Abstract:
:Ischemic renal disease (IRD) is defined as a clinically important reduction in glomerular filtration rate or loss of renal parenchyma caused by hemodynamically significant renal artery stenosis. IRD is a common and often overlooked clinical entity that presents itself in the setting of extrarenal arteriosclerotic vascular disease in older individuals with azotemia. Eleven to 14% of end-stage renal disease (ESRD) cases are attributable to chronic IRD. A high percentage of patients entering ESRD programs are hypertensive. Many patients with a presumed diagnosis of hypertensive nephrosclerosis actually have undiagnosed ischemic nephropathy as the etiology of their ESRD. It is important for the clinician to identify IRD, because IRD is a potentially reversible cause of chronic renal failure in a hypertensive patient. Atherosclerotic renal artery disease is common among patients with coronary artery disease and aortic and peripheral vascular disease. Atherosclerotic renal artery disease is a progressive disorder, and its progression is associated with loss of renal mass and functioning. A decrease in glomerular filtration rate sufficient to cause an elevation of the serum creatinine concentration requires injury to both kidneys. Consequently, IRD can arise from one of two main clinical situations: bilateral hemodynamically significant renal artery stenosis leading to bilateral renal ischemia; and hemodynamically significant renal artery stenosis in a solitary functioning kidney, or in a kidney that is providing the majority of a patient's glomerular filtration. The primary reason for establishing the diagnosis of IRD is the hope that correction of a renal artery stenosis will lead to improvement of renal function, or a delay in progression to ESRD. There are six major clinical settings in which the clinician could suspect IRD: acute renal failure caused by the treatment of hypertension, especially with angiotensin converting enzyme inhibitors; progressive azotemia in a patient with known renovascular hypertension; acute pulmonary edema superimposed upon poorly controlled hypertension and renal failure; progressive azotemia in an elderly patient with refractory or severe hypertension; progressive azotemia in an elderly patient with evidence of atherosclerotic disease; and unexplained progressive azotemia in an elderly patient. Noninvasive testing modalities that have been used recently include the angiotensin converting enzyme inhibitor renal scan, duplex Doppler sonography, magnetic resonance angiography, and the spiral computed tomography. Treatment methods include percutaneous transluminal angioplasty, endovascular stenting, and surgical revascularization. The results of treatment for preservation of renal function have been encouraging, with stabilization or improvement in renal function observed in a significant proportion of cases.
journal_name
J Hypertensjournal_title
Journal of hypertensionauthors
Preston RA,Epstein Mdoi
10.1097/00004872-199715120-00001subject
Has Abstractpub_date
1997-12-01 00:00:00pages
1365-77issue
12 Pt 1eissn
0263-6352issn
1473-5598journal_volume
15pub_type
社论,评审abstract:OBJECTIVE:We have previously shown that conduit arteries of normotensive (WKY) and hypertensive (SHR) Japanese rats differ from normotensive (LN) and hypertensive (LH) Lyon rats in terms of lower aortic thickness and higher collagen III content, whereas differences in vasoactive properties are unknown. METHODS:Aortic ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199917100-00007
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVES:Remodeling of small resistance arteries is an early sign of target organ damage in hypertension. Peripheral capillary morphology abnormalities in hypertension are not well studied. The study objective was to determine whether altered capillary morphology is associated with SBP, DBP, or both in individuals wi...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32833e113b
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:To examine the regulation by angiotensin II and by steroids of the expression of the angiotensin II AT1a and AT1b receptor genes in rat hearts. METHODS:Endogenous levels of angiotensin II in the rats were increased either by unilateral 0.2-mm renal artery clips or by subcutaneous infusions of frusemide (12 m...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1995-07-01 00:00:00
abstract::The treatment of essential hypertension continues to be carried out by drugs, combined with the adaptation of life style. The development of various types of antihypertensive drugs has not only greatly improved the management of hypertension, but also offered significant methodological sophistication of the pharmacolo...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/00004872-199917121-00002
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVE:We aim to synthesize effects of repeated administration (≥3 days) of inorganic nitrate on blood pressure and arterial stiffness measures. METHODS:We conducted a systematic review and meta-analysis of randomized controlled trials with at least 3 days treatment of inorganic nitrate on blood pressure and arteri...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002524
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:Hypertension is a major risk factor for cardiovascular disease. Polymorphism in the beta2-adrenergic receptor (ADRB2) and nitric oxide synthase 3 (NOS3) genes is associated with clinical cardiovascular phenotypes. The Arg16Gly and Glu298Asp polymorphisms of ADRB2 and NOS3 genes, respectively, have been report...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32832b7ead
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVES:Arterial stiffness is associated with excess morbidity and mortality, independently of other cardiovascular risk factors. Age is the main determinant responsible for arterial wall changes leading to arterial stiffening. Environmental and genetic factors may however influence the magnitude of the effects of a...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200103000-00008
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Reductions in albuminuria of more than 30% are considered a strong marker of delay of chronic kidney disease (CKD) progression. Single renin-angiotensin system (RAS) blockade represents the cornerstone of CKD treatment. However, as CKD progression still occurs, other nephroprotective options were explored; m...
