Abstract:
BACKGROUND:There is a need for an easily accessible biomarker of sympathetic nervous activation in essential hypertension, but none exists. Heart rate (HR) has been suggested, but requires validation, now doubly important as an elevated HR in hypertension has emerged as an independent cardiovascular risk factor. METHODS:Isotope dilution methodology was used to measure total and regional noradrenaline spillover and adrenaline secretion rates in 30 patients with unmedicated essential hypertension and in a comparator group of 48 healthy participants with normal blood pressure. The particular interest was in the relationship of measured HR to cardiac noradrenaline spillover, the measure of cardiac sympathetic activity. RESULTS:Sympathetic activation was present in the patients with essential hypertension, evident in significantly increased mean cardiac, renal and total noradrenaline spillover rates. Adrenaline secretion was normal. HR in hypertension correlated directly with cardiac noradrenaline spillover (r = 0.82, P = 9.3 × 10), but not with renal noradrenaline spillover or adrenaline secretion. 67% of the variance in HR was attributable to differences in cardiac sympathetic activity. Among hypertensive patients there was no internal correlation between cardiac noradrenaline spillover, renal noradrenaline spillover and adrenaline secretion; the sympathetic activation commonly was not 'global'. In healthy participants HR did not correlate with measures of sympathetic activity or adrenaline secretion. CONCLUSION:When sympathetic activation exists in essential hypertension it is differentiated, not necessarily involving all sympathetic outflows. An elevated HR proved to be a biomarker of cardiac sympathetic activation but not activation of the renal sympathetic outflow. Identifying activation of the cardiac sympathetic outflow as the prime mechanism of hypertension tachycardia is relevant to therapies which should now be considered to minimize cardiovascular risk in this clinical setting. Is an elevated HR a valid biomarker of sympathetic activation in essential hypertension? Yes, but only for the cardiac sympathetic outflow. The unavoidable principle is that regional differentiation of sympathetic responses in essential hypertension means that no simple test can ever represent each and every sympathetic outflow.
journal_name
J Hypertensjournal_title
Journal of hypertensionauthors
Esler M,Lambert G,Esler D,Ika Sari C,Guo L,Jennings Gdoi
10.1097/HJH.0000000000002407subject
Has Abstractpub_date
2020-08-01 00:00:00pages
1488-1495issue
8eissn
0263-6352issn
1473-5598journal_volume
38pub_type
杂志文章abstract:OBJECTIVE:To determine whether kidney stone disease (KSD) and hypertension (HTN) share a common familial component that is determined by a specific urinary biochemical abnormality. DESIGN:Familial aggregation study. PATIENTS:Two hundred and twelve KSD patients, aged 18-50 years, collected a 24-h urine sample to measu...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199917121-00012
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVES:To assess the expression of early cardiac genes, implicated in the hypertrophic growth response of the adult heart, in peripheral blood mononuclear cells in patients with essential hypertension and its relationship to ambulatory blood pressure monitoring (ABPM) parameters and to echocardiographic left ventri...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3283424bc4
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:The aim of this cross-sectional study was to investigate the association between consumption of sugar-sweetened and diet soft drinks with blood pressure (BP) in adolescents. METHODS:Fifth graders of 20 public schools were invited to participate in an intervention aimed at behavioral dietary changes and had t...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000800
更新日期:2016-02-01 00:00:00
abstract:PURPOSE:Cardiovascular reactivity to mental stress has been used as a tool to predict short-term hypertension risk in adults but the impact of cardiovascular reactivity in childhood on hypertension in adulthood is unknown. Using the 1970 British Cohort study, we examined the association between pulse rate reactivity in...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001023
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:Optimal medication use obscures the impact of physical activity on traditional cardiometabolic risk factors. We evaluated the relationship between step counts and carotid-femoral pulse wave velocity (cfPWV), a summative risk indicator, in patients with type 2 diabetes and/or hypertension. RESEARCH DESIGN AND...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001277
更新日期:2017-05-01 00:00:00
abstract::Hypertension in children and adolescents has gained ground in cardiovascular medicine, thanks to the progress made in several areas of pathophysiological and clinical research. These guidelines represent a consensus among specialists involved in the detection and control of high blood pressure in children and adolesce...
