BOOK
Hypertension: A Companion to Braunwald's Heart Disease E-Book
George L. Bakris | Matthew Sorrentino
(2017)
Additional Information
Book Details
Abstract
The third edition of Hypertension: A Companion to Braunwald's Heart Disease, by Drs. George L. Bakris and Matthew Sorrentino, focuses on every aspect of managing and treating patients who suffer from hypertensive disorders. Designed for cardiologists, endocrinologists and nephrologists alike, this expansive, in-depth review boasts expert guidance from contributors worldwide, keeping you abreast of the latest developments from basic science to clinical trials and guidelines.
- Features expert guidance from worldwide contributors in cardiology, endocrinology, neurology and nephrology.
- Covers behavior management as an integral part of treatment plans for hypertensives and pre-hypertensives.
- Covers new developments in epidemiology, pathophysiology, immunology, clinical findings, laboratory testing, invasive and non-invasive testing, risk stratification, clinical decision-making, prognosis, and management.
- Includes chapters on hot topics such as hypertension as an immune disease; sleep disorders including sleep apnea, a major cause of hypertension; a novel chapter on environmental pollution and its contribution to endothelial dysfunction, and more!
- Equips you with the most recent guidelines from the major societies.
- Updates sourced from the main Braunwald's Heart Disease text.
- Highlights new combination drug therapies and the management of chronic complications of hypertension.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC | ES1 | ||
| HYPERTENSION: A Companion to Braunwald’s Heart Disease | i | ||
| HYPERTENSION: A Companion to Braunwald’s Heart Disease | iii | ||
| Copyright | iv | ||
| Contributors | v | ||
| Foreword | ix | ||
| Preface | xi | ||
| ACKNOWLEDGMENTS | xi | ||
| Contents | xiii | ||
| Braunwald’s Heart Disease Family of Books | xv | ||
| BRAUNWALD’S HEART DISEASE COMPANIONS | xv | ||
| BRAUNWALD’S HEART DISEASE REVIEW AND ASSESSMENT | xvii | ||
| BRAUNWALD’S HEART DISEASE IMAGING COMPANIONS | xviii | ||
| COMING SOON! | xviii | ||
| HYPERTENSION: A Companion to Braunwald’s Heart Disease | xix | ||
| I - Epidemiology | 1 | ||
| 1 - General Population and Global Cardiovascular Risk Prediction | 1 | ||
| EPIDEMIOLOGY AND RISK FACTORS | 1 | ||
| PREVALENCE AND SECULAR TRENDS | 1 | ||
| RISK FACTORS FOR HYPERTENSION | 3 | ||
| Age | 4 | ||
| Weight | 4 | ||
| Other Risk Factors | 4 | ||
| Genetic Factors | 5 | ||
| CLASSIFICATION OF BLOOD PRESSURE | 5 | ||
| SEQUELAE AND OUTCOMES WITH HYPERTENSION | 6 | ||
| Importance of Systolic Blood Pressure | 6 | ||
| Renal Disease | 11 | ||
| Cognitive Function | 11 | ||
| Competing Outcomes With Hypertension | 11 | ||
| RISK FACTOR CLUSTERING | 11 | ||
| GLOBAL RISK ASSESSMENT AS A STRATEGY FOR HYPERTENSION TREATMENT | 12 | ||
| IMPORTANCE OF PREVENTING THE DEVELOPMENT OF ELEVATED BLOOD PRESSURE | 12 | ||
| SUMMARY | 13 | ||
| References | 13 | ||
| 2 - Hypertension in Latin/Hispanic Population | 15 | ||
| CARDIOVASCULAR DISEASE IN LATIN/HISPANIC POPULATION | 15 | ||
| ARTERIAL HYPERTENSION IN THE LATIN AMERICAN AND CARIBBEAN REGION AND THE UNITED STATES | 15 | ||
| SUMMARY AND CONCLUSIONS | 18 | ||
| ACKNOWLEDGMENTS | 18 | ||
| References | 19 | ||
| 3 - Hypertension in East Asians and Native Hawaiians | 21 | ||
| EPIDEMIOLOGY OF HYPERTENSION IN EAST ASIANS AND NATIVE HAWAIIANS | 21 | ||
| Prevalence of Hypertension | 21 | ||
| Awareness, Treatment, and Control of Hypertension | 21 | ||
| OUTCOME TRIALS IN HYPERTENSION IN EAST ASIANS AND NATIVE HAWAIIANS | 21 | ||
| Placebo-Controlled Trials | 21 | ||
| Actively Controlled Trials | 24 | ||
| Intensive Versus Less Intensive Blood Pressure Control | 24 | ||
| Subgroups of Multinational Trials | 25 | ||
| SUMMARY | 25 | ||
| CONFLICTS OF INTEREST | 25 | ||
| ACRONYMS OF TRIALS | 25 | ||
| References | 25 | ||
| 4 - HYPERTENSION IN SOUTH ASIANS | 27 | ||
| PREVALENCE OF HYPERTENSION IN SOUTH ASIAN POPULATIONS | 27 | ||
| Definition of Hypertension in the South Asian Population | 27 | ||
| Prevalence of Hypertension in South Asia | 27 | ||
| Prevalence of Hypertension in SouthAsians Who Have Migrated to NorthAmerica or Europe | 27 | ||
| RISK FACTORS FOR HYPERTENSION IN SOUTH ASIAN POPULATIONS | 27 | ||
| Genetic Factors | 27 | ||
| MANAGEMENT OF HYPERTENSION IN SOUTH ASIANS | 29 | ||
