Primary and Secondary Prevention of Cardiovascular Disease in Patients with Chronic Kidney Disease

AbstractPurpose of ReviewNon-dialysis-dependent chronic kidney disease (NDD-CKD) patients are at an increased risk of cardiovascular disease (CVD) –related deaths in comparison with the general population. This review summarizes recent guideline recommendations and studies on primary and secondary prevention of traditional cardiovascular (CV) risk factors in those with NDD-CKD.Recent FindingsThe use of antiplatelet agents for primary prevention in CKD is not supported by clinical trial evidence; however, they offer potential benefits when used for secondary prevention of CVD in the absence of an elevated bleeding risk. Lipid-lowering therapy reduces CV risk and is recommended for all NDD-CKD patients. In light of recent clinical trial findings, current clinical practice guidelines recommend a blood pressure (BP) goal<  130/80 mmHg and support the use of renin-angiotensin-aldosterone system inhibitors. Evidence supporting intensive glycemic control is limited in those with diabetes and CKD. Newer oral glycemic agents such as sodium-glucose co-transporter type 2 (SGLT2) inhibitors and glucagon-like-peptide-1 (GL P-1) receptor agonists reduce urinary albumin excretion, slow kidney disease progression, and reduce CV events. Despite the absence of dedicated clinical trials in the CKD population, lifestyle modifications including smoking cessation, intentional weight loss, and regular physical activity should b e recommended to those with CKD.SummaryPatients with NDD-CKD sh...
Source: Current Atherosclerosis Reports - Category: Cardiology Source Type: research