Current hypertension reports
-
Curr. Hypertens. Rep. · Dec 2006
ReviewPathophysiology and medical management of systemic hypertension in preeclampsia.
Hypertension that complicates preeclampsia in pregnancy is a disorder that requires special consideration in both prevention and pharmacologic treatment. In recent years, few advances have been made regarding the pathophysiology and prevention of preeclampsia; however, there have been some promising results from studies on possible modes of screening women for preeclampsia before clinical signs and symptoms are apparent. The recommendations for first-line drug therapy for the hypertensive complications of preeclampsia have changed little, primarily because first-line medications have had the advantage of extensive research experience. Recent clinical trials have demonstrated the efficacy and safety of various second-line drugs for the hypertensive complications of preeclampsia; whether these therapies can eventually replace the standard recommended first-line medications will require more extensive long-term investigation.
-
Curr. Hypertens. Rep. · Jun 2006
ReviewBlood pressure variability: its measurement and significance in hypertension.
Blood pressure (BP) fluctuations over time physiologically result from the complex interaction between environmental stimulation, genetic factors, and cardiovascular control mechanisms. Ambulatory BP-monitoring techniques, in particular systems providing beat-by-beat BP recording, have allowed a detailed description of the different components contributing to overall BP variability (BPV) over 24 hours, including short-lasting and more sustained BP changes. ⋯ Mathematic indices, such as the trough-to-peak ratio and the smoothness index, represent useful measures of the homogeneity of the antihypertensive effect over 24 hours. Further studies are still needed to confirm that, in humans, interventions that can reduce BPV can also reduce the rate of cardiovascular events.
-
Curr. Hypertens. Rep. · Oct 2004
Review Comparative StudyThe use of selective aldosterone antagonists.
Mineralocorticoid hormones, specifically aldosterone, have been shown to be increasingly important in the development and maintenance of cardiovascular disorders, particularly hypertension and congestive heart failure. The use of the mineralocorticoid receptor blocker, spironolactone, has been fraught with side effects, largely related to the poor specificity of this agent. ⋯ Many studies in hypertension as well as a major and compelling study in congestive heart failure have documented the efficacy and specificity of eplerenone with a minimum of side effects. The major findings with this new agent are presented herein.
-
Nonpharmacologic and pharmacologic treatment can significantly attenuate the symptoms of orthostatic hypotension. Some of the interventions that are used to treat orthostatic hypotension have been known for decades. However, several new treatment strategies have been developed in recent years. ⋯ A large subgroup of patients with severe autonomic failure show a profound pressor response to water drinking. This simple effect can be exploited to treat orthostatic and postprandial hypotension in some patients. New bioengineering technologies that attempt to replicate normal baroreflex mechanisms may become available for selected patients with central autonomic dysfunction.
-
Curr. Hypertens. Rep. · Jun 2001
ReviewSerum uric acid as a cardiovascular risk factor for heart disease.
Cardiovascular risk factors are those environmental, behavioral, genetic, and/or personal factors whose presence indicates a heightened risk of subsequent vascular disease events. Smoking, hypertension, and hyperlipidemia, initially identified by astute clinicians, were all subsequently confirmed and defined as risk factors through formal prospective epidemiologic study, long before evidence of causality was available. ⋯ The criterion for risk factor status is a strong, consistent, timely, and statistically significant association to disease events that is independent of and unconfounded by other known risk factors. The purpose of this review is to assess available data to determine whether or not serum uric acid meets the standard for designation as a risk factor.