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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Sara AlMarabeh, Mohammed H Abdulla, Ken D O'Halloran
Renal sensory nerves are important in the regulation of body fluid and electrolyte homeostasis, and blood pressure. Activation of renal mechanoreceptor afferents triggers a negative feedback reno-renal reflex that leads to the inhibition of sympathetic nervous outflow. Conversely, activation of renal chemoreceptor afferents elicits reflex sympathoexcitation. Dysregulation of reno-renal reflexes by suppression of the inhibitory reflex and/or activation of the excitatory reflex impairs blood pressure control, predisposing to hypertension...
2019: Frontiers in Physiology
Kui Yang, Yaqin Wang, Yanyun Ding, Haiju Cui, Deixi Zhou, Lu Chen, Zhangqing Ma, Wusan Wang, Wen Zhang, Jiajie Luan
BACKGROUND: Numerous clinical studies have evaluated valsartan and found more efficacious control of blood pressure (BP) variability when administered before sleep. The treatment leads to improved outcomes when compared to administration upon awakening. The mechanism underlying this etiology is not fully understood. The present study investigates the safety and efficacy of asleep administration of valsartan in spontaneously hypertensive rats (SHR) with a non-dipping blood pressure pattern compared to SHRs receiving administration during awake time...
May 17, 2019: Chronobiology International
Li Li, Ling Li
BACKGROUND/AIMS: Previous studies have reported inconsistent results regarding the treatment effects of intensive blood pressure (IBP) control in the prevention of cardiovascular and renal outcomes. We conducted this cumulative meta-analysis to evaluate the treatment effects of IBP control on cardiovascular and renal outcomes. METHODS: We systematically searched PubMed, EMBASE, and the Cochrane Library databases from the date of their inception to October 2017, to identify randomized controlled trials (RCTs)...
May 10, 2019: Kidney & Blood Pressure Research
Tim Montrief, Alex Koyfman, Brit Long
Scleroderma renal crisis (SRC) remains a high-risk clinical presentation, and many patients require emergency department (ED) management for complications and stabilization. This narrative review provides an evidence-based summary of the current data for the emergency medicine evaluation and management of SRC. While SRC remains a rare clinical presentation, surveillance data suggest an overall incidence between 4 and 6% of patients with scleroderma. The diagnostic criteria for SRC include a new onset blood pressure > 150/85 mm Hg OR increase ≥ 20 mm Hg from baseline systolic blood pressure, along with a decline in renal function, defined as an increase serum creatinine of ≥ 10% and supportive features...
May 10, 2019: Internal and Emergency Medicine
Rajiv Sinha, Abhijeet Saha, Joshua Samuels
Childhood hypertension has become a significant health concern. There have been a slew of important new findings in this field over the last decade. This has led to an update by the American Academy of Pediatrics of the original recommendation of United States Fourth Working Group on blood pressure. We herein describe the important changes in the guideline, which include an updated normative data, change in blood pressure classification, strong endorsement of ambulatory blood pressure measurement and the reduction in the blood pressure target for both chronic kidney disease and non-chronic kidney disease hypertensive children...
April 15, 2019: Indian Pediatrics
Rahul Aggarwal, Benjamin Petrie, Wasif Bala, Nicholas Chiu
Hypertension is highly prevalent and morbid in the chronic kidney disease population, and blood pressure (BP) targets for this population are unclear. We aimed to compare all-cause mortality outcomes with intensively targeting systolic BP to <130 mm Hg versus a standard of <140 mm Hg. Individual patient data from 4983 chronic kidney disease patients with hypertension were pooled from 4 multicenter randomized control trials-AASK (African American Study of Kidney Disease and Hypertension), ACCORD (Action to Control Cardiovascular Risk in Diabetes), MDRD (Modification of Diet in Renal Disease), and the SPRINT (Systolic Blood Pressure Intervention Trial)...
