Hypothesis: Unrecognized actions of ENaC blockade in improving refractory-resistant hypertension and residual cardiovascular risk.
Hypothesis: Unrecognized actions of ENaC blockade in improving refractory-resistant hypertension and residual cardiovascular risk.
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DOI：
10.1016/j.ijchy.2020.100048
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Laffer CL
中科院分区：
文献类型：
--
作者：
Elijovich F;Kirabo A;Laffer CL
在过去的七十年里，从20世纪50年代证明治疗恶性高血压可带来生存益处开始，流行病学研究（如心脏病研究）牢固确立了高血压作为心血管（CV）风险因素的作用。此外，在许多美国国立卫生研究院、退伍军人管理局和行业赞助的试验中，包括最近评估更严格治疗目标的SPRINT试验，证明了治疗越来越小程度的舒张压和收缩压（BP）升高的益处。这些研究的结果被纳入管理指南，从1980年到21世纪10年代初，更好的高血压治疗确实有助于美国每年CV死亡人数减少100，000人[1]。然而，治疗高血压的所有潜在益处尚未实现。即使在发达的富裕国家，知晓并接受治疗的高血压受试者的控制率也仅徘徊在50%左右[1]。未能取得更好结果的一些原因超出了卫生保健系统的范围，更多的是在社会干预领域（例如，健康保险，获得护理，药物费用）。其他属于心理行为领域（例如，坚持和遵守药物）。在后者中，通过能够测量依从性的技术（例如，用于检测生物液体中药物代谢物的质谱法）和通过测试患者护理的多学科方法已经取得了一些进展。
Over the last seven decades, starting with the demonstration of a survival benefit by treating malignant hypertension in the 1950s, epidemiological research such as the Framingham Heart Study firmly established the role of hypertension as a cardiovascular (CV) risk factor. Also, the benefits of treating lesser and lesser degrees of diastolic and systolic (BP) elevation were demonstrated in many National Institutes of Health-, Veterans Administration-, and industry-sponsored trials, including the recent SPRINT trial that assessed tighter treatment goals. Results of these studies were incorporated into management guidelines and better treatment of hypertension certainly contributed to the∼ 100,000 decrease in annual CV deaths in the US from 1980 until the early 2010s [1].However, not all the potential benefits of treating hypertension have been realized. Even in developed wealthy countries, control rates of aware and treated hypertensive subjects hover around 50% only [1]. Some reasons explaining the failure to achieve better results exceed the scope of the health care system and are more in the realm of societal interventions (eg, health insurance, access to care, cost of medications). Others belong to the psycho-behavioral sphere (eg, adherence and compliance with medications). In the latter, some inroads have been made by technology that enables measurements of compliance (eg, mass spectrometry for the detection of medication metabolites in biological fluids) and by testing multidisciplinary approaches to patient care.
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影响因子：
5.4
作者：
Lieb W;Enserro DM;Sullivan LM;Vasan RS
通讯作者：
Vasan RS
DOI：
10.1161/hyp.0000000000000084
发表时间：
2018-11
期刊：
Hypertension (Dallas, Tex. : 1979)
影响因子：
--
作者：
Carey RM;Calhoun DA;Bakris GL;Brook RD;Daugherty SL;Dennison-Himmelfarb CR;Egan BM;Flack JM;Gidding SS;Judd E;Lackland DT;Laffer CL;Newton-Cheh C;Smith SM;Taler SJ;Textor SC;Turan TN;White WB;American Heart Association Professional/Public Education and Publications Committee of the Council on Hypertension; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Genomic and Precision Medicine; Council on Peripheral Vascular Disease; Council on Quality of Care and Outcomes Research; and Stroke Council
通讯作者：
American Heart Association Professional/Public Education and Publications Committee of the Council on Hypertension; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Genomic and Precision Medicine; Council on Peripheral Vascular Disease; Council on Quality of Care and Outcomes Research; and Stroke Council
影响因子：
10.8
作者：
Ruggeri Barbaro N;Van Beusecum J;Xiao L;do Carmo L;Pitzer A;Loperena R;Foss JD;Elijovich F;Laffer CL;Montaniel KR;Galindo CL;Chen W;Ao M;Mernaugh RL;Alsouqi A;Ikizler TA;Fogo AB;Moreno H;Zhao S;Davies SS;Harrison DG;Kirabo A
通讯作者：
Kirabo A
影响因子：
4.9
作者：
Blacher, J;Evans, A;Ducimetière, P
通讯作者：
Ducimetière, P
影响因子：
24
作者：
Nadir, M. Adnan;Rekhraj, Sushma;Struthers, Allan D.
通讯作者：
Struthers, Allan D.