Hypertension and nephrology

[Effect of beta-blockers with or without vasodilating properties on central blood pressure]


NOVEMBER 01, 2021

Hypertension and nephrology - 2021;25(05)

[Beta-blockers are more and more excluded as frist-line option in recent hypertension guidelines – they are mainly used in the case of compelling indication. However beta-blockers are not a homogeneous drug-class as several differences exist between them regarding their effect on metabolism or vasoconstriction/vasodilation. The clinical implication of central blood pressure has recently arisen into the focus of interest in the light of the fact that different antihypertensives exert different effect on central blood pressure. The theory of ”stiffness-gradient” may help us to deepen our knowledge regarding the physiology of central blood pressure. Several studies investigated the effects of different beta-blockers on central blood pressure. Based on the unique effect of beta-blockers with vasodilating properties it can be emerged to form this group of drugs as a new antihypertensive class. ]


  1. Tolna Megyei Balassa János Kórház, I. Sz. Belgyógyászati Osztály (Kardiológia/Nefrológia), Szekszárd



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Hypertension and nephrology

[Subtype diagnosis, treatment, complications and outcomes of primary aldosteronism and future direction of research: a position statement and consensus of the Working Group on Endocrine Hypertension of the European Society of Hypertension – excerpts]

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[Primary aldosteronism is a frequent cause of secondary hypertension requiring a specific pharmacological treatment with mineralocorticoid receptor antagonist or with unilateral adrenalectomy. These treatments have shown to reduce the excess of cardiovascular risk characteristically associated with this disease. In this consensus, we discussed the procedures for the diagnosis of primary aldosteronism, we address the strategies for the differential diagnosis of primary aldosteronism subtypes and therapy. We also discuss the evaluation of outcomes and provide suggestions for follow-up as well as cardiovascular and metabolic complications specifically associated with primary aldosteronism. ]

Hypertension and nephrology

[Unattended automated office blood pressure measurement versus classic office automated blood pressure measurement in a hypertension outpatient clinic]


[Accurate measurement of blood pressure is a fundamental prerequisite requirement for an appropriate management of arterial hypertension. In order to eliminate the well-known limitations of classic office blood pressure measurements, the so-called unattended automatic office blood pressure measurement method can be a solution. In 52 patients arriving for regular followup into one of the Hypertension Outpatinet Clinic of the Nephrology-Hypertension Center of the University of Szeged 3-3 blood pressure measurements were made at 1-1 minute intervals first by a doctor with an MIT5 automatic device and then in a separate room unattended, starting alone by the patient with a Hem-907 device. ]

Hypertension and nephrology

[Beyond the diagnosis – the value of renal biopsy in clinical practice through the example of two glomerular diseases]

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[In this review, the publications that established the value of renal biopsy in nephrology are referenced, the pathomechanism of lupus nephritis (LN) and IgA glomerulonephritis (IgAGN) is briefly summarized, and a detailed account is given on the previous and currently accepted classification systems of LN and IgAGN and on the prognostic relevance of these systems. ]

Hypertension and nephrology

[Hypertension, cognitive function and dementia – Significance of antihypertensive therapy]

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[The significance of hypertension as one of the major cardiovascular risk factor is unquestionable. By achieving target blood pressure values differentiated by age and comorbidities, the risk of cardiovascular events can be significantly reduced. However, it is essential to the quality of life the patient spends the extra years of life thus gained. This is a really complex issue affecting many co-disciplines, but one of the most important of these is the mental health, maintaining cognitive functions, and avoiding dementia. High blood pressure impairs the blood supply to the target organs, including the brain, by damaging the smooth muscle of the arteries and accelerating atherosclerosis, which increases the risk, the frequency and the severity of mental decline in proportion to the degree of tension. This means serious implications not only for the individual, but for the family and the society, as well. A particular contradiction is that treating blood pressure to the target range does not automatically means preserving cognitive functions and avoiding the risk of dementia. Meta-analyzes of large studies have shown differences between the individual antihypertensive groups have been confirmed in this respect as well. Inhibitors of the renin-angiotensin system and calcium antagonists – mainly dihydropyridines – appear to be a priority in this regard. The authors provide an overview of the relationship between hypertension and mental abilities, with a review of the literature on the effects of antihypertensive therapy, with particular reference to the effects on cognitive function and dementia. ]

Hypertension and nephrology

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Hypertension and nephrology

[The clinical significance of peripheral and central blood pressure form the neurologist’s point of view]


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Hypertension and nephrology

[Effects of peripheral resistance lowering and elevating beta-blockers on central blood pressure - nebivolol in focus]


[Central blood pressure, that is, blood pressure (BP) in the ascending aorta, is considered an important physiologic parameter as it reflects the hemodynamic relationship between the heart and the aorta, both in systole and in diastole. In the systolic phase, central BP represents the pressure against which the left ventricle has to eject blood during systolic contraction. Thus, central arterial pressure reflects both left ventricular stroke volume and afterload, defines cardiac work, and contributes to the development of left ventricular hypertrophy in hypertensive individuals. In the diastolic phase, central BP is a key determinant of the blood flow delivery to the myocardium. Despite the increasing knowledge regarding the importance of central blood pressure and the availability of non-invasive measurement technics it couldn’t spread in everyday clinical practice and rarely or not mentioned in the therapeutic guidelines. The different antihypertensiv drugs significantly differs based on their effects on central blood pressure particularly β-blockers. The so-called ’classical’ β-blockers have un - favourable effect on central blood pressure due to increasing peripherial vascular resistance. In the opposit the vasodilating β-blockers including nebivolol markedly decrease central blood pressure which could explain their beneficial effects.]