June 2019: Hypertension
Anna Burgner, Julia B Lewis
Hypertension is frequently both a cause and complication of CKD. The optimal blood pressure target in CKD has been of hot debate over the decades with little data to inform the goals. Here, we review the data from the Systolic Blood Pressure Intervention Trial (SPRINT), Modification of Diet in Renal Disease (MDRD), African American Study of Kidney Disease and Hypertension (AASK), Ramipril Efficacy in Nephropathy-2 (REIN-2), and Action to Control Cardiovascular Risk in Diabetes (ACCORD) trials to use the available evidence to better inform what blood pressure goal should be recommended in patients with CKD and to answer the question "How low should we go?"...
March 2019: Advances in Chronic Kidney Disease
Raymond R Townsend
Early reports of renal denervation as a therapy for hypertension generated intense interest in this approach to management of elevated blood pressures despite ongoing treatment. The publication of the large, sham-controlled randomized clinical trial of renal denervation, Symplicity HTN-3, failed to show superiority of renal denervation by radiofrequency energy ablation compared with a sham procedure similar to the procedure used for denervation but without the application of energy to the renal artery. This prompted consideration of confounding factors and rethinking about the protocol and the procedure itself...
March 2019: Advances in Chronic Kidney Disease
Ian R Barrows, Ali Ramezani, Dominic S Raj
Hypertension is considered as the most common risk factor for cardiovascular disease. Inflammatory processes link hypertension and cardiovascular disease, and participate in their pathophysiology. In recent years, there has been an increase in research focused on unraveling the role of inflammation and immune activation in development and maintenance of hypertension. Although inflammation is known to be associated with hypertension, whether inflammation is a cause or effect of hypertension remains to be elucidated...
March 2019: Advances in Chronic Kidney Disease
Dia R Waguespack, Jamie P Dwyer
Hypertension is a global health problem and without adequate diagnosis and treatment is a risk factor for morbidity and mortality. Proper assessment of blood pressure is key to diagnosis and management of hypertension. Different methods of measurement are available for use and varying techniques are applied to patient care. Understanding the proper methods of blood pressure measurement both in and out of the physician's office is crucial for providing appropriate care to an individual patient. In addition, understanding the techniques used in research, on which current guidelines are based, is critical for proper application to daily practice...
March 2019: Advances in Chronic Kidney Disease
Nabeel Aslam, Samardia Missick, William Haley
Optimal control of blood pressure (BP) may reduce the risk of progression of CKD. Misclassification of hypertension (HTN) and status of control may result in suboptimal management. Clinic or home BP may overestimate or underestimate status of control compared with ambulatory BP monitoring (ABPM), which is considered the gold standard. The latter relates not only to the superiority of ABPM concerning outcome prognosis but also to its ability to accurately diagnose white coat and masked HTN, which is critical in assuring adequate BP control...
March 2019: Advances in Chronic Kidney Disease
Elaine Ku, Raymond K Hsu, Delphine S Tuot, Se Ri Bae, Michael S Lipkowitz, Miroslaw J Smogorzewski, Barbara A Grimes, Matthew R Weir
Background Obtaining 24-hour ambulatory blood pressure ( BP ) is recommended for the detection of masked or white-coat hypertension. Our objective was to determine whether the magnitude of the difference between ambulatory and clinic BP s has prognostic implications. Methods and Results We included 610 participants of the AASK (African American Study of Kidney Disease and Hypertension) Cohort Study who had clinic and ambulatory BPs performed in close proximity in time. We used Cox models to determine the association between the absolute systolic BP ( SBP ) difference between clinic and awake ambulatory BPs (primary predictor) and death and end-stage renal disease...
May 7, 2019: Journal of the American Heart Association
Gianfranco Parati, Juan Eugenio Ochoa, Grzegorz Bilo
See Article Ku et al.
May 7, 2019: Journal of the American Heart Association
Il Young Kim, Sang Heon Song
No abstract text is available yet for this article.