| Lifestyle and Behavioral Modification | 29 | ||
| Initiation of Antihypertensive Therapy and Treatment Targets | 29 | ||
| Choice of Pharmacotherapy | 29 | ||
| CONCLUSIONS | 31 | ||
| References | 31 | ||
| II - Pathophysiology | 33 | ||
| 5 - Pathogenesis of Hypertension | 33 | ||
| CONTROL OF BLOOD PRESSURE, BLOOD FLOW, AND CARDIAC OUTPUT | 33 | ||
| LONG-TERM BLOOD PRESSURE CONTROL: ROLE OF RENAL PRESSURE NATRIURESIS | 34 | ||
| SALT SENSITIVITY AND HYPERTENSION | 36 | ||
| Loss of Nephrons and Kidney Injury Cause Salt Sensitivity | 36 | ||
| Inability to Effectively Modulate the Renin-Angiotensin-Aldosterone System Causes Salt Sensitivity | 37 | ||
| Endothelin and Salt Sensitivity | 37 | ||
| Genetic Causes of Salt-Sensitive Hypertension | 37 | ||
| RENIN-ANGIOTENSIN ALDOSTERONE SYSTEM | 39 | ||
| Ang II and Long-Term Blood Pressure Regulation | 39 | ||
| SYMPATHETIC NERVOUS SYSTEM | 41 | ||
| ENDOTHELIN | 42 | ||
| NITRIC OXIDE | 42 | ||
| OXIDATIVE STRESS | 43 | ||
| PRIMARY (ESSENTIAL) HYPERTENSION | 43 | ||
| POSSIBLE ROLE OF GENE VARIANTS, GENE-ENVIRONMENT INTERACTIONS, AND EPIGENETICS IN PRIMARY HYPERTENSION | 43 | ||
| ROLE OF OVERWEIGHT AND OBESITY IN PRIMARY HYPERTENSION | 44 | ||
| Ang II Increases Sodium Reabsorption in Obesity Hypertension | 46 | ||
| Mineralocorticoid Receptor Activation Increases Sodium Reabsorption in Obesity Hypertension | 46 | ||
| Leptin May Link Increased Adiposity With Sympathetic Nervous System Activation | 47 | ||
| The Central Nervous System Proopiomelanocortin Pathway May Contribute to Sympathetic Nervous System Activation in Obesity | 47 | ||
| SUMMARY AND PERSPECTIVES | 48 | ||
| References | 49 | ||
| 6 - Genetics of Hypertension | 52 | ||
| THE CONTRIBUTION OF GENETICS TO THE BLOOD PRESSURE DISTRIBUTION | 52 | ||
| MONOGENIC (SECONDARY) HYPERTENSION | 52 | ||
| Glucocorticoid-Remediable Aldosteronism | 54 | ||
| Gordon Syndrome | 54 | ||
| Familial Hyperaldosteronism Type III | 54 | ||
| Liddle Syndrome | 54 | ||
| Syndrome of Apparent Mineralocorticoid Excess | 54 | ||
| Congenital Adrenal Hyperplasia | 55 | ||
| GENOMICS OF PRIMARY HYPERTENSION | 55 | ||
| Making Clinical Use of Blood Pressure Genomics | 56 | ||
| SUMMARY | 58 | ||
| References | 58 | ||
| 7 - Inflammation and Immunity in Hypertension | 60 | ||
| HISTORICAL ASPECTS REGARDING INFLAMMATION AND HYPERTENSION | 61 | ||
| BASIC MECHANISMS BY WHICH INFLAMMATION CONTRIBUTES TO HYPERTENSION | 62 | ||
| THE ROLE OF IMMUNITY AND INFLAMMATION AS MEDIATORS OF HYPERTENSION | 64 | ||
| Cytokine Release | 64 | ||
| Oxidative Injury | 65 | ||
| Matrix Reorganization | 65 | ||
| Enhanced Chemotaxis | 65 | ||
| MECHANISMS OF IMMUNE ACTIVATION IN HYPERTENSION: POSSIBLE ROLE OF NEOANTIGENS | 65 | ||
| CLINICAL IMPLICATIONS REGARDING INFLAMMATION IN HYPERTENSION | 66 | ||
| References | 69 | ||
| III - Diagnosis and Evaluation | 71 | ||
| 8 - The Environment and High Blood Pressure | 71 | ||
| Colder Ambient Temperature and Winter Season | 71 | ||
| Noise | 72 | ||
| Higher Altitude | 72 | ||
| Air Pollution | 73 | ||
| Other Environmental Factors | 74 | ||
| Summary of Evidence | 74 | ||
| CLINICAL PRACTICE IMPLICATIONS | 74 | ||
| References | 74 | ||
| 9 - Office Blood Pressure Measurement | 76 | ||
| A BRIEF HISTORY OF MORE THAN A CENTURY OF BLOOD PRESSURE MEASUREMENT | 77 | ||
| THE IMPORTANCE OF CAREFUL BLOOD PRESSURE MEASUREMENT FOR THE HEALTH CARE SYSTEM | 78 | ||
| ENVIRONMENTAL CONCERNS ABOUT ELEMENTAL MERCURY IN THE MEDICAL WORKPLACE | 79 | ||
| HOW CAN THE MEASUREMENT OF BLOOD PRESSURE BE IMPROVED IN CLINICAL PRACTICE? | 79 | ||
| BLOOD PRESSURE MEASUREMENT: PROPER TECHNIQUE FOR QUALITY ASSURANCE AND IMPROVEMENT | 80 | ||
| CRITICAL SKILLS FOR ANY BLOOD PRESSURE OBSERVER | 80 | ||
| MANOMETERS AND THEIR CALIBRATION | 81 | ||
| Calibrating the Manometer | 81 | ||
| STETHOSCOPES | 83 | ||
| SELECTION AND APPLICATION OF THE PROPER BLOOD PRESSURE CUFF | 83 | ||
| PREPARING FOR AN ACCURATE READING | 84 | ||
| MEASURING THE BLOOD PRESSURE | 84 | ||
| Which Arm Should Be Used? | 84 | ||
| STANDARDIZED MONITORING FOR ACCURACY, REPRODUCIBILITY, AND OBSERVER BIAS | 85 | ||
| INSPECT EQUIPMENT FOR QUALITY ASSURANCE | 85 | ||
| ASSESS KNOWLEDGE ABOUT BLOOD PRESSURE MEASUREMENT | 86 | ||
| ASSESS PERFORMANCE REGARDING BLOOD PRESSURE MEASUREMENTS | 87 | ||
| SUMMARY | 87 | ||
| References | 87 | ||
| 10 - Home Monitoring of Blood Pressure | 89 | ||
