更新日期:1999-03-01 00:00:00
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
doi:10.1093/ajh/hpz064
更新日期:2019-07-17 00:00:00
abstract:BACKGROUND:Salt sensitivity of blood pressure (SSBP) increases the risk of cardiovascular complications, and the heritability of SSBP is about 50% in Chinese population. However, studies identifying genes involved in BP responses to acute sodium loading and diuresis shrinkage are still limited. METHOD:A total of 342 e...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpx179
更新日期:2018-03-10 00:00:00
abstract:BACKGROUND:Ascending aortic fractional pulse pressure and fractional systolic pressure (FSP) were demonstrated to differentiate patients with and without coronary artery disease. However, no study so far has analyzed the relationship between FSP and fractional diastolic pressure (FDP) and the extent of coronary artery ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2004.01.009
更新日期:2004-08-01 00:00:00
abstract::Antioxidant protection provided by different doses of alpha-tocopherol was compared by determining nitric oxide synthase (NOS) activity in blood vessels of spontaneously hypertensive rats (SHR) treated with alpha-tocopherol. SHR were divided into four groups namely hypertensive control (C), treatment with 17 mg of alp...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00022-9
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Uncontrolled treatment-resistant hypertension (TRH), i.e., blood pressure (BP, mm Hg) ≥140/≥90mm Hg in and out of office on ≥3 different BP medications at optimal doses, is common and has a poor prognosis. Aldosterone antagonist (AA) and renin-guided therapy (RGT) are effective strategies for improving BP co...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpw016
更新日期:2016-08-01 00:00:00
abstract::In normal subjects, insulin decreases the urinary excretion of sodium, potassium, and uric acid. We tested whether these renal effects of insulin are altered in insulin resistant hypertension. In 37 patients with essential hypertension, we measured the changes in urinary excretion of sodium, potassium, and uric acid i...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/0895-7061(96)00098-2
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:New onset resistant hypertension in a previously stable patient with chronic hypertension should lead to consideration of secondary causes. Electrolyte abnormalities are useful clues for identifying some common causes, especially mineralocorticoid excess. CASE PRESENTATION:We report the case of a 69-year-ol...
journal_title:American journal of hypertension
pub_type:
doi:10.1093/ajh/hpz125
更新日期:2019-11-15 00:00:00
abstract:BACKGROUND:Previous autopsy studies suggested that a reduced nephron number is associated with increased risk of hypertension and chronic kidney disease. However, the significance of the nephron number estimated from a renal biopsy in patients with hypertensive nephrosclerosis (HNS) has not yet been elucidated. METHOD...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpu267
更新日期:2015-09-01 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:BACKGROUND:The presence of asymptomatic left ventricular diastolic dysfunction (LVDD) in hypertensive patients can be associated with the development of cardiac events. The increase in sympathetic activity may be 1 of the mechanisms that predisposes to this outcome. In this study, we analyzed 2 hypotheses: (i) whether ...
journal_title:American journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1093/ajh/hpt032
更新日期:2013-07-01 00:00:00
abstract::Despite intense investigation and clinical attention, many challenges remain in the management of the hypertensive patient. It is clear that hypertension remains inadequately controlled worldwide, with the control rate in the United States approximating 27%. Furthermore, several recent studies have underscored that it...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(02)02948-5
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:This study investigated the relationship of ethnicity to the differences between blood pressure (BP) measured in a clinic setting and by ambulatory blood pressure monitoring (ABPM) in individuals with a previous diagnosis of hypertension (HT) and without a previous diagnosis of hypertension (NHT). METHODS:A...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpu211
更新日期:2015-06-01 00:00:00
abstract::The objective of the present study was to determine the relationship between plasma renin levels, and the development of hypertension and cardiac hypertrophy in TGR (mREN2)27 hypertensive rats. Systolic blood pressure and left ventricular mass index (LVMI) were measured in transgenic heterozygote and normotensive Spra...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(95)00254-5
更新日期:1995-12-01 00:00:00
abstract::The regulation of atrial natriuretic peptide (ANP) synthesis within cardiac atrial myocytes was investigated in 8 patients undergoing cardiac surgery (valve replacement or coronary bypass graft). Hemodynamic data were obtained during cardiac catheterization and venous plasma samples for ANP were withdrawn prior to sur...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/3.3.234
更新日期:1990-03-01 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:This birth cohort study was conducted to investigate the contribution of prenatal and antenatal environmental exposures to later-life hypertensive status. METHODS:Two thousand five hundred and three individuals born in 1921-1954 at the Peking Union Medical College Hospital (PUMCH) were targeted; 2,081 (83.1...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2011.262
更新日期:2012-04-01 00:00:00
abstract::In a population of 887 men and 1159 women aged 40 to 89 years in southern California, age adjusted systolic and diastolic blood pressures correlated significantly with sodium/potassium ratios estimated from casual urine samples. The relationship was apparent over the whole range of blood pressures and urinary electrol...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/3.6.505
更新日期:1990-06-01 00:00:00