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Aldo Peixoto, MD

Professor of Medicine (Nephrology); Vice Chair for Quality & Safety, Department of Internal Medicine; Clinical Chief, Section of Nephrology

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Research Summary

My primary interest has been in the interplay between hypertension, kidney disease and vascular disease. Current interests include:

- Profile and outcomes of acute severe hypertension in hospitalized patients (Lama Ghazi MD PhD, Aldo Peixoto MD and Perry Wilson MD).

- Use of systemic hemodynamics to phenotype hypertension as a tool to redefine mechanisms of hypertension (cross sectional study, PI Marcelo Orias MD PhD).

- Study of arterial mechanics in elderly patients with hypertension (cohort study, PI Sebastiao Ferreira MD PhD).

- Clinical trials (Site PI: Aldo Peixoto): 1) droxidopa in neurogenic orthostatic hypotension (RESTORE).

(Updated January 2022)

Coauthors

Research Interests

Antihypertensive Agents; Hemodynamics; Hypertension; Hypotension, Orthostatic; Reproducibility of Results; Vascular Stiffness; Hemodynamic Monitoring

Research Images

Flow chart to guide the evaluation and management of acute severe hypertension

Critical steps in the evaluation and management of acute severe hypertension. There is very limited evidence guiding the management of hypertensive urgencies, so many of the recommendations are based on expert opinion. (Peixoto. N Engl J Med 2019: 381(19):1843-1852. doi: 10.1056/NEJMcp1901117.

Excessive Blood Pressure Response to Clonidine in Hospitalized Patients with Asymptomatic Severe Hypertension

Clonidine is a go-to drug in patients with acute severe hypertension without acute target organ injury. Previous data suggested that its "smoother" pattern of BP decline made it a useful drug. In this study, we challenge this concept, as up to 16% of patients had excessive BP reductions (>30%) and 7% had significant adverse events within 24h, mostly acute kidney injury. (Hanna, Ghazi, Yamamoto, Simonov, Shah, Wilson and Peixoto. Am J Hypertension 2022: doi: 10.1093/ajh/hpac004. Online ahead of print.)

Heart rate response to standing. The first step in the differential diagnosis of orthostatic hypotension.

The approach to the differential diagnosis of orthostatic hypotension starts with an analysis of the appropriateness of the heart rate response. This key step guides all further decision on diagnosis and treatment. (Peixoto. Clev Clin J Med 2022: 89 (1) 36-45; DOI: https://doi.org/10.3949/ccjm.89gr.22001)

