Does treated essential hypertension result in renal impairment? A cohort study.
To determine how frequently essential hypertension results in significant renal impairment we undertook a follow-up study of 176 patients with well documented essential hypertension first seen in 1975-1977. Six patients were Asian, two Negro, and the remainder Europid. Follow-up was achieved in 92% of the cohort at five years and in 87% at 12-14 years. At five years 13 (7%) patients had moved away or were lost, and 15 (9%) patients had died (11 cardiovascular deaths). Treated blood pressure was greater than 160/95 mmHg in 60/148 patients and greater than 200/100 mmHg in 16 patients. Despite this, no significant change in serum creatinine was detected in the group as a whole. Increments in serum creatinine of at least 35 mumol/l occurred in six patients. Over the ensuing 6-9 years serum creatinine had returned to normal in three of these patients and stabilized in two; the sixth patient died from myocardial infarction. No patient reached end-stage renal failure. We conclude that progressive deterioration in renal function in essential hypertension is rarely a significant problem in Caucasian patients. A decline in renal function should prompt a search for underlying primary renal disease.
Department of Medicine, University of Leicester, UK.
C R
CR
Tomson
K
K
Petersen
A M
AM
Heagerty
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D015331:Cohort Studies; D003401:Creatine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D007668:Kidney / Q000187:drug effects / Q000502:physiology; D007674:Kidney Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged
D000959:Antihypertensive Agents; D003401:Creatine