Blood pressure, antihypertensive therapy and risk for renal injury in African-Americans

Kaperonis, Nicholas; Bakris, George L.

doi:10.1097/00041552-200301000-00013

Cited by 11 publications

(8 citation statements)

References 30 publications

(29 reference statements)

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“…Family studies have shown that hypertension is more frequent in first-degree relatives of patients with primary glomerulopathies or diabetic nephropathy than in the general population (Adamczak et al 2002). Also, several studies have shown that African Americans are more likely than their white counterparts to develop hypertension-related ESRD (Marcantoni et al 2002;Hayden et al 2003;Kaperonis and Bakris 2003). Hypertension-related ESRD, or hypertensive nephropathy (HN), is a distinct histologic entity; however, in clinical practice, a kidney biopsy is not always performed when an affected individual presents with long-standing hypertension and renal failure.…”

mentioning

confidence: 99%

African American Hypertensive Nephropathy Maps to a New Locus on Chromosome 9q31-q32

Chung

Ferrell

Ellis

et al. 2003

The American Journal of Human Genetics

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Hypertensive nephropathy (HN) and focal segmental glomerulosclerosis (FSGS) are significant causes of end-stage renal disease (ESRD), but no genes or loci have been associated with this phenotype among African Americans, a group at high risk. We performed a genomewide linkage scan with approximately 400 microsatellite markers on 23 individuals of a large four-generation African American family with 18 affected individuals (7 with ESRD), in which the 13-year-old proband (also with ESRD) presented with hypertension and proteinuria (2-4 g/day) and underwent a kidney biopsy that revealed FSGS-like lesions with arteriolar thickening. A genomewide scan revealed LOD scores of >2.5 for markers on chromosomes 3 and 9, and fine mapping was performed on 5 additional members (total 28 members) that showed a maximum multipoint LOD score of 5.4 in the 9q31-q32 region, under an autosomal dominant model with 99% penetrance. This 8-cM (6-Mb) region is flanked by markers D9S172 and D9S105, and further candidate gene sequencing studies excluded the coding regions of three genes (ACTL7A, ACTL7B, and CTNNAL1). To our knowledge, this is the first report of a locus, denoted as "HNP1," for the HN/FSGS phenotype in a large African American family with dominantly inherited nephropathy characterized by ESRD, hypertension, and some features of FSGS.

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mentioning

confidence: 99%

African American Hypertensive Nephropathy Maps to a New Locus on Chromosome 9q31-q32

Chung

Ferrell

Ellis

et al. 2003

The American Journal of Human Genetics

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“…In the high-risk groups such as diabetics, DCCBs reduce new-onset dementia (85), which is a very critical parameter in improving the quality of life. DCCBs were effective in slowing progression of renal injury in African-Americans with hypertensive nephrosclerosis (38). Lercanidipine and losartan attenuated LDL oxidation in hypertensive diabetic patients (60).…”

Section: Therapeutic Advantage Of Angiotensin Receptor Blockers and Cmentioning

confidence: 99%

Untitled

2005

Cardiovascular Drug Reviews

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Current understanding of the genesis of diabetic vascular disease suggests that vascular complications, such as atherosclerosis and hypertension, are associated with changes in structural and functional parameters. Experimental and epidemiological data suggest that activation of the renin-angiotensin-aldosterone system plays an important role in the development of micro-and macro-vascular complications. Most of the negative cardiovascular actions of angiotensin II are mediated through AT 1 receptors, whereas the AT 2 receptors mediate largely beneficial effects. Hence, compared to angiotensin converting enzyme inhibitors (ACEIs), selective AT 1 receptor blockers (ARBs) should provide additional end organ protection via AT 2 receptors activation. Although ACEIs are useful therapeutically, they are being currently displaced by ARBs.Enhanced calcium ion channel activity is reported in vascular smooth muscles from diabetic animal models. Clinical benefits of calcium channel blockers (CCBs) in diabetic hypertensive patients are controversial, but there is increasing experimental evidence for the beneficial effects of dihydropyridine-type CCBs. Although the treatment of hypertension in diabetics reduces cardiovascular and microvascular complications, the ideal strategy for treating hypertension in diabetics has not been well defined and warrants a combination approach. Only limited clinical data regarding the use of ARBs in combination with CCBs in diabetics are available. The experimental data suggest that combination of a CCB and an AT 1 receptor blocker, or a hypothetical dual blocker of AT 1 receptors as well as of calcium channels would be an ideal regimen. There is, however, no conclusive 99

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“…In addition, African Americans with target organ kidney damage are more likely than Whites to develop hypertension-end stage renal disease (ESRD), also called hypertensive nephropathy (HN; Kaperonis & Bakris, 2003). Strong, continuous associations of blood pressure level with risks of target organ damage to the brain, heart, and kidneys make high blood pressure a major risk factor for stroke, heart attack, and kidney failure.…”

Section: Comorbidities Associated With Genetic and Environmental Riskmentioning

confidence: 99%

“…The incidence of end-stage renal disease (ESRD) is 3.6 times higher in African Americans than in non-African Americans and hypertension induced nephrosclerois is more prevalent in African Americans compared to Whites thus attributing hypertension as the second leading cause of ESRD in African Americans (Kaperonis & Bakris, 2003). In addition, African Americans with essential hypertension have an increased susceptibility to glomerular hyperfi ltration in response to salt intake leading to progressive renal injury-damage due to a greater lifetime exposure to sustained blood pressure elevation (Arnett et al, 2001).…”

Section: Comorbidities Associated With Genetic and Environmental Riskmentioning

confidence: 99%

Genetic Influences on Disparities in Hypertension and Obesity in Late Life

Taylor¹

2009

annu rev gerontol geriatr

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Blood pressure, antihypertensive therapy and risk for renal injury in African-Americans

Cited by 11 publications

References 30 publications

African American Hypertensive Nephropathy Maps to a New Locus on Chromosome 9q31-q32

African American Hypertensive Nephropathy Maps to a New Locus on Chromosome 9q31-q32

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Genetic Influences on Disparities in Hypertension and Obesity in Late Life

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