Chronic kidney disease with a worldwide prevalence of 10% in the general population is emerging as a major public health priority. Renal dysfunction is associated with a high risk for cardiovascular complications. The relationship between renal insufficiency and cardiovascular disease, termed the cardiorenal syndrome exists whether impairment of renal function is a consequence of primary renal parenchymal disease or primary heart disease.

Several pathophysiologic mechanisms have been postulated to explain the relationship between renal dysfunction and cardiovascular disease. Recent studies indicate an integrated response of the vascular smooth muscles and glomerular mesangial cells to traditional and uremia related cardiovascular risk factors. Traditional risk factors can incite renal impairment and cardiac damage. As renal function deteriorates, uremia-related risk factors play an increasing role both in reduction in glomerular filtration rate and cardiovascular damage. Several uremia related factors such as uncontrolled hypertension, disturbed glucose insulin metabolism, microalbuminuria, phosphate retention, secondary hyperparathyroidism, myocardial and vascular calcification, hypertensive-uremic cardiomyopathy, inflammation, oxidant injury, and neurohormonal dysregulation have been implicated in the pathogenesis of the cardiorenal syndrome. Recent data suggest that management of the cardiorenal syndrome requires aggressive control of traditional risk factors as well novel approaches to prevent or reverse uremia related processes.

This book provides a comprehensive update analysis of our current understanding of the cardiorenal syndrome including epidemiology, pathophysiologic mechanisms, and therapeutic approaches.

This book presents up-to-date information on how to assess early preclinical alterations in the heart, the small and large arteries and the kidney using the most sensitive, specific and cost-effective techniques. A wide variety of techniques are discussed, with careful attention to the latest developments. For each organ, evidence is documented regarding the prevalence of organ damage in the general and the hypertensive population. Information is provided on the potential induction of regression of organ damage by treatment, the criteria for establishing significant changes and the clinical prognostic significance of regression. The manual will be invaluable for all practitioners responsible for the clinical management of hypertensive patients, given that the assessment of early preclinical cardiovascular and renal damage permits more accurate risk stratification at baseline and facilitates evaluation of cardiovascular protection when regression of structural changes is achieved during treatment.

This book is not intended as a full detailed report on hypertension and related disorders, but instead focuses on particular issues in hypertension. It looks at emerging recently described forms of hypertension that are frequently encountered in clinical practice (prehypertension, white-coat and masked hypertension, hypertension in the elderly) and discusses novel aspects of target organ disease (for example, cognitive impairment, dementia, and sexual dysfunction), and changing concepts in the management of hypertension and antihypertensive pharmacotherapy. It also looks at specific topics that are rarely discussed in books, including hypertension control in postmenopausal women on hormonal replacement therapy, Ramadan fasting, painful inflammatory disorders, and aldosterone escape. Finally, it examines newer cardiovascular risk factors (for example, uric acid, circadian blood pressure changes, blood pressure variability).

As our knowledge about arterial disease is greatly expanding, the aim of this book is to explore all aspects of arterial pathology, including classification, clinical manifestations, pathogenesis, and therapeutic options. The discussion of pathophysiologic mechanisms of arterial disease is wide ranging, encompassing hemodynamic, metabolic, humoral, inflammatory, genetic and environmental factors. Particular emphasis is placed on recent concepts, such as: the role of age-associated arterial alterations in the initiation and progression of cardiovascular diseases in older persons, the importance of mineral metabolism-bone vascular interactions, the clinical and prognostic significance of the renal resistive index, retinal circulation, toxemia of pregnancy as an arterial disease, and the role of pulmonary/vascular interaction in pulmonary hypertension and cross-talk of macrocirculation and microcirculation in target organ involvement. Evaluation procedures are carefully explained, and the full range of currently available therapeutic options, including lifestyle modifications and pharmacologic approaches, are described and appraised.