journal_title:Journal of hypertension
pub_type: 杂志文章,meta分析
doi:10.1097/HJH.0000000000002187
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Chronic diabetes is associated with alterations in autonomic modulation of the cardiovascular system. Although the rat has been used extensively in studies of experimental diabetes, there have been no reports on the changes in autonomic modulation of the cardiovascular function in chronic diabetic rats. OBJ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199917040-00006
更新日期:1999-04-01 00:00:00
abstract::We have studied the norepinephrine (NE) uptake processes directly in synaptosomes isolated from the hypothalamus of both Dahl salt-sensitive (DS) and Dahl salt-resistant (DR) rats. Both DS and DR rats were divided into two dietary groups, one high salt diet group and one low salt diet group. NE uptake was highly sodiu...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198410000-00003
更新日期:1984-10-01 00:00:00
abstract:BACKGROUND:Sitagliptin, a new antidiabetic drug that inhibits dipeptidyl peptidase (DPP)-4 enzyme activity, has been reported to possess neuroprotective property. We tested the protective effects of sitagliptin against chronic cerebral hypoperfusion (CHP) in mice after bilateral carotid artery stenosis (BCAS). METHOD:...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000529
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism-related differences in ACE concentration do not result in differences in angiotensin levels. METHODS AND RESULTS:To investigate whether this relates to differences in the contribution of the ACE C-domain and N-domain, we quantified, u...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3282f465d2
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:The genetic background of orthostatic hypotension, an important risk factor for future cardiovascular morbidity and mortality, was investigated. DESIGN AND METHODS:The study subjects comprised 415 community-dwelling individuals, who were free from any cardiovascular complications, aged 50 years or older (mea...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200204000-00022
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of angiotensin II on cyclooxygenase-2 (COX-2) expression in aortic adventitial fibroblasts from normotensive [Wistar-Kyoto (WKY)] rats and spontaneously hypertensive rats (SHRs). METHODS:Protein expression was determined by western blot, mRNA levels by real-time PCR, transcriptional...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/hjh.0b013e328317a730
更新日期:2009-01-01 00:00:00
abstract::Angioplasty of renal artery stenosis has been used extensively in the last two decades for treating renovascular hypertension, and, more recently, for preserving the jeopardized renal function. A large body of evidence has accumulated indicating that this approach is by far the most convenient for patients with fibrom...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/00004872-199917120-00001
更新日期:1999-12-01 00:00:00
abstract::Emotional stress acutely and repetitively causing blood pressure increase or aggravating existing hypertension is usually not reflected by norepinephrine and epinephrine increase but by a sudden rise of dopamine, the third "defensive" catecholamine coping with the damaging neuropsychological and cardiovascular actions...
journal_title:Journal of hypertension
pub_type: 历史文章,杂志文章
doi:10.1097/01.hjh.0000052462.40108.fb
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Comprehensive studies have confirmed that particulate matter air pollution could trigger myocardial infarction, heart failure and reduce heart rate variability; however, its effect on blood pressure (BP) remains controversial. Therefore, we did a systematic review and meta-analysis to investigate the associa...
