Renal Components of the Hypertensive Syndrome

National High Blood Pressure Education Program Working Group: 1995 Update of the working group reports on chronic renal failure and renovascular hypertension Arch Intern Med 1996, 156:1938–1947. * This National Institutes of Health consensus panel (nephrologists) outline recommendations for the treatment of blood pressure, shown either to slow or to prevent renal disease progression.

United States Renal Data System: II - Incidence and prevalence of ESRD. 1997 Annual Data Report Am J Kidney Dis 1997, 30 (suppl 1):S40–S53.

Silverman M Bakris GL : Treatment of renal failure and blood pressure Curr Opin Nephrol Hypertens 1997, 6:237–242. * This paper reviews the risk factors for development of hypertension and treatment strategies considering the risk factor and renal disease.

Winkley MA Kraemer H Lin J Jalulis D Fortmann P : Sociodemographic influences on Hispanic-White differences in blood pressure Public Health Rep 1996, 111 (suppl 2):30–32.

Bakris G Mehler P Schrier R : Hypertension and diabetes In Diseases of the Kidney. 6th Edn. Edited by Schrier RW Gottschalk CW. Boston: Little, Brown and Company; 1996, 1455–1464. ∗ Presents a review of the factors implicated in development of hypertension in diabetic patients and therapeutic considerations.

Bakris GL : Pathogenesis of hypertension in diabetics Diabetes Rev 1995, 3:460–476. ∗ Presents an in-depth review of the etiologies in the pathogenesis of hypertension in diabetics including genetics, diet, ion channels, vasoactive substances and sympathetic activity.

Guyton AC Coleman TG Cowley AW Jr Scheel KW Manning RD Jr Norman RA Jr : Arterial pressure regulation: Overriding dominance of the kidneys in long-term regulation and in hypertension Am J Med 1972, 52:584–594.

Cowley AW Jr Roman RJ : The role of kidney in hypertension JAMA 1996, 275:1581–1589. ∗ This review article discusses the role of genetics, vasoactive substances and experimental animal models in the pathogenesis of hypertension due to altered kidney function.

Hall TE Brands MW Shek EW : Central role of the kidney and abnormal fluid volume control in hypertension J Hum Hypertens 1996, 10:633–639. ∗ Reviews the studies that demonstrate a role of the kidneys in controlling the salt and volume in hypertensive patients.

Rettig R Folberth C Stauss H Kopp D Waldhess R Unger T : Role of the kidney in primary hypertension: A renal transplantation study in rats Am J Physiol 1990, 25:F606–F611.

Guidi E Menghetti D Milani S Montagnino G Palazzi P Bianchi G : Hypertension may be transplanted with the kidney in humans: A long term historical prospective follow-up of recipients grafted with kidneys coming from donors with or without hypertension in their families J Am Soc Nephrol 1996, 7:1131–1138. ∗ This paper found a higher incidence of hypertension requiring more medications when a donor kidney with a family history of hypertension was transplanted to a recipient with no history of hypertension suggesting kidney as the modulating factor for development of hypertension.

Caulfield M Lavender P Farrall M Munroe P Lawson M Turner P : Linkage of the angiotensinogen gene to essential hypertension N Engl J Med 1994, 330:1629–1633.

Caulfield M Lavender P Newell-Price J Kamdar S Farrall M Clark AJ : Angiotensinogen gene in human essential hypertension Hypertension 1996, 28:1123–1125.

Hegele RA Harris SB Hanley AJG Sun F Connelly PW Zinman B : Angiotensinogen gene variation associated with variation in blood pressure in aboriginal Canadians Hypertension 1997, 29:1073–1077

Bloem LJ Foroud TM Ambrosius WT Hanna MP Tewksbury DA Pratt JH : Association of the angiotensinogen gene to serum angiotensinogen in blacks and whites Hypertension 1997, 29:1078–1082.

Fornage M Turner ST Sing CF Boerwinkle E : Variation at the M235T focus of the angiotensinogen gene and essential hypertension: A population-based case-control study from Rochester, Minnesota Hum Genet 1995, 96:295–300.

Marre M Bernadet P Gallois Y Savagner F Guyene TT Hallab M : Relationships between angiotensin I converting enzyme gene polymorphism, plasma levels and diabetic retinal and renal complications Diabetes 1994, 43:384–388.

