Masked Hypertension in CKD: Increased Prevalence and Risk for Cardiovascular and Renal Events

AbstractPurpose of ReviewHypertension and chronic kidney disease (CKD) are inextricably linked. The causal nature of the relationship is bidirectional. This relationship holds when blood pressure is assessed in the clinic and outside the clinic with home and ambulatory blood pressure monitoring. Patients with CKD are more likely to have high-risk hypertension phenotypes, such as masked and sustained hypertension, and are at increased risk for cardiovascular disease. The purpose of this review is to describe the increased prevalence of masked hypertension in patients with CKD and then describe the increased risk for target organ damage and adverse clinical events associated with masked hypertension in patients with CKD.Recent FindingsThe prevalence of masked hypertension is greater in patients with CKD than that of the general population. Recent studies have demonstrated that masked hypertension is associated with increased risk for target organ damage including left ventricular hypertrophy, elevated pulse wave velocity, proteinuria, and decreased estimated glomerular filtration rate in patients with CKD. Additionally, in patients with CKD, masked hypertension is associated with increased risk for cardiovascular disease, end-stage renal disease, and all-cause mortality.SummaryPatients with CKD are at increased risk for masked hypertension. Masked hypertension is associated with increased risk for target organ damage and adverse cardiovascular and renal outcomes in patients wit...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research

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Abstract Chronic kidney disease represents a heterogeneous group of disorders characterized by alterations in the structure and function of the kidney. Chronic kidney disease significantly increases the risk of adverse maternal and perinatal outcomes, and these risks increase with the severity of the underlying renal dysfunction, degree of proteinuria, as well as the frequent coexistence of hypertension. Further, renal anatomic changes result in dilatation of the collecting system, and physiologic adaptations include alterations in the balance of vasodilatory and vasoconstrictive hormones, resulting in decreased s...
Source: Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Obstet Gynecol Source Type: research
Conclusions: Our results suggested that normotensive persons with CBP abnormalities had TOD. In light of the data of this article, non-dipper status is detected in the early period and if the provision of diurnal blood pressure rhythm may reduce the incidence of future adverse events in nondipper normotensive subjects. PMID: 31122073 [PubMed - as supplied by publisher]
Source: Clinical and Experimental Hypertension - Category: Cardiology Authors: Tags: Clin Exp Hypertens Source Type: research
Abstract Chronic kidney disease represents a heterogeneous group of disorders characterized by alterations in the structure and function of the kidney. Chronic kidney disease significantly increases the risk of adverse maternal and perinatal outcomes, and these risks increase with the severity of the underlying renal dysfunction, degree of proteinuria, as well as the frequent coexistence of hypertension. Further, renal anatomic changes result in dilatation of the collecting system, and physiologic adaptations include alterations in the balance of vasodilatory and vasoconstrictive hormones, resulting in decreased s...
Source: Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Obstet Gynecol Source Type: research
In this study, we investigated the antihypertensive effect and underlying mechanisms of P. asiatica L. seeds extract (PASE) in spontaneously hypertensive rat (SHR). Male SHRs were treated with 2.5 mg/kg of fosinopril (FOS) and 400 mg/kg of PASE orally per day for once or 12 weeks. SHR or Wistar-Kyoto rats (WKY) receiving vehicle (distilled water) was used as control. The results demonstrated systolic, diastolic, and mean blood pressures (SBP, DBP, and MBP) were significantly lowered after single and long-term intragastric administration of PASE. The cardiac and aortic index and collagen accumulation were improved in the PA...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Objective: Increased carotid stiffness and remodelling is reported in patients with moderate and advanced chronic kidney disease (CKD) and is associated with cardiovascular events. Here, we tested the hypothesis that carotid artery alterations start earlier, during mild CKD. Methods: Within the Paris Prospective Study 3, a large prospective observational survey of nonreferred people aged 50–75 who received an extensive health check-up, there were 294 participants with glomerular filtration rate (GFR) of at least 45 and less than 60 ml/min per 1.73 m2 (Stage 3A CKD), 840 participants with GFR 60–89 ml...
Source: Journal of Hypertension - Category: Cardiology Tags: ORIGINAL PAPERS: Vessels Source Type: research
This article reviews relationships between mild to moderate essential hypertension and chronic kidney disease with a focus on the role of APOL1 in development of hypertension. Available evidence strongly supports that APOL1 renal-risk variants associate with glomerulosclerosis in African Americans, which then causes secondary hypertension, not with essential hypertension per se.
Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
Conclusion: Periodontal disease is significantly and positively correlated with increased risk of hypertension in Chinese population, and exact mechanisms of this association should be explored in future. Introduction Periodontal disease is a complex polymicrobial inflammation, including gingivitis and periodontitis. According to the 2015 Global Burden of Disease (GBD) study, the prevalence of severe chronic periodontitis in 2015 has reached 616 million (Kassebaum et al., 2017). In China, the periodontal disease standardized DALYs rate has risen from 24.7 in 1990 to 25.7 in 2013 according to the data from 2013 GBD ...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
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Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
In this study, we investigated the genetic contribution to renal disease in Tiwi Islanders by conducting a GWAS, in which associations were tested between SNP genetic variants and single measure ACR levels. A number of nominally significantly associated SNPs were identified. These SNPs did not reach genome wide significance, probably due to the small sample size. The top eight SNPs were re-tested for association in a separately collected cohort from the same population. Four of these SNPs were significantly associated with ACR in the replication sample (p
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
Conclusions: Underserved CKD Mexican women have a high rate of adverse maternal-fetal outcomes during pregnancy. The risk may be higher in patients needing dialysis during pregnancy, many of whom remained dialysis dependent after delivery.Am J Nephrol 2019;49:386 –396
Source: American Journal of Nephrology - Category: Neurology Source Type: research
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