Abstract:
:The "totality" of hypertension clinical trial endpoint data has shown that the absolute benefit of pharmacological blood pressure (BP) lowering is directly related to the BP level and baseline cardiovascular risk, albeit with attenuation of the relative risk reduction per unit of BP lowering in patients with diabetes and chronic kidney disease. Absolute risk reductions with pharmacological treatment are greater with advancing age. Cardiovascular risk and mortality reductions attributable to pharmacological BP lowering have been demonstrated for progressively lower BP levels extending well below the conventional BP threshold (140/90mm Hg) for hypertension. Hypertension endpoint trials have shifted from determining the relative clinical benefits of various antihypertensive drugs to exploring whether lower than conventional BP targets in persons with BP levels spanning the prehypertensive to much higher BP strata confer clinical benefit. The more recent of these trials were "relatively" agnostic to the drugs used for BP lowering although several trials provided, but did not mandate the use of, specific agents. Pharmacological treatment benefit has been demonstrated at pretreatment BP levels even lower than the intensive SPRINT BP target (<120mm Hg) and a growing body of evidence suggests that substantial risk reduction can be achieved by maintaining a normal BP over time (rather than waiting for BP to exceed 140/90mm Hg before treating). Thus there is a compelling rationale to lower the BP threshold not just for a therapeutic goal but also for the initiation of pharmacological intervention.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Flack JM,Nolasco C,Levy Pdoi
10.1093/ajh/hpw087subject
Has Abstractpub_date
2017-01-01 00:00:00pages
3-7issue
1eissn
0895-7061issn
1941-7225pii
hpw087journal_volume
30pub_type
杂志文章,评审abstract:BACKGROUND:Insulin inhibits contraction and migration of primary confluent, cultured canine vascular smooth muscle cells (VSMCs) with inducible nitric oxide synthase (iNOS) by stimulating cyclic GMP (cGMP) production. The present study was performed to determine how insulin stimulates guanylate cyclase activity in thes...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)02289-0
更新日期:2002-03-01 00:00:00
abstract::To analyze the determinants of left ventricular (LV) performance (myocardial afterload, chamber size, mass, and contractility) in Goldblatt hypertension, 19 anesthetized one-kidney, one-clip (1K1C) and 28 two-kidney, one-clip (2K1C) male Wistar rats were studied 58 to 62 days after clipping, together with 19 sham-oper...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/5.5.292
更新日期:1992-05-01 00:00:00
abstract::Endothelin-1 is a potent vasoconstrictor peptide produced in blood vessels and other tissues that may play an important role in the control of local blood flow and could be involved in the pathogenesis of hypertension. Our previous studies have documented increases in endothelin-1 peptide content and gene expression i...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(95)96213-4
更新日期:1995-03-01 00:00:00
abstract::To evaluate the existence of a relationship between atrial natriuretic factor (ANF) and plasma Na+/K+ATPase inhibitory activity in humans, we examined the hemodynamic and humoral response to volume expansion in 41 borderline hypertensive patients (BHT) with either normal (n = 33) or low plasma renin activity (n = 8). ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.7.618
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:Although the renin-angiotensin system and insulin resistance (IR) have been identified as major regulators of plasminogen activator inhibitor type-1 (PAI-1), their roles in hypertensive subjects is not clearly defined. METHODS:We examined the effect of dietary salt restriction on PAI-1 levels in 239 hyperte...
journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1016/s0895-7061(02)02952-7
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:We compare patterns of blood pressure (BP) and prevalence of hypertension between white-Dutch and their South-Asian and African minority groups with their corresponding white-English and their South-Asian and African ethnic minority groups; and the contribution of physical activity, body sizes, and socioecon...
journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1038/ajh.2010.39
更新日期:2010-06-01 00:00:00
abstract::Cardiovascular morbid events occur as a consequence of vascular and cardiac disease, which can be identified long before symptoms of organ involvement become apparent. Early detection of abnormalities in the small arteries, especially deficiency of endothelial nitric oxide bioactivity, and of structural changes of rem...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(01)02092-1
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:The association between hypertension (HTN) and inflammatory biomarkers (interleukin-6 [IL-6] and high-sensitivity C-reactive protein [hsCRP]) in HIV-positive persons with CD4+ count >500 cells/mm3 is unknown. METHODS:We studied HTN in participants of the Strategic Timing of AntiRetroviral Treatment (START) ...
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/hpz132
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:It is not known whether strict control of blood pressure (BP) in mild post-transplant hypertension gives any benefit. Our primary objective was to test the antihypertensive effects of lisinopril added to standard therapy on ambulatory BP (ABP) of post-transplant patients. The secondary objective was to monit...
