Long-term diuretic therapy and renal function in essential arterial hypertension

Alcázar, Jose María Morillas; Rodicio, José L.; Ruilope, Luís M.

doi:10.1016/0002-9149(90)90343-y

Cited by 11 publications

(12 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, despite the blood pressure reduction, the overall excretion rate was not significantly affected. This observation is in agreement with data from studies on patients with mild to moderate hypertension [12,13,15,261, as well as on hypertensive animals 1141, where adequate control of blood pressure using primarily &blockers and/or diuretics neither reduced the albumin excretion rate nor prevented progression of renal dysfunction. Information regarding the reduction in blood pressure obtained by use of calcium antagonists and related changes in albuminuria is limited.…”

Section: Discussionsupporting

confidence: 90%

Calcium antagonism in essential hypertension: effect on renal haemodynamics and microalbuminuria

Persson

Andersson

Wysocki

et al. 1992

Journal of Internal Medicine

View full text Add to dashboard Cite

Sixteen middle-aged men with primary hypertension were treated with the calcium antagonist isradipine over a 9-week period in a randomized, placebo-controlled, double-blind cross-over manner. At the end of the intervention period the urinary albumin excretion rate, systemic and renal haemodynamics, haemorheological properties of blood and plasma concentrations of atrial natriuretic peptide, noradrenaline and peripheral renin activity were determined. Treatment with isradipine resulted in a substantial reduction in blood pressure due to a reduction in peripheral resistance. The mean albumin excretion rate was not influenced by the isradipine treatment. In a multivariate analysis, changes in the urinary albumin excretion rate were only related to changes in blood pressure.

show abstract

Section: Discussionsupporting

confidence: 90%

Calcium antagonism in essential hypertension: effect on renal haemodynamics and microalbuminuria

Persson

Andersson

Wysocki

et al. 1992

Journal of Internal Medicine

View full text Add to dashboard Cite

show abstract

“…Indeed, there is accumulating evidence that end-organ damage can progress despite control of resting BP levels 30,31 and that BP levels during mental stress are more closely associated with left ventricular mass than are resting BP levels. 32 Beneficial changes in the hemodynamic pattern resulting from treatment were also observed.…”

Section: Georgiades Et Al Effects Of Exercise and Weight Loss On Elevmentioning

confidence: 99%

Effects of Exercise and Weight Loss on Mental Stress–Induced Cardiovascular Responses in Individuals With High Blood Pressure

et al. 2000

View full text Add to dashboard Cite

Abstract-The purpose of this study was to determine the effects of exercise and weight loss on cardiovascular responses during mental stress in mildly to moderately overweight patients with elevated blood pressure. Ninety-nine men and women with high normal or unmedicated stage 1 to stage 2 hypertension (systolic blood pressure 130 to 179 mm Hg, diastolic blood pressure 85 to 109 mm Hg) underwent a battery of mental stress tests, including simulated public speaking, anger recall interview, mirror trace, and cold pressor, before and after a 6-month treatment program. Subjects were randomly assigned to 1 of 3 treatments: (1) aerobic exercise, (2) weight management combining aerobic exercise with a behavioral weight loss program, or (3) waiting list control group. After 6 months, compared with control subjects, participants in both active treatment groups had lower levels of systolic blood pressure, diastolic blood pressure, total peripheral resistance, and heart rate at rest and during mental stress. Compared with subjects in the control group, subjects in the exercise and weight management groups also had greater resting stroke volume and cardiac output. Diastolic blood pressure was lower for the weight management group than for the exercise-only group during all mental stress tasks. These results demonstrate that exercise, particularly when combined with a weight loss program, can lower both resting and stress-induced blood pressure levels and produce a favorable hemodynamic pattern resembling that targeted for antihypertensive therapy. Key Words: hypertension, essential Ⅲ exercise Ⅲ obesity Ⅲ stress Ⅲ hemodynamics E pidemiological studies have shown that increased levels of physical activity reduce the incidence of all-cause mortality and cardiovascular-related deaths. 1 Although the mechanisms responsible for this benefit are not fully understood, exercise is known to have favorable effects on such traditional risk factors as elevated blood pressure (BP), 2 hyperinsulinemia, 3 and hyperlipidemia. 4 Recently, a number of biobehavioral risk factors that potentially may be modifiable with exercise have been identified. 5 For example, exercise has been shown to reduce depression, 6 anxiety, 7 and type A behavior. 8 An exaggerated cardiovascular response to mental stress is an additional risk factor, which has been shown to be associated with myocardial ischemia 9 and is predictive of the future development of hypertension 10,11 and coronary heart disease. 12 A series of cross-sectional studies have shown that individuals who are more active or physically fit have lower cardiovascular responses to stress. 13 Longitudinal studies are less consistent but generally demonstrate that heart rate (HR) and BP levels are attenuated after exercise training in healthy normotensive men and women. 14 However, to the best of our knowledge, the effects of exercise on BP stress responses in hypertensive individuals has not been studied. Moreover, because weight loss is associated with lower clinic BP 15 but has not been studied in...