| ADVANTAGES AND LIMITATIONS | 89 | ||
| CLINICAL INDICATIONS | 89 | ||
| PROGNOSTIC VALUE | 90 | ||
| Association With Target-Organ Damage | 90 | ||
| Prediction of Cardiovascular Events | 90 | ||
| HOME BLOOD PRESSURE MONITORING AND MANAGEMENT OF HYPERTENSION | 90 | ||
| Treatment Adjustment | 90 | ||
| Long-Term Follow-Up | 91 | ||
| Nocturnal Home Blood Pressure Monitoring | 91 | ||
| HOME BLOOD PRESSURE MONITORING IN SPECIAL POPULATIONS | 91 | ||
| Children | 91 | ||
| Elderly | 91 | ||
| Pregnancy | 92 | ||
| Obesity | 92 | ||
| Atrial Fibrillation | 92 | ||
| Diabetes | 92 | ||
| Chronic Kidney Disease | 92 | ||
| COST-EFFECTIVENESS | 92 | ||
| HOME BLOOD PRESSURE TELEMONITORING | 92 | ||
| HOME BLOOD PRESSURE MONITORING IN RESEARCH | 92 | ||
| HOME VERSUS AMBULATORY BLOOD PRESSURE MONITORING | 93 | ||
| HOME BLOOD PRESSURE MONITORING RECOMMENDATIONS (TABLE 10.2) | 93 | ||
| Devices | 93 | ||
| Monitoring Conditions and Procedure | 94 | ||
| Monitoring Schedule | 94 | ||
| Reporting of Home Blood Pressure Values | 94 | ||
| Diagnostic Threshold and Interpretation | 94 | ||
| SUMMARY | 94 | ||
| References | 94 | ||
| 11 - Ambulatory Blood Pressure Monitoring in Clinical Hypertension Management | 96 | ||
| CIRCADIAN VARIATION OF BLOOD PRESSURE | 96 | ||
| Clinical Importance of Nighttime Decline (“Dipping”) in Blood Pressure | 96 | ||
| PROGNOSTIC VALUE OF AMBULATORY BLOOD PRESSURE | 97 | ||
| USE OF AMBULATORY BLOOD PRESSURE MONITORING IN THE MANAGEMENT OF HYPERTENSION | 97 | ||
| USEFUL SITUATIONS FOR AMBULATORY BLOOD PRESSURE MONITORING IN ANTIHYPERTENSIVE DRUG TRIALS | 99 | ||
| Utility of Ambulatory Blood Pressure Monitoring in Dose-Finding Studies | 99 | ||
| Eprosartan | 99 | ||
| Eplerenone | 99 | ||
| Utility of Ambulatory Blood Pressure Monitoring in Clinical Comparator Trials | 99 | ||
| Comparisons within the Same Class | 99 | ||
| Comparisons of Drugs Across Different Classes | 100 | ||
| Timing of Drug Administration | 100 | ||
| CONCLUSIONS | 102 | ||
| References | 102 | ||
| 12 - White-Coat and Masked Hypertension | 104 | ||
| WHITE-COAT HYPERTENSION AND MASKED HYPERTENSION IN UNTREATED INDIVIDUALS | 104 | ||
| Definition | 104 | ||
| White-Coat Hypertension | 104 | ||
| Masked Hypertension | 104 | ||
| Prevalence | 105 | ||
| White-Coat Hypertension | 105 | ||
| Masked Hypertension | 106 | ||
| Clinical Significance | 107 | ||
| White-Coat Hypertension | 107 | ||
| Masked Hypertension | 108 | ||
| Management | 108 | ||
| White-Coat Hypertension | 108 | ||
| Masked Hypertension | 110 | ||
| WHITE-COAT RESISTANT AND MASKED UNCONTROLLED HYPERTENSION IN TREATED HYPERTENSIVE SUBJECTS | 110 | ||
| Definition | 110 | ||
| IV - Risk Stratification | 169 | ||
| 18 - The Natural History of Untreated Hypertension | 169 | ||
| PREHYPERTENSION AND HYPERTENSION | 170 | ||
| UNTREATED HYPERTENSION AND SUBCLINICAL TARGET ORGAN DAMAGE | 171 | ||
| Left Ventricular Hypertrophy | 171 | ||
| Albuminuria | 171 | ||
| Retinal Microvascular Changes | 172 | ||
| UNTREATED HYPERTENSION AND MORTALITY | 172 | ||
| UNTREATED HYPERTENSION AND CLINICAL CARDIOVASCULAR DISEASE | 173 | ||
| Coronary Heart Disease | 175 | ||
| Stroke | 175 | ||
| Heart Failure | 176 | ||
| Hypertension and Renal Disease | 177 | ||
| SUMMARY | 178 | ||
| References | 178 | ||
| 19 - Isolated Systolic Hypertension | 180 | ||
| EPIDEMIOLOGY OF ISOLATED SYSTOLIC HYPERTENSION | 180 | ||
| PATHOPHYSIOLOGICAL FEATURES OF ISOLATED SYSTOLIC HYPERTENSION | 181 | ||
| Some Considerations About Etiology | 181 | ||
| Hemodynamics | 181 | ||
| TARGET ORGAN DAMAGE IN ISOLATED SYSTOLIC HYPERTENSION | 183 | ||
| CARDIOVASCULAR RISK IN PERSONS WITH ISOLATED SYSTOLIC HYPERTENSION | 183 | ||
| Risk of Coronary Heart Disease | 183 | ||
| Risk of Cerebrovascular Disease | 184 | ||
| Vascular Complications | 184 | ||
| Other Aspects | 184 | ||
| TREATMENT OF ISOLATED SYSTOLIC HYPERTENSION | 185 | ||
| Evidence From Trials | 185 | ||
| Unanswered Questions | 186 | ||
| WHICH ANTIHYPERTENSIVE TREATMENT FOR ISOLATED SYSTOLIC HYPERTENSION? | 186 | ||
| SHOULD WE TARGET BLOOD PRESSURE OR ARTERIAL STIFFNESS? | 186 | ||
| SUMMARY | 187 | ||
| References | 187 | ||
| 20 - Assessment of Target Organ Damage | 189 | ||
| TARGET ORGAN “BRAIN” | 189 | ||
| Stroke | 189 | ||
| Prognostic Value of Change | 189 | ||
| Small Vessel Disease | 189 | ||
| White Matter Hyperintensity | 189 | ||
| V - Antihypertensive Therapy | 201 | ||
