ISSN (Print): 1573-4021
ISSN (Online): 1875-6506
Volume 16, 3 Issues, 2020
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ISSN (Print): 1573-4021
ISSN (Online): 1875-6506
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"As a clinician and investigator, I find Current Hypertension Reviews to be up-to-date, precise, focused and providing helpful information ranging from bench to bedside."
Helmy M. Siragy
Univ. of Virginia, USA
3 Abstract Ahead of Print are available electronically
27 Articles Ahead of Print are available electronically
Reactive oxygen species (ROS) are a class of molecules that includes O2
•- (superoxide anion), ONOO– (peroxynitrite), •OH
(hydroxyl radical), and H2O2 (hydrogen peroxide). Members of ROS play an important role in the pathogenesis of vascular
disease in that they contribute to the development of vascular complications including endothelial dysfunction, inflammation,
remodeling, apoptosis, endothelial cell migration, and activation of adhesion molecules. These events are significant to the
pathogeneses of distinctive cardiovascular diseases such as hypertension, atherosclerosis and diabetes mellitus. Many
enzymatic systems on the vascular wall may contribute to ROS generation, including nicotinamide adenine dinucleotide
phosphate (NADPH) oxidase, mitochondrial enzymes and uncoupled endothelial nitric oxide (NO) synthase (eNOS). Among
ROS generated in vascular cells, O2
•- and H2O2 are especially important for their association to elevations in intracellular
calcium levels, reduction in NO bioavailability, lipoperoxidation, and activation of redox-signaling pathways, which all lead to
vascular remodeling and contraction. In addition to smooth muscle and endothelial cells, the perivascular adipose tissue
(PVAT) is also recognized as a rich source of ROS, contributing to vascular dysfunction in many pathologies.
The current special issue of Current Hypertension Reviews is composed of articles that discuss the strong relationship
between oxidative stress and vascular disease with a focus on the biology of ROS signaling in vascular cells and how oxidative
stress contributes to vascular damage in several circumstances. In this special issue, the first article discusses basic aspects of
vascular oxidative stress. The molecular mechanisms that lead to vascular dysfunction and the role of the renin-angiotensin
system (RAS) in this process are discussed by Do Vale and Tirapelli . A brief update on the vascular sources of ROS, crucial
to multiple aspects of vascular damage during hypertension, is provided by Pinheiro and Oliveira-Paula . The review by
Phillips et al. concentrates on detailing mechanisms of vascular function, the role of oxidative stress in vascular biology and
how ethanol consumption may alter endothelial and smooth muscle cell function as well as microvascular function .
Most of the systemic blood vessels are surrounded by the perivascular adipose tissue (PVAT). Healthy PVAT is anticontractile
and anti-inflammatory, but a dysfunctional PVAT has been suggested to link cardiometabolic risk factors to vascular
dysfunction. In this context, the final paper in the special issue by Victorio and Davel discusses new findings describing major
sources of ROS in PVAT including mitochondria, NADPH oxidase and eNOS uncoupled, and finally, changes in ROS
production affecting vascular function in the presence of cardiometabolic risk factors and diseases . The role of ROS and
RAS in vascular toxicity induced by metals is discussed by Vassallo et al. in a review addressing the impact of mercury, lead
and cadmium in the vascular endothelium with a new perspective, calling into the question the impact of low doses of these
metals on the vascular function .
We thank the authors for all the considerable time, efforts and expertise they committed to the preparation of their
manuscripts. The papers presented in this issue provide considerable insight into the role of ROS in the pathogenesis of
vascular disease, which we hope, the readers will find both informative and stimulating.
It is estimated that 5-10% of hypertensive patients have secondary hypertension. The main causes of secondary
hypertension are parenchymal renal disease, primary aldosteronism and renovascular hypertension. The identification of
these patients is important because it enables the etiological management of the underlying disease and in some cases
leads to blood pressure control without antihypertensive medications. On the other hand, diagnostic evaluation for secondary
hypertension often includes complex and expensive tests and should be performed only in patients with a strong
clinical suspicion for its presence. If preliminary screening tests suggest the presence of secondary hypertension, these patients
should be referred to specialized centers for further diagnostic evaluation and comprehensive management.
Heart failure is one of the major causes of morbidity, mortality and growing public health cost. In the US alone, the number
of congestive heart failure patients is more than 4 million per year with more than 550,000 new annually reported cases. The
annual cost of heart failure management exceeds 35 billion dollars per year [1-3]. Keeping this in view, we decided to focus on
some entities of heart failure which are not well known and often poorly understood. This special issue on heart failure
highlights the essentials of Churg-Strauss syndrome and Eosinophilic myocarditis, Stiff left atrial syndrome and Myxedema
The first part delves into Acute Eosinophilic myocarditis and Churg-Strauss syndrome with cardiac involvement. The
histopathology, clinical spectrum, treatment and prognosis have been reviewed and would be significantly helpful to internists
and cardiologists as the diagnosis is often missed and can lead to fatality in a potentially treatable disease.
The second half emphasizes on clinical aspects of myxedema heart disease which is extremely uncommon and can be a
diagnostic dilemma with major prognostic implications. This disease process can masquerade valvular heart disease and
confound clinical scenarios and physician awareness is paramount in consideration of appropriate workup and therapeutic
The last part of the issue deals with Stiff left atrial syndrome which leads to diastolic heart failure and continues to mystify
clinicians as pathophysiology, diagnosis and treatment modalities are not well known. This clinical retrospective experience
and literature review very nicely carves out the latest and up to date features of the disease while ongoing studies will continue
to enhance the existing clinical knowledge.
Overall this issue would be clinically relevant to increase awareness amongst all physicians regarding these complex disease
processes. Enhanced comprehension and knowledge will hopefully lead to improved disease outcomes in heart failure patients
whose management continues to be a challenging task in day to day patient care.
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