journal_title:Journal of hypertension
pub_type: 杂志文章,meta分析,评审
doi:10.1097/HJH.0000000000000342
更新日期:2014-11-01 00:00:00
abstract::Ca2+ pump kinetics were investigated in erythrocytes from 22 essential hypertensive patients and 20 normotensive controls (under initial-rate and steady-state conditions, using Sr2+ as a Ca2+ analogue). The mean value of the apparent dissociation constant for total internal Ca2+ (KCa) was slightly but significantly in...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:Wide pulse pressure is a potent risk factor for atherosclerotic disease, and hypertension is induced by habitual alcohol drinking. This concise study investigated whether age affects the relationship between alcohol drinking and pulse pressure. METHODS:The participants were 99 661 male workers (20-69 years ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3280895b69
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the wave reflection characteristics in the aortic arch and common carotid artery of ex-preterm adolescents and assess their relationship to central blood pressure in a cohort followed prospectively since birth. METHODS:Central blood pressures, pulse wave velocity, augmentation index, microvascula...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001719
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE AND DESIGN:The early phase of weight loss induced by fasting is associated with diuresis, natriuresis and reduction in blood pressure through unclear mechanisms. Atrial natriuretic peptide (ANP) is a cardiac hormone with potent natriuretic, diuretic and hypotensive effects mediated by 'biologically active' re...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199511000-00004
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVES:To investigate the influence of angiotensin II (All) receptors in isolated hepatic nuclei on other genes regulated by All and to determine whether the function of these intracellular receptors is influenced by alterations in the endocrine renin system. METHODS:Nuclei were isolated from hepatic tissue of nor...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1996-08-01 00:00:00
abstract:AIMS:In order to eventually improve blood pressure (BP) management, the aim of this study was to identify subgroups of type 2 diabetes mellitus (T2DM) patients with distinct trajectories of SBP levels. Identifying subgroups with distinct SBP trajectories helps to better understand the course of SBP levels in T2DM patie...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000680
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:Aldosterone is produced in the ventricle of patients with hypertension. The present study was designed to examine whether adrenocorticotropic hormone (ACTH) and cortisol are also produced from the heart in patients with essential hypertension. METHODS:The study population consisted of 57 patients with essent...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200502000-00024
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:Hypertension is a leading global risk factor for the burden of cardiovascular disease. Data about changes in hypertension control are important to set intervention priorities. We conducted a systematic review and meta-analysis of epidemiological studies to determine the control of hypertension in Spain over t...
journal_title:Journal of hypertension
pub_type: 杂志文章,meta分析,评审
doi:10.1097/HJH.0b013e32834d30ec
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVES:The long-term consequences of extreme prematurity are becoming increasingly important, given recent improvements in neonatal intensive care. The aim of the current study was to examine the cardiovascular consequences of extreme prematurity in 11-year-olds born at or before 25 completed weeks of gestation. M...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e328347e333
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVES:The antihypertensive effect of thiazide diuretics in angiotensin II induced hypertension has never been characterized. In the current study, we sought to determine the effect of a thiazide diuretic on arterial pressure and renal fluid excretion in rats receiving a chronic intravenous infusion of angiotensin ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200109000-00012
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVES:A previous history of hypertension is overrepresented among patients with ischaemic heart disease. The present study aims at describing the influence of a previous history of hypertension upon the prognosis among patients hospitalized due to acute myocardial infarction. DESIGN:Patients were followed for 1 y...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199210000-00022
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:Telmisartan is a unique AT1 receptor blocker with a peroxisome proliferator-activated receptor gamma (PPAR-gamma) agonistic action. Activation of PPAR-gamma could prevent inflammation and brain damage. METHOD:We investigated the beneficial effect of telmisartan on ischemic brain damage via PPAR-gamma activa...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32833a551a
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Despite data from animal models and observational studies that are generally supportive for the soy/isoflavones lowering blood pressure (BP) and improving vascular function, the current findings from clinical trials are still inconclusive. OBJECTIVES:To examine whether soy protein with isoflavones or isofla...
journal_title:Journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1097/HJH.0b013e32835c0905
更新日期:2013-02-01 00:00:00