| 20 - Diet and Blood Pressure | 201 | ||
| DIETARY FACTORS THAT REDUCE BLOOD PRESSURE | 201 | ||
| Weight Loss | 201 | ||
| Reduced Salt (Sodium Chloride) Intake | 202 | ||
| Increased Potassium Intake | 204 | ||
| Moderation of Alcohol Consumption | 205 | ||
| Dietary Patterns | 205 | ||
| Vegetarian Diets | 205 | ||
| The Dietary Approaches to Stop Hypertension Diet | 205 | ||
| Mediterranean Diets | 206 | ||
| DIETARY FACTORS WITH LIMITED OR UNCERTAIN EFFECTS | 206 | ||
| Fish Oil Supplementation | 206 | ||
| Fiber | 206 | ||
| Calcium and Magnesium | 207 | ||
| Saturated Fat | 207 | ||
| Omega-6 Polyunsaturated Fat Intake | 207 | ||
| Monounsaturated Fat Intake | 207 | ||
| Carbohydrate | 207 | ||
| Cholesterol | 207 | ||
| Protein Intake | 207 | ||
| Vitamin C | 208 | ||
| GENE-DIET INTERACTIONS | 208 | ||
| EFFECTS OF MULTIPLE DIETARY CHANGES | 208 | ||
| BEHAVIORAL INTERVENTIONS TO ACCOMPLISH LIFESTYLE MODIFICATION | 208 | ||
| SPECIAL POPULATIONS | 208 | ||
| Children | 208 | ||
| Older-Aged Persons | 208 | ||
| African Americans | 209 | ||
| Health Care Providers | 209 | ||
| SUMMARY | 209 | ||
| References | 209 | ||
| 22 - Diuretics in Hypertension | 211 | ||
| PHARMACOLOGY | 211 | ||
| Thiazides and Thiazide-Like Diuretics | 211 | ||
| Potassium-Sparing Agents | 211 | ||
| CLINICAL TRIALS | 213 | ||
| PLACE OF DIURETICS IN MULTIDRUG THERAPY | 216 | ||
| DIURETIC DOSING | 216 | ||
| ADVERSE EFFECTS OF DIURETICS | 217 | ||
| Hypokalemia and Hyperkalemia | 217 | ||
| Hyponatremia | 217 | ||
| Hypomagnesemia | 217 | ||
| Hyperuricemia | 218 | ||
| METABOLIC ABNORMALITIES | 218 | ||
| Hyperglycemia | 218 | ||
| Hyperlipidemia | 218 | ||
| Other Adverse Effects | 218 | ||
| Impotence | 218 | ||
| Drug Allergy | 219 | ||
| ADVERSE DRUG INTERACTIONS | 219 | ||
| PRACTICAL CONSIDERATIONS | 219 | ||
| SUMMARY | 219 | ||
| References | 219 | ||
| 23 - Peripheral Adrenergic Blockers | 222 | ||
| THE SYMPATHETIC NERVOUS SYSTEM IN HYPERTENSION | 222 | ||
| ALPHA ADRENERGIC RECEPTORS | 222 | ||
| ALPHA1-ADRENERGIC RECEPTORS: ORGAN DISTRIBUTION AND ACTIVITY | 222 | ||
| Systemic Blood Vessels | 222 | ||
| Cerebral Circulation | 222 | ||
| Alpha1-Adrenergic Receptors and the Heart | 222 | ||
| CLINICAL INDICATIONS AND ADVERSE EFFECTS | 223 | ||
| Hypertension | 223 | ||
| Cardiac Safety | 226 | ||
| Pheochromocytoma | 226 | ||
| Adverse Effects | 226 | ||
| References | 227 | ||
| 24 - Renin Angiotensin Aldosterone System Blockers | 230 | ||
| ANGIOTENSIN-CONVERTING ENZYME INHIBITORS | 230 | ||
| Pharmacology of Angiotensin-Converting Enzyme Inhibitors | 230 | ||
| Mechanisms of Action | 230 | ||
| End-Organ Effects and Clinical Trials | 231 | ||
| Atherosclerotic Vascular Disease | 232 | ||
| Renal Effects | 232 | ||
| Diabetes | 232 | ||
| ANGIOTENSIN II RECEPTOR BLOCKERS | 233 | ||
| Pharmacology of Angiotensin II Receptor Blockers | 233 | ||
| Mechanisms of Action | 235 | ||
| End-Organ Effects and Clinical Trials | 235 | ||
| Cardiac Effects | 235 | ||
| Renal Effects | 236 | ||
| RENIN INHIBITOR | 237 | ||
| Pharmacology of Renin Inhibitor | 237 | ||
| Mechanisms of Action | 237 | ||
| Adverse Effects and Drug Interactions | 238 | ||
| MINERALOCORTICOID RECEPTOR (MCR) ANTAGONISTS | 238 | ||
| Mechanism of Action | 239 | ||
| End-Organ Effects and Clinical Trials | 239 | ||
| Cardiac Effects | 239 | ||
| Renal Effects | 240 | ||
| References | 240 | ||
| 25 - Calcium Channel Blockers | 242 | ||
| CALCIUM AND CELLS | 242 | ||
| MOLECULAR BIOLOGY AND PHYSIOLOGY OF VOLTAGE-GATED CALCIUM CHANNELS | 242 | ||
| Voltage-Gated Calcium Channel Subtypes | 242 | ||
| Voltage-Gated Calcium Channels in Cardiac and Smooth Muscle | 242 | ||
| DRUGS ACTING ON L-TYPE VOLTAGE-GATED CALCIUM CHANNELS | 243 | ||
| Dihydropyridines | 243 | ||
| Phenylalkylamines | 244 | ||
| Benzothiazipines | 245 | ||
| Pharmacokinetics and Drug Interactions | 245 | ||
| Ancillary Actions | 246 | ||
| CALCIUM CHANNEL BLOCKERS IN THE MANAGEMENT OF HYPERTENSION | 246 | ||
| Blood Pressure Lowering and Hemodynamic Actions | 246 | ||
| Effects on Target Organ Damage in Hypertension | 247 | ||
| Left Ventricular Hypertrophy | 247 | ||
| Arterial Stiffness | 247 | ||
| Renal Function and Progression of Kidney Disease | 247 | ||
| Cognitive Function and Dementia | 247 | ||
| Major Clinical Outcomes | 248 | ||
| Safety of Calcium Channel Blockers | 249 | ||
| Adverse Effects | 249 | ||
