Medical Clinics of North America Vol 88 issue 01 2004 Innovative Concepts of Hypertension to Understand and Manage the Disease

Cover......Page 1
Pathophysiology......Page 2
Management and therapy......Page 6
Glucocorticoid-remediable aldosteronism......Page 11
Liddle ’s syndrome......Page 12
Apparent mineralocorticoid excess......Page 13
Mineralocorticoid receptor......Page 14
Pseudohypoaldosteronism type II......Page 15
Autosomal-dominant hypertension with brachydactyly......Page 16
Renin-angiotensin-aldosterone system genes......Page 17
Epithelial sodium channel-related genes,adducin,and 11 beta hydroxysteroid dehydrogenase......Page 18
Endothelium-related factors......Page 20
Sympathetic tone, alpha ,and beta-adrenergic receptors......Page 21
Human linkage studies for new blood pressure loci and hypertension......Page 22
References......Page 24
Tissue renin angiotensin systems......Page 29
Tissue renin......Page 30
Other renin-angiotensin system components......Page 32
Intracellular angiotensin generation......Page 33
Regulation of local renin angiotensin system activity......Page 34
Angiotensins......Page 36
The function of tissue angiotensin......Page 37
Cell culture studies......Page 38
Intracrine renin angiotensin action......Page 39
Clinical implications......Page 41
Summary......Page 42
References......Page 43
Significance of recently identified peptides in hypertension: endothelin, natriuretic peptides, adrenomedullin, leptin......Page 49
Endothelins......Page 50
Natriuretic peptides......Page 55
Adrenomedullin......Page 59
Leptin......Page 62
Summary......Page 64
References......Page 65
Counterregulatory roles of insulin and angiotensin II in regulation of vascular tissues......Page 73
Insulin resistance, hyperinsulinemia, hypertension, and cardiovascular disease......Page 77
Relationship of obesity to insulin resistance and cardiovascular disease......Page 79
Visceral obesity, insulin resistance, hypertension,and cardiovascular disease......Page 80
Microalbuminuria, cardiometabolic syndrome, and type 2 diabetes......Page 82
References......Page 84
Fibrosis in hypertensive heart disease: role of the renin-angiotensin-aldosterone system......Page 93
Potential mechanisms......Page 94
Factors that facilitate the degradation of collagen......Page 96
Animal models......Page 97
Pharmacologic studies......Page 98
Stimulation of fibroblast proliferation......Page 99
Inhibition of collagen degradation......Page 100
Interaction with aldosterone......Page 101
References......Page 102
Coronary flow reserve measurements in hypertension......Page 108
Coronary flow and coronary vascular resistance......Page 109
Functional alterations of coronary microcirculation......Page 110
Structural alterations of the coronary microcirculation......Page 111
Diagnostic methods and assessment of coronary reserve......Page 112
Echocardiography......Page 113
Positron emission tomography......Page 114
Coronary sinus catheterization......Page 115
Angiographic methods......Page 116
Guidewire-based methods......Page 117
Summary......Page 118
References......Page 119
Historical perspective......Page 123
Hypertension and left atrial remodeling......Page 124
Mechanisms of left ventricular hypertrophy in hypertension......Page 125
Animal studies......Page 127
Human studies......Page 128
Hypertension and myocardial fibrosis......Page 129
References......Page 130
Renal function in the patient with hypertension......Page 139
Renal function during treatment......Page 142
Ischemic nephropathy......Page 143
Lead nephropathy......Page 144
Phenacetin nephropathy......Page 145
Hypokalemia......Page 146
References......Page 147
The rising incidence of hypertension......Page 149
The recognition of hypertension......Page 150
The decision to treat with drugs......Page 152
Choice of therapy......Page 153
References......Page 155
Evolving role of calcium antagonists in the management of hypertension......Page 157
Why calcium antagonists are uniquely suitable for managing hypertension......Page 158
Effects of calcium channel blockers on cytosolic calcium and its relationship to blood pressure control......Page 159
Effects of calcium channel blockers on the kidney......Page 160
Calcium antagonists and renal disease......Page 161
Race and ethnicity as a determinant of the responsiveness to calcium antagonists......Page 162
Different formulations of the same calcium antagonist can produce markedly different pharmacokinetic and pharmacodynamic .........Page 163
Relevance of different formulations to recent retrospective reviews......Page 164
Data from recent prospective studies......Page 165
End-stage renal disease......Page 166
Antiatherosclerotic properties......Page 167
Acknowledgments......Page 168
References......Page 169
Diuretics......Page 174
beta-Blockers......Page 177
Early clinical trial evidence......Page 178
Electrolytes......Page 180
Lipid changes......Page 182
Glucose and insulin metabolism......Page 184
beta-Blockers......Page 186
Recent trials and an update on recommendations......Page 187
The Anti-hypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial......Page 188
References......Page 190
What have we learned from the current trials?......Page 195
Cardiovascular disease......Page 198
Progression of nephropathy in patients with type II diabetes......Page 203
Progression of renal disease in African Americans......Page 207
Summary......Page 209
References......Page 210
Target organ involvement in hypertension: a realistic promise of prevention and reversal......Page 214
Hypertensive heart disease......Page 215
Effects of hypertension on the heart......Page 216
Effects of aging on hypertension......Page 217
Therapeutic intervention......Page 218
Endothelial dysfunction in hypertension......Page 219
Experimental studies......Page 220
Summary......Page 222
References......Page 223
Primary prevention of essential hypertension......Page 227
Classification of hypertension......Page 228
Primary prevention of hypertension......Page 229
Dietary sodium reduction......Page 230
Weight loss......Page 232
Physical activity......Page 234
Comprehensive lifestyle modification......Page 235
Interventions with uncertain or less proved efficacy......Page 236
Summary......Page 237
References......Page 238