Current Hypertension Reviews - Volume 3, Issue 1, 2007

It is time to recognize that the quality, not quantity, of myocardium in hypertensive heart disease is responsible for adverse cardiovascular events. Experimental and clinical available data indicate that myocardial fibrosis due to the exaggerated accumulation of collagen type I and type III fibers predisposes to an enhanced risk of diastolic and/or systolic ventricular dysfunction, symptomatic heart failure, ischemic heart disease, a Read More

Calcium channel blockers (CCB) represent a class of drugs widely used for treatment of hypertension and coronary heart disease. Some case-control studies published 10 years ago that included patients treated with short acting dihydropyridines reported several apparently harmful actions of this class of drugs, such as increased risk of myocardial infarction, cancer and gastrointestinal bleeding. However, in the last six years Read More

Beta-blockers are recommended as first line therapy in the treatment of essential hypertension since several decades and this recommendation has been endorsed by most if not all national and international guideline committees. Some concerns about their efficacy in elderly hypertensive patients have been raised in the mid-90ies. With the recent publication of the LIFE and ASCOT-BPLA trials showing the superiority of a lo Read More

Beta-adrenergic receptor blockers are one of the oldest class of cardiovascular drugs still in use. Several short and long-term clinical outcomes prospective studies have demonstrated their effectiveness and safety for the treatment of hypertension, coronary artery disease, myocardial infarction, heart failure and sudden death. Despite their proven benefits, some investigators have cautioned against their use, and other Read More

Albuminuria is the increased excretion of the serum protein albumin into the urine. Albuminuria is classically seen as an important diagnostic marker of declining kidney function, however, more recently albuminuria has also been implicated as a marker for cardiovascular and peripheral vascular disease indicating an important link between processes governing both cardiovascular and renal function. This review will discu Read More

The renin-angiotensin system (RAS) is a major physiological regulator of body fluid volume, electrolyte balance, and arterial blood pressure. Systemic suppression of the RAS through angiotensin converting-enzyme (ACE) inhibition and/or angiotensin receptor blockade (ARB) is an established and effective therapeutic approach for a range of cardiovascular disorders. One of the functions of renin is to catalyze the cl Read More

The epithelial Na+ channel (ENaC) forms the rate limiting step in transepithelial Na+ absorption across aldosterone- responsive tissues such as the distal nephron. After more than a decade of investigation it is clear that the mechanisms of ENaC regulation are complex with an array of ENaC-regulatory proteins having been identified. A variety of monogenic syndromes of low renin hypertension have been identified that serve, Read More

An increased concentration of homocysteine (Hcy) is considered an independent and graded cardiovascular risk factor. Hcy can be non-specifically activated by methionyl-tRNA synthetase to Homocysteine thiolactone (HTL). HTL is hydrolyzed to Hcy by the paraoxonase/Thiolactonase (PON1) enzyme. PON1 is a calcium-dependent esterase synthesized in the liver and contained in plasma High-Density Lipoproteins (HDLs). The P Read More

Hypertension is a serious complication in children after renal transplantation, it is an important risk factor not only for graft loss but also for cardiovascular morbidity and mortality of transplanted patients. The etiology of posttransplant hypertension is multifactorial - pretransplant hypertension, damaged native kidneys, immunosuppressive therapy (steroids, cyclosporine, tacrolimus), renal graft artery stenosis and Read More

Preeclampsia is defined as new onset hypertension with proteinuria during pregnancy. The initiating event in preeclampsia is postulated to be reduced uteroplacental perfusion which leads to widespread dysfunction of the maternal vascular endothelium. Inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF alpha) are thought to be important links between placental ischemia and cardio Read More

The heme oxygenase (HO) system has received significant attention in recent years as a possible novel target for antihypertensive therapy. HO is the rate limiting enzyme in the metabolism of heme releasing bioactive molecules carbon monoxide (CO) and bilirubin each with beneficial cardiovascular actions. Induction of HO-1 has been demonstrated to lower blood pressure in several animal models of hypertension In a Read More