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The double challenge of resistant hypertension and chronic kidney disease
- Source :
- The Lancet, The Lancet, Elsevier, 2015, 386 (10003), pp.1588-1598. ⟨10.1016/S0140-6736(15)00418-3⟩
- Publication Year :
- 2015
- Publisher :
- Elsevier BV, 2015.
-
Abstract
- International audience; Resistant hypertension is defined as blood pressure above goal despite adherence to a combination of at least three optimally dosed antihypertensive medications, one of which is a diuretic. Chronic kidney disease is the most frequent of several patient factors or comorbidities associated with resistant hypertension. The prevalence of resistant hypertension is increased in patients with chronic kidney disease, while chronic kidney disease is associated with an impaired prognosis in patients with resistant hypertension. Recommended low-salt diet and triple antihypertensive drug regimens that include a diuretic, should be complemented by the sequential addition of other antihypertensive drugs. New therapeutic innovations for resistant hypertension, such as renal denervation and carotid barostimulation, are under investigation especially in patients with advanced chronic kidney disease. We discuss resistant hypertension in chronic kidney disease stages 3-5 (ie, patients with an estimated glomerular filtration rate below 60 mL/min per 1·73 m(2) and not on dialysis), in terms of worldwide epidemiology, outcomes, causes and pathophysiology, evidence-based treatment, and a call for action.
- Subjects :
- medicine.medical_specialty
medicine.drug_class
medicine.medical_treatment
MESH: Renal Insufficiency, Chronic
Renal function
Blood Pressure
Renal artery stenosis
MESH: Hypertension
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
MESH: Risk Factors
Risk Factors
Internal medicine
Epidemiology
medicine
Humans
MESH: Diuretics
Renal Insufficiency, Chronic
Diuretics
Intensive care medicine
Antihypertensive drug
Antihypertensive Agents
Dialysis
MESH: Treatment Outcome
MESH: Antihypertensive Agents
MESH: Humans
business.industry
MESH: Blood Pressure
General Medicine
Diet, Sodium-Restricted
medicine.disease
3. Good health
Treatment Outcome
Blood pressure
MESH: Diet, Sodium-Restricted
Hypertension
Diuretic
business
Kidney disease
Subjects
Details
- ISSN :
- 01406736 and 09237577
- Volume :
- 386
- Database :
- OpenAIRE
- Journal :
- The Lancet
- Accession number :
- edsair.doi.dedup.....8f1d2a2b79475e430a4861c2ea8dcb70