摘要:

The reviews by Drs. Mulvany, McVeighet al., Koren and Devereux, and Somerset al., were edited by Dr. Cohn and those by Drs. Pedrazziniet al., Romero and Strick, Palmer, and Lüscher, by Dr. Lüscher.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

It is well established that essential hypertension is associated with alterations in the structure of the resistance vasculature, such that the ratio of the media thickness to the lumen diameter (media-to-lumen ratio) is increased. Although these abnormalities are commonly thought to be due to vascular growth, they could be due to a rearrangement of a normal amount of material around a smaller lumen, a process known asremodeling.This paper reviews evidence for the relative contributions of growth and remodeling regarding subcutaneous resistance arteries taken from patients with essential hypertension. The available evidence suggests that the increased media-to-lumen ratio is due more to remodeling than to growth. This finding raises the possibility that vascular growth may not play a dominant role in the etiology of essential hypertension.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Traditionally, hypertension has been defined in terms of an elevated resistance to flow confined predominantly to the precapillary vasculature. More recently, changes in arterial compliance have been used to estimate vascular adaptations in the larger conduit arteries. This review outlines and updates the many varied techniques employed to estimate arterial compliance changes during hypertension. Most measures of compliance assess changes in small segments of the arterial vasculature. Because hypertension is a disease that influences structure and reactivity in all parts of the systemic circulation, it is desirable that clinical techniques for monitoring vascular adaptations with disease should address the generalized changes in the systemic vasculature.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Left ventricular hypertrophy is a common manifestation of systemic hypertension and a strong independent risk factor for adverse cardiovascular events and death. This article reviews studies that have defined the strength and scope of the association between increased left ventricular mass and prognosis, techniques of measuring left ventricular mass, and mechanisms believed responsible for left ventricular hypertrophy. Recent data suggesting the benefit of left ventricular mass reduction during hypertension treatment and the role of echocardiography in assessing patients with elevated blood pressure are discussed.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This review discusses the role of the sympathetic nervous system in the pathogenesis and maintenance of human hypertension. Three points are emphasized: first, there are mechanisms by which the sympathetic nervous system can contribute to the long-term regulation of vascular resistance and arterial pressure in addition to the moment-to-moment regulation of arterial pressure; second, the microneurographic method for direct intraneural recording of sympathetic nerve activity in humans has provided mounting evidence for increased sympathetic neural activity in human essential and renovascular hypertension; and third, there are both peripheral reflex and humoral mechanisms that may contribute to sympathetic overactivity in human hypertension.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Neuropeptide Y is a vasoactive peptide and is widely distributed throughout the central and peripheral nervous systems. Neuropeptide Y is coreleased with noradrenaline by perivascular nerve endings. At high concentrations, it has a direct vasoconstrictor effect. In addition, it enhances the vascular effect of various agonists, including noradrenaline and angiotensin II. Moreover, neuropeptide Y has an inhibitory effect on renin secretion. This peptide may have an important role in cardiovascular regulation.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A wealth of evidence shows that nitric oxide can modulate the autoregulation of renal blood flow, the glomerular surface area available for filtration, the glomerulotubular feedback response, and the release of renin. From an integrative point of view, inhibition of nitric oxide synthesis will alter the function of all of these homeostatic mechanisms and impair the pressure-induced natriuresis secondary to increases in intrarenal vascular resistance and tubular sodium reabsorption. These effects, along with an elevation of both total peripheral resistance and vascular tone of the capacitance vessels, are the most likely determinants of the volume-dependent elevation of blood pressure (ie, salt-sensitive hypertension) that occurs during partial inhibition of nitric oxide synthesis. This observation has important physiological and pathologic implications because it shows for the first time that the blockade of a single endogenous vasodilator substance can produce a sustained increase in blood pressure that can be influenced by changes in blood volume. Because of these characteristics, this review emphasizes in particular the characteristics of the nitric oxide synthesis pathway and briefly describes several known methods of increasing the biologic activity of nitric oxide; these methods eventually may be modified and used as therapeutic interventions in humans with deficient nitric oxide synthesis.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The L-arginine: nitric oxide pathway is widely recognized as an important regulator of cell function and communication in a variety of physiological and pathophysiological situations. Recent advances in the biochemistry and molecular biology of nitric oxide synthases have contributed significantly to our understanding of the regulation of nitric oxide synthesis in health and disease. This pathway has been implicated in the pathogenesis of septic shock, hypertension, and atherosclerosis as well as in the antihypertensive action of converting enzyme inhibitors. Progress in this field, which spans the cardiovascular, immune, and nervous systems, has been rapid, and its full potential is yet to be realized.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Endothelial dysfunction appears to be an early event in most forms of cardiovascular disease. The dysfunction may involve a decreased formation, inactivation, or action of nitric oxide or prostacyclin as well as an increased formation of contracting factors,eg, prostaglandin H2and endothelin-1. Cardiovascular drugs can improve endothelial function either indirectly through their effects on cardiovascular risk factors, such as hypertension, hyperlipidemia, and diabetes or directly through endothelial actions. Direct and indirect endothelial protective effects of cardiovascular drugs may significantly contribute to normal organ perfusion and a reduced incidence of myocardial infarction, stroke, and renal failure in patients. Endothelium-dependent vascular regulation in health and in various cardiovascular diseases as well as the effects of currently available cardiovascular drugs are reviewed.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID