1. We studied the effect of oral prazosin on blood pressure, plasma active renin and angiotensin II in 16 recumbent hypertensive patients between 09.00 and 12.00 hours. 2. In untreated patients there were no significant changes in blood pressure, plasma active renin or angiotensin II during the 3 h period. 3. After an initial dose of prazosin (2 mg) there was a significant fall in recumbent blood pressure with progressive increases in plasma active renin and angiotensin II concentrations. 4. After 3--4 weeks' treatment with oral prazosin only, recumbent blood pressure at 09.00 hours, 15 h after the last dose of prazosin, was significantly lower than before treatment, but plasma active renin and angiotensin II were not significantly different from untreated values. 5. After the usual morning dose of prazosin, blood pressure did not change, but there were significant rises in plasma active renin and angiotensin II, less marked than after the first dose of prazosin. 6. Prazosin therefore stimulates the renin--angiotensin system acutely, both after the initial dose and during long-term therapy; however, no effect on renin and angiotensin II is apparent 15 h after the last dose of prazosin.
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http://dx.doi.org/10.1042/cs061457s | DOI Listing |
Curr Opin Nephrol Hypertens
January 2025
The University of Melbourne Department of Medicine (Melbourne Health and Northern Health), Royal Melbourne Hospital, Parkville, Victoria, AUSTRALIA.
Purpose Of Review: The recent widespread availability of genetic testing has resulted in the diagnosis of many more people with Alport syndrome. This increased recognition has been paralleled by advances in understanding clinical consequences, genotype-phenotype correlations and in the development of new therapies.
Recent Findings: These include the international call for a change of name to 'Alport spectrum' which better reflects the diverse clinical features seen with autosomal dominant and X-linked Alport syndrome; the demonstration of how common Alport syndrome is in people with haematuria, proteinuria, or kidney failure; the inability of current genetic testing to detect all pathogenic variants in suspected Alport syndrome; the different genotype-phenotype correlations for autosomal dominant and X-linked disease; and the novel treatments that are available including SGLT2 inhibitors for persistent albuminuria despite renin-angiotensin-aldosterone blockade, as well as early studies of gene-modifying agents.
Chronic kidney disease (CKD) attributed to diabetes, termed diabetic kidney disease (DKD), is increasing with the rising global prevalence of diabetes. Patterns of DKD onset and progression have shifted in recent years because of population aging and advances in the treatment of diabetes. Prevention of the onset and progression of micro/macro-albuminuria is possible through comprehensive and strict management of lifestyle, blood glucose, blood pressure, and lipids in people with diabetes and early DKD.
View Article and Find Full Text PDFFront Med (Lausanne)
January 2025
Department of Pharmacology, Faculty of Medicine, Kagawa University, Takamatsu, Japan.
Angiotensin receptor-neprilysin inhibitors (ARNIs) represent a novel class of medications characterized by their dual action on major cardiorenal regulators, specifically the renin-angiotensin system (RAS) and the natriuretic peptide (NP) system. Sacubitril/valsartan, a pioneering ARNI, has demonstrated strong antihypertensive effect as well as superior efficacy in preserving renal function compared to RAS inhibitors in heart failure patients with reduced ejection fraction. Here, we gathered evidence on the impact of sacubitril/valsartan on the preservation of kidney function in patients with cardiorenal syndrome (CRS).
View Article and Find Full Text PDFCurr Hypertens Rev
January 2025
Pharmacogenomics and CADD Lab, Department of Bioinformatics, Alagappa University, Karaikudi, Tamil Nadu, India.
Introduction: Hypertension is a chronic medical state and a major determining factor for cardiovascular and renal diseases. Both genetic and non-genetic factors contribute to hypertensive conditions among individuals. The renin-angiotensin-aldosterone system (RAAS) is a major genetic target for the anti-hypertension approach.
View Article and Find Full Text PDFSevere sepsis is cognate with life threatening multi-organ dysfunction. There is a disturbance in endocrine functions with alterations in several hormonal pathways. It has frequently been linked with dysfunction in the hypothalamic pituitary-adrenal axis (HPA).
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