Abstract:
:This review and update focuses on the clinical features of hydrochlorothiazide (HCTZ), the thiazide-like agents chlorthalidone (CTDN) and indapamide (INDAP), potassium-sparing ENaC inhibitors and aldosterone receptor antagonists, and loop diuretics. Diuretics are the second most commonly prescribed class of antihypertensive medication, and thiazide-related diuretics have increased at a rate greater than that of antihypertensive medications as a whole. The latest hypertension guidelines have underscored the importance of diuretics for all patients, but particularly for those with salt-sensitive and resistant hypertension. HCTZ is 4.2-6.2 systolic mm Hg less potent than CTDN, angiotensin-converting enzyme inhibitors, beta blockers, and calcium channel blockers by 24-hour measurements and 5.1mm Hg systolic less potent than INDAP by office measurements. For reducing cardiovascular events (CVEs), HCTZ is less effective than enalapril and amlodipine in randomized trials, and, in network analysis of trials, it is less effective than CTDN and HCTZ-amiloride. Combined with thiazide-type diuretics, potassium-sparing agents decrease ventricular ectopy and reduce the risk for sudden cardiac death relative to thiazide-type diuretics used alone. A recent synthesis of 44 trials has shown that the relative potencies in milligrams among spironolactone (SPIR), amiloride, and eplerenone (EPLER) are approximately from 25 to 10 to 100, respectively, which may be important when SPIR is poorly tolerated. SPIR reduces proteinuria beyond that provided by other renin angiotensin aldosterone inhibitors. EPLER also reduces proteinuria and has beneficial effects on endothelial function. While guidelines often do not differentiate among specific diuretics, this review demonstrates that these distinctions are important for managing hypertension.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Roush GC,Sica DAdoi
10.1093/ajh/hpw030subject
Has Abstractpub_date
2016-10-01 00:00:00pages
1130-7issue
10eissn
0895-7061issn
1941-7225pii
hpw030journal_volume
29pub_type
杂志文章,评审abstract::Previous work in this laboratory has shown that supplemental dietary calcium using milk as the source can lower blood pressure and serum cholesterol levels. Attempting to circumvent lactose intolerance, a 6-month crossover study of blood pressure and serum lipids in 50 free-living volunteers was done comparing 1,150 m...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/1.3.149s
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Subclinical cardiac damage has recently emerged as a potential predictor of adverse renal outcome. We therefore retrospectively evaluated the effect of left-ventricular hypertrophy (LVH), diagnosed electrocardiographically, on the renal outcome of hypertensive patients managed in primary care. METHODS:From ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hps100
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:The adverse association between blood pressure and carotid artery intima-media thickness (IMT), a surrogate measure of subclinical atherosclerosis, is well-known. However, whether the G-6A polymorphism of the angiotensinogen (AGT) gene, a candidate gene of hypertension and vascular remodeling, modulates this...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2007.06.001
更新日期:2007-10-01 00:00:00
abstract::We tested the reproducibility of ambulatory blood pressure monitoring (ABPM) by the use of agreement plots. Thirty-two normotensive volunteers underwent ABPM on four separate days (interval 28 days), on the same typical weekday. Sleeping time was restricted to the ABPM nighttime subperiod from 11:00 PM to 7:00 AM. Twe...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/s0895-7061(97)00126-x
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:We postulated that acute hypoxemia increases susceptibility to orthostatic hypotension by increasing the sensitivity of cardiovascular baroreceptors. METHODS:Hemodynamics were measured noninvasively in 17 healthy, normotensive subjects while being subjected to decreasing venous return by exposure to lower b...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2006.02.005
更新日期:2006-09-01 00:00:00
abstract::High levels of plasma homocyst(e)ine (H[e]) are associated with increased vascular risk. Treatment is being contemplated, but the level at which patients should be treated is not known. We compared the response of carotid plaque to vitamin therapy in patients with H(e) above and below 14 micromol/L, a level commonly r...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/s0895-7061(99)00180-6
更新日期:2000-01-01 00:00:00
abstract::Medical literature that has coalesced during the past two to three decades has identified adequate intake of nutrients from dairy foods as a common factor in the reduction of the disease burden of several common medical conditions. These include obesity, hypertension, type 2 diabetes, osteoporosis, kidney stones, cert...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/j.amjhyper.2003.08.008
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Obese and overweight patients are at increased risk of arterial stiffness, and visceral, epicardial and hepatic fat accumulation is associated with cardiovascular disease risk. In general, muscular lipids are stored either in interstitial adipose tissue (extramyocellular lipid (EMCL)) or in lipid droplets wi...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpv041
更新日期:2015-12-01 00:00:00
abstract::To evaluate the possible physiologic role of atrial natriuretic factor (ANF) in the observed dissociation of aldosterone secretion from the renin-angiotensin system during hypoxic exercise, 12 untrained men, ages 18 to 24, were studied on two separate days for 30 min during hypoxic (16% O2) and normoxic (room air) exe...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.4.341
更新日期:1991-04-01 00:00:00
abstract::Ambulatory blood pressure (BP) and heart rate (HR) were measured in a physically fit, normotensive postmenopausal African American woman, before and after 15 weeks of aerobic training. Mean BP, HR, and HR variability were normal at the outset and were further improved by training. Training had no effect on circadian B...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(02)02973-4
更新日期:2002-09-01 00:00:00
abstract::The polymorphism of the angiotensin-converting enzyme gene is considered to be associated with increased risk for stroke, but there is a diversity in the results obtained. The genetic involvement of the renin-angiotensin system in stroke also remains unclear. To predict the genetic risk of lacunar infarction, we condu...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00184-3
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Hypertension and smoking independently contribute to the risk of stroke. Our objective was to investigate home blood pressure (HBP) levels, day-by-day BP variability, and smoking in the prediction of stroke in Japanese men. METHODS:In this study, 902 men (mean age, 58.6 years) without a past history of stro...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2012.62
