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Here's an essential reference for anyone needing an advanced understanding of the nature and treatment of hypertension. Dr. Laragh, a pioneering clinician and scientist, demonstrates the central role of an overactive renin system for causing most hypertension. In his new book, Dr. Laragh discusses his research and its relevance to caring for everything from asymptomatic patients to hypertensive emergencies. And, he provides visit-by-visit details of his new pathophysiologically and biochemically guided treatment. The result of his work is a specific approach that makes it possible to more effectively prevent, arrest, and treat hypertension and its consequences--including congestive heart failure, myocardial infarction, kidney failure and stroke.
Chronic kidney disease is one of the world's major public health problems, and the prevalence of kidney failure is rising steadily. Among the risk factors for a faster progression of renal disease are hypertension and proteinuria, many studies clearly demonstrating that hypertension is both a cause and consequence of chronic kidney disease. Namely, renal blood pressure regulation seems to be involved in five major pathophysiological mechanisms (all closely related to the renin-angiotensin system): Pressure-natriuresis, renal sympathetic nervous system, renal blood flow, intraglomerular pressure and tubuloglomerular feedback. This book reviews experimental data which form the basis of our current understanding of the association between hypertension and kidney diseases: The pathogenesis of increased blood pressure, the mechanisms by which systemic hypertension promotes progressive kidney failure, and the impact of antihypertensive agents on experimental renal mechanisms involved in hypertension. Furthermore, the role of angiotensin II receptor blockers in both the control of systemic blood pressure and the reduction of proteinuria is examined in an attempt to define optimal therapeutic strategies to prevent the otherwise inexorable deterioration of renal function in patients with chronic kidney disease.
The revised and updated 2nd Edition provides a logical, practical framework for managing patients with hypertension. Today's leading experts discuss all aspects of the field-from pathophysiology, pharmacological treatments, and lifestyle modifications to secondary hypertension and cardiovascular complications. Assesses the risks of specific pharmacological treatments * offers expert analysis of recent clinical trials * and provides Delivers strategies for managing patients with comorbid conditions such as diabetes, renal disease, and ischemic heart disease. Explains the role of vascular biology in the pathogenesis of hypertension. Includes 11 new chapters: The National High Blood Pressure Education Program * Angiotensin 1-7 * Aldosterone and Minealocorticoids * Vasodilator Peptides * Clinical Outcome Trials of Hypertension with Angiotensin Receptor Blockers * ACE Inhibitor Trials: Effects in Hypertension * Obesity and Hypertension: Role of Diet Drugs * Exercise and Hypertension * Pharmacokinetics of Antihypertensive Drugs * Hypertension in Children * and Dietary Approaches to Hypertension Management: The DASH Studies. Provides complete revisions of all other existing chapters. Features new clinical pearls * evidence-based therapeutic ladders that summarize key therapy regimens * and preferred treatment boxes that highlight important information.
The present book covers the basic principles of cardiovascular physiology, pathophysiology and advanced pharmacology with particular emphasis on cellular mechanisms of drug action. It provides an update on the progress made in several aspects of cardiovascular diseases so that it might kindle scientists and clinicians alike in furthering basic and translational research. In addition, the book is expected to fill imperative gaps in understanding and optimally treating cardiovascular disease.
The main aim of this book is to evaluate the concept of stress and provide tools for physicians to identify patients who might benefit from stress management. This will incorporate a detailed description of the physiological and pathophysiological consequences of acute and chronic stress that might lead to cardiovascular disease. The book will aim to critically evaluate interventional research (behavioural and other therapies) and provide evidence based recommendations on how to manage stress in the cardiovascular patient. Our intentions are to define and highlight stress as an etiological factor for cardiovascular disease, and to describe an evidence based "tool box" that physicians may use to identify and manage patients in whom stress may be an important contributing factor for their disease and their risk of suffering cardiovascular complications.
Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate The Dietary Reference Intakes (DRIs) are quantitative estimates of nutrient intakes to be used for planning and assessing diets for healthy people. This new report, the sixth in a series of reports presenting dietary reference values for the intakes of nutrients by Americans and Canadians, establishes nutrient recommendations on water, potassium, and salt for health maintenance and the reduction of chronic disease risk. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate discusses in detail the role of water, potassium, salt, chloride, and sulfate in human physiology and health. The major findings in this book include the establishment of Adequate Intakes for total water (drinking water, beverages, and food), potassium, sodium, and chloride and the establishment of Tolerable Upper Intake levels for sodium and chloride. The book makes research recommendations for information needed to advance the understanding of human requirements for water and electrolytes, as well as adverse effects associated with the intake of excessive amounts of water, sodium, chloride, potassium, and sulfate. This book will be an invaluable reference for nutritionists, nutrition researchers, and food manufacturers.
Classic and modern tools of genetics have been applied to hypertension research for some 20 years. This volume in the Handbook of Hypertension series aims to go beyond a simple summary of discoveries and provides a critical commentary on many controversial issues. It will be particularly useful for clinician scientists at all stages of their careers, graduate students and post-doctoral scientists as well as all those interested in cardiovascular medicine and research throughout the entire spectrum from bench to bedside. As in every relatively young area of research, the initial excitement over the early positive observations has not always been confirmed by subsequent larger studies with greater statistical power. Issues related to current recommendations on design of studies and their analysis are therefore included. Pharmacogenetics and pharmacogenomics have been the subjects of many debates in recent years and are of particular importance in hypertension as life-long treatments, frequently with multiple drugs are given to millions of people world-wide. A critical appraisal of this controversial topic is provided. Several chapters on experimental genetics of hypertension with a special focus on physiological genomics are also included.
MICHEL E. SAFAR and MICHAEL F. O'ROURKE One of the principal problems of hypertension is the precise definition of blood pressure as a cardiovascular risk factor. Clinicians indicate peak systolic pressure and end diastolic pressure in the brachial artery as the principal criteria for blood pressure measurement. Consequently, these values are as indicators for clinical management and therapeutic adjustment. This used methodology, based on indirect blood pressure measurements at the site of the brachial artery relates only to the highest and lowest pressure in that vessel, and does not give any information of the blood pressure curve itself; this carries more information than peak systolic pressure and end diastolic pressure. As a first step in better analysis of the blood pressure curve, research workers in experimental hypertension defined in addition to peak systolic pressure and end diastolic, another blood pressure value, mean arterial pressure, i. e. the average pressure throughout the cardiac cycle, and about which pressure fluctuates. This is the pressure recorded by Hales [1] and by Poiseuille [2] in their pioneering studies. By application of Poiseuille's Law, this definition of mean arterial pressure led to the concept that increased mean arterial pressure (and therefore hypertension) was related, at any given value of cardiac output, to an increase in vascular resistance, i. e. to a reduc tion in the caliber of the small arteries.
This reference book contains a comprehensive selection of the most frequently used assays for reliably detecting pharmacological effects of potential drugs, including tests for cardiovascular, analgesic, psychotropic, metabolic, endocrine, respiratory, renal, and immunomodulatory activities. Each of the over 700 assays comprises a detailed protocol with the purpose and rationale of the method, a description of the experimental procedure, a critical assessment of the results and their pharmacological and clinical relevance, and pertinent references. Identification of specific tests is facilitated by the enclosed CD-ROM which allows for a quick and full text research. An appendix with guidelines and legal regulations for animal experiments in various countries will help to plan these experiments properly in accordance with the welfare of laboratory animals.