title: Escalating antihypertensive medications in end-stage renal disease patients does not improve blood pressure control.
abstract: The authors examined the efficacy of antihypertensive medication use in end-stage renal disease (ESRD). They compared achieved blood pressures (BPs) in a cross-sectional study of 106 ESRD patients whose medications had not been changed for at least 2 months. Group 1 (n=36) included patients who took 0 or 1 medication; group 2 (n=56), 2 or 3 medications; and group 3 (n=14), > or =4 medications. The population's mean age was 55.1 years, 87% were African American, and 57% were men weighing 76.9 kg who were on 229 minutes of hemodialysis with an edKt/V of 1.35; there was no difference between the 3 groups. The authors found a difference in the mean BPs: 139/72 mm Hg in group 1, 154/82 mm Hg in group 2, and 165/91 mm Hg in group 3 (P=.01 for systolic, P=.002 for diastolic), with a mean arterial pressure difference of 94.4, 106.4, and 115.4 mm Hg (P=.002). The authors conclude that in this group of primarily African American patients, the control of hypertension in ESRD is not achieved by escalating the number of antihypertensive medications.
authors.affiliation: Department of Nephrology, Louisiana State University Health Science Center Shreveport, 1501 Kings Highway, Shreveport, LA 71130, USA. mtapolyai@aol.com
authors.forename: Mihály
authors.initials: M
authors.lastname: Tapolyai
authors.forename: Jariatul
authors.initials: J
authors.lastname: Karim
authors.forename: Atif
authors.initials: A
authors.lastname: Fakhruddin
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000188:drug therapy*; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D017211:Treatment Failure
chemical_list: D000959:Antihypertensive Agents