Recently, intensified antihypertensive treatment has been recommended for patients with proteinuric renal disease, and a target blood pressure of 125/75 mmHg has been proposed.
In a retrospective crossectional study, all consecutive patients with renal disease and reduced GFR seen in the renal outpatient clinic Heidelberg during a specified time period were analysed.
Physicians administered antihypertensive agents according to their clinical judgment aware of recent recommendations, but without structured guidelines.
(i) to monitor achieved blood pressure (clinic measurement, self measurement, ambulatory BP measurement) ; (ii) to monitor the number of antihypertensive medications required ; and (iii) to analyse the factors which determine achieved blood pressure and the number of antihypertensive agents required.
There were 201 non-transplanted patients, median age 60 years (range 20 86), 131 male, 70 female, median S-creatinine 2.33 mg/dl (1.4-10.9).
Fifty-two of the patients had diabetes, 41 GN, 18 ADPKD, 17 vasculitis, seven reflux nephropathy, three analgesic nephropathy and 63 other or unknown renal diseases.
When the patients had originally been referred to the renal clinic, median clinic BP had been 160 mmHg systolic (104-260) and 95 mmHg diastolic (65-160).
Under nephrological care, achieved clinic systolic (140 ; 90-190) and diastolic BP values (85 ; 45-130) were significantly (P<0.0001) lower. (...)
Mots-clés Pascal : Insuffisance rénale, Indication, Chimioprophylaxie, Hypertension artérielle, Antihypertenseur, Inhibiteur angiotensin converting enzyme, Antagoniste, Canal ionique, Sodium, Faisabilité, Surveillance, Efficacité traitement, Homme, Appareil urinaire pathologie, Rein pathologie, Appareil circulatoire pathologie
Mots-clés Pascal anglais : Renal failure, Indication, Chemoprophylaxis, Hypertension, Antihypertensive agent, ACE inhibitor, Antagonist, Ionic channel, Sodium, Feasibility, Surveillance, Treatment efficiency, Human, Urinary system disease, Kidney disease, Cardiovascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0023045
Code Inist : 002B02F05. Création : 31/05/1999.