Annotated Bibliography

Annotated Bibliography

Annotated Bibliography

Calò. L.(2009). Revisiting essential hypertension- a "mechanism-based" approach may argue for a better definition of hypertension. Clinical Nephrology, 72(2), 83-86.

The author is a medical doctor and researcher, affiliated with the Department of Clinical and Experimental Medicine in Italy. In collaboration with other scholars he has conducted and published research studies related to the etiology of hypertension (HTN) and defining the term. Calo's literary review is very informative and would be of interest to healthcare professionals and scientists interested in revisiting contemporary theories on hypertension. The purpose of the article is to educate the reader about the difference between essential HTN and HTN. Calo also argues for a more accurate definition of HTN, and proposes a mechanism-based approach for defining the etiology.

Mounting evidence has documented that pathways of the central nervous system such as elevated sympathetic tone, depletion in the nitric oxide system, and endothelia cell nitric oxide synthase cause as well as maintains high blood pressure. The latter two pathways were first proven to cause hypertension in animal models. Scientists would later demonstrate these pathophysiological pathways also cause HTN in humans. Guyenet and Scheuer's studies, cited below, concur with the author suppositions. A weakness in Calo's study is his reference to a small segment of the population has essential HTN. The older population is the fast growing segment. Calo's research will aid in establishing the proposed topic hypotheses that also argues for a more accurate HTN definition, improving patient adherence, and placing more emphasis on behavioral, psychological, physiological factors that cause HTN.

Elliott, W. (2009). Improving outcomes in hypertensive patients: focus on adherence and persistence with antihypertensive therapy. Journal Of Clinical Hypertension

(Greenwich, Conn.), 11(7), 376-382. Retrieved from MEDLINE with Full Text database.

The author is affiliated with the Department of Preventive Medicine, Rush Medical College at Rush University Medical Center. Elliot has collaborated with scientists from prestigious universities on the prevalence of hypertension in America. The purpose of the study is to inform physicians as well as pharmaceutical companies that blood pressure control is less than optimal even with the use of antihypertensive medication. The problem is, of the 50 million hypertensive Americans, a third have poor adherence and are not managing their pressure. Another third of the 50 million who are taking medication are not reaching optimum blood pressure levels. Elliot's hypothesis is that

patient adherence can improve if drug side effects are minimized and more generic drugs are available. Although Elliot links side effects to poor adherence, this does not explain why people who do not experience side effects and take their medication as prescribed; still have poor regulation of blood pressure. The question of drug efficacy or drug type needs to be investigated, because there use has not improved blood pressure management. The author discusses how knowledge and awareness impacts patient adherence. This correlation was also observed in Haafkens's research as cited below. The meta-analysis was among the highlight of studies. A limitation was not discussing the cause of HTN, which affects ...