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- Title
Management of Hypertension in Chronic Kidney Disease.
- Authors
Pugh, Dan; Gallacher, Peter J.; Dhaun, Neeraj
- Abstract
Chronic kidney disease (CKD) is an increasingly prevalent condition globally and is strongly associated with incident cardiovascular disease (CVD). Hypertension is both a cause and effect of CKD and affects the vast majority of CKD patients. Control of hypertension is important in those with CKD as it leads to slowing of disease progression as well as reduced CVD risk. Existing guidelines do not offer a consensus on optimal blood pressure (BP) targets. Therefore, an understanding of the evidence used to create these guidelines is vital when considering how best to manage individual patients. Non-pharmacological interventions are useful in reducing BP in CKD but are rarely sufficient to control BP adequately. Patients with CKD and hypertension will often require a combination of antihypertensive medications to achieve target BP. Certain pharmacological therapies provide additional BP-independent renoprotective and/or cardioprotective action and this must be considered when instituting therapy. Managing hypertension in the context of haemodialysis and following kidney transplantation presents further challenges. Novel therapies may enhance treatment in the near future. Importantly, a personalised and evidence-based management plan remains key to achieving BP targets, reducing CVD risk and slowing progression of CKD.
- Subjects
ANTIHYPERTENSIVE agents; PREVENTION of disease progression; BLOOD pressure; CARDIOVASCULAR diseases risk factors; COMBINATION drug therapy; CHRONIC kidney failure; HEMODIALYSIS; HYPERTENSION; KIDNEY transplantation; POSTOPERATIVE period; TREATMENT effectiveness
- Publication
Drugs, 2019, Vol 79, Issue 4, p365
- ISSN
0012-6667
- Publication type
Article
- DOI
10.1007/s40265-019-1064-1