Current opinion in nephrology and hypertension
-
Curr. Opin. Nephrol. Hypertens. · May 2004
ReviewBlood pressure measurement in research and in clinical practice: recent evidence.
For over a century the technique of blood pressure measurement developed by Riva-Rocci and Korotkoff has provided most of the data on hypertension diagnosis and treatment. Its limitations, however, are becoming increasingly evident and therefore alternative solutions are under investigation. This paper is intended to provide an overview of important recent progress in this field, and to highlight future perspectives. ⋯ Blood pressure measurement is a rapidly developing field, the importance of which is increasingly acknowledged in the light of the growing awareness of the impact of hypertension on public health. Despite remarkable progress, many methodological issues still remain to be properly addressed.
-
Curr. Opin. Nephrol. Hypertens. · Mar 2004
ReviewThe association between congestive heart failure and chronic renal disease.
Recent findings on the relationship between congestive heart failure and renal failure are summarized in this review. ⋯ Adequate and early detection and aggressive treatment of congestive heart failure and chronic kidney disease and the associated anemia may markedly slow the progression of both diseases.
-
Curr. Opin. Nephrol. Hypertens. · Nov 2003
ReviewPolyomavirus nephropathy: morphology, pathophysiology, and clinical management.
Viral nephropathies, particularly those caused by polyomaviruses of the BK-virus strain, are serious complications following renal transplantation. The review will highlight the morphological, pathophysiological and clinical aspects of BK-virus nephropathy. New patient management strategies are discussed. ⋯ BK-virus nephropathy is a significant complication following renal transplantation. Recent advances have improved our understanding of the morphological changes, potential risk factors and patient management strategies would be optimized. The availability of quantitative viral load measurements now offers the opportunity for a more accurate and timely clinical intervention.
-
Curr. Opin. Nephrol. Hypertens. · May 2003
ReviewWhat is the most important component of blood pressure: systolic, diastolic or pulse pressure?
Diastolic blood pressure has traditionally been considered the most important component of blood pressure and the primary target of antihypertensive therapy. However, over 30 years ago important epidemiological studies pointed out the importance of systolic blood pressure, and research during the 1990s has strengthened this view. Unlike diastolic blood pressure, systolic blood pressure increases progressively with age, and in the ageing societies elevated systolic pressure is the most common form of hypertension. The characteristic changes of systolic and diastolic blood pressure with age lead to increases in pulse pressure (systolic minus diastolic), which has emerged as a new, potentially independent risk factor. In this review we compare the relative importance of various blood pressure components. ⋯ Epidemiological and treatment studies suggest that systolic blood pressure should be the primary target of antihypertensive therapy, although consideration of systolic and diastolic pressure together improves risk prediction. The greatest practical concern at the moment is the undertreatment of hypertension, especially systolic, and total cardiovascular risk.