1,721,199 research outputs found
Dual renin-angiotensin systemblockade and vascular remodeling. Is this a real advantage for vascular protection?
No full textEssential hypertension is characterized by increased peripheral vascular resistance to blood flow particularly in younger individuals. Resistance arteries undergo vascular remodeling (reduced vascular lumen with increased media thickness) that may be functional, mechanical, and/or structural [1,2][1,2]. Small decreases in the lumen diameter significantly increase resistance to blood flow. Increased media-to-lumen ratio (M/L) is the most reproducible parameter of vascular remodeling of resistance arteries [1,3][1,3]. Interestingly, an increased M/L ratio of subcutaneous small resistance arteries is a potent predictor of cardiovascular events in patients with increased blood pressure values [4–6][4–6][4–6] and different cardiovascular risk [4,5][4,5]. In hypertensive patients, it is thought that increased M/L ratio could be the earliest alteration that occurs in the vasculature [7] and may precede endothelial dysfunction [7,8][7,8]. The extent of structural alterations in subcutaneous small resistance arteries is particularly pronounced in hypertensive patients with type 2 diabetes mellitus [9] or obesity [10–12][10–12][10–12]. Thus, the association of several cardiovascular risk factors may have a synergistic, deleterious effect on the microcirculation. Furthermore, the remodeled resistance arteries are the sites of origin of most of the wave reflections that travel backward toward the heart, contributing to the stiffness of large arteries and the increased central SBP
Flavanol-rich cocoa at breakfast: the right remedy after a sleepless night to prevent negative effects on blood pressure and cognition?
No full textComment on
Flavanol-rich chocolate acutely improves arterial function and working memory performance counteracting the effects of sleep deprivation in healthy individuals. [J Hypertens. 2016
Does skin microcirculation represent a faithful mirror of uric acid alterations?
No full textnot availabl
Can we predict outcome by noninvasive assessment of renal haemodynamics in hypertension? The role of renal resistive index
No full textVentricular-arterial coupling in the clinical evolution of acute ischemic stroke
No full textEditorial Comment related to a paper published in the same issue of the Journal of Hypertensio
Juxtaposing Hypertension Guidelines: Are They Different? A Pragmatic Look to ESC and ESH Guidelines on (Arterial) Hypertension
Full text linkHypertension is a major public health challenge as its
prevalence continues to increase despite the optimisation
of therapies. According to the latest WHO/Europe report,
“Action on salt and hypertension”, 36.9% of people in
Europe have hypertension [1]. In 2019, more than 20% of
deaths in Europe have been caused by high systolic blood
pressure, and the proportion of hypertensive patients who
do not achieve adequate blood pressure control was from
more than 60% up to over than 80%, very heterogeneous if
we look at each European country individually [2
A lesson from polycystic ovarian syndrome: untangling the role of renal sympathetic nervous system on hypertension and insulin resistance
No full text[No abstract available
Is It All about Endothelial Dysfunction? Focusing on the Alteration in Endothelial Integrity as a Key Determinant of Different Pathological Mechanisms
No full textElevated heart rate and cardiovascular risk in hypertension
No full textEpidemiological studies have shown that chronically elevated resting heart rate (HR) is significantly associated with organ damage, morbidity and mortality in a wide range of patients including hypertensive patients. Evidence is also available that an increased HR reflects sympathetic nervous system overdrive which is also known to adversely affect organ structure and function and to increase the risk of unfavourable outcomes in several diseases. The causal relationship between elevated HR, organ damage, and cardiovascular outcomes can thus be explained by its relationship with sympathetic cardiovascular influences although evidence of sympathetically-independent adverse effect of HR increases per se makes it more complex. Interventions that target HR by modulating the sympathetic nervous system have therefore a strong pathophysiological and clinical rationale. As most clinical guidelines now recommend the use of combination therapies in patients with hypertension, it might be desirable to consider as combination components drugs which lower HR, if HR is elevated such as, according to guideliines, when it is above 80 b/min
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