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Volume 347:1528-1530 November 7, 2002 Number 19
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Renovascular Hypertension, Endothelial Function, and Oxidative Stress

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 by Sowers, J. R.
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 by Higashi, Y.
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To the Editor: In their elegant study, Higashi et al. (June 20 issue)1 conclude that elevated angiotensin II levels in patients with renovascular hypertension constitute a principal cause of increased oxidative stress that results in impaired endothelium-dependent vasodilatation. Down-regulation of the renin–angiotensin system after angioplasty in conjunction with reduced levels of markers of oxidative stress and improved forearm blood flow is cited as supporting evidence. However, there is an alternative explanation for these findings.

It is well established that total plasma levels of the putative atherothrombotic amino acid homocysteine are inversely related to the glomerular filtration rate.2,3 Thus, as the . . . [Full Text of this Article]




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