Selected Publications

Correlates of Spontaneous Blood Pressure Reduction Following Severe Inpatient Hypertension DevelopmentGarg K, Staunton M, Peixoto A, Wilson F, Ghazi L. Correlates of Spontaneous Blood Pressure Reduction Following Severe Inpatient Hypertension Development. American Journal Of Hypertension 2023, 37: 273-279. PMID: 37988620, DOI: 10.1093/ajh/hpad112.
Neurogenic orthostatic hypotension after treatment with sorafenibWippel C, Deshpande H, Patwa H, Peixoto A. Neurogenic orthostatic hypotension after treatment with sorafenib. BMJ Case Reports 2022, 15: e247140. PMID: 36549761, PMCID: PMC9791444, DOI: 10.1136/bcr-2021-247140.
Effect of intravenous antihypertensives on outcomes of severe hypertension in hospitalized patients without acute target organ damageGhazi L, Li F, Simonov M, Yamamoto Y, Nugent J, Greenberg J, Bakhoum C, Peixoto A, Wilson F. Effect of intravenous antihypertensives on outcomes of severe hypertension in hospitalized patients without acute target organ damage. Journal Of Hypertension 2022, 41: 288-294. PMID: 36583354, PMCID: PMC9799038, DOI: 10.1097/hjh.0000000000003328.
Blood pressure response to commonly administered antihypertensives for severe inpatient hypertensionGhazi L, Li F, Chen X, Simonov M, Yamamoto Y, Biswas A, Hanna J, Shah T, Peixoto AJ, Wilson FP. Blood pressure response to commonly administered antihypertensives for severe inpatient hypertension. PLOS ONE 2022, 17: e0265497. PMID: 35385506, PMCID: PMC8985959, DOI: 10.1371/journal.pone.0265497.
Severe inpatient hypertension prevalence and blood pressure response to antihypertensive treatmentGhazi L, Li F, Chen X, Simonov M, Yamamoto Y, Biswas A, Hanna J, Shah T, Townsend R, Peixoto A, Wilson FP. Severe inpatient hypertension prevalence and blood pressure response to antihypertensive treatment. Journal Of Clinical Hypertension 2022, 24: 339-349. PMID: 35174627, PMCID: PMC8925013, DOI: 10.1111/jch.14431.
Excessive Blood Pressure Response to Clonidine in Hospitalized Patients With Asymptomatic Severe HypertensionHanna J, Ghazi L, Yamamoto Y, Simonov M, Shah T, Wilson F, Peixoto A. Excessive Blood Pressure Response to Clonidine in Hospitalized Patients With Asymptomatic Severe Hypertension. American Journal Of Hypertension 2022, 35: 433-440. PMID: 35038322, PMCID: PMC9088839, DOI: 10.1093/ajh/hpac004.
Evaluation and management of orthostatic hypotension: Limited data, limitless opportunityPeixoto AJ. Evaluation and management of orthostatic hypotension: Limited data, limitless opportunity. Cleveland Clinic Journal Of Medicine 2022, 89: 36-45. PMID: 34983800, DOI: 10.3949/ccjm.89gr.22001.
Abstract 57: Risk Factors For Severe Reductions In Blood Pressure After Treatment Of Severe Inpatient HypertensionGhazi L, Li F, Chen E, Simonov M, Yamamoto Y, Biswas A, Hanna J, Shah T, Peixoto A, Wilson F. Abstract 57: Risk Factors For Severe Reductions In Blood Pressure After Treatment Of Severe Inpatient Hypertension. Hypertension 2021, 78: a57-a57. DOI: 10.1161/hyp.78.suppl_1.57.
Abstract P110: Intravenous Hydralazine Effect On Blood Pressure Following Severe Inpatient Hypertension DevelopmentGhazi L, Li F, Chen E, SIMONOV M, Yamamoto Y, Biswas A, Hanna J, Shah T, Peixoto A, Wilson F. Abstract P110: Intravenous Hydralazine Effect On Blood Pressure Following Severe Inpatient Hypertension Development. Hypertension 2021, 78: ap110-ap110. DOI: 10.1161/hyp.78.suppl_1.p110.
ASSOCIATION BETWEEN CARDIOVASCULAR RISK ESTIMATION BY THE ASCVD RISK ESTIMATOR AND CAROTID-FEMORAL PULSE WAVE VELOCITY IN OLDER INDIVIDUALSFerreira-Filho S, Souza D, Freitas E, Peixoto A, Araujo L. ASSOCIATION BETWEEN CARDIOVASCULAR RISK ESTIMATION BY THE ASCVD RISK ESTIMATOR AND CAROTID-FEMORAL PULSE WAVE VELOCITY IN OLDER INDIVIDUALS. Journal Of Hypertension 2021, 39: e167. DOI: 10.1097/01.hjh.0000746248.89781.62.
The Association of COVID-19 With Acute Kidney Injury Independent of Severity of Illness: A Multicenter Cohort StudyMoledina DG, Simonov M, Yamamoto Y, Alausa J, Arora T, Biswas A, Cantley LG, Ghazi L, Greenberg JH, Hinchcliff M, Huang C, Mansour SG, Martin M, Peixoto A, Schulz W, Subair L, Testani JM, Ugwuowo U, Young P, Wilson FP. The Association of COVID-19 With Acute Kidney Injury Independent of Severity of Illness: A Multicenter Cohort Study. American Journal Of Kidney Diseases 2021, 77: 490-499.e1. PMID: 33422598, PMCID: PMC7791318, DOI: 10.1053/j.ajkd.2020.12.007.