April 24, 2019: Kidney Research and Clinical Practice
Alfred K Cheung, Tara I Chang, William C Cushman, Susan L Furth, Joachim H Ix, Roberto Pecoits-Filho, Vlado Perkovic, Mark J Sarnak, Sheldon W Tobe, Charles R V Tomson, Michael Cheung, David C Wheeler, Wolfgang C Winkelmayer, Johannes F E Mann
In September 2017, KDIGO (Kidney Disease: Improving Global Outcomes) convened a Controversies Conference titled Blood Pressure in Chronic Kidney Disease (CKD). The purpose of the meeting was to consider which recommendations from the 2012 KDIGO Clinical Practice Guideline for the Management of Blood Pressure in CKD should be reevaluated based on new evidence from clinical trials. Participants included a multidisciplinary panel of clinical and scientific experts. Discussions focused on the optimal means for measuring blood pressure (BP) as well as managing BP in CKD patients...
May 2019: Kidney International
Claudia Diederichs, Hannelore Neuhauser
Strong evidence exists for the benefits of screening for hypertension to reduce the risk of cardiovascular disease and death. The aim of this study was to analyze the frequency and determinants of blood pressure (BP) measurement by a health professional in the general population and in individuals without hypertension in Germany.Data from 17,431 participants 15+ years from the cross-sectional GEDA2014/2015-EHIS survey were used to calculate the percentage of the population who had no BP measurement within the last year and the last 3 years...
April 2019: Medicine (Baltimore)
Anila Duni, Evangelia Dounousi, Paraskevi Pavlakou, Theodoros Eleftheriadis, Vassilios Liakopoulos
Management of arterial hypertension in patients with chronic kidney disease (CKD) remains a major challenge due to its high prevalence and its associations with cardiovascular disease (CVD) and CKD progression. Several clinical trials and meta-analyses have demonstrated that aggressive treatment of hypertension in patients with and without CKD lowers the risk of CVD and all-cause mortality, nevertheless the effects of blood pressure (BP) lowering in terms of renal protection or harm remain controversial. Both home and ambulatory BP estimation have shown that patients with CKD display abnormal BP patterns outside of the office and further investigation is required, so as to compare the association of ambulatory versus office BP measurements with hard outcomes and adjust treatment strategies accordingly...
April 15, 2019: Current Hypertension Reviews
L V Melnikova, E V Osipova, O A Levashova
AIM: to study relationship between genetic disorders and features of intrarenal blood flow in patients with essential arterial hypertension (AH) of 1-2 degree. MATERIALS AND METHODS: We examined 100 patients (60 women, 40 men) aged 35 to 58 years with 1-2‑degree essential arterial hypertension (AH) and chronic kidney disease (CKD) stages I-III. Examination included triplex scanning of renal arteries on the ultrasound scanner Vivid-7 Dimension, genotyping of single-nucleotide polymorphism А1166С of the AGTR1 gene by real time polymerase chain reaction (PCR), estimation of glomerular filtration rate (GFR) using CKD-EPI formula...
April 12, 2019: Kardiologiia
Christoffer Bjerre Haase, János Valery Gyuricza, John Brodersen
No abstract text is available yet for this article.
April 12, 2019: BMJ: British Medical Journal
Kristen L Nowak, Michel Chonchol, Anna Jovanovich, Zhiying You, Jeffrey Bates, Capri Foy, Stephen Glasser, Anthony A Killeen, John Kostis, Carlos J Rodriguez, Mark Segal, Debra L Simmons, Addison Taylor, Laura C Lovato, Walter T Ambrosius, Mark A Supiano
BACKGROUND: High dietary sodium intake may induce a small, yet physiologically relevant rise in serum sodium concentration, which associates with increased systolic blood pressure (SBP). Cellular data suggest that this association is mediated by increased endothelial cell stiffness. We hypothesized that higher serum sodium levels were associated with greater arterial stiffness in participants in the Systolic Blood Pressure Intervention Trial (SPRINT). METHODS: Multivariable linear regression was used to examine the association between baseline serum sodium level and a) pulse pressure (PP; n=8,813; a surrogate measure of arterial stiffness) and b) carotid-femoral pulse-wave velocity (CFPWV; n=591 in an ancillary study to SPRINT)...
April 12, 2019: American Journal of Hypertension
2019-04-15 07:30:21
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