journal_title:Journal of hypertension
pub_type: 杂志文章,实务指引
doi:10.1097/HJH.0b013e32832f4f6b
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:International recommendations have classified brachial blood pressure (BP) in subgroups enabling better cardiovascular risk stratification. Central BP is an independent predictor of cardiovascular risk, differing from brachial BP through the predominant influence of arterial stiffness and wave reflections. C...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3282f16a9c
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:Secondary activation of the renin-angiotensin system plays a major role in the progression of chronic nephropathies, and blockade of endothelin (ET) receptors has been shown to confer nephroprotection in experimental models of proteinuric renal disease. We tested the nephroprotective potential of selective en...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200312000-00028
更新日期:2003-12-01 00:00:00
abstract:AIMS:Myocardial fibrosis is a relevant component of hypertensive heart disease (HHD). Novel cardiovascular magnetic resonance (CMR) imaging techniques have shown potential in quantification of diffuse cardiac fibrosis, with T1 mapping, and estimating preclinical cardiac dysfunction, with strain analysis. Molecular biom...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002504
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Fibromuscular dysplasia (FMD) and atherosclerotic renal artery stenosis (ARAS) are the most common causes of renovascular hypertension. So far, FMD is believed to cause hypertension via similar mechanisms as in ARAS, that is, a decrease in renal blood flow, which subsequently leads to increased renin secreti...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001243
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND AND AIM:Central blood pressure (BP) is increasingly considered as a better estimator of hypertension associated risks. We aimed to evaluate the association of 24-h central BP, in comparison with 24-h peripheral BP, with the presence of target organ damage (TOD). METHODS:Cross-sectional study of 208 hyperten...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001431
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:In 68 randomized controlled trials (RCTs), blood pressure (BP) lowering was obtained by using drugs of different classes. We have investigated whether BP lowering by any of the major drug classes is effective in reducing the cardiovascular outcomes. METHODS:A total of 55 RCTs (19,5 267 indivi...
journal_title:Journal of hypertension
pub_type: 杂志文章,meta分析,评审
doi:10.1097/HJH.0000000000000447
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Renal infarction can cause abrupt and severe hypertension and less frequently renal failure. Renal infarction results from disruption of renal blood flow in the main ipsilateral renal artery or in a segmental branch. Underlying mechanism is either general, 'embolic' or 'thrombophilic', or local related to pr...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001588
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:To investigate whether the glycoprotein (gp130)-mediated survival pathway, which protects cardiomyocytes from apoptosis, is depressed in left ventricular hypertrophy hypertensive patients with chronic heart failure. METHODS:Transvenous endomyocardial biopsies were obtained in 52 hypertensive patients with le...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32828626e2
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Results from previous studies suggested that a blunted response of renal plasma flow (RPF) to angiotensin II infusion during a high-sodium diet (a phenotype associated with nonmodulation) is an intermediate phenotype for essential hypertension. OBJECTIVE:To determine whether RPF traits used to investigate n...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199715050-00003
更新日期:1997-05-01 00:00:00
abstract::: The aim of the current article is to review the current evidence on the role of morning blood pressure (BP) in the management of hypertension. Morning BP surge had been and will continue to be a hot topic of hypertension research. However, more evidence is needed to prove its clinical usefulness in the management of...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/HJH.0000000000001379
更新日期:2017-08-01 00:00:00
abstract::We have previously reported that pressor doses of angiotensin II induce atrial natriuretic factor (ANF) release. Since the number of glomerular and vascular ANF receptors may vary inversely with plasma ANF levels, we investigated whether they are modified by angiotensin II. Male rats were infused intraperitoneally for...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND:Beta-blockers are not recommended as the initial therapy for hypertension. Reports on associations between use of beta-blockers and stroke severity are inconclusive. We assessed associations between prestroke use of beta-blockers and stroke severity, poststroke disability and death in a large group of hypert...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001218
