title: Management of Hypertension in Patients with Chronic Kidney Disease in Asia.
abstract: Hypertension is both a cause and consequence of chronic kidney disease (CKD). According to the Chinese national survey in 2007-2010, the prevalence of CKD was much higher in hypertensive patients (18.9%, n=16,691) than in the overall population sample (10.8%, n=47,204). CKD in hypertension confers risks to the kidneys as well as other organs. Probably because of high dietary salt intake, Asian hypertensive patients with CKD show high prevalence of non-dipping and reversed dipping blood pressure pattern, and may have even higher risks of cardiovascular disease. Therefore, out-of-office blood pressure evaluation and comprehensive cardiovascular evaluations are required. Most of current hypertension guidelines recommend intensive antihypertensive treatment in hypertensive patients with CKD. This is probably of particular relevance for cardiovascular prevention in Asia, because stroke, as a major complication of hypertension in Asia, is more closely related to blood pressure than coronary events. Intensive blood pressure control to 130/80 mmHg is often required to prevent CKD progression and cardiovascular complications. The inhibitors of the renin-angiotensin system (RAS) are recommended as the first line antihypertensive medications in patients with a glomerular filtration rate higher than 30 ml/min/1.73 m², which may more efficaciously prevent end-stage renal disease and cardiovascular events. Nonetheless, combination therapy of RAS inhibitors with other classes of antihypertensive drugs, such as calcium-channel blockers, diuretics, etc, is required to control blood pressure to the target.
authors.forename: Qi-Fang
authors.initials: QF
authors.lastname: Huang
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hoshide
authors.forename: Hao-Min
authors.initials: HM
authors.lastname: Cheng
authors.forename: Sungha
authors.initials: S
authors.lastname: Park
authors.forename: Chang-Gyu
authors.initials: CG
authors.lastname: Park
authors.forename: Chen-Huan
authors.initials: CH
authors.lastname: Chen
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Kario
authors.affiliation: The Shanghai Institute of Hypertension, Ruijin 2nd Road 197, Shanghai 200025, China.
authors.forename: Ji-Guang
authors.initials: JG
authors.lastname: Wang
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001208:Asia / Q000453:epidemiology; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000453:epidemiology; D012084:Renin-Angiotensin System / Q000187:drug effects; D012982:Sodium, Dietary / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D012982:Sodium, Dietary
keywords: Asia; Hypertension; RAS; chronic kidney disease