Document Detail


Resistant hypertension: prevalence and evolving concepts.
MedLine Citation:
PMID:  17215648     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Resistant hypertension is a common medical disorder. Although the exact incidence of resistant hypertension is not established, estimates derived from recent outcome studies including the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), Valsartan Antihypertensive Long-term Use Evaluation (VALUE), and Controlled Onset Verapamil Investigation of Cardiovascular End Points (CONVINCE) emphasize that this condition may be more common than previously thought. A major advance in our understanding of the pathogenesis and management of resistant hypertension is the recognition of the importance of aldosterone. Several investigators have postulated a direct role of aldosterone excess as an important mechanism for drug resistance in hypertension. The mechanisms whereby aldosterone elevates BP are complex. It was previously thought that aldosterone produced hypertension primarily by promoting sodium retention with consequent hypervolemia. Recent studies of the effects of aldosterone on vascular smooth muscle have, however, delineated several extrarenal mechanisms whereby aldosterone produces hypertension-primarily by its direct vasoconstrictor effects and by altering vascular compliance. Consequently, aldosterone blockade constitutes an effective intervention for treating resistant hypertension.
Authors:
Murray Epstein
Related Documents :
20927128 - Characteristics of resistant hypertension: ageing, body mass index, hyperaldosteronism,...
15854148 - The 'body fluid pressure control system' relies on the renin-angiotensin-aldosterone sy...
3908128 - Cardiovascular, baroreflex and humoral responses in hypertensive patients during nicard...
20921428 - Dietary sodium, aldosterone, and left ventricular mass changes during long-term inhibit...
15947288 - Reversibility of airflow obstruction by hypoglossus nerve stimulation in anesthetized r...
17276688 - Long distance running increases plantar pressures beneath the metatarsal heads: a baref...
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of clinical hypertension (Greenwich, Conn.)     Volume:  9     ISSN:  1524-6175     ISO Abbreviation:  J Clin Hypertens (Greenwich)     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-11     Completed Date:  2007-04-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888554     Medline TA:  J Clin Hypertens (Greenwich)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2-6     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Miami School of Medicine, Miami, FL, USA. murraye@gate.net
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aldosterone / metabolism
Humans
Hypertension* / drug therapy,  epidemiology,  pathology
Prevalence
Recurrence*
Sleep Apnea, Obstructive
Treatment Failure*
Chemical
Reg. No./Substance:
52-39-1/Aldosterone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Uncorrected tetralogy of Fallot in an 86-year-old patient.
Next Document:  Clinical characteristics of resistant hypertension: the importance of compliance and the role of dia...