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By Gabi Djab Nephrologist
Pantelis A Sarafidis, Luis M Ruilope, Charalampos Loutradis, Manuel Gorostidi, Alejandro de la Sierra, Juan J de la Cruz, Ernest Vinyoles, Juan A Divisón-Garrote, Julián Segura, José R Banegas
OBJECTIVE: Increased BP-variability predicts cardiovascular morbidity and mortality in hypertensives. This study aimed to examine short-term BP-variability according to renal function stage. METHODS: We included 16 546 patients [10 270 (62.1%) without/6276 (38.9%) with CKD Stage 1-5] from the Spanish Ambulatory-Blood-Pressure Monitoring (ABPM) Registry. Stages of CKD were defined according to K/DIGO criteria, based on estimated glomerular filtration rate calculated with the CKD-EPI equation and albumin-to-creatine ratio...
May 2018: Journal of Hypertension
David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
Jongha Park
Cardiovascular (CV) risk assessment is not easy in chronic kidney disease (CKD) patients. Age, male sex, race, family history of CV disease, smoking status and diabetes should be considered as CV risk factors as the general population. It is also accepted that hypertension (HTN) is associated with the greater risk of CV complications in this population. However, there are some concerns in this issue.First, supporting evidence for specific blood pressure (BP) targets in CKD is scarce. Many observational studies reported a J-shaped association between BP level and CV mortality unlike a linear association in the general population...
September 2016: Journal of Hypertension
Montserrat Baldan-Martin, Laura Mourino-Alvarez, Laura Gonzalez-Calero, Rafael Moreno-Luna, Tamara Sastre-Oliva, Gema Ruiz-Hurtado, Julian Segura, Juan Antonio Lopez, Jesus Vazquez, Fernando Vivanco, Gloria Alvarez-Llamas, Luis M Ruilope, Fernando de la Cuesta, Maria G Barderas
Albuminuria is a risk factor strongly associated with cardiovascular disease, the first cause of death in the general population. It is well established that renin-angiotensin system suppressors prevent the development of new-onset albuminuria in naïf hypertensive patients and diminish its excretion, but we cannot forget the percentage of hypertensive patients who develop de novo albuminuria. Here, we applied multiple proteomic strategy with the purpose to elucidate specific molecular pathways involved in the pathogenesis and provide predictors and chronic organ damage indicators...
July 2016: Hypertension
Yang Li, Peng Xia, Lubin Xu, Yang Wang, Limeng Chen
BACKGROUND: Recent studies have demonstrated that there is an association between prehypertension and an increased risk of end-stage renal disease. However, there is conflicting evidence regarding the relationship between prehypertension and chronic kidney disease (CKD). This meta-analysis aimed to demonstrate the association between prehypertension and the incidence of CKD and identify the impacts of gender and ethnic differences. METHODS: MEDLINE, EMBASE, Cochrane Library (from inception through March 2016) and article reference lists were searched for relevant studies regarding blood pressure and CKD...
2016: PloS One
Andrew Mente, Martin O'Donnell, Sumathy Rangarajan, Gilles Dagenais, Scott Lear, Matthew McQueen, Rafael Diaz, Alvaro Avezum, Patricio Lopez-Jaramillo, Fernando Lanas, Wei Li, Yin Lu, Sun Yi, Lei Rensheng, Romaina Iqbal, Prem Mony, Rita Yusuf, Khalid Yusoff, Andrzej Szuba, Aytekin Oguz, Annika Rosengren, Ahmad Bahonar, Afzalhussein Yusufali, Aletta Elisabeth Schutte, Jephat Chifamba, Johannes F E Mann, Sonia S Anand, Koon Teo, S Yusuf
BACKGROUND: Several studies reported a U-shaped association between urinary sodium excretion and cardiovascular disease events and mortality. Whether these associations vary between those individuals with and without hypertension is uncertain. We aimed to explore whether the association between sodium intake and cardiovascular disease events and all-cause mortality is modified by hypertension status. METHODS: In this pooled analysis, we studied 133,118 individuals (63,559 with hypertension and 69,559 without hypertension), median age of 55 years (IQR 45-63), from 49 countries in four large prospective studies and estimated 24-h urinary sodium excretion (as group-level measure of intake)...
July 30, 2016: Lancet
Francesco Paolo Cappuccio, Michelle Avril Miller
Cardiovascular disease, including stroke, heart failure and kidney disease, has been common in sub-Saharan Africa for many years, and rapid urbanization is causing an upsurge of ischaemic heart disease and metabolic disorders. At least two-thirds of cardiovascular deaths now occur in low- and middle-income countries, bringing a double burden of disease to poor and developing world economies. High blood pressure (or hypertension) is by far the commonest underlying risk factor for cardiovascular disease. Its prevention, detection, treatment and control in sub-Saharan Africa are haphazard and suboptimal...
April 2016: Internal and Emergency Medicine
Laura Salanova Villanueva, Carmen Sánchez González, José Antonio Sánchez Tomero, Abelardo Aguilera, Esther Ortega Junco
Cardiovascular factors are one of the main causes of morbidity and mortality in patients with chronic kidney disease. Bone mineral metabolism disorders and inflammation are pathological conditions that involve increased cardiovascular risk in chronic kidney disease. The cardiovascular risk involvement of bone mineral metabolism classical biochemical parameters such as phosphorus, calcium, vitamin D and PTH is well known. The newest markers, FGF23 and klotho, could also be implicated in cardiovascular disease...
July 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Bjørn O Eriksen, Vidar T N Stefansson, Trond G Jenssen, Ulla D Mathisen, Jørgen Schei, Marit D Solbu, Tom Wilsgaard, Toralf Melsom
Although hypertension is a risk factor for end-stage renal disease, this complication develops in only a minority of hypertensive patients. Whether non-malignant hypertension itself is sufficient to cause reduced glomerular filtration rate (GFR) is unclear. Therefore, we investigated whether elevated blood pressure (BP) was associated with accelerated GFR decline in the general population. The study was based on the Renal Iohexol Clearance Survey in Tromsø 6 (RENIS-T6), which included a representative sample of 1594 individuals aged 50 to 62 years from the general population without baseline diabetes or kidney or cardiovascular disease...
August 2016: Kidney International
Sandra J Taler
No abstract text is available yet for this article.
July 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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