Marre M Jeunemaitre X Gallois Y Rodice M Chatellier G Sert C : Contribution of genetic polymorphism in the renin-angiotensin system to the development of renal complications in insulin dependent diabetes J Clin Invest 1997, 99:1585–1595. * This paper found a relationship between IDDM associated nephropathy and ACE I/D and DD genotype. Angiotensinogen gene was not found to be an independent risk factor.

Robert Z Amanda S Naohaue I Brian M : Association analyses of SA gene variation in essential hypertension Am J Hypertens 1997, 10:235–242.

Nabika T : Genetic analysis of responsible genes for essential hypertension Rinsho Byori 1997, 45:107–111.

Weinberger M : Salt sensitivity of blood pressure in humans Hypertension 1996, 27:481–490.

Svetkey LP McKeown SP Wilson AF : Heritability of salt sensitivity in Black Americans Hypertension 1996, 28:854–858.

Sullivan JM : Salt sensitivity. Definition, conception, methodology and long term issues Hypertension 1991, 17 (suppl 1):I-61-I-68.

Campese V : Salt sensitivity in hypertension, renal and cardiovascular implications Hypertension 1994, 23:2531–2550. * This paper presents an in-depth review regarding the role of salt sensitivity in the pathogenesis of hypertension and the different mechanisms involved.

Midgley JP Matthew AG Greenwood CMT Logan AG : Effect of reduced dietary sodium on blood pressure. A meta-analysis of randomized controlled trials JAMA 1996, 275:1590–1597.

Takeshia V Freida K Kazuhiko I Satoko N Takeshia I Genejiro K : High sodium sensitivity implicates nocturnal hypertension in essential hypertension Hypertension 1996, 28:139–142.

Turner ST Sing CF : Erythrocyte sodium transport and the probability of having hypertension J Hypertens 1996, 14:829–837.

Mara F Grazia T Sergio S Monica F Rossara M Pablo B : Renal Na-K ATPase in genetic hypertension Hypertension 1996, 28:1018–1025.

Stec DE Mattson DI Roman RJ : Inhibition of renal outer medullary 20-HETE production produces hypertension in Lewis rats Hypertension 1997, 29:315–319.

Zou AP Drummond HA Roman RJ : Role of 20-HETE in elevating loop chloride reabsorption in Dahl SS/Jr/ rats Hypertension 1996, 27:631–635.

Ferri C Piccoli A Laurenti O Bellini C De Mania G Santucci A : Atrial natriuretic factor in hypertensive and normotensive diabetic patients Diabetes Care 1994, 17:195–200.

Ribstein J du Cailar G Mimran A : Combined renal effects of overweight and hypertension Hypertension 1995, 26:610–615.

Robert G Kazimerz RB Ross DF : Human insulin-mediated enhancement of vascular β-adrenergic responsiveness Hypertension 1994, 23:551–555.

Suzuki H Ikenaga H Hayashida T Otsuka K Kanno Y Ohno Y : Sodium balance and hypertension in obese and fatty rats Kidney Int 1996, 49 (suppl 55):S150–S153.

Weir MR : Insulin resistance and salt sensitivity. A renal hemodynamic abnormality? Am J Hypertens 1996, 9:193S–199S. ∗ Insulin resistance can increase the sympathetic tone and has an antinatriuretic effect. This paper reviews the role of insulin resistance, hyperinsulinemia and its relation to salt sensitivity.

Bakris GL Bursztyn M Gavras I Breshnanhan M Gavras H : Role of vasopressin in essential hypertension; racial differences J Hypertens 1997, 15:545–550. ∗ This article demonstrates that high vasopressin and low renin levels are present in hypertensive African Americans compared to Caucasians. The data support the concept that vasopressin plays a major role in the pathogenesis of hypertension among African-Americans.

Bakris GL Kusmirek SL Smith AC Gavras I Gavras H : Calcium antagonism abolishes the antipressor action of vasopressin (V1) receptor antagonism Am J Hypertens 1997, (in press).

de Paula RB Plavnik FL Rodrigues CI de A Neves F Kohlmann O Jr Ribeiro AB : Contribution of vasopressin to orthostatic blood pressure maintenance in essential hypertension Am J Hypertens 1993, 6:794–798.

Barri YM Wingo CS : The effects of potassium depletion and supplementation on blood pressure: A clinical review Am J Med Sci 1997, 314:37–40.

Sudhir K Forman A Yi S Sorof J Schmidlin O Sebastian A : Reduced dietary potassium reversibly enhances vasopressor response to stress in African Americans Hypertension 1997, 29:1083–1090. * This study found an increased vasopressor responsiveness in African Americans when potassium was decreased in diet and was attenuated with normalization of dietary potassium.

