Current hypertension reports
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Curr. Hypertens. Rep. · Oct 2012
ReviewBlood pressure variability, cardiovascular risk, and risk for renal disease progression.
The adverse cardiovascular consequences of high blood pressure (BP) not only depend on absolute BP values, but also on BP variability (BPV). Evidence has been provided that independently of mean BP levels, BP variations in the short- and long-term are associated with the development, progression and severity of cardiac, vascular and renal organ damage, and with an increased risk of CV events and mortality. Alterations in BPV have also been shown to be predictive of the development and progression of renal damage, which is of relevance if considering that impaired renal function in a hypertensive patient constitutes a very potent predictor of future CV events and mortality even in treated subjects. This review will address whether antihypertensive treatment should target alterations in BPV, in addition to reducing absolute BP levels, in order to achieve the highest CV and renal protection in hypertensive and renal patients.
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Curr. Hypertens. Rep. · Oct 2012
ReviewHypertension and kidney disease: what do the data really show?
Hypertension is the most common co-morbidity in chronic kidney disease (CKD) and the optimal target BP to prevent CKD progression has been hotly debated. Prior recommendations by various groups for BP targets for CKD in the range of less than 130/80 mm Hg have been based on the assumed benefits of lower BP in this population with exceedingly high risk for cardiovascular disease (CVD). ⋯ There are ongoing studies which will provide more data on BP targets in CKD. Based on the currently available data we recommend a BP goal of less than 140/90 mm Hg in all patients with CKD.
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Curr. Hypertens. Rep. · Oct 2012
ReviewPerioperative hypertension: defining at-risk patients and their management.
Hypertension is an extremely pervasive condition that affects a large percentage of the world population. Although guidelines exist for the treatment of the patient with elevated blood pressure, there remains a paucity of literature and accepted guidelines for the perioperative evaluation and care of the patient with hypertension who undergoes either cardiac or noncardiac surgery. Of particular importance is defining the patients most vulnerable to complications and the indications for immediate and rapid antihypertensive treatment and/or cancellation of surgery to reduce these risks in each of the three perioperative settings: preoperative, intraoperative, and postoperative. This review also examines the parenteral antihypertensive medications most commonly administered in the perioperative setting.
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Curr. Hypertens. Rep. · Apr 2011
ReviewHypertension due to loss of clock: novel insight from the molecular analysis of Cry1/Cry2-deleted mice.
In our consumer-oriented society, in which productivity requires around-the-clock activity and demanding shift work, the biologic system that regulates our internal rhythms is being compromised. Poor sleep patterns and hectic lifestyle are detrimental to harmonious physiological and metabolic body systems, with severe impact on public health. ⋯ In these mice, a novel 3β-hydroxyl-steroid dehydrogenase (3β-Hsd) gene under clock control is severely overexpressed specifically in aldosterone-producing cells in the adrenal cortex, leading to hyperaldosteronism and ultimately to salt-sensitive hypertension. The human homologue of this aldosterone-producing, cell-specific enzyme was also characterized and represents a new possibility in the pathogenesis of hypertension.