scholarly journals Atrial fibrillation and arterial hypertension

2011 ◽  
Vol 17 (4) ◽  
pp. 293-304
Author(s):  
E. I. Baranova
Keyword(s):  
Atrial Fibrillation ◽  
Arterial Hypertension ◽  
Enzyme Inhibitors ◽  
Anticoagulation Therapy ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Angiotensin Ii Receptor ◽  
Primary And Secondary Prevention ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers

Review deals with atrial fibrillation and arterial hypertension. Possible pathological mechanisms of atrial fibrillation due to hypertension include haemodynamic effects, structural and electrophysiological heart remodeling partly connected with activation of renin-angiotensin-aldosterone system. Problems of primary and secondary prevention of atrial fibrillation in hypertensive patients are discussed, particularly the role of antihypertensive treatment including angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. Risk stratification for stroke and thromboembolism and anticoagulation therapy are discussed.

scholarly journals Atrial fibrillation and arterial hypertension

2011 ◽  
Vol 17 (4) ◽  
pp. 293-304 ◽  
Author(s):  
E. I. Baranova
Keyword(s):  
Atrial Fibrillation ◽  
Arterial Hypertension ◽  
Enzyme Inhibitors ◽  
Anticoagulation Therapy ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Angiotensin Ii Receptor ◽  
Primary And Secondary Prevention ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers

Review deals with atrial fibrillation and arterial hypertension. Possible pathological mechanisms of atrial fibrillation due to hypertension include haemodynamic effects, structural and electrophysiological heart remodeling partly connected with activation of renin-angiotensin-aldosterone system. Problems of primary and secondary prevention of atrial fibrillation in hypertensive patients are discussed, particularly the role of antihypertensive treatment including angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. Risk stratification for stroke and thromboembolism and anticoagulation therapy are discussed.

scholarly journals The role of adiponectin in renal physiology and development of albuminuria

2014 ◽  
Vol 221 (2) ◽  
pp. R49-R61 ◽  
Author(s):  
Georgios A Christou ◽  
Dimitrios N Kiortsis
Keyword(s):  
Glomerular Filtration ◽  
Enzyme Inhibitors ◽  
Albumin Excretion Rate ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Renal Physiology ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Filtration Barrier ◽  
Receptor Blockers

Adiponectin is secreted by the adipose tissue and is downregulated in states of obesity and insulin resistance. There is a growing body of evidence indicating that adiponectin has renoprotective effects and protects against the development of albuminuria in rodent experiments. Adiponectin crossing the glomerular filtration barrier possibly inhibits inflammation, fibrosis and oxidative stress in kidneys through activation of AMP-activated protein kinase. Moreover, microalbuminuria is a well established early sign of progressive cardiovascular and renal disease, even in subjects with preserved glomerular filtration rate. Studies investigating the relationship between serum adiponectin levels and urinary albumin excretion rate (UAE) have yielded conflicting data and the mechanisms underlying the interplay between adiponectin and albuminuria remain to be elucidated. This article constitutes a critical review attempting to clarify any remaining confusion about this matter. Furthermore, this article examines the clinical significance of adiponectin–albuminuria interplay, suggesting that adiponectin is possibly involved in the development of albuminuria that is associated with obesity, diabetes and cardiovascular disease and may mediate, at least in part, the actions of medical treatments that influence UAE, such as angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, thiazolidinediones, fenofibrate and diet. Further studies to investigate more thoroughly the renoprotective role of adiponectin in the human setting should be carefully planned, focusing on causality and the possible influence of adiponectin on the development of albuminuria in specific clinical settings.

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