Abnormal Renal Hemodynamics in Black Salt-Sensitive Patients With Hypertension (1991) Quality Study. скачать в хорошем качестве

Abnormal Renal Hemodynamics in Black Salt-Sensitive Patients With Hypertension (1991) Quality Study.

Extremely thorough study on Black patients with Salt-Sensitivity and Hypertension. As more videos with research articles are uploaded & progress to more current dates, you will notice that the thoughts, questions, observations/implications noted throughout this current study will lessen. Pertinent findings from the research: During the high Na+ intake period, glomerular filtration rate did not change in either group; effective renal blood flow increased in salt-resistant patients (from 455±25 to 524±27.7 ml/min,p0.01), but it decreased in salt-sensitive patients (from 538±20 to 426±15.8 ml/min, p0.01); filtration fraction decreased (from 21±1.8 to 19±1.5%) in salt-resistant patients, but it increased (from 19±0.9 to 23± 1.5%, p0.01) in salt-sensitive patients; glomerular pressure decreased (from 58±2.0 to 52±1.5 mm Hg,/?0.01) in salt-resistant patients, but it increased (from 48±1.6 to +58±1.5 mm Hg, p0.01) in salt-sensitive patients. During the period of high Na intake, nifedipine decreased arterial pressure, renal vascular resistance, and filtration fraction and increased renal blood flow in salt-sensitive but not in salt-resistant patients. These studies show that an abnormal renal hemodynamic adaptation occurs in salt-sensitive patients during high Na+ intake. The rise in filtration fraction and in intraglomerular pressure during high Na+ suggests that these renal hemodynamic derangements might be partially responsible for the greater propensity to renal failure in hypertensive African-Americans. This was a very telling reflection made by the authors when comparing their current study to a previous study: "Such patients were termed "non-modulators" by the investigators. In so-called non-modulators, renal blood flow failed to increase in response to high dietary sodium intake, whereas in normal subjects and in hypertensive patients with normal renal vascular and adrenal modulation, renal blood flow increased by at least 120 ml/min 1.73 m . Non-modulators also manifested a derangement in the capacity to handle sodium along with an increase in blood pressure during high dietary sodium intake. Obviously, many of the renal hemodynamic characteristics observed in the non-modulators mimic those observed by us in black SS patients. The difference between these two studies is that we have not selected patients with normal plasma renin activity, a criterion that would have excluded most of the hypertensive black patients, who notoriously have reduced levels of plasma renin activity". Although this study was funded by Pfizer, it does appear to be a very appropriate and well thought out study with appropriate suggestions for future research while noting the need for more research, specifically noting: "It is obvious that a prospective study involving a large number of SS patients (black and white) is needed to establish whether a relation exists between these renal hemodynamic derangements and the greater propensity for the development of renal failure in black hypertensive patients, whether renal failure is more likely to develop in SS black patients than in SR blacks, and whether SS white patients have similar hemodynamic derangements and a similar propensity for the development of renal failure as a result of protracted hypertension as black patients". Further they noted, more in vivo (human) studies are necessary rather than in vitro (artificial setting/outside of human body). Many studies done today are in fact, done in vitro. Source: Abnormal Renal Hemodynamics in Black Salt-Sensitive Patients With Hypertension. Vito M. Campese, Mario Parise, Frederick Karubian, and Roberto Bigazzi {Hypertension 1991;18:805-812) It is extremely unusual to have a study with the ratio of Blacks and Whites this current study did. A significant amount of research done today has a greater than 75% White demographic & a limited number of Blacks/other minority races. This is especially true for vaccine research. Please make note and request a FDA label insert to note the demographics of the clinical trials prior to FDA approval & also to note any adverse events. Nifedipine is a Calcium Channel Blocker, a class of antihypertensives. Calcium Channel Blockers should be considered as the first line agent in the management of Hypertension in Blacks. More so, as evidenced by the findings in this study, decreasing sodium intake should be the first objective in treating asymptomatic Hypertension in Blacks; more attention than a passing comment, or a notation on a handout is necessary. Direct patient benefit/gains can be seen & trust established by the visual presentation, review & discussion of research findings & requesting demonstration of verbal understanding. *Consideration should be given to a 30 day trial of significant sodium reduction, BP & weight monitoring before initiation of antihypertensive therapy. #pharma #fda #cdc #knightsofmalta #districtofcolumbia #vatican #jesuits #msom #gatekeepers #worldeconomicforum #who