ISSN:0263-6352    

出版商:OVID    

年代:2004

数据来源: OVID

摘要:

The pathogenic role of angiotensin II (ANG II), dietary sodium chloride, sympathetic activation, obesity and aldosterone in the development of structural vascular changes (SVCs) in hypertension is considered from three perspectives (criteria): their utility in predicting hypertension and its complications (predictability); the effect of their inhibition or removal on the reversal of SVCs (reversibility); and their ability to induce SVCs in experimental animals (reproducibility). Only ANG II meets all three criteria. Importantly, ANG II increases preglomerular vascular resistance by inducing structural changes in renal cortical resistance arteries and arterioles. High salt intake, by dilating and thereby stiffening some arteries, may play a role in the development of systolic hypertension with aging, but does not produce structural changes in renal cortical resistance vessels. While high circulating levels of norepinephrine are associated with SVCs, the experimental evidence for the role of sympathetic nerve stimulation in the development of SVCs is inconclusive. Obesity is associated with hypertension, but is not known to be associated with SVCs. Salt-loading is required for aldosterone to produce SVCs, but vascular pathology in this experimental model differs from that in benign essential hypertension. The findings of this review indicate that SVCs in extra-renal sites by themselves do not lead to hypertension; structural changes in renal cortical arteries and arterioles that increase preglomerular vascular resistance are needed. Progressive trophic stimulation of preglomerular resistance vessels by itself may lead to hypertension. ANG II is prime candidate for such stimulus.

ISSN:0263-6352    

出版商:OVID    

年代:2004

数据来源: OVID

摘要:

PurposeTo examine the prevalence and the level of awareness, treatment and control of hypertension in different world regions.Study selectionA literature search of the MEDLINE database, using the Medical Subject Headings prevalence, hypertension, blood pressure and cross-sectional studies, was conducted. Published studies, which reported the prevalence of hypertension and were conducted in representative population samples, were included in the review. The search was restricted to studies published from January 1980 through July 2003.Data extractionAll data were extracted independently by two investigators using a standardized protocol and data collection form.ResultsThe reported prevalence of hypertension varied around the world, with the lowest prevalence in rural India (3.4% in men and 6.8% in women) and the highest prevalence in Poland (68.9% in men and 72.5% in women). Awareness of hypertension was reported for 46% of the studies and varied from 25.2% in Korea to 75% in Barbados; treatment varied from 10.7% in Mexico to 66% in Barbados and control (blood pressure<140/90 mmHg while on antihypertensive medication) varied from 5.4% in Korea to 58% in Barbados.ConclusionHypertension is an important public health challenge in both economically developing and developed countries. Significant numbers of individuals with hypertension are unaware of their condition and, among those with diagnosed hypertension, treatment is frequently inadequate. Measures are required at a population level to prevent the development of hypertension and to improve awareness, treatment and control of hypertension in the community.

ISSN:0263-6352    

出版商:OVID    

年代:2004

数据来源: OVID

ISSN:0263-6352    

出版商:OVID    

年代:2004

数据来源: OVID

ISSN:0263-6352    

出版商:OVID    

年代:2004

数据来源: OVID

ISSN:0263-6352    

出版商:OVID    

年代:2004

数据来源: OVID

ISSN:0263-6352    

出版商:OVID    

年代:2004

数据来源: OVID

ISSN:0263-6352    

出版商:OVID    

年代:2004

数据来源: OVID

ISSN:0263-6352    

出版商:OVID    

年代:2004

数据来源: OVID

ISSN:0263-6352    

出版商:OVID    

年代:2004

数据来源: OVID