show abstract

“…The efficacy of BP treatment or control is traditionally assessed at rest and in certain cases; the advent of ambulatory BP monitoring has allowed BP control to be assessed on the go 5. It has been suggested that end-organ damage progresses despite control of resting BP 6–8. This may be related to the level of BP control and the BP response that is generated as individuals go about their routine daily activities.…”

Section: Introductionmentioning

confidence: 99%

Blood Pressure Control and Exaggerated Blood Pressure Response in Nigerians with Essential Hypertension

Abiodun

Balogun

Adebayo

et al. 2014

Clin Med Insights Cardiol

View full text Add to dashboard Cite

BACKGROUNDBlood pressure (BP) control in hypertensives is important in preventing cardiovascular (CV) morbidity and mortality. This work was done to assess control of BP among Nigerian hypertensives at rest and during exercise.MATERIALS AND METHODSA total of 85 male hypertensives were recruited consecutively and had clinical evaluation and treadmill (TM) exercise testing using the Bruce protocol. Independent t-test, chi-square, and Fisher’s exact tests were used to compare patients with controlled and uncontrolled BP using SPSS version 16 software. Adjustment for confounders was by logistic regression and general linear model.RESULTSResting systolic BP (rSBP) (mmHg) and resting diastolic BP (rDBP) (mmHg) were significantly lower in the controlled group (115.0 ± 12.29, 133.1 ± 12.27, P = <0.001 and 76.00 ± 6.55, 91.4 ± 8.00, P = <0.001). The proportion of subjects with controlled BP was 37.7%. Adjusted peak SBP (PSBP) during exercise (mmHg) was significantly higher in the uncontrolled than in the controlled group (210.5 ± 27.31, 191.8 ± 20.77, P = 0.001). Adjusted exaggerated blood pressure response (EBPR) was found in 37 subjects (44%) in the uncontrolled group while seven subjects (0.1%) had EBPR in the controlled group (P = 0.003).CONCLUSIONThis study shows that EBPR is significantly higher in subjects with uncontrolled BP compared with those with controlled BP. Therefore, good BP control may be the key factor in preventing EBPR in hypertensives.

show abstract

Long-term diuretic therapy and renal function in essential arterial hypertension

Cited by 11 publications

References 16 publications

Calcium antagonism in essential hypertension: effect on renal haemodynamics and microalbuminuria

Calcium antagonism in essential hypertension: effect on renal haemodynamics and microalbuminuria

Effects of Exercise and Weight Loss on Mental Stress–Induced Cardiovascular Responses in Individuals With High Blood Pressure

Blood Pressure Control and Exaggerated Blood Pressure Response in Nigerians with Essential Hypertension

Contact Info

Product

Resources

About