BookAlberto Morganti, Enrico Agabiti Rosei, Franco Mantero, editors.
Summary: This book offers an overview of the latest advances in the epidemiological, pathophysiological, diagnostic and therapeutic aspects of secondary hypertension, provided by a group of the most highly respected European experts in this field. It is common belief that secondary forms of hypertension are rare, although in 95% of patients the cause of high blood pressure is unknown - euphemistically referred to as "essential". There is increasing evidence from epidemiological studies that the prevalence of secondary hypertension is much higher than previously thought, accounting for 20%-25% of all hypertensive patients. There are additional, very good reasons for identifying those patients with secondary hypertension: firstly, they are exposed to a greater risk of suffering major cardiovascular events than patients with essential hypertension who have the same blood pressure level, and for this reason require particular care. Secondly, these patients can be relieved of a lifetime of pharmacological therapy or, at least, have a chance to be treated with more specific and effective medications. A high degree of clinical skill is required to recognize the often vague and subtle symptoms and signs that characterize patients with secondary hypertension, and clinicians need to fully comprehend the mechanisms responsible for the development and maintenance of high blood pressure. Shedding new light on a complex area of cardiovascular medicine, the book enables readers to better treat affected patients.
Contents:
Intro
Preface
Contents
Renal Parenchymal Disease
Introduction
Epidemiology
Pathophysiology of Hypertension in CKD
Hypertension as a Risk Factor for Kidney Function Loss in CKD
Special Conditions
Resistant Hypertension in CKD
Hypertension in Patients on Dialysis
Hypertension in Renal Transplant Patient
Antihypertensive Treatment and Target BP in CKD According to Recent Guidelines
Conclusion
References
Atherosclerotic Renovascular Disease
Introduction
Renal Artery Stenosis and Blood Pressure
Pathophysiological Mechanisms Clinical Significance of Renal Artery Stenosis
When and How to Search for Atherosclerotic Renal Artery Stenosis?
Treatment Issues
Conclusions
References
Fibromuscular Dysplasia: From a Rare Cause of Renovascular Hypertension to a More Frequent Systemic Arterial Disease
Introduction
Definition of FMD
Differential Diagnosis
Classification
Possible Manifestations
Stenosis
Dissections
Aneurysms
Arterial Tortuosity
Aetiological Factors
Genetics
Focus on Renal FMD
What Is the Prevalence of Renal FMD?
In the General Population? In Hypertensive Patients?
What Is the Profile of Patients with Renal FMD?
In Whom to Screen for Renal FMD?
What Is the Best Screening and Diagnostic Strategy?
What Are the Essential Steps to Consider in the Management/Work-Up of Renal FMD?
Has Smoking an Influence on FMD?
Which Medical Treatment in the Patient with FMD?
How to Assess Haemodynamic Significance of FMD-Related Renal Artery Stenosis?
Whom to Revascularize?
How to Revascularize?
Is FMD a Systemic Disease?
Which Usual Work-Up in Patients with Renal Artery FMD?
When to Look for Familial FMD? How to Prepare Pregnancy in a Patient with FMD?
Can FMD Affect the Heart?
Are There Specificities of FMD in Elderly Patients?
Are There Specificities of FMD in Children?
Is FMD a Progressive Disease?
Which Follow-Up in Patients with Renal Artery FMD?
Conclusion
References
Primary Aldosteronism
Introduction
Detection Rate and Screening Strategy
Diagnosis
Conditions for Testing
Exclusion of Primary Aldosteronism
Imaging
Subtyping of Primary Aldosteronism
Adrenal Vein Sampling
Alternative Strategy for Subtyping
Genetic Testing
Treatment