Hypertension in chronic kidney disease (CKD): diagnosis, classification and therapeutic targets.

Hypertension in chronic kidney disease (CKD): diagnosis, classification and therapeutic targets. Am J Hypertens. 2020 Dec 17;: Authors: Georgianos PI, Agarwal R Abstract Blood pressure (BP) in the office is often recorded without standardization of the technique of measurement. When office BP measurement is performed with a research-grade methodology, it can inform better therapeutic decisions. The reference-standard method of ambulatory BP monitoring together with the assessment of BP in the office enables the identification of white-coat and masked hypertension, facilitating the stratification of cardiorenal risk. Compared with general population, the prevalence of resistant hypertension is 2- to 3-fold higher among patients with chronic kidney disease (CKD). The use of ambulatory BP monitoring is mandatory in order to exclude the white-coat effect, a common cause of pseudoresistance, and confirm the diagnosis of true-resistant hypertension. After the premature termination of SPRINT due to an impressive cardioprotective benefit of intensive BP-lowering, the 2017 AHA/ACC guideline reappraised the definition of hypertension and recommended a tighter BP target of <130/80 mmHg for the majority of adults with a high cardiovascular risk profile, inclusive of patients with CKD. However, the benefit/risk ratio of intensive BP-lowering in particular subsets of patients with CKD (i.e. those with diabetes or more advanced CKD) continues to...
Source: American Journal of Hypertension - Category: Cardiology Authors: Tags: Am J Hypertens Source Type: research