| Proposal of RAS-diuretic vs. RAS-calcium antagonist strategies in high-risk hypertension: insight from the 24-hour ambulatory blood pressure profile and central pressure. | |
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MedLine Citation:
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PMID: 20728424 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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I here propose an individualized renin angiotensin system (RAS) inhibitor-based combination therapy with calcium-channel blockers (CCBs) or with diuretics, based on the 24-hr ambulatory blood pressure (BP) profiles and central pressure in relation to the target organ damage in high-risk hypertensive patients. For high-risk patients with increased circulating volume, such as that caused by chronic kidney disease (CKD) or congestive heart failure (CHF), who are likely to exhibit a non-dipper/riser pattern of nocturnal BP fall, diuretics are recommended in combination with a RAS inhibitor to reduce nocturnal BP preferentially. For high-risk patients with arterial diseases such as cardiovascular disease and increased arterial stiffness, who are likely to exhibit exaggerated BP variability, such as morning BP surge and day-to-day BP variability, a CCB is recommended for use in combination with a RAS inhibitor to reduce BP variability and central BP. In particular, bedtime dosing of a RAS inhibitor targeting sleep-early morning activation of RAS may be particularly effective for cardiorenal protection. |
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Authors:
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Kazuomi Kario |
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Publication Detail:
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Type: Editorial Date: 2010-08-21 |
Journal Detail:
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Title: Journal of the American Society of Hypertension : JASH Volume: 4 ISSN: 1933-1711 ISO Abbreviation: J Am Soc Hypertens Publication Date: 2010 Sep-Oct |
Date Detail:
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Created Date: 2010-10-13 Completed Date: 2011-01-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101312518 Medline TA: J Am Soc Hypertens Country: United States |
Other Details:
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Languages: eng Pagination: 215-8 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 American Society of Hypertension. Published by Elsevier Inc. All rights reserved. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Blood Pressure Monitoring, Ambulatory* Calcium Channel Blockers / therapeutic use* Diuretics / therapeutic use* Drug Therapy, Combination Humans Hypertension / diagnosis*, drug therapy*, epidemiology Renin-Angiotensin System / drug effects Risk Factors |
| Chemical | |
Reg. No./Substance:
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0/Calcium Channel Blockers; 0/Diuretics |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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