No abstract

Figure 2. Renal proximal tubule urate transportasome; ABCG2-ATP binding cassette multidrug transporter; OAT-organic anion transporter; URAT-1-uric acid transporter 1.

Patient preparationPatients should refrain from drinking coffee, smoking cigarettes, and using other stimulants for at least 30 minutes before the measurement Measurement should be performed after at least 5 minutes of rest, in a sitting position with the back supported, in a quiet room at comfortable ambient temperature. The arm on which BP is measured should be flexed at the elbow and loosely supported at the level of the heart. The upper arm should be free from any restrictive clothing Measurement techniqueWhen measuring using the classical (auscultatory) technique, the cuff should be inflated to 30 mm Hg above the audible sounds (palpable pulse). The cuff should be deflated at a rate of 2 mm Hg/s Initially, BP should be measured on both arms, with further measurements on the arm with the higher BP reading for long-term BP monitoring and evaluation of the effectiveness of antihypertensive therapy With the auscultatory technique, systolic blood pressure (SBP) is defined as the appearance of the first tone during cuff deflation -Korotkoff phase I, and diastolic blood pressure (DBP) is defined as the disappearance of the last tone during cuff deflation -Korotkoff phase V BP should be calculated as the mean of 2 last measurements, the standard being at least 3 BP measurements performed 1-2 minutes apart during the same visit. If BP values differ between subsequent measurements (> 10 mm Hg), additional measurements should be performed BP measurements in patients with arrhythmia (e.g., atrial fibrillation) should be performed using the auscultatory technique At the initial evaluation, orthostatic challenge (active standing) test should be performed in all patients, with BP measurements at 1 and 3 minutes after standing up from the sitting position. Orthostatic hypotension is defined as SBP fall by ≥ 20 mm Hg or to < 90 mm Hg or DBP fall by ≥ 10 mm Hg. Active lying-to-standing test (standing up from the lying position) should be considered in the elderly, diabetic patients, and patients with other conditions associated with an increased risk of orthostatic hypotension. Extending orthostatic BP measurements to 5 minutes should be considered in these groups Pulse rate should be measured to exclude significant arrhythmia. Resting heart rate is also used for cardiovascular risk evaluation If a BP difference is found between the arms, the higher value should be taken as actual BP (preferred simultaneous BP measurement, and if not available -sequential BP measurement) BP -blood pressure; DBP -diastolic blood pressure; SBP -systolic blood pressure

No abstract

Allopurinol does not produce additional antihypertensive effects in patients with treated arterial hypertension. Allopurinol increases aortic compliance independently of ACE-I or thiazide-based, antihypertensive therapy. However, this effect is significantly dependent on the initial PWV in the aorta and on SBP changes during allopurinol therapy.