Current hypertension reports
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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.
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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.
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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.