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Osteopontin (Opn) is highly upregulated in many different animal models of renal disease, where it is suspected to participate in progression of the disease. In some models, angiotensin II (Ang II) seems to induce the elevated Opn production. Therefore, we examined the regulation of Opn in two-kidney, one-cl...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(02)03266-1
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Both increased night blood pressure (BP) and nondipping are associated with worse cardiovascular risk and prognosis. However, as they are often related features, their relative importance has been difficult to assess separately. In this study we address separate associations of nocturnal hypertension and non...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpt175
更新日期:2014-05-01 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
abstract::We compared three drugs representing different classes of antidiabetic pharmacology (glyburide, a sulfonylurea; pioglitazone, a thiazolidinedione; and metformin, a biguanide) in terms of their direct effects on proliferation of cultured arterial smooth muscle cells (SMC). Rat aortic SMC were seeded at 4 x 10(4)/35 mm ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(95)00393-2
更新日期:1996-02-01 00:00:00
abstract:BACKGROUND:As hypertension, obesity, and leanness are reported to be associated with poor cognitive function, it is possible that obesity or leanness in hypertensive patients may also be associated strongly with poor cognitive function. METHODS:We recruited 184 elderly hypertensive patients comprising 93 very elderly ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2008.157
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Family history of hypertension is a primary predictor of high blood pressure (BP). This study attempted to determine whether there is a gradual increase in BP between individuals with two hypertensive parents, one hypertensive parent, and normotensive parents and whether this increase is apparent with both a...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.09.025
更新日期:2006-05-01 00:00:00
abstract::Time-related changes in plasma levels of aldosterone, deoxycorticosterone, corticosterone, and cortisol were studied during treatment with spironolactone in 8 patients with primary aldosteronism due to adenomas. Plasma renin activity (PRA), serum sodium and serum potassium were also measured. The patients were treated...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/3.7.533
更新日期:1990-07-01 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::There is evidence that hyperinsulinemia and insulin resistance play a role in the development of hypertension. Accordingly, in our ongoing longitudinal study of pregnancy-induced hypertension, we have measured fasting levels of insulin and glucose at 18 to 25 weeks gestation in 140 nulliparous African-American women f...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(94)00166-9
更新日期:1995-01-01 00:00:00
abstract::Use of thiazide diuretics and beta-blockers in the treatment of hypertension may result in metabolic derangements and/or disturbances in the parameters of renal function, which offset the benefits of blood pressure reduction by adversely affecting other cardiovascular risk factors, particularly in special patient grou...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,多中心研究
doi:
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:Expression of matrix metalloproteinase (MMP) has been shown in aortic dissection and aneurysms indicating increased proteolysis compared with the normal aorta. However, its role in the development of aortic root dilatation has not been studied. We therefore attempted to determine the relationship between aor...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.08.013
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:This study examines the interrelationship between gestational weight gain, pre-pregnancy body mass index (BMI), race/ethnicity, and their association with hypertensive disorders during pregnancy (HDP). METHODS:Data from the 2004-2011 national Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpv184
更新日期:2016-06-01 00:00:00
abstract::Post-transplant hypertension remains an important risk factor for cardiovascular mortality and graft function. There are multiple mechanisms responsible for post-transplant hypertension. The details of these mechanisms are poorly understood. Steroids, acute and chronic rejection, recurrent renal disease, native kidney...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/3.9.721
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:Activation of RhoA/Rho kinase (ROK) pathway by angiotensin II (Ang II) is involved in the pathophysiology of hypertension and remodeling. In Bartter's and Gitelman's syndrome (BS/GS), the short-term and long-term signaling of Ang II are blunted. The BS/GS have also reduced expression and response on Ang II c...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.03.747
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:In hypertensives, nondippers are more likely than dippers to suffer silent, as well as overt, hypertensive target organ damage. In this study, we investigated whether a nondipper status was associated with target organ damage in normotensives. METHODS:We performed ambulatory blood pressure (BP) monitoring, ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(03)00567-3
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Many studies have examined differences in hypertension across race/ethnic groups but few have evaluated differences within groups. METHODS:We investigated within-group geographic variations in hypertension prevalence among 3,322 black and white participants of the Multi-Ethnic Study of Atherosclerosis (MESA...
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:Elastin microfibril interfacer 1 (EMILIN-1) is a negative regulator of the transforming growth factor-beta (TGF-beta) signaling, which is involved in blood pressure (BP) homeostasis. Emilin1 knockout mice display elevated BP. The aim of the present study was to assess the association between the human EMILIN...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.16
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Adiposity measures are associated with increased pediatric blood pressure (BP). However, this correlation can be confounded by the relationship of both variables to height. We evaluated whether adiposity and anthropometric measures were associated with pediatric BP before and after adjusting each value for h...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.82
更新日期:2010-08-01 00:00:00