Pathophysiology and Potential Non-Pharmacologic Treatments of Obesity or Kidney Disease Associated Refractory Hypertension

Jemtel, Thierry H. Le; Richardson, William; Samson, Rohan; Jaiswal, Abhishek; Oparil, Suzanne

doi:10.1007/s11906-017-0713-6

Cited by 8 publications

(6 citation statements)

References 199 publications

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“…Renal denervation does not appear to have a role in the management of obesity or chronic kidney disease associated hypertension. 52…”

Section: Antihypertensive Drug Selection In Overweight and Obese Patimentioning

confidence: 99%

Obesity and Hypertension

Ersoy

2019

Turkish Journal of Internal Medicine

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Obesity is an important public health problem with increasing frequency, leading to different comorbidities including hypertension and can cause mortality. Possible mechanisms that increase blood pressure in overweight and obese people are renal damage, activation of the renin-angiotensin-aldosterone system, insulin resistance, hyperinsulinemia, sleep apnea syndrome, leptin-melanocortin pathway and genetic predisposition. Most of these mechanisms stimulate the sympathetic nervous system. Medical nutrition therapy, lifestyle interventions, medical and/or surgical antiobesity treatment modalities contribute to the control of blood pressure via weight loss. Besides antihypertensive medications should be chosen carefully in overweight and obese patients and drug groups preventing weight loss should not be preferred if possible.

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“…Renal denervation does not appear to have a role in the management of obesity or chronic kidney disease associated hypertension. 52…”

Section: Antihypertensive Drug Selection In Overweight and Obese Patimentioning

confidence: 99%

Obesity and Hypertension

Ersoy

2019

Turkish Journal of Internal Medicine

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“…It has been estimated that 20–25% of kidney disease patients in the world are obese, and this number may be significantly increased after intermediate disease including type 2 diabetes mellitus (T2DM) and hypertension. Many epidemiological studies have shown that obesity is independently related to proteinuria, chronic kidney disease, Acute kidney injury (AKI), and End-Stage Renal Disease (ESRD) [ 5 ]. The results of a large-scale study have shown that, when the BMI increased to more than 25 kg/m, the risk of a decreased glomerular filtration rate was also increased.…”

Section: Cellular Senescence In Metabolic-associated Kidney Diseasesmentioning

confidence: 99%

“…Under these combined effects, the glomerular protein filtration rate is increased, and segmental necrosis and glomerular sclerosis can occur. Impairment of the glomerular filtration barrier will lead to proteinuria and podocyte reduction, which then leads to the exposure of and damage to the glomerular basement membrane [ 5 ]. With the prolongation of injury, cell stress will continue to accumulate, stimulating the process of cellular senescence.…”

Section: Cellular Senescence In Metabolic-associated Kidney Diseasesmentioning

confidence: 99%

“…In the kidney, differing from acute senescence, under chronic senescence, the accumulation of senescent cells acts against recovery of the tissue and contributes to the chronic progression of the metabolic-associated kidney diseases mentioned above. In addition, it serves to reduce renal function—for example, through accelerating glomerulosclerosis, affecting the regenerative capacity of the kidney, and promoting renal allograft rejection [ 5 ]. The cellular senescence we discuss here refers to “chronic senescence”.…”

Section: Introductionmentioning

confidence: 99%

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Cellular Senescence in Metabolic-Associated Kidney Disease: An Update

Gao

Zou

Sun

et al. 2022

Cells

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Cellular senescence is described as the state where the cell cycle is arrested irreversibly, which occurs in response to various forms of stress factors in cells, leading to the senescence-associated secretory phenotype (SASP). We can assess the accumulation of senescent cells in tissues or organs through biomarkers of cellular senescence such as p16INK4a, p53, p21, and SA-β-GAL. In recent decades, a large number of studies have reported the biomarkers of increased cell senescence in pathogenic tissues, demonstrating the possible connection between cell senescence and various diseases. Kidney damage often occurs in the pathophysiological process of certain metabolic diseases, resulting in metabolic-associated kidney diseases. For example, hypertension causes systemic arteriosclerosis, and the kidney can be seriously affected by abundant blood vessels, which may lead to a decreased glomerular filtration rate (GFR) and proteinuria, resulting in hypertension-related kidney diseases. The accumulation of senescent cells may also be observed in some metabolic-associated kidney diseases (such as obesity-related nephropathy, hypertension-related nephropathy, and diabetic nephropathy). In this paper, we review existing knowledge regarding the influence of cellular senescence on metabolic-associated kidney diseases, providing new ideas for future treatment.

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“…In addition, other studies have shown that diabetes is associated with a resistant hypertension [13,14]. Studies show that resistant AH is associated with an increase in age, female gender, Negroid race, the presence of diabetes mellitus, obesity, chronic kidney disease, and left ventricular hypertrophy [1,10,[15][16][17][18][19]. For early detection of resistant AH, aggressive therapy can reduce both cardiovascular morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Resistance Hypertension and Achievement of Target Blood Pressure Levels in Patients with Resistant Hypertension

Sirenko¹,

Rekovets²,

Torbas³

2020

Understanding the Molecular Crosstalk in Biological Processes

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Uncontrolled arterial pressure is associated with a fourfold increase in the risk of developing cardiovascular events compared to patients with hypertension who have reached the target blood pressure level. The aim of this study is to evaluate the characteristics of patients with resistant arterial hypertension undergoing inpatient treatment at the Department of Symptomatic Hypertension and assess the prevalence of true resistant hypertension in a cohort of patients who take 3 and more antihypertensive agents, the clinical predictors of resistant hypertension. The study included 1146 patients with resistant AH who received 3 or more antihypertensive drugs with the level of office blood pressure at admission ≥140/90 mm Hg. Patients were followed by the next examinations: body height and body measurements, office blood pressure, echocardiography, sleep apnea determination, blood biochemical analysis, determination of levels of TTH, T3, T4, blood renin, blood aldosterone, metanephrine urine, and cortisol. Our data showed that 31% of patients who received 3 or more antihypertensive drugs had true resistant hypertension. Fixed combinations were taken by 71.9% of patients. We have found which factors were significantly associated with the treatment regimen with ≥3 or 4 drugs. Also we have demonstrated predictors for blood pressure reduction.

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Pathophysiology and Potential Non-Pharmacologic Treatments of Obesity or Kidney Disease Associated Refractory Hypertension

Cited by 8 publications

References 199 publications

Obesity and Hypertension

Obesity and Hypertension

Cellular Senescence in Metabolic-Associated Kidney Disease: An Update

Predictors of Resistance Hypertension and Achievement of Target Blood Pressure Levels in Patients with Resistant Hypertension

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