A Possible Interaction Between Systemic and Renal Angiotensinogen in the Control of Blood Pressure
Por: Nirupama Ramkumar, Deborah Stuart, Jian Ying y Donald E. Kohan. American Journal of Hypertension, Volume 26, Issue 4, Pp. 473-480.
Angiotensinogen (AGT) is synthesized in the liver and proximal tubule. AGT overexpression at either site might increase blood pressure (BP). We used transgenic mice with AGT overexpression in proximal tubule (K), liver (L), or both sites (KL) to determine the relative contributions of hepatic- and proximal tubule–derived AGT in modulating BP. Mice with liver AGT overexpression manifest salt-sensitive hypertension, whereas mice with renal AGT overexpression are hypertensive regardless of salt intake. Systemic AGT may stimulate endogenous renal AGT synthesis during high sodium intake, leading to hypertension in L mice. [Actualizado: 3 de junio 2013]
Esta sección expone trabajos actuales, de carácter investigativo sobre la hipertensión arterial.
How important is it to control nocturnal hypertension with angiotensin II type 1 receptor blockers?
Por: Shin-ichiro Miura y Keijiro Saku. Hypertension Research (2013) 36, 194–195.
Better blood pressure (BP) control is associated with remarkable clinical benefits with regard to cardiovascular (CV) and renal protection. Patients with chronic kidney disease (CKD) are at significantly higher risk of CV disease (CVD),1 and patients with overt proteinuria as well as albuminuria without a reduction in the estimated glomerular filtration rate (eGFR) are also at significantly higher risk.1 In addition, proteinuria or albuminuria itself should be a target for reducing hard end points. Angiotensin II (Ang II) type 1 (AT1) receptor blockers (ARBs) are highly selective for the AT1 receptor and block the deleterious effects of Ang II.2 ARBs clearly decrease proteinuria and protect the kidneys.3 A nocturnal increase in BP on ambulatory monitoring is superior to office BP for predicting a worsening of albuminuria in elderly individuals with type 2 diabetes. [Actualizado: 11 de marzo 2013]
A critical appraisal of the clinical effectiveness of a fixed combination of valsartan, amlodipine, and hydrochlorothiazide in achieving blood pressure goals. [En idioma inglés]
Por: Cheryl L Laffer y Fernando Elijovich. Integr Blood Press Control. 2011; 4: 1–5.
Las recientes directrices para el tratamiento de la hipertensión se han centrado en la necesidad de medicamentos múltiples para obtener la mayoría de los pacientes con el objetivo de presión arterial (PA). De dos a tres diferentes clases de fármacos antihipertensivos se requieren con frecuencia, aumentando el riesgo de incumplimiento de la terapia. Por lo tanto, las directrices han recomendado a partir de la terapia de combinación en pacientes con presión arterial que es más de 20 mm Hg de sistólica o 10 mm Hg en la diastólica por encima de meta. El último avance en el régimen de tratamiento ha sido el desarrollo de combinaciones de triple terapia de un bloqueador del receptor de la angiotensina, la amlodipina, e hidroclorotiazida.
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