Different Forms Of Hypertension Research Articles

A narrative review of Hyporeninemic hypertension-an indicator for monogenic forms of hypertension.

While the role of the renin-angiotensin-aldosterone system (RAAS) in the development of hypertension is well known, the significance and contribution of low renin hypertension is often overlooked. RAAS stimulation results in more tubular absorption of sodium and water along the nephron, contributing to a higher circulating vascular volume. In addition, members of the RAAS system, such as angiotensin II, have direct effects on vascular vasoconstriction, the heart, aldosterone synthesis in the adrenal glands, the sympathetic nervous system, and the central nervous system. This has resulted in a line of antihypertensive therapeutics targeting RAAS with angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and renin inhibitors, which prevent conversion of angiotensinogen to angiotensin. While general practitioners and nephrologists are well aware of the causes and the long-term consequences of elevated renin and aldosterone levels, the opposite situation with low renin and/or low aldosterone levels is frequently underappreciated. The objective of this review is to provide insight to the less common forms of hyporeninemic hypertension. We searched the PubMed online library for keywords related to hyporeninemic hypertension and focused on the pediatric population. For pathophysiology we focused on literature of the last 5 years. The low renin and aldosterone levels may be indicators of inherited (especially when associated with hypokalemia), monogenic forms of hypertension stimulating excessive tubular sodium and water absorption which subsequently results in plasma volume expansion and hypertension. These forms of hypertension require frequently specific forms of therapy. This underlines the importance of the practitioner to be familiar with these rare diseases. In this review article, we outline the different forms of hypertension characterized by low renin/low aldosterone and low renin/high aldosterone levels, how to diagnose these forms of hypertension, and how to treat them.

Circular RNAs in hypertension: challenges and clinical promise.

Hypertension (HT), or high blood pressure (BP), is a chronic disease that is common among populations worldwide. The occurrence of HT is one of the leading causes of cardiovascular morbidity and mortality in adults. Although multiple studies have stressed the multifactorial and multigenic nature of HT, uncertainties about its etiology persist, and current diagnostic biomarkers can explain only a small part of the phenotypic variance of BP. Hence, the search for novel biomarkers that enable early disease prevention and guided therapy is warranted. Regulatory circRNAs have emerged as the newest player in HT-related gene networks and hold promise for improving the accuracy of diagnosis. These RNAs are genome products that are formed through back-splicing of specific regions of pre-mRNAs. Evidence suggests that these RNA species are involved in various metabolic diseases. Recent studies have revealed that aberrant expression of circRNAs is relevant to the occurrence and development of HT. Accordingly, circRNAs are proposed as a new generation of predictive biomarkers and potential therapeutic targets for different forms of HT, including pulmonary hypertension and preeclampsia. This paper presents an overview of the findings from current research focusing on the emerging role of circRNAs in the pathogenesis of hypertension. Furthermore, some of the challenges encountered by circRNA studies are highlighted, and perspectives are provided on the future of research in this area.

Impact of Flexible Polyurethane Foam Cocoon on Premature Babies of Mothers with Pathologic Pregnancies

Proper positioning of premature babies resulting from different maternal chronic conditions before pregnancy and hypertension induced during pregnancy can promote normal balanced development with maximizing the sleeping conditions and minimizing the gastric reflux. We conducted a retrospective study on data from Bega Clinics - Obstetrics and Gynecology and Neonatology for 2012-2013 about premature babies of mothers with pathologic pregnancies. Part of the newborns was positioned in a flexible polyurethane foam cocoon and clinical observations on sleeping states and the presence of gastric reflux were noted. In our study, 453 (10.5%) cases of women with different pathological conditions out of 4,312 cases were encountered. Most of them (48%) had a diagnosis of chronic hypertension, followed by chronic renal diseases (34%). Hypertension developed during pregnancy for both years, happened in 340 (7.88%) cases. Severe forms of hypertension were noted in 57.05% of them. Incidence of preterm birth babies was 11.22% (484 cases), of which 12 cases (8.67%) resulted from pregnancies with different forms of hypertension. Clinical observations stated that sleeping quietly and awake and quiet have increased the most when compared with babies positioned in the cocoon (44 babies) compared with babies (45) out of cocoons. Only 8 (18.2%) babies positioned in the cocoon experienced gastric reflux comparatively with 41 babies that were positioned in regular conditions.