| SPECIAL INDICATIONS AND CONTRAINDICATIONS FOR CALCIUM CHANNEL BLOCKERS | 251 | ||
| Angina Pectoris | 251 | ||
| Heart Failure | 251 | ||
| Hypertensive Disorders of Pregnancy | 251 | ||
| CONCLUSIONS | 251 | ||
| References | 251 | ||
| 26 - Central Sympathetic Agents and Direct Vasodilators | 254 | ||
| MECHANISM OF ACTION | 254 | ||
| HEMODYNAMIC EFFECTS | 254 | ||
| CLINICAL APPLICATION | 254 | ||
| ADVERSE EFFECTS | 254 | ||
| THE CENTRAL SYMPATHOLYTICS | 255 | ||
| Clonidine | 255 | ||
| Antihypertensive Effects | 255 | ||
| Adverse Effects | 255 | ||
| Methyldopa | 256 | ||
| Antihypertensive Effect | 256 | ||
| Adverse Effects | 256 | ||
| Guanabenz | 256 | ||
| VI - Hypertension Management | 281 | ||
| 30 - Approach to Difficult to Manage Primary Hypertension | 281 | ||
| DEFINITION OF HYPERTENSION | 281 | ||
| HOW TO DIAGNOSE HYPERTENSION | 281 | ||
| HOW TO MEASURE BLOOD PRESSURE | 282 | ||
| HYPERTENSION EVALUATION | 282 | ||
| LIFESTYLE MODIFICATION | 282 | ||
| PHARMACOLOGIC TREATMENT OF HYPERTENSION | 283 | ||
| Compelling Indications | 283 | ||
| Secondary Causes of Hypertension | 283 | ||
| The Salt-Sensitive Patient | 283 | ||
| The Hyperadrenergic Patient | 285 | ||
| BLOOD PRESSURE TREATMENT TARGETS | 286 | ||
| SUMMARY | 286 | ||
| References | 287 | ||
| 31 - Hypertension in Ischemic Heart Disease | 288 | ||
| RELATIONSHIP BETWEEN HYPERTENSION AND CORONARY ARTERY DISEASE | 288 | ||
| PRIMARY PREVENTION OF CORONARY ARTERY DISEASE IN PATIENTS WITH HYPERTENSION | 289 | ||
| Evidence for Antihypertensive Drugs for Primary Prevention of Coronary Heart Disease | 289 | ||
| Diuretics and Beta-Blockers | 289 | ||
| Calcium Channel Blockers | 290 | ||
| Angiotensin-Converting Enzyme Inhibitors | 290 | ||
| Angiotensin Receptor Blockers | 290 | ||
| Blood Pressure Targets | 291 | ||
| MANAGEMENT OF HYPERTENSION IN PATIENTS WITH ESTABLISHED CORONARY ARTERY DISEASE | 292 | ||
| Stable Angina | 292 | ||
| Beta-Blockers | 293 | ||
| Calcium Channel Blockers | 293 | ||
| Renin-Angiotensin Aldosterone System Inhibitors | 293 | ||
| Acute Coronary Syndromes | 294 | ||
| MANAGEMENT OF HYPERTENSION IN PATIENTS WITH PERIPHERAL ARTERIAL DISEASE | 295 | ||
| CONCLUSION | 295 | ||
| References | 295 | ||
| 32 - Heart Failure | 298 | ||
| THE HEART FAILURE EPIDEMIC | 299 | ||
| HYPERTENSION IN THE DEVELOPMENT OF HEART FAILURE | 299 | ||
| HYPERTENSIVE HEART DISEASE | 300 | ||
| Left Ventricular Hypertrophy and Remodeling | 300 | ||
| Systolic and Diastolic Dysfunction | 301 | ||
| Cellular and Extracellular Changes | 301 | ||
| Genetic | 302 | ||
| LANDMARK HYPERTENSION TRIALS TO PREVENT SYMPTOMATIC HEART FAILURE | 302 | ||
| HYPERTENSION TREATMENT IN HEART FAILURE WITH REDUCED EJECTION FRACTION | 305 | ||
| Angiotensin-Converting Enzyme Inhibitors | 305 | ||
| Angiotensin II Receptor Blockers | 305 | ||
| Beta-Blockers | 306 | ||
| Mineralocorticoid Receptor Antagonists | 306 | ||
| Hydralazine/Isosorbide Dinitrate | 306 | ||
| Loop Diuretics | 306 | ||
| Newer Therapies for Heart Failure | 306 | ||
| HYPERTENSION TREATMENT IN HEART FAILURE WITH PRESERVED EJECTION FRACTION | 307 | ||
| A STRATEGY FOR GUIDING HYPERTENSION TREATMENT TO PREVENT HEART FAILURE | 307 | ||
| SUMMARY | 307 | ||
| CURRENT EVIDENCE GAPS | 307 | ||
| CONCLUSION | 308 | ||
| References | 308 | ||
| 33 - Hypertension and Chronic Kidney Disease | 311 | ||
| PATHOPHYSIOLOGY OF HYPERTENSION IN KIDNEY DISEASE | 311 | ||
| BLOOD PRESSURE GOALS IN CHRONIC KIDNEY DISEASE | 311 | ||
| Reduction in Albuminuria | 314 | ||
| Cardiovascular Risk Modification | 314 | ||
| SELECTION OF ANTIHYPERTENSIVE AGENT | 315 | ||
| Volume Control in Chronic Kidney Disease | 315 | ||
| OUT-OF-OFFICE-BLOOD PRESSURE MONITORING | 318 | ||
| CONCLUSION | 318 | ||
| References | 318 | ||
| 34 - Transplant Hypertension | 321 | ||
| PATHOGENESIS | 321 | ||
| Immunosuppressive Therapy | 321 | ||
| CLINICAL FEATURES | 322 | ||
| EVALUATION | 323 | ||
| TREATMENT | 323 | ||
| Nonpharmacologic Therapy | 324 | ||
| Pharmacologic Therapy | 324 | ||
| General Concepts | 324 | ||
| Calcium Channel Blocking Agents | 325 | ||
| Renin Angiotensin System Blockers | 325 | ||
| Diuretics | 326 | ||
| Additional Treatment Choices | 326 | ||
| Modification of Immunosuppressive Regimen | 326 | ||
| Native Nephrectomy | 326 | ||
| SUMMARY | 326 | ||
| References | 326 | ||
| 35 - Obesity | 328 | ||
| ASSOCIATION OF OBESITY AND HYPERTENSION | 328 | ||