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on pneumonia hospitalization in patients with stroke history in Taiwan. METHODS:We conducted a case-crossover study using the National Health Insurance Research Database in Taiwan during the period from...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e328357a87a
更新日期:2012-11-01 00:00:00
abstract:INTRODUCTION:Hypertension in midlife adults is associated with cognitive decline later in life. In individuals treated for hypertension, blood pressure (BP) loads have been associated with end organ damages. This study examines whether BP load inversely correlates with performance in cognitive tasks in normotensive or ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002155
更新日期:2019-11-01 00:00:00
abstract::: In 2010, 1.4 billion people globally had hypertension, with 14% controlled to systolic blood pressure (SBP, mmHg) below 140, which contributes to 18 million cardiovascular deaths annually. Recent hypertension guidelines endorsed SBP targets below 130 or lower for all or some hypertensive patients to reduce cardiovas...
journal_title:Journal of hypertension
pub_type: 社论
doi:10.1097/HJH.0000000000002021
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:Studies of experimental animals show glomerular hypertension to be important in the progression of glomerular disease. We evaluated this connection clinically by examining the relationship between glomerular hemodynamics and histological changes in patients with immunoglobulin (Ig)A nephropathy. METHODS:The ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200018010-00015
更新日期:2000-01-01 00:00:00
abstract::We studied 56 patients with essential hypertension to determine whether responses to standardized laboratory mental and physical challenges accurately reflect blood pressure variability during routine daily activities. Four activities were performed in the laboratory: mental arithmetic, a reaction time test, isometric...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198712000-00014
更新日期:1987-12-01 00:00:00
abstract::Hypertension is a leading risk factor for mortality. Detecting, treating and monitoring hypertensive patients require accurate blood pressure measurements. Protocols for validation of automatic sphygmomanometers exist, but quality control of validations is limited to peer review of published reports, which has severe ...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/HJH.0b013e32833e1011
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Childhood hypertension is an established predictor of adult hypertension and organ damage, an underestimated problem in developing countries. The aim of the study was to assess the prevalence of arterial hypertension, as well as the relationship of blood pressure values and weight class and urinary abnormali...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3283407fe3
更新日期:2011-02-01 00:00:00
abstract:INTRODUCTION:Recent randomized controlled trials have confirmed the ability of renal denervation to lower blood pressure (BP) in patients, resistant to the BP-lowering effect of multiple antihypertensive drug administration. Evidence is limited, however, in patients with end-stage renal disease (ESRD) and haemodialysis...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002358
更新日期:2020-05-01 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:OBJECTIVE:To investigate the role of ouabain in human hypertension and to establish whether immunoreactive endogenous ouabain is secreted by the adrenal gland under the influence of dopaminergic regulation. METHODS:We measured plasma levels of endogenous ouabain by immunoassay, together with other variables, including...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199510000-00013
更新日期:1995-10-01 00:00:00
abstract::This study was designed to assess the contribution of thromboxane (Tx) A2 to the pathogenesis of renal dysfunction in rats with angiotensin II (Ang II)-salt hypertension. Hypertension was induced in rats drinking 0.15 mol/l NaCl by infusion of Ang II (125 ng/min, intraperitoneally) for 12 days. Relative to values in w...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199001000-00012
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND AND METHOD:This study evaluated the effects of a linear block strength training programme on the parameters of cardiac remodelling in spontaneously hypertensive rats. Thirty-nine rats were equally distributed in four groups: normotensive sedentary, normotensive trained, hypertensive sedentary and hypertensiv...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002188
更新日期:2020-01-01 00:00:00