Изменение церебральной гемодинамики при различных формах артериальной гипертензии в третьем триместре беременности

Изменение церебральной гемодинамики при различных формах артериальной гипертензии в третьем триместре беременности

Antibodies to extracellular regions of G protein-coupled receptors and receptor tyrosine kinases as one of the causes of autoimmune diseases

One of the causes of autoimmune diseases is the production of antibodies to extracellular loops of hormonal receptors coupled with heterotrimeric G-proteins (GPCR) and to ectodomains of receptors with tyrosine kinase activity. In recent years, the range of these diseases has considerably extended, raising interest to the mechanisms of their genesis and actualizing the search for effective ways of their prevention and treatment. The antibodies against extracellular regions of α1-, β1- and β2-adrenergic receptors and m2-muscarinic acetylcholine receptors (m2-MAChR) were found in patients with various forms of cardiomyopathy and other pathologies of the cardiovascular system; the antibodies against m3-MAChR were detected in Sjogren’s syndrome and biliary cirrhosis; the antibodies against angiotensin receptors type 2 were found in pregnant women with pre-eclampsia and in different forms of hypertension; the antibodies to thyroid-stimulating hormone receptor were detected in Graves’ disease and other autoimmune thyroid pathologies. The role of antibodies specific to the ectodomain of muscle specific receptor tyrosine kinase in the development of generalized myasthenia and those against the extracellular domain of platelet-derived growth factor receptor in the development of systemic sclerosis and other fibroses was shown. In the present review, we systematize and analyze the data on the molecular mechanisms that underlie the production of antibodies to GPCR and receptor tyrosine kinases and determine the development of autoimmune diseases they induce. Possible approaches toward their prevention and correction are also discussed.

O8. Cardiovascular risk factors, renin-angiotensin system gene polymorphisms, pregnancy course and outcomes in women with different forms of hypertension

Introduction The hypertensive disorders of pregnancy remain the leading causes of maternal and perinatal morbidity and mortality. Each form of hypertension during pregnancy has its outcome. The investigations of characteristics of genetic and cardiovascular risk factors in different forms of hypertension are necessary to carry out. Objectives The aim of our research was to study the frequency of cardiovascular risk factors, renin-angiotensin system gene polymorphisms, pregnancy course and outcomes in women with different forms of hypertension. Methods Prospective cohort study. The study included 300 patients (200 – with hypertension, 100 – without hypertension). Women with hypertension were divided into 4 groups: 106 patients with chronic hypertension (CH), 63 patients with gestational hypertension, 10 patients with preeclampsia (PE), 21 with PE superimposed on CH. Control group included 100 women without hypertension. Molecular genetic testing was used for detection of three polymorphic variants in angiotensin-converting enzyme (ACE I/D), angiotensinogen (AGT 174 T/M) and angiotensin II type 1 receptor (ATR1 1166 A/C) genes by polymerase chain reaction (“Lytech”, Russia). Statistical analysis was performed using the statistical software package version 11.5.0 MedCalc®. Gene-gene interactions were studied using entropy-based multifactor dimensionality reduction (MDR) method (software version 3.0.2). Results Pregnant women with CH and with PE superimposed on CH were more frequently of age over 35 years, overweight, obese and smoking and a high incidence of hypertension in the family history compared with pregnant women without hypertension. In pregnant women with CH a higher frequency of D allele and DD-genotype of ACE (I/D) and C allele of ATR1 (A1166C) were observed and compared with a control group. In pregnant women with PE a higher frequency of M allele and MM-genotype AGT (T174M) was noted. To assess independent associations of clinical and genetic factors with combined adverse outcome (fetal growth restriction or/and premature delivery or/and small gestational age) we have used MDR. The best interaction model included: age >35 years, hypertension in the family history, failure to achieve target blood pressure to 27–28 weeks and C allele of ATR1 (A1166C). The established model precisely predicted combined adverse outcome in 79.5% cases. Conclusion Analysis of cardiovascular risk factors, renin-angiotensin system gene polymorphisms may be helpful for evaluation adverse outcomes in pregnant women with different forms of hypertension.

Genetic and potential autoimmune triggers of primary aldosteronism.

Hypertension is a major life-threatening disease of high morbidity and mortality, which affects between 10% to 40% of the general population in an age-dependent manner. The pathogenesis of essential hypertension is multifactorial, with various underlying contributory mechanisms. Primary aldosteronism (PA) is the leading cause of secondary hypertension that affects 4.3% of patients in the general hypertensive population and 9.5% of patients referred to hypertension units.1 The 2 predominant causes of the constitutive aldosterone secretion that define PA is either aldosterone-producing adenomas (APA) or bilateral adrenal hyperplasia (BAH, also called idiopathic hyperaldosteronism). Exome sequencing has unraveled the pathogenetic basis of around half of APA, but the underlying cause of the aldosterone excess in BAH remains an enigma. The diagnosis of PA is made by a multistep process, recommended by the Endocrine Society guidelines,2 that ends with the invasive protocol of adrenal venous sampling. Once diagnosed, it is imperative to distinguish the surgically correctable forms (APA) from those that should be treated pharmacologically with mineralocorticoid receptor antagonists (BAH). With the application of wider screening for PA, >70% of cases of aldosterone excess have been defined as caused by BAH, with APA making up most of the remainder. APA and BAH are sporadic forms of PA, but 3 rarer familial forms of PA also exist called familial hyperaldosteronism (FH) types I, II, and III, described in more detail below. Three familial forms of PA with distinct clinical characteristics have been described.3,4 FH type I or glucocorticoid remediable aldosteronism is caused by a hybrid gene resulting from the unequal crossing-over between the adjacent genes CYP11B1 and CYP11B2 .5,6 Only few families (≈50) have been identified worldwide. FH type II seems to be inherited as an autosomal dominant trait. A locus has been mapped on chromosome 7p22 …

Prognostic Value of Central Aortic Pressure in Pregnant Women With Hypertension

Prognostic value of central aortic pressure and peripheral blood pressure in relation to the development of pre-eclampsia was assessed in pregnant women with different forms of hypertension. It was shown that development of pre-eclampsia was associated with higher mean 24-hour systolic blood pressure (BP), time index of systolic BP, variability of diastolic BP, and pulse BP measured on weeks 16-22 of gestation. Pregnant women with hypertension, especially those with pre-eclampsia were characterized by absence of proper nocturnal BP lowering or BP elevation during night hours (non-dippers and night-peakers). Critical values for prediction of preeclampsia were daily average central (aortic) systolic BP higher than 115 mm Hg and a mean daily brachial systolic BP above 131 mm Hg.

Состояние органов-мишеней при различных формах артериальной гипертензии у беременных

We have estimated the state of target-organ damage in 95 pregnant women with different forms of hypertension. The early and potentially reversible pathophysiological and pathomorphological changes of the target organs in pregnant women with hypertension are structural and functional changes of the heart and kidneys. To assess the state of the target organs we were examined the blood vessels of the ocular fundus, the presence of left ventricular hypertrophy, the thickness of the intima-media complex and the presence of microalbuminuria. It was shown that the earliest target-organ damage in pregnant women with hypertension was left ventricular hypertrophy regardless of its form. Detection of microalbuminuria depending on gestational age may serve as an additional criterion of pre-eclampsia. With consideration of the high frequency changes in the retinal vessels, especially in preeclampsia superimposed on chronic hypertension, is required further researches to evaluate the prognostic significance of these changes. Assessment of target organs in pregnant women with hypertension can be used as a surrogate prediction point of complications and adverse pregnancy outcomes.

Estimation of central blood pressure and arterial stiffness in pregnant women with different forms of hypertension

To estimate central (aortic) blood pressure (BP) and arterial stiffness and their prognostic value in the development of preeclampsia (PE) in pregnant women with different forms of hypertension. The study included 106 patients with chronic hypertension, 21 with the latter concurrent with PE, 63 with gestational hypertension, 10 with PE, and 100 without hypertension. All the women underwent 24-hour BP monitoring by an oscillometric method to estimatecentral (aortic) BP and arterial stiffness at 16-22 weeks' gestation. The highest average daily central systolic and diastolic BP was in the pregnant women with PE. ROC analysis showed that the average daily aortic systolic BP greater than 115 mm Hg was most significant for the prediction of PE. The highest values of arterial stiffness (augmentation index, stiffness, maximum rate of blood pressure rise) were detected in the pregnant women with PE in the presence of chronic hypertension. 24-four BP monitoring inpregnant women can provide additional characteristics that reflect the stiffness of the aorta and peripheral arteries, which may be used to predict PE.