| Assessment of Overweight and Obesity | 328 | ||
| Body Fat Distribution | 328 | ||
| PATHOPHYSIOLOGY OF OBESITY-RELATED HYPERTENSION | 328 | ||
| Historical Milestones | 328 | ||
| The Pressure-Natriuresis Relationship and Salt Sensitivity | 329 | ||
| Sympathetic Stimulation and the Metabolic Economy of the Obese State | 330 | ||
| THE METABOLIC SYNDROME AND CARDIOVASCULAR RISK | 330 | ||
| Critical Components of the Metabolic Syndrome | 330 | ||
| Insulin and the Metabolic Syndrome | 330 | ||
| CARDIOVASCULAR RISK OF OBESITY-RELATED HYPERTENSION | 331 | ||
| TREATMENT OF OBESITY-RELATED HYPERTENSION | 331 | ||
| Management of Obesity-Related Hypertension by Lifestyle Changes | 331 | ||
| Low Energy Diets | 332 | ||
| Effect of Diet on Blood Pressure | 332 | ||
| Physical Activity | 332 | ||
| Salt Restriction | 332 | ||
| Alcohol Moderation | 332 | ||
| Antihypertensive Agents | 333 | ||
| Pharmacologic Treatment of Obesity | 333 | ||
| Surgical Treatment of Obesity | 333 | ||
| SUMMARY | 334 | ||
| References | 334 | ||
| 36 - Cerebrovascular Disease | 335 | ||
| A NEW DEFINITION OF STROKE | 335 | ||
| BRIEF OVERVIEW OF STROKE EPIDEMIOLOGY | 335 | ||
| Hypertension and Risk for Stroke | 335 | ||
| TREATMENT OF ACUTE ISCHEMIC STROKE | 336 | ||
| Blood Pressure Lowering in Acute Ischemic Stroke | 336 | ||
| Updated Trial Findings | 336 | ||
| Blood Pressure Variability | 337 | ||
| MANAGEMENT OF CHRONIC STROKE | 337 | ||
| BLOOD PRESSURE MANAGEMENT FOR SELECT RECURRENT STROKE PREVENTION CONDITIONS | 338 | ||
| Preservation of Cognition and Blood Pressure | 338 | ||
| High-Grade Occlusive Large Artery Disease | 339 | ||
| SUMMARY | 339 | ||
| References | 339 | ||
| 37 - Diabetes Mellitus | 341 | ||
| EPIDEMIOLOGY OF DIABETES, HYPERTENSION, AND DIABETIC COMPLICATIONS | 341 | ||
| PATHOGENESIS OF DIABETES, HYPERTENSION, AND DIABETIC COMPLICATIONS | 341 | ||
| CLINICAL MANAGEMENT OF HYPERTENSION IN DIABETES | 343 | ||
| Effects of Blood Pressure Control on Diabetic Complications | 343 | ||
| CONCLUSION | 351 | ||
| References | 351 | ||
| 38 - Dyslipidemia | 353 | ||
| EPIDEMIOLOGY OF HYPERLIPIDEMIA | 353 | ||
| Prevalence | 353 | ||
| Awareness, Treatment, and Temporal Trends | 353 | ||
| AMERICAN COLLEGE OF CARDIOLOGY/AMERICAN HEART ASSOCIATION 2013 GUIDELINES FOR THE TREATMENT OF ELEVATED BLOOD CHOLESTEROL | 353 | ||
| THERAPEUTIC CONSIDERATIONS SPECIFIC TO THE MANAGEMENT OF PATIENTS WITH DYSLIPIDEMIA AND HYPERTENSION | 355 | ||
| A Comprehensive Treatment Approach | 355 | ||
| The Polypill | 357 | ||
| Modifying Effects of Statins on Blood Pressure and Antihypertensive Medications on Lipid Levels | 357 | ||
| SUMMARY | 357 | ||
| References | 359 | ||
| VII - Special Populations and Special Situations | 361 | ||
| 39 - Hypertension in Pregnancy | 361 | ||
| CLASSIFICATION AND DEFINITIONS | 361 | ||
| Chronic Hypertension | 361 | ||
| Preeclampsia-Eclampsia | 361 | ||
| CLINICAL FEATURES AND MANAGEMENT OF CHRONIC HYPERTENSION DURING PREGNANCY | 362 | ||
| Clinical Features and Diagnosis | 362 | ||
| Maternal Risks | 364 | ||
| Fetal Risks | 364 | ||
| Management | 364 | ||
| Nonpharmacologic Management | 364 | ||
| Blood Pressure Treatment Targets | 364 | ||
| Pharmacologic Management | 365 | ||
| Central Adrenergic Agonists | 365 | ||
| Beta-Adrenoceptor Blockers | 365 | ||
| Alpha-Adrenergic Blockers | 366 | ||
| Calcium Channel Blockers | 366 | ||
| Diuretics | 366 | ||
| Direct Vasodilators | 367 | ||
| Serotonin2-Receptor Blockers | 367 | ||
| Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers | 367 | ||
| CLINICAL FEATURES AND MANAGEMENT OF PREECLAMPSIA | 367 | ||
| Risk Factors for Preeclampsia | 367 | ||
| Prediction of Preeclampsia | 368 | ||
| Pathophysiology of Preeclampsia | 368 | ||
| Immune Dysregulation | 368 | ||
| Blood Pressure in Preeclampsia | 368 | ||
| Metabolic Disturbances in Preeclampsia | 368 | ||
| Renal Changes in Preeclampsia | 368 | ||
| Cardiac Function in Preeclampsia | 369 | ||
| Central Nervous System | 369 | ||
| Prevention of Preeclampsia | 369 | ||
| Treatment of Preeclampsia | 369 | ||
| Delivery | 369 | ||
| Blood Pressure Control in Preeclampsia | 370 | ||
| Intravenous Fluid | 370 | ||
| GESTATIONAL HYPERTENSION | 370 | ||
| POSTPARTUM MANAGEMENT OF HYPERTENSION | 370 | ||
| ANTIHYPERTENSIVE MEDICATIONS AND LACTATION | 371 | ||
| SUMMARY | 371 | ||
| References | 371 | ||
