title: Routine bioimpedance-derived volume assessment for all hypertensives: a new paradigm.
abstract: Hypertension is one of the most common worldwide diseases. Is linked with increased morbidity and mortality and amplified costs to society; in this context, preventing and treating hypertension is an imperative public health challenge. Unidentified, clinically unapparent volume expansion is an important cause for hypertension. Optimization of fluid status was associated with an improvement in BP control, a substantial regression of the left ventricular mass index, arterial stiffness and better survival rate in several cohorts. Clinical assessment of hydration status is an inaccurate clinical science. Bioimpedance provides a noninvasive and reliable, simple, reproducible technology for diagnosing subclinical fluid accumulation. Several small studies and a recent meta-analysis performed in patients with resistant hypertension reported an improved BP control in the impedance treated group compared with the group of patients treated as per clinical judgment alone. A combined approach (using both sphygmomanometers and bioimpedance) and individualized antihypertensive treatment in hypertensive's patients it seems probable to improve BP control and possibly end organ damage.
authors.affiliation: Nephrology Clinic, Dialysis and Renal Transplant Center, C.I. Parhon University, Hospital, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania.
authors.forename: Adrian
authors.initials: A
authors.lastname: Covic
authors.forename: Luminita
authors.initials: L
authors.lastname: Voroneanu
authors.forename: David
authors.initials: D
authors.lastname: Goldsmith
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D017097:Electric Impedance; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D051436:Renal Insufficiency, Chronic / Q000150:complications; D014882:Water-Electrolyte Balance; D014883:Water-Electrolyte Imbalance / Q000150:complications / Q000175:diagnosis*
chemical_list: D000959:Antihypertensive Agents