CLINICAL-ANAMNESTIC AND MOLECULAR-GENETIC FACTORS IN DIFFERENT FORMS OF HYPERTENSION AND ITS RELATIONSHIP TO COURSE AND PREGNANCY OUTCOMES

To assess of the relationship of clinical and molecular genetic factors in the course and outcome of pregnancy in different forms of hypertension in pregnant women. A total of 125 pregnant women who were divided into the following groups: with chronic hypertension (n = 45), with gestational hypertension (n = 20), with pre-eclampsia (n = 10), superimposed preeclampsia upon chronic hypertension (n = 15) and 35 women without hypertension in control group. In pregnant women with chronic hypertension and superimposed preeclampsia upon chronic hypertension were observed higher incidence of overweight and obesity, smoking before pregnancy and family history of hypertension and thrombosis, the course and outcomes of pregnancy characterized by higher frequency of obstetric complications, higher frequency of polymorphisms of genes identified the renin-angiotensin system, folate cycle and endothelial function. Molecular-genetic factors, combined with the factors of cardiovascular risk may make some contribution to the phenotypic realization of pregnancy complications and adverse pregnancy outcomes in pregnant women with different forms of hypertension.

Changes in cardiovascular variability in response to stress in rats with two different forms of hypertension

Previously our lab demonstrated an association between an exaggerated response to air jet stress (AJS) in the spontaneously hypertensive rat (SHR) and dysregulation of corticotrophin (CRH) peptide expression in the amygdala (CEA). Changes in the production and release of CEA‐CRH have also been linked to elevated salt‐intake. The present study aimed to evaluate the stress response in normotensive (Sprague Dawley, SD) and hypertensive (SHR vs SD‐DOCA‐salt) rats. Adult 12 wk old male rats (3 to 4/group) were chronically instrumented for blood pressure (BP) and heart rate (HR) measurement and exposed to 20 min. of AJS. At rest, systolic BP variability in the VLF was significantly elevated in the both SHR and SD‐DOCA compared to the SD, and this corresponded to a significantly elevated resting BP (163±6 mmHg). During AJS, the rise in BP was significantly elevated in the SHR compared to both the SD‐DOCA and SD (30±1 vs 20±2 vs 17±2 mmHg, respectively). Alternatively, the rise in HR was lower in the SD‐DOCA. In both the SHR and SD‐DOCA rats HR remained elevated for 10 min post‐AJS compared to the SD. Differences in HR were paralleled by evidence of altered HR HF power during AJS in the SD‐DOCA and altered baroreflex function post stress in the SD‐DOCA and SHR. These data suggest that although high salt intake triggers a sustained hypertension comparable to the SHR, the response to stress is different.

Amelioration of Endothelial Dysfunction in Middle Cerebral Arteries (MCA) of Fawn‐Hooded Rats by Antioxidant Treatment and Chromosomal Substitution

The Fawn‐Hooded Hypertensive (FHH) rat is a genetic model of spontaneous high‐renin systemic hypertension and multiple other disorders. As such, it is important to gain an increased understanding of genetic factors controlling systemic vascular reactivity in this strain. We evaluated vascular function in isolated middle cerebral arteries (MCA) from 8–10 week old FHH rats and 3 consomic panels carrying Brown Norway (BN) chromosomes (1,5, and 13) shown to be important in regulating vascular reactivity. All rats were maintained on a low salt (0.4% NaCl) diet since weaning. MCA's from FHH failed to dilate to acetylcholine (ACh, 10−10M to 10−5M). Introgression of BN chromosomes 1 and 13 partially restored ACh‐induced dilation. Introgression of BN chromosome 5 (carrying CYP4A alleles), acute addition of the superoxide (O2• −) scavenger tempol, and scavenging of mitochondrial O2• − with mito‐Q caused a dramatic restoration of ACh‐induced vascular relaxation. Mitochondrial O2• − levels (evaluated with the specific fluorescent probe MitoSOX) were significantly higher in MCA of FHH vs. the well characterized Sprague‐Dawley rat. These findings indicate that chronic elevations in oxidant stress disrupt cerebral vascular reactivity in FHH rats, and that different genes and chromosomes are likely to contribute to vascular dysregulation in different forms of hypertension. (NIH #HL‐65289; #HL‐72920, #HL‐92026).