| 40 - Hypertension in Older People | 374 | ||
| INCREASE IN SYSTOLIC BLOOD PRESSURE IN OLDER ADULTS: A CONSEQUENCE OF THE ARTERIAL AGING | 374 | ||
| The Reasons for the Increase in Pulse Pressure With Age | 374 | ||
| The Increasing Impact of Systolic/Pulse Pressure in Older Adults | 375 | ||
| FRAILTY, MULTIMORBIDITY, POLYPHARMACY, AND LOSS OF AUTONOMY | 375 | ||
| CLINICAL EVALUATION | 376 | ||
| ANTIHYPERTENSIVE THERAPY | 377 | ||
| Benefits of Lifestyle Modifications | 377 | ||
| Benefits of Pharmacological Treatment | 377 | ||
| OTHER IMPORTANT ISSUES IN OLDER HYPERTENSIVE PATIENTS | 379 | ||
| Postural Hypotension and Nocturnal Dipping | 379 | ||
| Cognitive Impairment | 379 | ||
| SUMMARY | 380 | ||
| References | 380 | ||
| 41 - Hypertension in African Americans | 383 | ||
| EPIDEMIOLOGY OF HYPERTENSION INAFRICAN AMERICANS | 383 | ||
| Hypertension Risk Factors | 383 | ||
| Hypertension Incidence | 383 | ||
| Hypertension Prevalence | 383 | ||
| Hypertension Severity | 383 | ||
| Awareness, Treatment, and Control | 384 | ||
| Mortality and Morbidity | 385 | ||
| PATHOPHYSIOLOGY | 386 | ||
| INCREASED SYMPATHETIC NERVOUS SYSTEM ACTIVITY | 386 | ||
| Psychosocial Stress | 387 | ||
| STRATEGIES FOR HYPERTENSION TREATMENT AND CONTROL | 387 | ||
| Behavioral and Lifestyle Interventions | 387 | ||
| Dietary Interventions | 387 | ||
| Physical Activity Interventions | 387 | ||
| Sleep-Disordered Breathing and Sleep Apnea | 388 | ||
| Drug Treatment | 388 | ||
| CLINICAL PRACTICE GUIDELINES | 389 | ||
| DISPARITIES IN CARE AND CLINICAL OUTCOMES | 389 | ||
| RESEARCH IMPLICATIONS | 390 | ||
| SUMMARY | 391 | ||
| Disclaimer | 391 | ||
| References | 391 | ||
| 42 - Orthostatic Hypotension | 393 | ||
| PATHOPHYSIOLOGY | 393 | ||
| CLINICAL CONSEQUENCES OF ORTHOSTATIC HYPOTENSION | 393 | ||
| EVALUATION OF THE PATIENT WITH ORTHOSTATIC HYPOTENSION | 393 | ||
| MANAGEMENT OF HYPERTENSION IN THE PATIENT WITH ORTHOSTATIC HYPOTENSION | 394 | ||
| MANAGEMENT OF ORTHOSTATIC HYPOTENSION IN THE HYPERTENSIVE PATIENT | 394 | ||
| Goal of Treatment and Overall Strategy | 394 | ||
| Remove Offending Factors | 394 | ||
| Nonpharmacological Countermeasures | 395 | ||
| Pressor Agents | 395 | ||
| SUMMARY | 396 | ||
| Disclaimer | 396 | ||
| References | 396 | ||
| 43 - Resistant Hypertension | 398 | ||
| FACTORS CONTRIBUTING TO RESISTANT HYPERTENSION | 399 | ||
| Characteristics of Patients With Resistant Hypertension | 399 | ||
| Lifestyle Factors | 399 | ||
| Nonadherence to Antihypertensive Treatment | 400 | ||
| Clinical Inertia | 401 | ||
| Screening for Secondary Hypertension | 401 | ||
| Screening for Drug-Induced Hypertension | 401 | ||
| Drugs or Substances Associated With Apparent Mineralocorticoid Excess or Activation of the Renin Angiotensin System | 402 | ||
| Drugs or Substances With Direct Vasopressor Properties | 403 | ||
| Drugs or Substances With Diverse Mechanisms of Action | 403 | ||
| Drugs or Substances Affecting the Pharmacokinetics or Pharmacodynamic Effects of Antihypertensive Drugs | 403 | ||
| PROPOSED TREATMENT FOR PATIENTS WITH RESISTANT HYPERTENSION | 403 | ||
| Lifestyle Changes | 404 | ||
| New Drugs | 405 | ||
| SUMMARY | 405 | ||
| References | 406 | ||
| 44 - Hypertension and the Perioperative Period | 409 | ||
| PERIOPERATIVE BLOOD PRESSURE CHANGES | 409 | ||
| CLINICAL GUIDELINES AND PERIOPERATIVE HYPERTENSION | 409 | ||
| HYPERTENSION AND PERIOPERATIVE CARDIOVASCULAR RISK | 410 | ||
| ANTIHYPERTENSIVE MEDICATIONS DURING THE PERIOPERATIVE PERIOD | 411 | ||
| Older Medications | 411 | ||
| Calcium Channel Blockers | 411 | ||
| Alpha 2 Agonists | 411 | ||
| Fenoldopam | 412 | ||
| Beta-Blockers | 412 | ||
| Renin Angiotensin System Blockers | 413 | ||
| ALGORITHM FOR THE MANAGEMENT OF HYPERTENSIVE PATIENTS UNDERGOING SURGERY | 413 | ||
| SUMMARY | 414 | ||
| References | 414 | ||
| 45 - Aorta and Peripheral Arterial Disease in Hypertension | 416 | ||
| AORTIC DISEASE IN HYPERTENSION | 416 | ||
| Thoracic Aortic Disease | 416 | ||
| Acute Aortic Syndromes (i.e., Aortic Dissection) | 416 | ||
| Aortic Dissection | 416 | ||
| Long-Term Blood Pressure Management Following Repair of Type A Dissections | 418 | ||
| Long-Term Blood Pressure Management Type B Dissections | 420 | ||
| Physical Activity and Lifestyle Recommendations Following Aortic Dissection | 420 | ||
| Thoracic Aortic Aneurysms | 420 | ||
| Abdominal Aortic Aneurysms | 421 | ||
