The clinical problems of hypertension treatment in hemodialysis patients.

The clinical problems of hypertension treatment in hemodialysis patients. Curr Vasc Pharmacol. 2017 Apr 14;: Authors: Loutradis CN, Tsioufis C, Sarafidis PA Abstract Hypertension (HT) is present in >80% of patients undergoing haemodialysis (HD). Elevated blood pressure (BP) in hemodialysis patients is associated with cardiovascular events and mortality only when BP is recorded with home or ambulatory monitoring, since pre- and post-dialysis measurements are not valid estimates of BP levels during the inter-interval. Sodium and water overload is the most important of several mechanisms involved in HT development in HD. In this context, non-pharmacologic measures to ensure water and sodium balance by achieving patient dry weight and decreasing daily sodium intake, through modification of sodium level in the diet or in dialysis dialysate, are fundamental for HT control. After these strategies are properly implemented, the introduction of drug treatment can further help in achieving optimum BP. All major antihypertensive classes, with the exception of diuretics, can be considered in HT management, as current evidence suggest that the use of agents from these classes was associated with reduced cardiovascular risk. The choice of a specific antihypertensive drug should be based on the co-morbid conditions of the patient, and the pharmacologic characteristics of the agent, including dialyzability. Of note, the need of increasing the ...
Source: Current Vascular Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Curr Vasc Pharmacol Source Type: research