Brain natriuretic peptide: its relevance to the cardiologist

Brain natriuretic peptide, or Btype natriuretic peptide (BNP), is a cardiac hormone secreted mainly from the ventricles. It is natriuretic, diuretic, vasodilaton, lowers blood pressure and suppresses the renin-angiotensin-aldosterone system. Its concentration in plasma is normally very low but is markedly raised in congestive heart failure, suggesting that it may have a pathophysiological function. Short-term intravenous infusion of BNP is beneficial in heart failure but an effective oral agent is not yet available. Plasma BNP concentration may be measured to assess cardiac function, as it correlates directly with pulmonary capillary wedge pressure and inversely with ejection fraction.published_or_final_versio

Blockade of the renin-angiotensin system

The renin-angiotensin-aldosterone system plays a key role in the regulation of fluid and electrolyte balance. Angiotensin-converting enzyme inhibitors inhibit angiotensin-converting enzyme and have been shown to be effective in many cardiovascular diseases. They should be considered for the treatment of hypertension in patients with heart failure, previous myocardial infarction, diabetes, or proteinuria. There are a number of side-effects associated with angiotensin-converting enzyme inhibitors, especially persistent dry cough. Angiotensin II receptor antagonists (sartans) provide a more specific blockade of the renin-angiotensin-aldosterone system and are associated with fewer side-effects, including cough. Their long-term efficacy and tolerability in the treatment of patients with hypertension has, however, yet to be established. Periodic monitoring of renal function and electrolytes is required in patients treated with an angiotensin-converting enzyme inhibitor or a sartan.published_or_final_versio

Hypertension

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Beta-Blockers a Second Rate Treatment for Hypertension?

Editorialpublished_or_final_versio

Is cardiovascular disease preventable?

Conference Theme: Bridging the Gap: From Evidence to Practicepublished_or_final_versio

Sartans for hypertension - Implications of the Valsartan Antihypertensive Long-Term Use Evaluation (VALUE) trial

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Is it safe to use calcium channel blockers in hypertension?

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The new cardiovascular continuum

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Evolution of the Postgraduate Medical Journal

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Challenges in the management of hypertension in Asia

This journal suppl. contain Abstracts from the ICC 2012Hypertension is common in Asian populations and is a major cause of cardiovascular diseases. Even a small reduction in blood pressure can lead to a substantial decrease in the risk of stroke. The prevalence of hypertension appears to be increasing in many countries, partly because of ageing of the population, but also because of increasing obesity. While much effort has gone into promoting the awareness of hypertension, the rates of detection, treatment, and control remain low. As hypertension is very prevalent in the general population, it makes sense to adopt population approaches towards the detection and treatment of hypertension, and its prevention. As obesity is a major cause of hypertension in Asia, tackling it will help to lower the incidence of hypertension in the future. Lowering sodium contents in foods and promotion of regular physical activity will also help to lower blood pressure at the population level. Asians appear to respond well to calcium channel blockers but have a higher incidence of dry cough with angiotensin-converting enzyme inhibitors.The costs of long-term follow-up and treatment impose a certain economic burden, whether on the individual or on the health provider.postprin