| Antihypertensive Treatment in Setting of AAA | 421 | ||
| Aortic Coarctation | 422 | ||
| PERIPHERAL ARTERIAL DISEASE IN HYPERTENSION | 422 | ||
| Epidemiology of Peripheral Artery Disease | 422 | ||
| Nonpharmacologic Treatment: Exercise | 423 | ||
| Nonpharmacologic Treatment: Diet | 424 | ||
| Pharmacologic Therapy | 424 | ||
| Angiotensin-Converting Enzyme Inhibitors | 424 | ||
| Angiotensin II Receptor Blockers | 424 | ||
| Beta-Blockers | 424 | ||
| Calcium Channel Blockers | 424 | ||
| Combinations of Antihypertensive Agents | 424 | ||
| SUMMARY | 424 | ||
| References | 425 | ||
| 46 - Hypertensive Emergencies and Urgencies | 427 | ||
| CONTEMPORARY DEFINITIONS | 427 | ||
| Hypertensive Emergency | 427 | ||
| CLINICAL EVALUATION | 428 | ||
| CLINICAL MANAGEMENT | 428 | ||
| Hypertensive Emergencies | 429 | ||
| SPECIAL SITUATIONS | 430 | ||
| Aortic Dissection | 430 | ||
| Myocardial Infarction | 431 | ||
| Pulmonary Edema/Heart Failure | 431 | ||
| Ischemic Stroke | 431 | ||
| Hemorrhagic Stroke | 431 | ||
| Preeclampsia | 431 | ||
| Catecholamine Crisis | 431 | ||
| Perioperative Hypertension | 431 | ||
| Miscellaneous | 431 | ||
| SUMMARY | 432 | ||
| References | 432 | ||
| VIII - Outcome Trials | 433 | ||
| 47 - Meta-Analyses of Blood Pressure Lowering Trials and the Blood Pressure Lowering Treatment Trialists’ Collaboration | 433 | ||
| META-ANALYSES | 433 | ||
| THE BLOOD PRESSURE LOWERING TREATMENT TRIALISTS’ COLLABORATION | 434 | ||
| OVERALL EFFECTS OF BLOOD PRESSURE LOWERING AMONG HIGH-RISK PATIENTS WITH ELEVATED BLOOD PRESSURE | 434 | ||
| COMPARISONS OF DIFFERENT DRUG CLASSES | 435 | ||
| BLOOD PRESSURE-DEPENDENT AND BLOOD PRESSURE-INDEPENDENT EFFECTS OF BLOOD PRESSURE TREATMENT | 436 | ||
| EFFECTS IN IMPORTANT PATIENT SUBGROUPS | 437 | ||
| Effects in Patients of Different Ages | 439 | ||
| Effects in Men and Women | 439 | ||
| SUMMARY | 439 | ||
| References | 441 | ||
| IX - Hypertension Treatment in the Future | 443 | ||
| 48 - Team-Based Care for Hypertension Management | 443 | ||
| TEAM-BASED CARE OF HYPERTENSION | 445 | ||
| Systematic Reviews | 445 | ||
| Cost-Effectiveness Analyses | 446 | ||
| Nurse Case Management of Hypertension | 446 | ||
| Community Pharmacy | 446 | ||
| Pharmacists Embedded Within Clinics | 447 | ||
| Telephone Interventions | 448 | ||
| Medicaid and Underserved Populations | 448 | ||
| AN INTEGRATED MODEL TO PROVIDE HYPERTENSION CARE | 449 | ||
| SUMMARY | 450 | ||
| References | 450 | ||
| 49 - Understanding and Improving Medication Adherence | 452 | ||
| PREDICTORS OF NONADHERENCE | 453 | ||
| REASONS FOR NONADHERENCE | 453 | ||
| STRATEGIES AND INTERVENTIONS TO IMPROVE ADHERENCE | 454 | ||
| EFFECTIVE INTERVENTIONS TO REDUCE MEDICATION NONADHERENCE SHOULD BE “SIMPLE” | 454 | ||
| MEASURING MEDICATION ADHERENCE | 456 | ||
| SPECIFIC STRATEGIES FOR IMPROVING HYPERTENSION MEDICATION ADHERENCE | 456 | ||
| Team-Based Care | 456 | ||
| SUCCESS STORY | 457 | ||
| Case Management Intervention | 457 | ||
| SUMMARY | 457 | ||
| MEDICATION ADHERENCE TOOLS FOR PROVIDERS | 457 | ||
| References | 458 | ||
| X - Guidelines | 459 | ||
| 50 - Updated American Heart Association/American College of Cardiology; European Society of Hypertension/International Society of Hyp... | 459 | ||
| UNITED STATES OF AMERICA HYPERTENSION GUIDELINES (PORTION) | 459 | ||
| Background Story | 459 | ||
| 2014 Expert Panel Report | 461 | ||
| Which Guideline? | 462 | ||
| Not Covered in Depth | 462 | ||
| EUROPEAN GUIDELINES | 463 | ||
| Background Story | 463 | ||
| Stratification of Cardiovascular Risk | 464 | ||
| First Choice Drugs | 465 | ||
| Choice of Drugs | 466 | ||
| Treatment Strategies | 466 | ||
| Other Characteristics | 467 | ||
| References | 467 | ||
| 51 - Putting All Guidelines Into Perspective | 469 | ||
| BACKGROUND | 469 | ||
| UNITED STATES GUIDELINES | 469 | ||
| UNITED STATES GUIDANCE VERSUS NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE AND EUROPEAN GUIDANCE | 471 | ||
| References | 474 | ||
| Index | 475 | ||
| A | 475 | ||
| B | 477 | ||
| C | 479 | ||
| D | 481 | ||
| E | 482 | ||
| F | 483 | ||
| G | 483 | ||
| H | 483 | ||
| I | 487 | ||
| J | 487 | ||
| K | 487 | ||
| L | 487 | ||
| M | 488 | ||
| N | 489 | ||
| O | 490 | ||
| P | 491 | ||
| Q | 493 | ||
| R | 493 | ||
| S | 494 | ||
| T | 495 | ||
| U | 496 | ||
| V | 496 | ||
| W | 496 | ||
| Y | 497 | ||
| Z | 497 | ||
| IBC | ES2 |