Arterial Mechanics following Living Kidney DonationPeixoto AJ. Arterial Mechanics following Living Kidney Donation. Clinical Journal Of The American Society Of Nephrology 2020, 15: 1237-1239. PMID: 32857062, PMCID: PMC7480545, DOI: 10.2215/cjn.12280720.
Is There a Role for Device Therapies in Resistant Hypertension?: The CON Side.Peixoto AJ. Is There a Role for Device Therapies in Resistant Hypertension?: The CON Side. Kidney360 2020, 1: 9-13. PMID: 35372851, PMCID: PMC8808493, DOI: 10.34067/kid.0000742019.
Chapter 46 Approach to the Patient with Hypertensive NephrosclerosisPeixoto A, Bakris G. Chapter 46 Approach to the Patient with Hypertensive Nephrosclerosis. 2020, 737-752. DOI: 10.1016/b978-0-12-815876-0.00046-2.
Identification of Two Forms of Human Plasma Renalase, and Their Association With All-Cause MortalityChang J, Guo X, Rao V, Gromisch ES, Chung S, Kluger HM, Cha C, Gorelick F, Testani J, Safirstein R, Crowley S, Peixoto AJ, Desir GV. Identification of Two Forms of Human Plasma Renalase, and Their Association With All-Cause Mortality. Kidney International Reports 2019, 5: 362-368. PMID: 32154458, PMCID: PMC7056858, DOI: 10.1016/j.ekir.2019.12.002.
Acute Severe HypertensionPeixoto AJ. Acute Severe Hypertension. New England Journal Of Medicine 2019, 381: 1843-1852. PMID: 31693807, DOI: 10.1056/nejmcp1901117.
Seronegative autoimmune autonomic ganglionopathy from dual immune checkpoint inhibition in a patient with metastatic melanomaGao CA, Weber UM, Peixoto AJ, Weiss SA. Seronegative autoimmune autonomic ganglionopathy from dual immune checkpoint inhibition in a patient with metastatic melanoma. Journal For ImmunoTherapy Of Cancer 2019, 7: 262. PMID: 31623673, PMCID: PMC6796437, DOI: 10.1186/s40425-019-0748-0.
MON-334 TWO FORMS OF RENALASE (BOUND AND FREE) IDENTIFIED IN HUMAN PLASMA BY A NEW ELISARao V, Guo X, Chang J, Peixoto A, Testani J, Desir G. MON-334 TWO FORMS OF RENALASE (BOUND AND FREE) IDENTIFIED IN HUMAN PLASMA BY A NEW ELISA. Kidney International Reports 2019, 4: s67. DOI: 10.1016/j.ekir.2019.05.180.
SAT-183 % FREE RENALASE IS ASSOCIATED WITH PROGRESSION OF CKD, AND IS AN INDEPENDENT PREDICTOR OF ALL CAUSE MORTALITYDesir G, Chang J, Guo X, Gromisch E, Peixoto A. SAT-183 % FREE RENALASE IS ASSOCIATED WITH PROGRESSION OF CKD, AND IS AN INDEPENDENT PREDICTOR OF ALL CAUSE MORTALITY. Kidney International Reports 2019, 4: s84-s85. DOI: 10.1016/j.ekir.2019.05.217.
Arterial stiffness in elderly patients with normotension and hypertension in Brazilde Mendonça G, de Souza D, de Alvarenga Cunha Brunelli A, de Oliveira Peres C, Freitas EGB, Lacerda GN, Dorneles MC, Peixoto AJ, Ferreira‐Filho S. Arterial stiffness in elderly patients with normotension and hypertension in Brazil. Journal Of Clinical Hypertension 2018, 20: 1285-1293. PMID: 30039916, PMCID: PMC8031136, DOI: 10.1111/jch.13358.
Assessment of Hypertension in Chronic Kidney DiseasePeixoto A. Assessment of Hypertension in Chronic Kidney Disease. 2016, 15-33. DOI: 10.1007/978-1-4939-6436-9_2.
PS 08-77 AGREEMENT AMONG SEQUENTIAL CAROTID-FEMORAL PULSE WAVE VELOCITY (CF-PWV) MEASUREMENTS IN ELDERLY HYPERTENSIVE PATIENTS(*)Souza D, de Alvarenga Brunelli A, Peres C, Dorneles M, de Assis Nolasco G, Mendonca G, Freitas E, Peixoto A, Ferreira-Filho S. PS 08-77 AGREEMENT AMONG SEQUENTIAL CAROTID-FEMORAL PULSE WAVE VELOCITY (CF-PWV) MEASUREMENTS IN ELDERLY HYPERTENSIVE PATIENTS(*). Journal Of Hypertension 2016, 34: e314. DOI: 10.1097/01.hjh.0000500771.66141.71.
Agreement among sequential carotid-femoral pulse wave velocity (cf-PWV) measurements in elderly hypertensive patientsSouza D, Brunelli A, Peres C, Dorneles M, Nolasco G, Mendonça G, Freitas E, Peixoto A, Ferreira-Filho S. Agreement among sequential carotid-femoral pulse wave velocity (cf-PWV) measurements in elderly hypertensive patients. International Journal Of Cardiology Cardiovascular Risk And Prevention 2016, 10: e36-e37. DOI: 10.1016/j.jash.2016.03.086.
Ambulatory Blood Pressure in Patients with Chronic Kidney DiseaseAsch W, Santos S, Peixoto A. Ambulatory Blood Pressure in Patients with Chronic Kidney Disease. 2016, 277-298. DOI: 10.1007/978-3-319-22771-9_14.
Managing Blood Pressure in the Elderly: What Is Different?Santos S, Pazhayattil G, Peixoto A. Managing Blood Pressure in the Elderly: What Is Different? 2015, 67-83. DOI: 10.1007/978-1-4939-3320-4_7.
