Hypertensive black men and women. Quality of life and effects of antihypertensive medications. Black Hypertension Quality of Life Multicenter Trial Group

Sh, Croog; Bw, Kong; Levine, Sol; Mr, Weir; Rm, Baume; Saunders, Elijah

doi:10.1001/archinte.150.8.1733

Cited by 46 publications

(27 citation statements)

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“…Drugs targeting the RAAS (angiotensin I-converting enzyme (ACE) inhibitors or angiotensinogen II receptor type 1 antagonists) have been shown to reduce hypertension and decrease proteinuria (Collier, et al, 1973;Gavras, et al, 1974;Pickering and Prinzmetal, 1940) with a concomitant reduction in rate of renal injury in chronic kidney disease. These drugs have been shown to be effective, with a range of effects, in a majority of patients (Corvol and Plouin, 2002;Croog, et al, 1990).…”

Section: Introductionmentioning

confidence: 99%

Functional genetic variation in aminopeptidase A (ENPEP): Lack of clear association with focal and segmental glomerulosclerosis (FSGS)

Tonna

Dandapani

Uscinski

et al. 2008

Gene

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The aminopeptidase A (APA) ectopeptidase is an integral membrane-bound zinc metalloprotease that cleaves aspartic and glutamic acidic residues from the N-terminus of a number of protein substrates that includes angiotensin II. Angiotensin II, the most vasoactive component of the reninangiotensin-aldosterone (RAAS) pathway, can contribute to renal disease by causing an increase in arterial blood pressure leading to glomerular injury and fibrosis. APA is expressed in many organs, including the kidney where it localizes mainly to the podocyte cell membrane and brush borders of the proximal tubule cells. Antibodies directed to the APA peptide can induce an acute massive albuminuria in wild type BALB/c mice after intravenous injection.We examined whether variants in the APA encoding gene (ENPEP) are more frequent in individuals with the proteinuric disease focal and segmental glomerulosclerosis (FSGS) compared to control individuals. The ENPEP coding sequence was resequenced in 188 FSGS patients and 48 controls. Genetic variants were further genotyped in 181 individuals without any known kidney disease. We then examined the effect of the non-synonymous coding variants identified on their cell surface APA activity after transfection in COS-1 cells.Several of these ENPEP variants lead to reproducibly altered APA activity. However, we did not see a clear correlation between the presence of a functional ENPEP variant and FSGS. However, the existence of these variants with marked effect on APA activity suggests that both rare and common variation in ENPEP may contribute to the development of renal and hypertensive disorders and warrants further study.

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Section: Introductionmentioning

confidence: 99%

Functional genetic variation in aminopeptidase A (ENPEP): Lack of clear association with focal and segmental glomerulosclerosis (FSGS)

Tonna

Dandapani

Uscinski

et al. 2008

Gene

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“…It was noted above that in the study that compared captopril, atenolol and verapamil in 306 Black men and women no pattern of difference emerged (Croog et al 1990). On the positive side, the study was substantial and a reasonable battery of instruments was used -although they did differ from those in the earlier trial (Croog et al 1986), and no justification for the difference was given.…”

Section: Other Antihypertensive Agentsmentioning

confidence: 93%

“…In 2 very substantial trials, quantitatively (and probably clinically) important differences appeared after 24 weeks of active treatment that were not apparent during earlier assessments (Croog et al 1986;Testa et al 1990). A duration of only 8 weeks might have contributed as much to the absence of a difference between atenolol, captopril and verapamil in their influence on quality oflife measures as did the limited power imposed by enrolling both males and females (Croog et al 1990). …”

Section: Consensusmentioning

confidence: 99%

“…Certainly any study that attempts to assess both men and women should stratify for gender, which demands a large increase in study size to maintain power. A recent study on antihypertensive agents enrolled both men and women (Croog et al 1990). Although 394 were randomised, and each treatment group included over 100 patients, the necessity of analysing and reporting the results by gender must have reduced the power substantially, and perhaps contributed to the authors' failure to identify differences among the effects of atenolol, verapamil and captopril.…”

Section: Confounding Factorsmentioning

confidence: 99%

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Quality of Life as a Therapeutic End-Point An Analysis of Therapeutic Trials in Hypertension

1991

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The term 'quality of life' is finding increasing use in the popular press and the medical community. In both areas, its use often lacks precision: a comprehensive and universal definition probably does not exist. Indeed, the precise elements contributing probably vary from person to person and from time to time. There is broad agreement that 5 major areas always need assessment, including physical and emotional state, performance of social roles, intellectual function and general feelings of well-being or life satisfaction. A wide range of instruments has been employed in a large number of studies on the effects of antihypertensive agents on quality of life in the patient with hypertension. Hypertension represents a special problem in which the patient is thought to be free of related symptoms, and treatment designed to improve natural history brings with it the burden of adverse reactions. Although some insights have been gained on the relative influence of various therapeutic regimens on the quality of life of treated patients, in many of the studies too little consideration has been given to the use of instruments that have been validated in the patient population to be studied, to the power of the study and its design, to the contribution of confounding variables such as age and gender, and to evidence that short term trials (measured in weeks) can miss important changes that occur over months in a process where treatment is life-long. For these reasons, we believe, the literature on the subject is burdened by many reports that describe no difference among treatment regimens where important differences might exist. On the positive side, important advances have been made in our understanding of the elements that contribute to quality of life and in approaches to its assessment.

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“…[6][7][8] Several studies also show that quality of life with selective ␤ 1 -blockers cannot be differentiated from that with angiotensinconverting enzyme (ACE)-inhibitors, 7,9-14 and calcium antagonists. [15][16][17] Compared to ␤-blockers and ACE inhibitors, quality of life with diuretics has not been studied extensively, 4,9 and conclusions were inconsistent. 18 Some studies showed a negative impact on quality of life of thiazide diuretics given as monotherapy, 18 or added to existing antihypertensive treatment.…”

Section: Introductionmentioning

confidence: 99%

Impact of antihypertensive treatment on quality of life: comparison between bisoprolol and bendrofluazide

et al. 1999

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Hypertensive black men and women. Quality of life and effects of antihypertensive medications. Black Hypertension Quality of Life Multicenter Trial Group

Cited by 46 publications

References 0 publications

Functional genetic variation in aminopeptidase A (ENPEP): Lack of clear association with focal and segmental glomerulosclerosis (FSGS)

Functional genetic variation in aminopeptidase A (ENPEP): Lack of clear association with focal and segmental glomerulosclerosis (FSGS)

Quality of Life as a Therapeutic End-Point An Analysis of Therapeutic Trials in Hypertension

Impact of antihypertensive treatment on quality of life: comparison between bisoprolol and bendrofluazide

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