Italian audit on therapy of hypertension in chronic kidney disease: the TABLE-CKD study.
A large body of evidence supports the validity of decreasing blood pressure to target levels in patients with essential hypertension to prevent cardiovascular disease. This issue becomes even more critical in chronic kidney disease because of the remarkably greater risk for cardiovascular fatal and nonfatal events. Indeed, renal patients should maintain blood pressure levels less than those suggested for the general population. Paradoxically, management of hypertension in this high-risk patient population is far from optimal and certainly worse with respect to essential hypertension. The Target Blood Pressure Levels in Chronic Kidney Disease (TABLE-CKD) study, performed in Italian patients with mild to advanced chronic kidney disease regularly followed-up by nephrologists, has shown that the prevalence of patients at target blood pressure is less than 20%. The assessment of antihypertensive strategy in these patients, however, suggests that there is room for improvement; in particular, a more aggressive treatment of volume expansion may ameliorate hypertension control in this population characterized by a high salt sensitivity of blood pressure.
De Nicola
Luca
L
Division of Nephrology, Second University of Naples, Naples, Italy. luca.denicola@unina2.it
Minutolo
Roberto
R
Zamboli
Pasquale
P
Cestaro
Raffaele
R
Marzano
Luigi
L
Giannattasio
Paolo
P
Cristofano
Claudio
C
Chimienti
Stefano
S
Savica
Vincenzo
V
Bellinghieri
Guido
G
Rapisarda
Francesco
F
Fatuzzo
Pasquale
P
Conte
Giuseppe
G
D017677:Age Distribution; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001795:Blood Pressure Determination; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D007558:Italy; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011446:Prospective Studies; D012015:Reference Standards; D006435:Renal Dialysis / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution
D000959:Antihypertensive Agents