Journal of hypertension
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Journal of hypertension · Jun 2012
Randomized Controlled TrialPredictors of lowering SBP to assigned targets at 12 months in the Secondary Prevention of Small Subcortical Strokes study.
Lowering blood pressure for secondary stroke prevention remains a challenge. These analyses were conducted to identify factors predicting achievement of SBP targets in the Secondary Prevention of Small Subcortical Strokes (SPS3) study. ⋯ These results demonstrate that it is feasible to achieve targets of SBP control in this multiethnic stroke cohort across multiple sites and countries. The results highlight the important variables reflecting clinical site management.
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Journal of hypertension · Jun 2012
Liver growth factor treatment reverses vascular and plasmatic oxidative stress in spontaneously hypertensive rats.
Liver growth factor (LGF) is an albumin-bilirubin complex with antioxidant actions in vitro. In spontaneously hypertensive rats (SHRs), short LGF treatment exerts antihypertensive and antifibrotic effects. ⋯ LGF treatment of SHRs normalizes the level of plasma oxidative stress biomarkers through a reduction of vascular superoxide anion produced by NADPH and xanthine oxidases. These effects might be linked to the cardiovascular regenerative actions of LGF.
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Journal of hypertension · May 2012
The Rho kinase inhibitor SAR407899 potently inhibits endothelin-1-induced constriction of renal resistance arteries.
Increased renal vascular resistance contributes to the pathogenesis of hypertension. The new Rho kinase (ROCK) inhibitor SAR407899 more potently lowers arterial pressure than the commercially available ROCK inhibitor Y27623. We tested whether ROCK inhibition more effectively reduced agonist-induced vasoconstriction in renal than in nonrenal resistance arteries and if SAR407899 more potently inhibits agonist-induced vasoconstriction than Y27632. ⋯ ET-1-induced vasoconstriction is more ROCK-dependent in renal than in nonrenal resistance arteries. SAR407899 causes a greater inhibition of ET-1-induced vasoconstriction in renal resistance arteries from ZDF rats and patients than Y27632. The greater efficacy in renal vessels may contribute to the higher antihypertensive potency of SAR407899 compared with Y27632.
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Journal of hypertension · Apr 2012
ReviewInhibition of the renin-angiotensin-aldosterone system: is there room for dual blockade in the cardiorenal continuum?
Antagonism of renin-angiotensin-aldosterone system is exerted through angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists, renin inhibitors and mineralocorticoid receptor antagonists. These drugs have been successfully tested in numerous trials and in different clinical settings. The original indications of renin-angiotensin-aldosterone system blockers have progressively expanded from the advanced stages to the earlier stages of cardiorenal continuum. ⋯ The data from the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET) study do not support this specific dual blockade approach. However, the dual blockade of angiotensin-converting enzyme inhibitors/angiotensin receptor antagonists with direct renin inhibitors is currently under investigation while that based on an aldosterone blocker with any of the previous three drugs requires more evidence beyond heart failure. In this review, we revisited potential advantages of dual blockade of renin-angiotensin-aldosterone system in arterial hypertension and diabetes.
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Journal of hypertension · Apr 2012
Clinical TrialImpact of lower achieved blood pressure on outcomes in hypertensive patients.
Hypertensive patients with ECG left-ventricular hypertrophy (LVH) are at increased risk of cardiovascular morbidity and mortality, and regression of ECG LVH is associated with improved cardiovascular outcomes. Although tighter control of systolic blood pressure (SBP) has been associated with a lower rate of ECG LVH, whether tighter vs. standard control of SBP is associated with greater reduction of cardiovascular risk is unclear. ⋯ Achieved SBP 130 mmHg or less is not associated with lower cardiovascular risk than SBP of 131 to 141 mmHg and is associated with a significantly increased risk of death and trend towards increased cardiovascular mortality. These findings support the need for randomized evaluation of treatment to more aggressive vs. conventional SBP targets.