ISSN:0268-4705    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The number of growth factors shown to stimulate smooth muscle cell growth has steadily increased. Recent data have established important regulatory interactions among these different growth factors. Specifically, individual growth factors have been shown to regulate their own expression as well as the expression of other growth factors and their receptors. In addition, the importance of the extracellular matrix as both a reservoir and a facilitator of growth-factor action has been established for transforming growth factor-β and fibroblast growth factor. Immobilization of growth factors by proteoglycans in the matrix establishes a tight spatial control of growth-factor activity that may have major significance in the formation and maintenance of tissue architecture. In this light, alterations in the vessel matrix induced by hypertension should have important effects on growth-factor activity and vascular growth.

ISSN:0268-4705    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

A recently recognized role for angiotensin II is that of promoting growth in muscle cells of cardiovascular and renal lineage. This includes vascular smooth muscle cells, mesangia! cells, and possibly cardiomyocytes. Pathologic growth of these cells leads to the intimal hyperplasia of atherosclerosis and postangioplasty restenosis, glomerulosclerosis, and left ventricular hypertrophy, respectively. Use of angiotensin-converting enzyme inhibitors has helped to uncover the role of angiotensin II in growth, because these antihypertensive agents have been effective in slowing the development of atherosclerosis and angioplasty restenosis in animal models, the development and progression of glomerulosclerosis in diabetic nephropathy, and the development of left ventricular hypertrophy in pressure overload models in animals and in humans. Understanding specific mechanisms of angiotensin II on the growth process will ultimately 1) elucidate the role of the circulating and tissue renin-angiotensin systems in cardiovascular and renal growth, 2) establish the interaction among vasoconstrictors, growth factors, protooncogenes, and other factors in development of hypertrophy and proliferation, and 3) define a potential therapeutic and preventative approach to cardiovascular and renal diseases in which smooth muscle cell growth plays a critical pathophysiologic role.

ISSN:0268-4705    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0268-4705    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Prevention of renal injury due to vascular disease is a major goal of antihypertensive therapy. However, recent data suggest that, to date, antihypertensive drugs may have failed to protect from renal damage, suggesting that arterial pressure control alone may be insufficient to maintain renal function. Experimental reports have indicated that glomerular hypertension and hyperfiltration may be one likely mechanism that promotes end-stage renal disease in hypertension. Therefore, to prevent patients from developing this injury, clearer understanding of intrarenal hemodynamics is necessary, particularly the exquisite control of the balance of afferent and efferent arteriolar tone. To this end, more complete knowledge of the intrarenal hemodynamic action of endogenous and exogenous vasoactive substances is crucial. It follows, then, that therapeutic vasoactive agents that can reduce glomerular hydrostatic pressure while also controlling arterial pressure must be more desirable. At present, however, it is still unclear which antihypertensive agents are the most useful in protecting glomeruli from glomerular hypertension, hyperfiltration, and subsequent nephrosclerosis and end-stage renal disease. However, among the chief potential compounds are the angiotensin-converting enzyme inhibitors, certain calcium antagonists, and possibly the α-1-adrenergic receptor inhibitors. This report reviews recent experience with these compounds.

ISSN:0268-4705    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The purpose of the present study is threefold: to analyze pulsatile changes of arterial diameter as an adequate method of evaluating arterial stiffness, to evaluate spontaneous changes of arterial diameter in subjects with untreated essential hypertension, and to study the modifications observed after antihypertensive therapy.

ISSN:0268-4705    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Differences in the prevalence and severity of hypertension and vascular disease between blacks and whites continue to be unexplained, but comparisons of cardiovascular and metabolic disease prevalences in Mexican and Native Americans with those in blacks and whites have sharpened the focus. Whereas obesity and diabetes are frequent in all three minority groups compared with whites, hypertension is common only in blacks. Studies of target organ damage continue to indicate greater severity in blacks than whites. As for nephrosclerosis, there is growing evidence that factors in addition to hypertension are responsible for progression to renal failure. Antihypertensive drug therapy, however, remains an imperative and the debate continues about blood pressure responsiveness to specific agents. The recently reported Systolic Hypertension in the Elderly study showed that systolic hypertension in blacks responded as well to treatment as it did in whites, and that black women had the greatest reduction of stroke incidence of all race and sex groups.

ISSN:0268-4705    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The commonest cause of death in patients with hypertension remains coronary artery disease, despite major therapeutic advances over the past 20 years. In view of this, there continues to be considerable interest in ways of further elucidating the relationship between these two disorders, into further understanding their pathophysiology, and towards finding effective therapy for reducing coronary mortality. This paper focuses on recent published articles furthering our knowledge of hypertension and coronary disease in the areas of epidemiology, pathophysiology, and recent therapeutic trials.

ISSN:0268-4705    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Hypertension is commonly observed in patients with renal insufficiency. The pathogenesis of this condition is multifactorial and not clearly understood. Recently, a great deal of attention has been paid to the role of endothelial factors, such as endothelin and endothelial-derived relaxing factor, in the regulation of the microcirculation and in the pathogenesis of hypertension. The role of these factors in the pathogenesis of hypertension in patients with renal insufficiency is reviewed. In addition, cyclosporine and erythropoietin have recently been used to prevent rejection in renal transplant patients and to treat anemia in patients with renal insufficiency. We review the evidence that these agents may cause or aggravate hypertension in patients with renal failure.

ISSN:0268-4705    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

This review summarizes research in three principal areas of stroke and hypertension. Prospective cohort studies and case-control studies have investigated risk factors for stroke. In addition to hypertension, a sedentary lifestyle, cigarette smoking, diabetes, and dyslipidemia increase the risk of cerebral infarction, whereas alcohol consumption and low cholesterol are risk factors for hemorrhagic stroke. Carotid endarterectomy has been shown to prevent strokes in symptomatic patients with severe carotid stenosis but not in patients with mild stenosis. Recent trials indicate that drug treatment of both diastolic and isolated systolic hypertension in the elderly prevents stroke and has a favorable effect on total mortality. Future research should focus on stroke by subtype. Additional issues are the identification of other patient groups who benefit from carotid endarterectomy and the determination of whether classes of antihypertensive drugs differ in their ability to prevent stroke.

ISSN:0268-4705    

出版商:OVID    

年代:1992

数据来源: OVID