Hemodynamic and volume factors in the choice and followup of antihypertensive therapy.
Hypertension is a multifaceted hemodynamic abnormality which cannot be characterized only by considerations of cardiac output and calculated systemic resistance. The spectrum of its hemodynamic patterns has been shown to be much wider than a monotonous increase in resistance with normal or reduced output. Disturbances of extracellular fluid and of intravascular volume, as well as of cardiac performance and of large-vessel distensibility, play important roles in modifying the clinical characteristics and therapeutic responses. Cardiovascular performance is influenced not only by functional neurogenic and humoral factors, but also by structural alterations which have been shown to develop early in the disease and which do not necessarily parallel the changes in blood pressure alone. In the treatment of hypertension, hemodynamic and volume determinants are probably more important in combination therapy and in the assessment of resistant cases than in the empirical choice of the first-line drug.
D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D001810:Blood Volume / Q000187:drug effects; D002306:Cardiac Volume / Q000187:drug effects; D005110:Extracellular Space / Q000502:physiology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology
D000959:Antihypertensive Agents