Throup C Persson AEG : Macula densa derived nitric oxide in regulation of glomerular capillary pressure Kidney Int 1996, 49:430–436.

Woltz M Schmetterer L Ferber W Artner E Mensik C Eichler HG : Effect of nitric oxide synthase inhibition on renal hemodynamics in humans: Reversal by L-arginine Am J Physiol 1997, 272:F178–F182.

Pollock DM Polakowski JS Divish BJ Opgenoeth TJ : Angiotensin blockade reverses hypertension during long term nitric oxide synthase inhibition Hypertension 1993, 21:660–666.

Lahera V Navarro-Cid J Cachofeiro V Graecia-Estan J Ruilope LM : Nitric oxide, the kidney and hypertension Am J Hypertens 1997, 10:129–140.

Ono H Ono Y Frohlich E : ACE inhibition prevents and reverses L-NAME exacerbated nephrosclerosis in spontaneously hypertensive rats Hypertension 1996, 27:176–183.

Yamada SS Sassaki AL Fujihara CK Malheiros DM De Nucci G Zatz R : Effect of salt intake and inhibitor dose on arterial hypertension and renal injury induced by chronic nitric oxide blockade Hypertension 1996, 27:1165–1172.

Wilcox CS Welch WJ : TGF and nitric oxide: Effects of salt intake and salt sensitive hypertension Kidney Int 1996, 49 (suppl 55):S9–S13.

Thorup C Persson AEG : Impaired effect of nitric oxide synthesis inhibition on tubuloglomerular feedback in hypertensive rats Am J Physiol 1996, 40:F246–F252.

Matsuoka H Nishida H Nomura G Vliet BNV Toshima H : Hypertension induced by nitric oxide synthesis inhibition is renal nerve dependent Hypertension 1994, 23:2:971–975.

Griffin KA Picken MM Bidani AK : Deleterious effects of calcium channel blockade on pressure transmission and glomerular injury in rat remnant kidney J Clin Invest 1995, 96:793–800. * This animal study provides a strong rationale for the relative lack of renal protection by dihydropyridine calcium channel blockers in spite of blood pressure reduction. Obliteration of autoregulation is strongly implicated.

Bidani AK Griffin KA Plott W Schwartz MM : Renal ablation acutely transforms ‘benign’ hypertension to ‘malignant’ nephrosclerosis in hypertensive rats Hypertension 1994, 24:309–316.

Sealy JE Blumenfeld JD Bell GM Pecker MS Sommers SC Laragh JH : On the renal basis for essential hypertension: Nephron heterogeneity with discordant renin secretion and sodium excretion causing a hypertensive vasoconstriction-volume relationship J Hypertens 1988, 6:763–777. * This paper reviews the concept of a population of ischemic glomeruli, causing renin stimulation; among normal glomeruli and its role in the pathogenesis of hypertension.

Bakris GL Re RN Bhandaru S : Endothelin modulates angiotensin II induced mitogenesis of human mesangial cells Am J Physiol 1993, 264:F937–F942. ∗ Mesangial cell proliferation and endothelin production was increased in the presence of angiotensin II. When they blocked the endothelin-1 by antibodies, the investigators were able to decrease the mesangial proliferation, thereby suggesting ET-1 as a mediator for the Ap II mitogenic effect.

Phillipe W Lucia M Jung N Theig P : Two kidney, one clip and one kidney, one clip hypertension in mice Hypertension 1997, 29:1025–1030

Bakris GL : Microalbuminuria: Prognostic implications Curr Opin Nephrol Hypertens 1996, 5:219–223. * This article reviews the pathophysiologic and epidemiologic aspects of microalbuminuria in the context of renal disease progression as well as of cardiovascular mortality.

Pontermoli R Cheli V Sofia A Tirotta A Ravera M Nicolella C : Prevalence of microalbuminuria and macroalbuminuria and their relationship with other cardiovascular risk factors in essential hypertension Nephrol Dial Transplant 1995, 10 (suppl 6):6–9.

Bianchi S Bigazzi R Baldari G Sgherri G Campese VM : Diurnal variations of blood pressure and microalbuminuria in essential hypertension Am J Hypertens 1994, 7:23–29.

Cerasola G Cottone G Mule G Narde E Mangano MT Renda F : Relationship between microalbuminuria, blood pressure and cardiovascular changes in essential hypertension Contrib Nephrol 1996, 119:130–134.