Hypertension in pregnancy

Hypertension complicates 5% to 7% of all pregnancies. A subset of preeclampsia, characterized by new-onset hypertension, proteinuria, and multisystem involvement, is responsible for substantial maternal and fetal morbidity and is a marker for future cardiac and metabolic disease. This American Society of Hypertension (ASH) position paper summarizes the clinical spectrum of hypertension in pregnancy, focusing on preeclampsia. Recent research breakthroughs relating to etiology are briefly reviewed. Topics include classification of the different forms of hypertension during pregnancy, and status of the tests available to predict preeclampsia, and strategies to prevent preeclampsia and to manage this serious disease. The use of antihypertensive drugs in pregnancy, and the prevention and treatment of the convulsive phase of preeclampsia, eclampsia, with intravenous MgSO 4 is also highlighted. Of special note, this guideline article, specifically requested, reviewed, and accepted by ASH, includes solicited review advice from the American College of Obstetricians and Gynecologists.

ASH position paper: hypertension in pregnancy.

The American Society of Hypertension is publishing a series of Position Papers in their official journals throughout the 2008-2009 years. The following Position Paper originally appeared: JASH. 2008;2(6):484-494. Hypertension complicates 5% to 7% of all pregnancies. A subset of preeclampsia, characterized by new-onset hypertension, proteinuria, and multisystem involvement, is responsible for substantial maternal and fetal morbidity and is a marker for future cardiac and metabolic disease. This American Society of Hypertension, Inc (ASH) position paper summarizes the clinical spectrum of hypertension in pregnancy, focusing on preeclampsia. Recent research breakthroughs relating to etiology are briefly reviewed. Topics include classification of the different forms of hypertension during pregnancy, status of the tests available to predict preeclampsia, and strategies to prevent preeclampsia and to manage this serious disease. The use of antihypertensive drugs in pregnancy, and the prevention and treatment of the convulsive phase of preeclampsia, eclampsia, with intravenous magnesium sulfate is also highlighted. Of special note, this guideline article, specifically requested, reviewed, and accepted by ASH, includes solicited review advice from the American College of Obstetricians and Gynecologists.

Hypertension in pregnancy

Hypertension complicates 5% to 7% of all pregnancies. A subset of preeclampsia, characterized by new-onset hypertension, proteinuria, and multisystem involvement, is responsible for substantial maternal and fetal morbidity and is a marker for future cardiac and metabolic disease. This American Society of Hypertension (ASH) position paper summarizes the clinical spectrum of hypertension in pregnancy, focusing on preeclampsia. Recent research breakthroughs relating to etiology are briefly reviewed. Topics include classification of the different forms of hypertension during pregnancy, and status of the tests available to predict preeclampsia, and strategies to prevent preeclampsia and to manage this serious disease. The use of antihypertensive drugs in pregnancy, and the prevention and treatment of the convulsive phase of preeclampsia, eclampsia, with intravenous MgSO 4 is also highlighted. Of special note, this guideline article, specifically requested, reviewed, and accepted by ASH, includes solicited review advice from the American College of Obstetricians and Gynecologists.