The Manual of Hypertension of the European Society of Hypertension reflects emerging concepts that have the potential to impact diagnostic and therapeutic approaches to hypertension. Updating all material, this new edition also delves into a number of areas that have received heightened interest in recent years or have become a matter of debate due to the controversial interpretation of the available data. FEATURES Reflects emerging concepts impacting diagnostic and therapeutic approaches Explores background, history, epidemiology, and risk factors Describes pharmacological, nonpharmacological, and medical treatments Examines hypertension in special populations and treatment

The Manual of Hypertension of the European Society of Hypertension reflects emerging concepts that have the potential to impact diagnostic and therapeutic approaches to hypertension. Updating all material, this new edition also delves into a number of areas that have received heightened interest in recent years or have become a matter of debate due to the controversial interpretation of the available data. FEATURES Reflects emerging concepts impacting diagnostic and therapeutic approaches Explores background, history, epidemiology, and risk factors Describes pharmacological, nonpharmacological, and medical treatments Examines hypertension in special populations and treatment

A growing number of people suffer from so-called resistant hypertension, that is to say, high blood pressure that does not respond to treatment. This disorder is of great current interest and importance for public health, being a common clinical problem faced by both primary care clinicians and specialists. Furthermore, as older age and obesity are among the strongest risk factors for uncontrolled hypertension, the incidence of resistant hypertension will likely increase as the population becomes more elderly and heavier. While the prognosis of resistant hypertension is unknown, cardiovascular risk is undoubtedly increased since patients often have a history of long-standing, severe hypertension complicated by multiple other cardiovascular risk factors. This volume, compiled by a panel of world-renowned experts, offers a comprehensive exploration of resistant hypertension, covering epidemiology, complex diagnostic aspects, and the therapeutic options currently available, with due attention to overall treatment strategies. New therapeutic agents and procedures, such as renal denervation and baroreceptor stimulation, are also described. In addition, the book addresses the economic aspects of resistant hypertension and the role of the different professional figures, from GPs to hypertension specialists, in dealing with it.

This book addresses all aspects of white coat hypertension the phenomenon of raised blood pressure in a medical setting yet not elsewhere from its history to its pathophysiology, diagnosis and treatment. White coat hypertension is a common condition, accounting for 30 40% of the overall hypertensive population. While many studies have addressed this condition, controversy still exists over whether it causes an increased risk to sufferers and should be treated.

In the volume neurogenic and non-neurogenic mechanisms are discussed and the significance of various predictive factors, evaluated. The association of white coat hypertension with dysmetabolic risk factors, new-onset diabetes and other conditions is carefully reviewed. Further chapters consider the occurrence of asymptomatic organ damage and cardiovascular outcomes in affected patients and helpful guidance is also provided on the controversial issue of when to treat and when not to treat. "White Coat Hypertension" is based largely on work done during the past 30 years by renowned researchers working in Milan, who have made key contributions in improving knowledge of the condition and whose work is well known across the world."

Since angiotensin II is one of the most potent vasoconstrictors and an important stimulus for the secretion of aldosterone from the adrenal gland, the development of of angiotensin II inhibitors is an important step in regulating blood pressure. This class of drug is well-tolerated by pateints and these drugs have the added advantage over ACE inhibitors in that they are not associated with cough. Because most drugs can be given once daily and, like ACEIs, they have a useful additive hypotensive effect in combination with diuretics, they are a welcome therapeutic tool in the treatment of hypertension. This Second Edition builds on the success of the first and brings to the reader all the latest developments, clinical trial data, and the contributors's personal perspectives when treating patients with angiotensin II receptors antagonists. -offers chapters by well-known contributors in the fields of both hypertension and heart failure, especially with regard to pharmacological interventions -covers the new role of AIIR in neuroprotection -builds upon the strengths of the first edition

This book is not intended as a full detailed report on hypertension and related disorders, but instead focuses on particular issues in hypertension. It looks at emerging recently described forms of hypertension that are frequently encountered in clinical practice (prehypertension, white-coat and masked hypertension, hypertension in the elderly) and discusses novel aspects of target organ disease (for example, cognitive impairment, dementia, and sexual dysfunction), and changing concepts in the management of hypertension and antihypertensive pharmacotherapy. It also looks at specific topics that are rarely discussed in books, including hypertension control in postmenopausal women on hormonal replacement therapy, Ramadan fasting, painful inflammatory disorders, and aldosterone escape. Finally, it examines newer cardiovascular risk factors (for example, uric acid, circadian blood pressure changes, blood pressure variability).

