Abstract:
BACKGROUND:About one-half of all hypertensive adults do not have their blood pressure controlled. They are often prescribed medications that conform to national guidelines but they continue to have elevated blood pressure. This public health problem might be improved by applying plasma renin guided therapy. RESULTS:A contributor to the public health problem of unsuccessfully treated hypertension is that the circulating renin-angiotensin system (RAS) is not recognized in treatment guidelines as clinically relevant for the treatment of hypertension or as important as the body salt status for determining blood pressure levels. Another contributor to the problem is the lack of specificity in the package inserts for antihypertensive drugs. They do not specifically state under the heading "Indications" that RAS blockers are primarily most effective in hypertensive subjects with medium and high plasma renin levels; by contrast, natriuretic drugs are most effective in those with low plasma renin levels. METHODS:Literature review. CONCLUSIONS:To address the problem of unsuccessfully treated hypertension, we recommend that the "Indications" section of package inserts for antihypertensive drugs be more specific. The primary indication for RAS blockers ought to be hypertension with medium and high plasma renin levels, and natriuretic agents for those with low plasma renin levels. Similar language ought to be added to treatment guidelines. Additionally, 3 other reasons for lack of blood pressure control also need to be addressed-failure to prescribe antihypertensive drugs to hypertensive subjects, failure of patients to fill prescriptions, and low drug adherence.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Furberg CD,Sealey JE,Blumenfeld JDdoi
10.1093/ajh/hpx068subject
Has Abstractpub_date
2017-09-01 00:00:00pages
857-860issue
9eissn
0895-7061issn
1941-7225pii
3803703journal_volume
30pub_type
杂志文章abstract:BACKGROUND:High waist circumference (WC) (women: >88 cm; men: >102 cm) increases cardiovascular risk. Less is known about moderate WC (women: 80-88 cm; men: 94-102 cm). Therefore, we examined the association between moderate WC and hypertension prevalence, independent of body mass index (BMI). METHODS:Among 24,247 eli...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.258
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Microalbuminuria is recognized as a marker of generalized vascular dysfunction. However, the associations between microalbuminuria and pulse wave velocity (PWV), carotid intima-media thickness (IMT), and ambulatory blood pressure (ABP), respectively, have not been investigated. METHODS:Brachial-ankle PWV (b...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2007.77
更新日期:2008-04-01 00:00:00
abstract::Fenoldopam (Corlopam), a new dopaminergic agent in clinical development by SmithKline Beecham Pharmaceuticals, is a dopamine-1 (DA1) agonist at post-synaptic dopamine receptors. Preclinical and clinical studies have demonstrated that it is a potent renal vasodilator as well as a peripheral vasodilator. In both normal ...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/3.6.120s
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(94)00168-B
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abstract::In this study, 395 healthy children had blood pressure and heart rate measured both at rest and during a stressful video game. Identical measurement procedures were used for three annual examinations. Consistently, black children demonstrated significantly greater pressor responses than white children. In view of the ...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1093/ajh/4.7.630
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:Hypertension in African Americans is characterized by greater systemic vascular resistance (SVR) compared with Caucasian Americans, but the responsible mechanisms are not known. The present study sought to determine if peripheral vascular hypertrophy is a potential mechanism contributing to elevated SVR in A...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpw080
更新日期:2016-12-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.220
更新日期:2010-02-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa011
更新日期:2020-04-29 00:00:00
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pub_type: 杂志文章
doi:10.1093/ajh/6.11.951
更新日期:1993-11-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
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更新日期:2003-11-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpt065
更新日期:2013-09-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(97)00159-3
更新日期:1997-09-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/j.amjhyper.2004.10.021
更新日期:2005-03-01 00:00:00
abstract::This study was designed to analyze the cardiac effects of aging and of hypertension in patients with essential hypertension and with or without left ventricular hypertrophy (LVH). Thirty-one patients <55 years old and 66 patients >64 years old with essential hypertension were divided according to the presence or absen...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(97)00500-1
更新日期:1998-04-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.260
更新日期:2010-04-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/3.2.133
更新日期:1990-02-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(98)00276-3
更新日期:1999-01-01 00:00:00
abstract::To evaluate the reactivity to psychological stress in patients with essential hypertension we investigated hemodynamic and endocrinologic changes during a mental arithmetic task (MAT) and a mirror drawing test (MDT) in 10 hypertensive subjects. Hemodynamic changes were assessed continuously using an ambulatory radionu...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/s0895-7061(96)00382-2
更新日期:1997-03-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2006.05.012
更新日期:2006-12-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
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更新日期:2003-01-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章,meta分析
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更新日期:2015-04-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/1.1.91
更新日期:1988-01-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2011.239
更新日期:2012-04-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(96)00321-4
更新日期:1997-02-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0895-7061(03)00062-1
更新日期:2003-05-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
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更新日期:1997-03-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
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更新日期:2011-11-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
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更新日期:2015-06-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)02220-8
更新日期:2001-11-01 00:00:00
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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/3.12.903
更新日期:1990-12-01 00:00:00