Pontermoli R Cheli V Tirotta A Ravera M Nicolella C Ruello N : Microalbuminuria is associated with a worse cardiovascular risk profile and target organ damage in essential hypertension Contrib Nephrol 1996, 119:115–120. ∗ Microalbuminuria was associated with higher diastolic and mean arterial pressure. Lower levels of HDL-cholesterol, HDL/LDL-Cholesterol ratio and higher prevalence of major ECG changes were also noted in this group; suggesting higher cardiovascular risk factors with microalbuminuria.

de Mora Martin M Aranda Lara P Aranda Lara FJ Barakat S Zafra Sanchez J Rubio Alcaide A : Diastolic dysfunction, left ventricular hypertrophy, and microalbuminuria in mild to moderate essential arterial hypertension Rev Esp Cardiol 1997, 50:233–238

Bakris GL Weir MR : Salt intake and reductions in arterial pressure and proteinuria. Is there a direct link? Am J Hypertens 1996, 9 (suppl):200S–206S. ∗ This paper reviews the effect of salt on glomerular hemodynamics and permeability as they affect proteinuria and the antiproteinuric effect of nondihydropyridine calcium channel blockers and ACEI.

Bakris GL Smith A : Effects of sodium intake on albumin excretion in patients with diabetic nephropathy treated with long acting calcium antagonists Ann Intern Med 1996, 125:201–204. ∗ This paper highlights the fact that high sodium intake blunts the antiproteinuric effect of diltiazem even with blood pressure control. The dihydropyridine calcium-channel blocker nifedipine was shown to have no antiproteinuric effect regardless of blood pressure control or sodium intake.

Bigazzi R Bianchi S Baldari D Sgherri G Baldari G Campese V : Microalbuminuria in salt sensitive patients. A marker for renal and cardiovascular risk factors Hypertension 1994, 23:195–199.

Vallon V Kieschenmann D Wead LN Lortie MJ Saterano J Blantz RC : Effect of chronic salt loading on kidney function in early and established diabetes mellitus in rats J Lab Clin Med 1997, 130:76–82.

Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC VI): Sixth Report. Arch Intern Med 1997, in press. ∗ This report will set guidelines for hypertension management. It discusses the treatment strategies including combination of antihypertensives.

Kilaru PK Bakris GL : Calcium channel blockade and/or ACE inhibition for prevention of diabetic and hypertensive nephropathy In Combination Drug Therapy for Hypertension. Chapter 12. Edited by Opie L Messerli F. Philadelphia: Lippincott-Raven Publishers; 1997:123–137.

Bakris GL Slataper R Vicknair N Sadler R : ACEI mediated reductions in renal size and microalbuminuria in normotensive, diabetic subjects J Diabetes Complications 1994, 8:2–6.

Brown SA Walton CL Crawford P Bakris GL : Long term effects of antihypertensive regimens on renal hemodynamics and proteinuria Kidney Int 1993, 43:1210–1218.

Carmines PK Navar G : Disparate effects of Ca channel blockade on afferent and efferent arteriolar responses to ANG II Am J Physiol 1989, 256:F1015–1020.

Jyothirmayi GN Reddi AS : Effect of diltiazem on glomerular heparan sulfate and albuminuria in diabetic rats Hypertension 1993, 21:795–802.

Bakris GL Mangrum A Copley JB Vicknair N : Calcium channel or β blockade on progression of diabetic renal disease in African Americans Hypertension 1997, 29:745–750. ∗ A five year randomized study of NIDDM hypertensives treated with nondihydropyridine calcium-channel blockers verapamil or beta blocker atenolol. Verapamil slowed the progression of renal disease and had significant antiproteinuric effect compared to atenolol even with equal blood pressure control.

Gaber L Walton C Brown S Bakris GL : Effects of different antihypertensive treatments or morphologic progression of diabetic nephropathy in uninephrectomized dogs Kidney Int 1994, 46:161–169. * Glomerular scarring and proteinuria was studied in diabetic dogs. The investigators found decreased glomerular scarring with ACEI and NDCCB.

Bakris GL : Combination therapy for hypertension and renal disease in diabetics as compared to non-diabetics In The Kidney and Hypertension in Diabetes Mellitus. Chapter 55. Edited by Mogensen CE. London: Kluwer Academic Publishers; 1996:561–568. ∗ Beneficial effects of combination of antihypertensive agents is discussed in the content of hemodynamic and non-hemodynamic effects of these agents for use in diabetics and non-diabetics.