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/s0895-7061(02)02992-8
更新日期:2002-10-01 00:00:00
abstract::Cultured vascular smooth muscle cells (VSMCs) of the spontaneously hypertensive rat (SHR) show a higher density (Bmax) of ANP receptors and a blunted cyclic (c) GMP response to the hormone. To explore the idea that a higher cytosolic free Ca2+ (Cai2+) may be responsible for a blunted cGMP response to ANP, we examined ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/2.2.111
更新日期:1989-02-01 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
abstract:BACKGROUND:Hypertensive disorders of pregnancy, including preeclampsia (PE), affect approximately 7-10% of pregnancies in the US. Clinical and experimental studies strongly suggest that the maternal immune system plays a role in the development of these disorders; however, few therapeutic options exist aside from deliv...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.125
更新日期:2009-10-01 00:00:00
abstract::Antihypertensive drugs are often initiated and adjusted over a period of weeks to months. It is not clear whether the time and inconvenience of this approach is necessary. We studied whether or not drug adjustment over several days in the context of a physician-nurse team could produce a durable blood pressure benefit...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(00)01273-5
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:The prevalence of childhood elevated blood pressure (BP) has increased in the United States, particularly among African Americans. The influence of maternal plasma folate levels, alone or in combination with maternal cardiometabolic risk factors (hypertensive disorders, diabetes, and prepregnancy obesity), o...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpx003
更新日期:2017-05-01 00:00:00
abstract::The comparative efficacy of the calcium antagonists isradipine and nifedipine in reducing left ventricular peak systolic wall tension was assessed in 25 patients with essential hypertension (20 men, 5 women; mean age: 49 years). After 2 weeks of treatment with either isradipine (2.5 mg twice daily) or slow-release nif...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/ajh/6.3.92s
更新日期:1993-03-01 00:00:00
abstract::Evidence is presented that bradykinin inhibits norepinephrine efflux from sympathetic nerves innervating canine mesenteric and pulmonary arteries, in part, by releasing endothelium-derived relaxing factor (EDRF) from the vascular endothelium. Moreover, in the absence of vascular endothelium, bradykinin also inhibits n...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.5.464
更新日期:1991-05-01 00:00:00
abstract::The objective of this study was to test the relationship between neurologic and microvascular complications of type 1 diabetes mellitus. It was hypothesized that the mechanisms operative in autonomic dysfunction seen in diabetic patients with microangiopathy play a role in the rapidity of progression to renal failure....
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(97)00472-x
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND:There are no comprehensive guidelines on management of hypertensive emergency (HTNE) and complications. Despite advances in antihypertensive medications HTNE is accompanied with significant morbidity and mortality. METHODS:We queried the 2002-2012 nationwide inpatient sample database to identify patients wi...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpx048
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Although insulin resistance (IR) is thought to be related to vascular dysfunction, the difference in the relationship of IR to microvasculature and macrovasculature reactivity has not yet been clarified. The present study was conducted to clarify whether the IR is more closely related to the macrovasculature...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.3
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Evaluating effect of acute or chronic use of antihypertensives on risk of falls in older adults. METHODS:Data sources: Systematic search of primary research articles in CINAHL, Cochrane, EBM, EMBASE, and MEDLINE databases from January 1 2007 to June 1 2017. Study selection: Research studies of cohort, case-...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpx189
更新日期:2018-03-10 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::To examine the influence of angiotensin-converting enzyme (ACE) on pressor, renal vascular, and adrenal responses during angiotensin I (Ang I) infusion, we studied 10 normotensive, healthy men. Each was in balance with a 10-mEq sodium, 100-mEq potassium intake and was studied before and during ACE inhibition with enal...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00223-x
更新日期:2000-05-01 00:00:00
abstract::The treatment of diseases has been based on the concept of homeostasis and has not incorporated an understanding of biologic rhythms and their underlying mechanisms. Biologic rhythms are implicated in cardiovascular events. Failure to recognize the circadian decline in blood pressure may result in iatrogenic chronopat...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)02173-2
更新日期:2001-09-01 00:00:00
abstract::When injected into the medullary site of the hypotensive action of clonidine, imidazolines and related compounds decrease blood pressure (BP), whereas no phenylethylamine compounds were capable of producing such an effect at the same site. There is much biochemical and pharmacologic evidence to support the involvement...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(01)02238-5
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:The expression of Na(+)-K(+)-2Cl(-) cotransporter 1 (NKCC1) is upregulated in spontaneously hypertensive rat (SHR). We investigated whether expression of NKCC1 is epigenetically regulated during postnatal development of hypertension. METHODS:The mesenteric arteries from 5-, 10-, and 18-week-old Wistar-Kyoto...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2011.136
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence and determinants of hypertension in India based on a new definition by the 2017 American College of Cardiology/American Heart Association (2017 ACC/AHA) Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults, and compare prevalence estima...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpz181
更新日期:2020-03-13 00:00:00
abstract::A significant and positive association between red blood cell sodium lithium countertransport (Na-Li CT) and blood pressure has been found in numerous studies. However, the majority of the studies presented to date are cross-sectional in nature and limited information exists on the longitudinal association between Na-...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(96)00261-0
更新日期:1996-11-01 00:00:00
abstract::To clarify characteristics of the patients in whom exercise training lowers blood pressure and to elucidate the mechanisms by which exercise training lowers blood pressure, we evaluated 24-h blood pressure, glomerular filtration rate (GFR), renal blood flow (RBF), filtration fraction (FF), plasma renin activity (PRA),...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/s0895-7061(97)00109-x
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:There is conflicting information with regard to the effect of beta-blockers on arterial stiffness and wave reflection. We compared a vasodilating beta-blocker, nebivolol, with atenolol. METHODS:We randomized 40 subjects with untreated hypertension (mean +/- s.e.m. systolic/diastolic blood pressure (BP) of 1...
journal_title:American journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1038/ajh.2008.156
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Feeding stroke-prone spontaneously hypertensive rats (SHRSP) a diet rich in fructose results in a profound glucose intolerance not observed in the normotensive Wistar Kyoto (WKY) strain. The aim of this study was to investigate the role of the liver in the underlying mechanisms in the SHRSP. METHODS:SHRSP a...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2008.41
更新日期:2008-06-01 00:00:00