Hypertension as Cardiovascular Risk Factor in Chronic Kidney Disease.
Details
Serval ID
serval:BIB_3F745C0868C6
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Hypertension as Cardiovascular Risk Factor in Chronic Kidney Disease.
Journal
Circulation research
ISSN
1524-4571 (Electronic)
ISSN-L
0009-7330
Publication state
Published
Issued date
14/04/2023
Peer-reviewed
Oui
Volume
132
Number
8
Pages
1050-1063
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Publication Status: ppublish
Abstract
Hypertension is the leading modifiable cause of premature death and hence one of the global targets of World Health Organization for prevention. Hypertension also affects the great majority of patients with chronic kidney disease (CKD). Both hypertension and CKD are intrinsically related, as hypertension is a strong determinant of worse renal and cardiovascular outcomes and renal function decline aggravates hypertension. This bidirectional relationship is well documented by the high prevalence of hypertension across CKD stages and the dual benefits of effective antihypertensive treatments on renal and cardiovascular risk reduction. Achieving an optimal blood pressure (BP) target is mandatory and requires several pharmacological and lifestyle measures. However, it also requires a correct diagnosis based on reliable BP measurements (eg, 24-hour ambulatory BP monitoring, home BP), especially for populations like patients with CKD where reduced or reverse dipping patterns or masked and resistant hypertension are frequent and associated with a poor cardiovascular and renal prognosis. Even after achieving BP targets, which remain debated in CKD, the residual cardiovascular risk remains high. Current antihypertensive options have been enriched with novel agents that enable to lower the existing renal and cardiovascular risks, such as SGLT2 (sodium-glucose cotransporter-2) inhibitors and novel nonsteroidal mineralocorticoid receptor antagonists. Although their beneficial effects may be driven mostly from actions beyond BP control, recent evidence underline potential improvements on abnormal 24-hour BP phenotypes such as nondipping. Other promising novelties are still to come for the management of hypertension in CKD. In the present review, we shall discuss the existing evidence of hypertension as a cardiovascular risk factor in CKD, the importance of identifying hypertension phenotypes among patients with CKD, and the traditional and novel aspects of the management of hypertensives with CKD.
Keywords
Humans, Cardiovascular Diseases/diagnosis, Cardiovascular Diseases/epidemiology, Cardiovascular Diseases/etiology, Antihypertensive Agents/therapeutic use, Antihypertensive Agents/pharmacology, Blood Pressure Monitoring, Ambulatory/adverse effects, Risk Factors, Hypertension/diagnosis, Hypertension/drug therapy, Hypertension/epidemiology, Renal Insufficiency, Chronic/diagnosis, Renal Insufficiency, Chronic/epidemiology, Renal Insufficiency, Chronic/complications, Blood Pressure, Heart Disease Risk Factors, blood pressure, diabetes, epidemiology, heart failure, hypertension, kidney, risk factor
Pubmed
Web of science
Open Access
Yes
Create date
17/04/2023 12:10
Last modification date
11/07/2023 5:56