Chronic kidney disease with a worldwide prevalence of 10% in the general population is emerging as a major public health priority. Renal dysfunction is associated with a high risk for cardiovascular complications. The relationship between renal insufficiency and cardiovascular disease, termed the cardiorenal syndrome exists whether impairment of renal function is a consequence of primary renal parenchymal disease or primary heart disease. Several pathophysiologic mechanisms have been postulated to explain the relationship between renal dysfunction and cardiovascular disease. Recent studies indicate an integrated response of the vascular smooth muscles and glomerular mesangial cells to traditional and uremia related cardiovascular risk factors. Traditional risk factors can incite renal impairment and cardiac damage. As renal function deteriorates, uremia-related risk factors play an increasing role both in reduction in glomerular filtration rate and cardiovascular damage. Several uremia related factors such as uncontrolled hypertension, disturbed glucose insulin metabolism, microalbuminuria, phosphate retention, secondary hyperparathyroidism, myocardial and vascular calcification, hypertensive-uremic cardiomyopathy, inflammation, oxidant injury, and neurohormonal dysregulation have been implicated in the pathogenesis of the cardiorenal syndrome. Recent data suggest that management of the cardiorenal syndrome requires aggressive control of traditional risk factors as well novel approaches to prevent or reverse uremia -related processes. This book provides a comprehensive update analysis of our current understanding of the cardiorenal syndrome including epidemiology, pathophysiologic mechanisms, and therapeutic approaches.

This book addresses all aspects of white coat hypertension – the phenomenon of raised blood pressure in a medical setting yet not elsewhere – from its history to its pathophysiology, diagnosis and treatment. White coat hypertension is a common condition, accounting for 30–40% of the overall hypertensive population. While many studies have addressed this condition, controversy still exists over whether it causes an increased risk to sufferers and should be treated. In the volume neurogenic and non-neurogenic mechanisms are discussed and the significance of various predictive factors, evaluated. The association of white coat hypertension with dysmetabolic risk factors, new-onset diabetes and other conditions is carefully reviewed. Further chapters consider the occurrence of asymptomatic organ damage and cardiovascular outcomes in affected patients and helpful guidance is also provided on the controversial issue of when to treat and when not to treat. White Coat Hypertension is based largely on work done during the past 30 years by renowned researchers working in Milan, who have made key contributions in improving knowledge of the condition and whose work is well known across the world.

A growing number of people suffer from so-called resistant hypertension, that is to say, high blood pressure that does not respond to treatment. This disorder is of great current interest and importance for public health, being a common clinical problem faced by both primary care clinicians and specialists. Furthermore, as older age and obesity are among the strongest risk factors for uncontrolled hypertension, the incidence of resistant hypertension will likely increase as the population becomes more elderly and heavier. While the prognosis of resistant hypertension is unknown, cardiovascular risk is undoubtedly increased since patients often have a history of long-standing, severe hypertension complicated by multiple other cardiovascular risk factors. This volume, compiled by a panel of world-renowned experts, offers a comprehensive exploration of resistant hypertension, covering epidemiology, complex diagnostic aspects, and the therapeutic options currently available, with due attention to overall treatment strategies. New therapeutic agents and procedures, such as renal denervation and baroreceptor stimulation, are also described. In addition, the book addresses the economic aspects of resistant hypertension and the role of the different professional figures, from GPs to hypertension specialists, in dealing with it.