Chronic kidney disease as a situation of high added risk in hypertensive patients.
Recent guidelines for the management of hypertension have recognized the relevance of renal function on cardiovascular prognosis of hypertensive patients. In fact, growing evidences have confirmed that as soon as renal function exhibits minor derangements, cardiovascular risk starts a continuous rise until the development of end-stage renal disease. Both estimated glomerular filtration rate and urinary albumin excretion are associated with an increased incidence of cardiovascular events and death among hypertensive patients and in general population. Consequently, hypertensive patients presenting with chronic kidney disease are considered by guidelines as high-risk patients, and strict blood pressure control should be considered as a part of an integrative therapeutic approach, including correction of anemia, treatment of dyslipidemia, cessation of tobacco use, and antiplatelet therapy. This paper briefly reviews the most recent evidences about pharmacologic therapies in high-risk patients, focusing on benefits related to improvement of cardiovascular risk factors in hypertensive patients with chronic kidney disease.
Segura
Julian
J
Hypertension Unit, Nephrology Department, Hospital 12 de Octubre, 28041 Madrid, Spain. juliansegura@mi.madritel.es
García-Donaire
Jose A
JA
Praga
Manuel
M
Ruilope
Luis M
LM
D000419:Albuminuria / Q000378:metabolism; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis; D002986:Clinical Trials as Topic; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000175:diagnosis*; D011507:Proteinuria / Q000378:metabolism; D012306:Risk
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors