Abstract:
:Safety in the drug treatment of hypertension can only be seen in relation to efficacy, which has now come to mean not just blood pressure (BP) reduction but improvements in hard end points including mortality. Information on safety can come from a variety of sources, in an ascending hierarchy, which is as follows: case-control studies, cohort studies, randomized control trials (RCTs), and metaanalyses based on good RCTs. Only in the case of metaanalyses are definite criteria for acceptability established, but evaluation of case-control and cohort studies remains subjective. Despite these reserves about the data sources, it is proposed that the case-control study pointing to the risk of acute myocardial infarction during therapy with short-acting calcium channel blockers (CCBs) can be balanced out by another better more recent study, and by a large cohort study from Israel. In a very elderly population, a well-designed cohort study strongly suggests that short-acting nifedipine can be linked to increased mortality and that the specific links may be with a high dose and when the initial BP is less than 160/90 mm Hg. However, initial BP was only available in an unspecified number of patients. The risk of using short-acting verapamil was no more than that of beta-blockade. These differences can be attributed at least in part to the low catecholamine profile of verapamil and the marked rapid adrenergic activation with short-acting nifedipine, which could also explain the adverse effects found when this agent is given to patients with acute coronary syndromes. During the chronic use of long-acting dihydropyridine (DHP) CCBs, most evidence suggests that there is little or no catecholamine activation, or in the case of amlodipine, even a decrease in plasma catecholamine levels. These differences may explain why the expected regression of left ventricular hypertrophy is obtained with long- but not short-acting DHPs. At present the results of several large randomized controlled trials with long-acting CCBs are awaited. In the meantime, when the decision has been made to use a CCB, the preferential choice is for the use of a non-DHP for hypertension with clinical ischemia or for postinfarct hypertension, for a long-acting CCB for the control of left ventricular hypertrophy, and for the DHP amlodipine when there is associated depression of myocardial function.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Opie LHdoi
10.1016/s0895-7061(96)00508-0subject
Has Abstractpub_date
1997-05-01 00:00:00pages
565-77issue
5 Pt 1eissn
0895-7061issn
1941-7225pii
S0895706196005080journal_volume
10pub_type
杂志文章,评审abstract::Previous studies showed that alpha 2-adrenergic receptors and imidazoline-guanidinium receptive sites (IGRS) are colocalized in rabbit and human renal proximal tubule. In the present study we investigated the localization of these two binding sites in the renal medulla from human kidney. Binding studies performed with...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/5.4.69s
更新日期:1992-04-01 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::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:BACKGROUND:Mice with targeted deletion of neuronal nitric oxide (NO) synthase (nNOS⁻(/)⁻) display inability to increase plasma renin concentration (PRC) in response to sodium restriction. nNOS has a distinct expression at the macula densa (MD), and in the present study, it was tested whether nNOS supports renin release...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.153
更新日期:2010-11-01 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
abstract:BACKGROUND:There is evidence from genome wide association study that single-nucleotide polymorphisms (SNPs) in the 5' end of the uromodulin gene (UMOD) affect uromodulin excretion and blood pressure (BP). Uromodulin is almost exclusively expressed in the thick ascending limb of the loop of Henle (TAL) and its effect on...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa166
更新日期:2020-10-21 00:00:00
abstract::The importance of the level to which blood pressure is reduced becomes increasingly important when one considers preservation of renal function. It is clear that three major subsets of patients emerge as requiring levels of blood pressure control of < 130/85 mm Hg to preserve renal function. Such individuals include b...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(98)00190-3
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:There may be a link among stress, adrenal medullary activation, and the development of hypertension. Obesity is characterized by sympathetic activation and predisposes to hypertension, but may be associated with low or normal adrenal medullary activity. We hypothesized that plasma epinephrine (E) levels and ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2004.03.676
更新日期:2004-07-01 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::Concentrations of sodium-transport inhibitors (STI) which block the sodium-potassium-ATPase pump are increased in the plasma and urine of volume-expanded and low-renin hypertensive humans and animals. To evaluate the physiologic relevance of STI to blood-pressure-raising mechanisms, we have examined the in vitro prope...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/2.10.754
更新日期:1989-10-01 00:00:00
abstract::Understanding the causes and treatment of chronic hypotension is of benefit to affected patients and may also shed light on the physiology and genetics of mechanisms of blood pressure control. Symptomatic hypotension (almost always with a blood pressure fall greater than or equal to 20/10 mm Hg) may reflect unrecogniz...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
abstract::This study was performed to investigate the role of endogenous epinephrine in the regulation of vascular tone in hypertension. The release of endogenous epinephrine and norepinephrine from the vascular adrenergic neurons by periarterial nerve stimulation was examined in spontaneously hypertensive rats (SHR) and age-ma...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/3.1.52
更新日期:1990-01-01 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:BACKGROUND:Hypertension presents high prevalence rates following kidney transplantation (Tx). The aims of the present study were to investigate the prevalence and possible risk factors for hypertension and blood pressure (BP) control over time after pediatric kidney Tx, as well as to assess possible effects of hyperten...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpv192
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Dyslipidemia is one the most well-established risk factors for cardiovascular disease development. Moreover, hypercholesterolemia and plasma cholesterol level in the high to normal range are established triggers for impairment in endothelial function. Evidence indicates that endothelial function is closely l...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hps016
更新日期:2013-02-01 00:00:00
abstract::While only a small percentage of the population has high blood pressure, a much larger segment of the US population has a high-normal (above optimal) blood pressure, and is at increased risk for hypertension and its cardiovascular sequelae. Hypertension is thus a population-wide problem and must be approached in much ...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/4.11s.646s
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:Complement factor H (CFH) is a plasma protein that is essential in the regulation of the alternative complement pathway and has been implicated as taking part in complement inhibition in atherogenesis. We evaluated the association of the Y402H polymorphism with incident coronary heart disease (CHD), incident...
journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1038/ajh.2007.81
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:The aim of our study was to investigate the control of hypertension (HT) in treated children using ambulatory blood pressure (BP) monitoring (ABPM). METHODS:We retrospectively reviewed all ABPM studies in our center. Controlled HT was defined as systolic and diastolic BP index (patients' BP divided by the 9...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2011.218
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Physical activity (PA) has been associated with decreased left ventricular (LV) hypertrophy in previous studies. However, little is known about the relationship between PA and LV structure and factors which influence this relationship among African Americans. METHODS:We evaluated 1,300 African Americans wit...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpx044
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Endothelium-dependent vascular relaxation is impaired in various disease states including hypertension. METHODS:We investigated whether a single bolus dose of clofibrate could rapidly reverse saline-induced endothelial dysfunction, in vivo, in salt-loaded Sprague-Dawley (S-D) rats. S-D rats, 5 weeks of age,...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2006.04.005
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Type B acute aortic dissection (AAD) carries a high short- and midterm mortality rate; however, knowledge related to long-term outcome is largely incomplete. The objective of this study was to identify long-term predictors including antihypertensive medications in type B AAD. METHODS:We conducted a clinical...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.5
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Aortic pulse wave velocity (PWV) is a measure of arterial stiffness and has proved useful in predicting cardiovascular morbidity and mortality in several populations of patients, including the healthy elderly, hypertensives and those with end-stage renal disease receiving hemodialysis. Little data exist char...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.240
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Functional status may be useful for identifying older adults who benefit from lower blood pressure. We examined whether functional status modifies the effect of antihypertensive treatment among older adults. METHODS:Post hoc analyses of the Systolic Hypertension in the Elderly Program (SHEP), a randomized t...
journal_title:American journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1093/ajh/hpv177
更新日期:2016-06-01 00:00:00
abstract::To determine whether baroreflex is changed centrally before the development of hypertension in DOCA-salt treated rats, aortic depressor nerve was stimulated electrically 5 days after DOCA-salt treatment in urethane-anesthetized rats: compared with those of sham-operated control rats, blood pressure was not elevated in...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/1.3.23s
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Masked hypertension (MHT), defined as normal blood pressure (BP) at office associated with high BP at home, has been shown to be associated with an increased risk of vascular events. However, MHT is poorly known in the elderly, although this age segment is at high risk of hypertension-related vascular events...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2011.23
更新日期:2011-06-01 00:00:00
abstract::Molecular evidence, using DNA fingerprint analyses, of extensive genetic heterogeneity between spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY) and even within some of the WKY colonies has been reported. Thus we investigated the genetic relations between Dahl S and R rats newly inbred by Dr. Iwai. Gen...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1997-05-01 00:00:00
abstract::Cardiovascular diseases (CVD) are the major causes of mortality in persons with diabetes, and many factors, including hypertension, contribute to this high prevalence of CVD. The incidence of hypertension in patients with diabetes is approximately twofold higher than in age-matched subjects without the disease, and co...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/j.amjhyper.2003.07.009
更新日期:2003-11-01 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: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::Among the major mechanisms controlling the renal release of renin, renal nerves are known to exert a direct stimulating action on juxtaglomerular cells that is mediated by beta-adrenoceptors. Activation of the renal nerves also exerts an important permissive role in order to amplify and possibly accelerate responses t...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/2.2.7s
更新日期:1989-02-01 00:00:00