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