Hypertensive renal vascular disease and cardiovascular endpoints.
OBJECTIVE
Hypertension involves the entire cardiovascular system, and hypertensive vascular disease may promote and exacerbate cardiac and renal dysfunction. We discuss the coexistence of cardiorenal disease as a manifestation of vascular involvement in hypertension, and the relationship of biomarkers of renal vascular involvement in hypertension with cardiovascular endpoints.


RESULTS
Markers of renal dysfunction, especially microalbuminuria, have been considered recently as potent predictors of cardiovascular morbidity and mortality in all explored populations, including hypertensive individuals. Microalbuminuria, per se, is related to vascular injury and to the increased glomerular permeability of albumin as a direct manifestation of renal vascular involvement in hypertension, a systemic vascular disease. Left ventricular hypertrophy in hypertension develops even before proteinuria or impairment of renal function. Factors including anemia, inflammation and hyperuricemia are either induced or exacerbated by renal vascular disease, and each of these may exert additional influence in determining the increased incidence of cardiovascular events with progressive renal dysfunction.


CONCLUSIONS
The development and progression of vascular disease is the primary determinant in the progressive cardiac and renal dysfunction observed in hypertension and, therefore, is the underlying mechanism of the overall clinical manifestations of cardiorenal disease. Commonly used biomarkers of renal and vascular function are important tools for determination of the progression and, hence, management of hypertensive disease and its complications.
Matavelli
Luis C
LC
Hypertension Research Laboratories, Ochsner Clinic Foundation, New Orleans, LA 70121, USA.
Zhou
Xiaoyan
X
Frohlich
Edward D
ED
D000419:Albuminuria / Q000209:etiology; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002097:C-Reactive Protein / Q000378:metabolism; D018450:Disease Progression; D004921:Erythropoietin / Q000097:blood; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D033461:Hyperuricemia / Q000209:etiology; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D051437:Renal Insufficiency / Q000097:blood / Q000150:complications / Q000209:etiology* / Q000503:physiopathology*; D014527:Uric Acid / Q000097:blood
D015415:Biomarkers; D004921:Erythropoietin; D020097:Natriuretic Peptide, Brain; D014527:Uric Acid; D002097:C-Reactive Protein