Hypertension in renal disease

In the treatment of hypertension, ACE inhibitors are as effective as diuretics, (3-adrenoceptor antagonists, or calcium channel blockers in lowering blood pressure. However, increased survival rates have only been demonstrated for diuretics and (3-adrenoceptor antagonists. ACE inhibitors are approved for monotherapy as well as for combinational regimes. ACE inhibitors are the dtugs of choice for the treatment of hypertension with renal diseases, particularly diabetic nephropathy, because they prevent the progression of renal failure and improve proteinuria more efficiently than the other diugs. 

MA M13 M13.001 Neprilysin Drug target in hypertension and renal disease... 

Caution is advised when using diethylcarbamazine in patients with hypertension or renal disease. 

Evidence now strongly indicates a role for the sympathetic nerve activity in the pathogenesis of hypertension in renal failure (ESRD). Hypertension occurs commonly and early in renal disease and is paralleled by increases in sympathetic nerve activity, as indicated... 

Cangiano JL, Martinez-Maldonado M. Isolated systolic hypertension in the elderly. In M. Martinez-Maldonado, editor. Hypertension and renal disease in the elderly. Oxford Blackwell Scientific Publications 1992. p. 79-94. 

Caloric overnutrition is an extremely important problem in many parts of the world. The many hazards of obesity have been well documented by Armstrong. Obesity is associated with an increase in mortality rate and an increase in the incidence of a number of diseases, namely, hypertension, atherosclerosis, renal disease, diabetes mellitus, gall bladder disease, and even neoplasia. Possible relationships between fat metabolism and diseases of the blood vessels will be discussed in a subsequent section. In most instances, obesity is the result of simple overeating, the caloric intake being greater than the energy expenditure. It is related only rarely to disease of the endocrine glands. 

XXXV lowers blood pressure In hypertensive rats mainly by a peripheral mechanism. 34 y bbott 41596 (XXXVl), the best of a series of amino acid amides of dopamine, causes renal vasodilation of 3 hours duration at 12 mg/kg p.o. In dogsl It will be tested clinically for potential prophylactic use In hypertension and In renal diseases. A series of phosphodiesterase inhibitors from Merck show cardiostimulant, bronchodilator and hypotensive properties In animals. In this series, compound XXXVII shows good hypotension at doses that show no cardiac stimulation. The clonidine analog XXXVIII is active at 0.5 mg/kg p.o. in renal hypertensive... 

Erythropoietin (Eprex ) is physiologically produced in the kidney and regulates proliferation of committed progenitors of red blood cells. It is used to substitute erythropoietin in severe anemias due to end stage renal disease or treatment of cancer with cytostatic agents. Side effects include hypertension and increased risk of thrombosis. 

Insulin resistance occurs when the normal response to a given amount of insulin is reduced. Resistance of liver to the effects of insulin results in inadequate suppression of hepatic glucose production insulin resistance of skeletal muscle reduces the amount of glucose taken out of the circulation into skeletal muscle for storage and insulin resistance of adipose tissue results in impaired suppression of lipolysis and increased levels of free fatty acids. Therefore, insulin resistance is associated with a cluster of metabolic abnormalities including elevated blood glucose levels, abnormal blood lipid profile (dyslipidemia), hypertension, and increased expression of inflammatory markers (inflammation). Insulin resistance and this cluster of metabolic abnormalities is strongly associated with obesity, predominantly abdominal (visceral) obesity, and physical inactivity and increased risk for type 2 diabetes, cardiovascular and renal disease, as well as some forms of cancer. In addition to obesity, other situations in which insulin resistance occurs includes... 

Loop diuretics are used in the treatment of edema associated with CHF, cirrhosis of the liver, and renal disease, including the nephrotic syndrome. These drug s are particularly useful when a greater diuretic effect is desired. Furosemide is the drug of choice when a rapid diuresis is needed or if the patient has renal insufficiency. Furosemide and torsemide are also used to treat hypertension. Ethacrynic acid is also used for the short-term management of ascites caused by a malignancy, idiopathic edema, or lymphedema. 

National and international trends over the past 15 years depict modest improvements in the treatment and/or control of blood pressure (BP) for hypertensive patients. This observation is made despite efforts to promote awareness, treatment, and the means available to aggressively manage high blood pressure. Over 65 million Americans have hypertension, which was listed as the primary cause of death for over 261,000 individuals in the United States in 2002.1 Hypertension is also a significant cause of end-stage renal disease and heart failure. National and international organizations continually refine their recommendations of how... 

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