Document Detail

Arterial hypertension and chronic liver disease.
MedLine Citation:
PMID:  16179891     Owner:  NLM     Status:  MEDLINE    
This review looks at the alterations in the systemic haemodynamics of patients with chronic liver disease (cirrhosis) in relation to essential hypertension and arterial hypertension of renal origin. Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counterregulatory systems (renin-angiotensin-aldosterone system, sympathetic nervous system, release of vasopressin), and resistance to vasopressors. The vasodilatory state is mediated through adrenomedullin, calcitonin gene-related peptide, nitric oxide, and other vasodilators, and is most pronounced in the splanchnic area. This provides an effective (although relative) counterbalance to raised arterial blood pressure. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development of chronic liver disease, and arterial hypertension is rarely manifested in patients with cirrhosis, even in those with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This probably includes the combination of vasodilatation and vasoconstriction in parallel.
J H Henriksen; S Møller
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Minerva medica     Volume:  96     ISSN:  0026-4806     ISO Abbreviation:  Minerva Med.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-09-23     Completed Date:  2005-12-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0400732     Medline TA:  Minerva Med     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  233-46     Citation Subset:  IM    
Department of Clinical Physiology, University of Copenhagen, H:S Hvidovre Hospital, Copenhagen, Denmark.
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MeSH Terms
Baroreflex / physiology
Blood Pressure / physiology
Blood Volume
Cardiovascular System / physiopathology
Chronic Disease
Hypertension / physiopathology*
Kidney Failure / physiopathology
Liver Cirrhosis / physiopathology*
Vascular Resistance / physiology
Vasodilation / physiology

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