Mitochondrial Dysfunction in the Pathogenesis of Preeclampsia
AbstractPurpose of ReviewPreeclampsia complicates 5 –10% of all pregnancies and is a leading cause of maternal and perinatal mortality and morbidity. The placenta plays a pivotal role in determining pregnancy outcome by supplying the fetus with oxygen and nutrients and by synthesizing hormones. Placental function is highly dependent on energy suppl ied by mitochondria. It is well-known that preeclampsia is originated from placental dysfunction, although the etiology of it remains elusive.Recent FindingsDuring the last three decades, substantial evidence suggests that mitochondrial abnormality is a major contributor to pl...
Source: Current Hypertension Reports - March 7, 2022 Category: Primary Care Source Type: research
Racial Disparities in Diagnosis, Management, and Outcomes in Preeclampsia
AbstractPurpose of the ReviewRacial disparities are prevalent in many aspects of obstetric care in the USA. Non-Hispanic black women have a higher prevalence of the diagnosis of hypertensive disorders of pregnancy in addition to associated morbidity and mortality. The purpose of this review is to review current data regarding racial disparities in the diagnosis and management of hypertensive disorders of pregnancy.Recent FindingsDiagnosis of hypertensive disorders of pregnancy is more common among non-Hispanic black women even after adjustment for comorbidities. Furthermore, prevalence of severe morbidity among those with ...
Source: Current Hypertension Reports - March 7, 2022 Category: Primary Care Source Type: research
Obstructive Sleep Apnea and Hypertension: Updates to a Critical Relationship
AbstractPurpose of ReviewObstructive sleep apnea (OSA) is an underdiagnosed illness linked to essential hypertension (HTN), resistant hypertension (r-HTN), and cardiovascular disease (CVD). This review provides updates on the epidemiology, pathophysiology, and treatments of OSA-associated HTN.Recent FindingsMild sleep apnea increases the risk for HTN. Eighty-nine percent of young patients aged 18 –35 with HTN not attributed to secondary causes have underlying OSA. Home sleep studies are noninferior to formal polysomnography for OSA diagnosis. Nocturnal oxygen desaturation rate is positively correlated with HTN severity. ...
Source: Current Hypertension Reports - March 5, 2022 Category: Primary Care Source Type: research
Sodium Intake and Risk of Hypertension: A Systematic Review and Dose –Response Meta-analysis of Observational Cohort Studies
AbstractPurpose of the ReviewTo assess the relationship between sodium intake and hypertension risk in cohort studies, based on a systematic review up to January 21, 2022, that also employed a dose –response meta-analysis.Recent FindingsDose –response analysis of available cohort studies (n = 11), using a dietary intake or urinary sodium excretion of 2 g/day as the reference category, showed an excess risk starting at 3 g/day. However, we found a linear relationship across the entire range of sodium exposure in an analysis restricted to studies that used 24 h urinary sodium exc retion information and had a low r...
Source: Current Hypertension Reports - March 4, 2022 Category: Primary Care Source Type: research
Targeting Features of the Metabolic Syndrome Through Sympatholytic Effects of SGLT2 Inhibition
AbstractPurpose of ReviewThe moderate glucose-lowering effect of sodium glucose co-transporter 2 (SGLT2) inhibitors is unlikely to explain SGLT2 inhibitor-mediated beneficial outcomes, and unravelling the underlying mechanisms is a high priority in the research community. Given the dominant pathophysiologic role of the sympathetic nervous system activation in conditions such as hypertension and perturbed glucose homeostasis, it is pertinent to postulate that SGLT2 inhibitors may exert their beneficial effects at least in part via sympathetic inhibition.Recent FindingsSGLT2 inhibitors have shown enormous potential to improv...
Source: Current Hypertension Reports - March 2, 2022 Category: Primary Care Source Type: research
Advances in the Pathophysiology and Management of Supine Hypertension in Patients with Neurogenic Orthostatic Hypotension
AbstractPurpose of ReviewPatients with neurogenic orthostatic hypotension (OH) frequently have hypertension in the supine position (sHTN). We review the controversies surrounding the need and safety of treating sHTN in patients with OH.Recent FindingsThe presence of sHTN complicates the management of OH because treatment of one can worsen the other. New approaches have been developed to treat OH without worsening sHTN by preferentially improving standing blood pressure, such as medications that harness the patient ’s residual sympathetic tone like pyridostigmine and atomoxetine, and devices such as an automated abdominal...
Source: Current Hypertension Reports - March 1, 2022 Category: Primary Care Source Type: research
Does Excess Tissue Sodium Storage Regulate Blood Pressure?
AbstractPurpose of ReviewThe regulation of blood pressure is conventionally conceptualised into the product of “circulating blood volume” and “vasoconstriction components”. Over the last few years, however, demonstration of tissue sodium storage challenged this dichotomous view.Recent FindingsWe review the available evidence pertaining to this phenomenon and the early association made with blood pressure; we discuss open questions regarding its originally proposed hypertonic nature, recently challenged by the suggestion of a systemic, isotonic, water paralleled accumulation that mirrors absolute or relative extrace...
Source: Current Hypertension Reports - February 22, 2022 Category: Primary Care Source Type: research
Metabolic Syndrome Among American Indian and Alaska Native Populations: Implications for Cardiovascular Health
We describe the presentation, etiology, and roles of structural racism and social determinants of health on metabolic syndrome.Recent FindingsMuch of what is known about metabolic syndrome in American Indian and Alaska Native populations comes from the Strong Heart Study as there is scant literature. American Indian and Alaska Native adults have an increased propensity towards metabolic syndrome as they are 1.1 times more likely to have high blood pressure, approximately three times more likely to have diabetes, and have higher rates of obesity compared with their non-Hispanic White counterparts. Culturally informed lifest...
Source: Current Hypertension Reports - February 18, 2022 Category: Primary Care Source Type: research
High Prevalence of Autonomous Aldosterone Production in Hypertension: How to Identify and Treat It
AbstractPurpose of ReviewPrimary aldosteronism (PA) affects millions of individuals worldwide. When unrecognized, PA leads to cardiovascular and renal complications via mechanisms independent from those mediated by hypertension. In this review, we emphasize the importance of PA screening in at-risk populations, and we provide options for customized PA therapy, with consideration for a variety of clinical care settings.Recent FindingsCompelling evidence puts PA at the forefront of secondary hypertension etiologies. Cardiovascular and renal damage likely begins in early stages of renin-independent aldosterone excess. PA must...
Source: Current Hypertension Reports - February 14, 2022 Category: Primary Care Source Type: research