Chapter 38 Approach to the Patient with Hypertensive NephrosclerosisPeixoto A, Bakris G. Chapter 38 Approach to the Patient with Hypertensive Nephrosclerosis. 2015, 455-469. DOI: 10.1016/b978-0-12-411602-3.00038-x.
Response to ‘“Labile hypertension” can be due to autonomic nervous system failure’Peixoto A, Zar T. Response to ‘“Labile hypertension” can be due to autonomic nervous system failure’. Kidney International 2009, 75: 860-861. DOI: 10.1038/ki.2008.670.
Paroxysmal hypertension due to baroreflex failureZar T, Peixoto A. Paroxysmal hypertension due to baroreflex failure. Kidney International 2008, 74: 126-131. PMID: 18322544, DOI: 10.1038/ki.2008.30.
174 Vasopressin Response in Intradialytic HypotensionRho M, Perazella M, Peixoto A, Parikh C, Brewster U. 174 Vasopressin Response in Intradialytic Hypotension. American Journal Of Kidney Diseases 2007, 49: b68. DOI: 10.1053/j.ajkd.2007.02.181.
Ambulatory Blood Pressure in Patients With Chronic Kidney DiseaseSantos S, Peixoto A. Ambulatory Blood Pressure in Patients With Chronic Kidney Disease. 2007, 389-410. DOI: 10.1007/978-1-59259-978-3_16.
Kidney and Blood Pressure—The Story Unfolds Renalase Is a Novel, Soluble Monoamine Oxidase That Regulates Cardiac Function and Blood Pressure. J Clin InvestJ X, G L, P W, H V, X Y, Y L, Y W, A P, S C, GV D. Kidney and Blood Pressure—The Story Unfolds Renalase Is a Novel, Soluble Monoamine Oxidase That Regulates Cardiac Function and Blood Pressure. J Clin Invest. Journal Of The American Society Of Nephrology 2005, 16: 2521-2527. DOI: 10.1681/asn.2005070751.
Reproducibility of ambulatory blood pressure monitoring in hemodialysis patientsPeixoto A, Santos S, Mendes R, Crowley S, Maldonado R, Orias M, Mansoor G, White W. Reproducibility of ambulatory blood pressure monitoring in hemodialysis patients. American Journal Of Kidney Diseases 2000, 36: 983-990. PMID: 11054355, DOI: 10.1053/ajkd.2000.19100.
K028: Prediction of interdialytic ambulatory blood pressure in 91 hemodialysis patientsSantos S, Mendes R, Crowley S, Mansoor G, White W, Peixoto A. K028: Prediction of interdialytic ambulatory blood pressure in 91 hemodialysis patients. American Journal Of Hypertension 2000, 13: 290a-291a. DOI: 10.1016/s0895-7061(00)01059-1.
C037: Reproducibility of ambulatory blood pressure in hemodialysis patientsPeixoto A, Santos S, Mendes R, Crowley S, Orias M, Maldonado R, Mansoor G, White W. C037: Reproducibility of ambulatory blood pressure in hemodialysis patients. American Journal Of Hypertension 2000, 13: 223a-223a. DOI: 10.1016/s0895-7061(00)00757-3.
Validation of the SpaceLabs 90207 ambulatory blood pressure device for hemodialysis patientsPeixoto A, Gray T, Crowley S. Validation of the SpaceLabs 90207 ambulatory blood pressure device for hemodialysis patients. Blood Pressure Monitoring 1999, 4: 217-226. PMID: 10547641, DOI: 10.1097/00126097-199900450-00003.
Validation of the SpaceLabs 90207 ambulatory blood pressure device for hemodialysis patientsPeixoto A, Gray T, Crowley S. Validation of the SpaceLabs 90207 ambulatory blood pressure device for hemodialysis patients. Blood Pressure Monitoring 1999, 4: 217-221. DOI: 10.1097/00126097-199910000-00003.
Delayed Gallium-67 uptake in renal atheroembolic diseasePeixoto A, Reilly R, Crowley S. Delayed Gallium-67 uptake in renal atheroembolic disease. American Journal Of Kidney Diseases 1999, 34: 161-165. PMID: 10401032, DOI: 10.1016/s0272-6386(99)70124-1.
Validation of the SpaceLabs 90207 ambulatory blood pressure device for hemodialysis patientsPeixoto A, Gray T, Crowley S. Validation of the SpaceLabs 90207 ambulatory blood pressure device for hemodialysis patients. Blood Pressure Monitoring 1999, 4: 217???226. DOI: 10.1097/00126097-199904000-00003.
Valor clínico da monitorização ambulatorial da pressão arterialPeixoto A, Mansoor G, White W. Valor clínico da monitorização ambulatorial da pressão arterial. Revista Da Associação Médica Brasileira 1998, 44: 325-330. PMID: 9852653, DOI: 10.1590/s0104-42301998000400012.
Effects of three methods of analysis on ambulatory blood pressure indices and the early morning rise in blood pressure.Mansoor G, Peixoto A, White W. Effects of three methods of analysis on ambulatory blood pressure indices and the early morning rise in blood pressure. Blood Pressure Monitoring 1996, 1: 355-360. PMID: 10226259.

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Aldo Peixoto, MD

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