Hypertension and peripheral arterial disease

Atherosclerotic vascular diseases (peripheral arterial disease (PAD), coronary artery disease (CAD) and cerebrovascular disease (CVD)) are leading causes of global morbidity and mortality. While manifesting in different vascular territories, these diseases all share the common pathophysiological process of atherothrombosis. Given the overlap that exists between these different territories, once atherosclerosis is established in one territory, risk factor modification is vital for the secondary prevention of cardiovascular events. Hypertension is the most common cardiovascular risk factor, as well as a risk factor for atherosclerosis. The mechanisms by which it contributes to this have not been fully elucidated but include abnormalities in platelet activation and fibrinolysis, endothelial cell dysfunction and abnormal levels of haemostatic factors. Hypertension perhaps exerts similar effects on the arterial wall to hyperlipidaemia. For example, the increase in oxidative stress, common in both conditions, may activate genes involved in generating an inflammatory response that in the presence of hyperlipidaemia leads to the formation of atherosclerotic plaques. In hypertension, there is an increase in mean arterial pressure and total peripheral resistance reflecting a reduction in arteriolar calibre. With it there is also an increase in arterial stiffness, resulting in changes in amplitude of pulse pressure waves and timing of central wave reflections. Several components of blood pressure (BP), including systolic BP (SBP), diastolic BP (DBP) and pulse pressure, have been reported to be independent cardiovascular risk factors. The risk of cardiovascular disease increases progressively and continuously with increases in SBP and DBP independent of other risk factors; in particular, increased SBP levels are more important than increased DBP. Peripheral arterial disease and hypertension are associated diseases with 35–55% of patients with PAD also having hypertension at presentation. In PAD, hypertension is a risk factor for the development of both asymptomatic and symptomatic disease. A recent study on Chinese hypertensives found that SBP, but not DBP, was an independent risk factor for low ankle–brachial pressure index and that low ankle–brachial pressure index in these patients was associated with higher all cause and cardiovascular mortality. Increased systolic hypertension is more frequently observed in patients with cerebrovascular complications, including both ischaemic and haemorrhagic stroke. Treating hypertension is therefore extremely important in the secondary prevention of cardiovascular complications. The antihypertensive of choice may also differ according to the dominant site of vascular disease as different drug classes are more efficient at preventing either cardiovascular or cerebrovascular complications. In this issue of the Journal of Human Hypertension, Safar et al. report the associations between different forms of hypertension (isolated systolic hypertension (ISH), systolic–diastolic hypertension) with cardiovascular disease in different vascular territories as part of the ATTEST study. This relationship has been poorly evaluated in the past, and the ATTEST study comprised 37.6% isolated PAD, 37.6% PAD with associated CAD and/or CVD and 24.8% CAD/CVD without PAD, reflecting the participant selection methods of the study (notably, two patients with PAD selected for every patient with CAD/CVD identified from general practice registers). The ATTEST study reported ISH to be the most prevalent form of hypertension, overall suggesting that this may be an important factor for consideration in the secondary prevention of cardiovascular complications. In the cohort of isolated PAD, ISH was more prevalent than systolic–diastolic hypertension, as opposed to the CAD/CVD cohort in whom the latter form was more prevalent. Safar et al. also report that all cardiovascular risk factors Correspondence: PC Bennett, University Department of Medicine, City Hospital, Birmingham B18 7QH, UK. E-mail: philip.bennett@doctors.org.uk Published online 16 October 2008 Journal of Human Hypertension (2009) 23, 213–215 & 2009 Macmillan Publishers Limited All rights reserved 0950-9240/09 $32.00

Metabolic Syndrome Affects Cardiovascular Risk Profile and Response to Treatment in Hypertensive Postmenopausal Women

Metabolic syndrome is increasingly recognized as an important cardiovascular risk factor in hypertension, but its influence on the cardiovascular risk profile in hypertensive postmenopausal women has not been studied. The aim of the present study was to investigate the impact of metabolic syndrome on the cardiovascular risk profile and the response to treatment. We enrolled 350 hypertensive postmenopausal women, 55+/-6 years of age (range 47 to 60 years of age). Patients were divided into 2 groups according to the presence of metabolic syndrome. Compared with those without, women with metabolic syndrome had higher waist circumference, body mass index, and levels of glucose, triglycerides, and HDL cholesterol, as would be expected, based on definition. In addition, patients with metabolic syndrome had a cardiovascular risk profile less favorable, characterized by a significantly higher highly sensitive C-reactive protein (2.2+/-0.6 versus 1.7+/-0.7 ng/L; P<0.01), a more compromised endothelial function (flow-mediated vasodilation 2.4+/-2.2 versus 4.4+/-2.5%; P=0.01), and a significantly higher left ventricular mass (44+/-15 versus 41+/-16 g/m(2.7)). Also, antihypertensive treatment induced a more modest improvement of both endothelial dysfunction and subclinical inflammation in women with metabolic syndrome. The results of our study show that in postmenopausal women, there are 2 different forms of hypertension: that which is isolated, and that which is associated with metabolic syndrome. This last form is related to a more severe risk profile, and response to therapy is less favorable.

Psychosis and Agitation in Dementia: Should General Psychiatrists Care?

Article AbstractBecause this piece has no abstract, we have provided for your benefit the first 3 sentences of the full text.Why read an article addressing whether a medicationcalled memantine might or might not help people with Alzheimer's ? Isn†t Alzheimer's a rare disorder,and a diagnosis of exclusion?†‹

Delineating the contributions of AT1a and AT1b receptor-mediated uptake of ANG II in kidneys and adrenals

inappropriately elevated angiotensin ii (ANG II) levels induced by infusion of ANG II or overexpression of the renin-angiotensin system (RAS) commonly result in increased intrarenal and intra-adrenal ANG II content ([8][1]). Derangement of renal function due to inappropriate activation of intrarenal