The journal of clinical hypertension
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J Clin Hypertens (Greenwich) · Mar 2014
The relationship between renal resistive index, arterial stiffness, and atherosclerotic burden: the link between macrocirculation and microcirculation.
The renal resistive index (RRI) measured by Doppler sonography is a marker of microvascular status that can be generalized to the whole of the arterial tree. Its association with large-vessel dysfunction, such as arterial stiffness or the atherosclerotic burden, can help to establish physiopathological associations between macrocirculation and microcirculation. The authors conducted a cross-sectional study of hypertensive patients (n=202) and a healthy control group (n=16). ⋯ In the multivariate analysis, independent factors for increased RRI were age, renal function, 24-hour diastolic blood pressure, and arterial stiffness. The authors concluded that there is an independent association between renal hemodynamics and arterial stiffness. This, together with the atherosclerotic burden and endothelial dysfunction, suggests that there is a physiopathologic relationship between macrovascular and microvascular impairment.
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J Clin Hypertens (Greenwich) · Feb 2014
Case ReportsOrthostatic hypotension associated with baroreceptor dysfunction: treatment approaches.
Orthostatic hypotension (OH) is a relatively common heterogeneous and multifactorial disorder often caused by autonomic dysfunction. This condition has a deleterious impact on quality of life and contributes to higher mortality rates. Supine hypertension is very common in patients with autonomic failure, limits the use of pressor agents, and can result in end-organ damage. ⋯ If needed, pharmacologic options such as fludrocortisones and midodrine are also available in patients with severe symptoms. Supine hypertension represents a challenge in the treatment of this condition. Therefore, elevation of the bed of the head and dosing of short-acting antihypertensive agents at bedtime is often indicated.