Treatment of hypertension in nondiabetic renal disease.

R. D. Toto, H. C. Mitchell, W. A. Pettinger

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Over the past two decades the incidence of stroke and myocardial infarction in hypertensive populations has decreased, yet the incidence of end-stage renal disease attributed to hypertension has increased. This apparent paradox has raised questions about the adequacy of blood pressure control in hypertensive patients with renal disease. Chronic renal failure is commonly associated with hypertension, and is often severe and difficult to control, particularly in patients with hypertensive nephrosclerosis. The optimal level of blood pressure control in these patients has not been established. Long-term diastolic blood pressure control to a level lower than 90 mm Hg is associated with stable or improving renal function in hypertensive nephrosclerosis and with slowing of the deterioration in renal function from other causes of renal failure. Moreover, recent studies indicate that when blood pressure control is achieved and maintained at a level of about 130/86 mm Hg (systolic/diastolic), deterioration in renal function can be halted even in black patients with hypertensive nephrosclerosis. Therefore, in hypertensive nephrosclerosis we attempt to control diastolic blood pressure at 80 to 85 mm Hg. Newer antihypertensive agents such as calcium channel blockers and angiotensin-converting enzyme inhibitors contribute to lowering blood pressure and preserving renal function. However, they have yet to be proven superior to conventional agents in double-blind randomized clinical trials in humans with hypertensive nephrosclerosis. Importantly, minoxidil is still relied on for aggressive control of blood pressure in many patients with hypertensive nephrosclerosis.

Original languageEnglish (US)
Pages (from-to)279-285
Number of pages7
JournalCurrent Opinion in Nephrology and Hypertension
Volume3
Issue number3
StatePublished - May 1994

Fingerprint

Nephrosclerosis
Blood Pressure
Hypertension
Kidney
Therapeutics
Chronic Kidney Failure
Minoxidil
Incidence
Calcium Channel Blockers
Angiotensin-Converting Enzyme Inhibitors
Antihypertensive Agents
Renal Insufficiency
Randomized Controlled Trials
Stroke
Myocardial Infarction
Population

ASJC Scopus subject areas

  • Internal Medicine
  • Nephrology

Cite this

Treatment of hypertension in nondiabetic renal disease. / Toto, R. D.; Mitchell, H. C.; Pettinger, W. A.

In: Current Opinion in Nephrology and Hypertension, Vol. 3, No. 3, 05.1994, p. 279-285.

Research output: Contribution to journalArticle

Toto, R. D. ; Mitchell, H. C. ; Pettinger, W. A. / Treatment of hypertension in nondiabetic renal disease. In: Current Opinion in Nephrology and Hypertension. 1994 ; Vol. 3, No. 3. pp. 279-285.
@article{2d7fb3d05bab45dd824c68e3d7812198,
title = "Treatment of hypertension in nondiabetic renal disease.",
abstract = "Over the past two decades the incidence of stroke and myocardial infarction in hypertensive populations has decreased, yet the incidence of end-stage renal disease attributed to hypertension has increased. This apparent paradox has raised questions about the adequacy of blood pressure control in hypertensive patients with renal disease. Chronic renal failure is commonly associated with hypertension, and is often severe and difficult to control, particularly in patients with hypertensive nephrosclerosis. The optimal level of blood pressure control in these patients has not been established. Long-term diastolic blood pressure control to a level lower than 90 mm Hg is associated with stable or improving renal function in hypertensive nephrosclerosis and with slowing of the deterioration in renal function from other causes of renal failure. Moreover, recent studies indicate that when blood pressure control is achieved and maintained at a level of about 130/86 mm Hg (systolic/diastolic), deterioration in renal function can be halted even in black patients with hypertensive nephrosclerosis. Therefore, in hypertensive nephrosclerosis we attempt to control diastolic blood pressure at 80 to 85 mm Hg. Newer antihypertensive agents such as calcium channel blockers and angiotensin-converting enzyme inhibitors contribute to lowering blood pressure and preserving renal function. However, they have yet to be proven superior to conventional agents in double-blind randomized clinical trials in humans with hypertensive nephrosclerosis. Importantly, minoxidil is still relied on for aggressive control of blood pressure in many patients with hypertensive nephrosclerosis.",
author = "Toto, {R. D.} and Mitchell, {H. C.} and Pettinger, {W. A.}",
year = "1994",
month = "5",
language = "English (US)",
volume = "3",
pages = "279--285",
journal = "Current Opinion in Nephrology and Hypertension",
issn = "1062-4821",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Treatment of hypertension in nondiabetic renal disease.

AU - Toto, R. D.

AU - Mitchell, H. C.

AU - Pettinger, W. A.

PY - 1994/5

Y1 - 1994/5

N2 - Over the past two decades the incidence of stroke and myocardial infarction in hypertensive populations has decreased, yet the incidence of end-stage renal disease attributed to hypertension has increased. This apparent paradox has raised questions about the adequacy of blood pressure control in hypertensive patients with renal disease. Chronic renal failure is commonly associated with hypertension, and is often severe and difficult to control, particularly in patients with hypertensive nephrosclerosis. The optimal level of blood pressure control in these patients has not been established. Long-term diastolic blood pressure control to a level lower than 90 mm Hg is associated with stable or improving renal function in hypertensive nephrosclerosis and with slowing of the deterioration in renal function from other causes of renal failure. Moreover, recent studies indicate that when blood pressure control is achieved and maintained at a level of about 130/86 mm Hg (systolic/diastolic), deterioration in renal function can be halted even in black patients with hypertensive nephrosclerosis. Therefore, in hypertensive nephrosclerosis we attempt to control diastolic blood pressure at 80 to 85 mm Hg. Newer antihypertensive agents such as calcium channel blockers and angiotensin-converting enzyme inhibitors contribute to lowering blood pressure and preserving renal function. However, they have yet to be proven superior to conventional agents in double-blind randomized clinical trials in humans with hypertensive nephrosclerosis. Importantly, minoxidil is still relied on for aggressive control of blood pressure in many patients with hypertensive nephrosclerosis.

AB - Over the past two decades the incidence of stroke and myocardial infarction in hypertensive populations has decreased, yet the incidence of end-stage renal disease attributed to hypertension has increased. This apparent paradox has raised questions about the adequacy of blood pressure control in hypertensive patients with renal disease. Chronic renal failure is commonly associated with hypertension, and is often severe and difficult to control, particularly in patients with hypertensive nephrosclerosis. The optimal level of blood pressure control in these patients has not been established. Long-term diastolic blood pressure control to a level lower than 90 mm Hg is associated with stable or improving renal function in hypertensive nephrosclerosis and with slowing of the deterioration in renal function from other causes of renal failure. Moreover, recent studies indicate that when blood pressure control is achieved and maintained at a level of about 130/86 mm Hg (systolic/diastolic), deterioration in renal function can be halted even in black patients with hypertensive nephrosclerosis. Therefore, in hypertensive nephrosclerosis we attempt to control diastolic blood pressure at 80 to 85 mm Hg. Newer antihypertensive agents such as calcium channel blockers and angiotensin-converting enzyme inhibitors contribute to lowering blood pressure and preserving renal function. However, they have yet to be proven superior to conventional agents in double-blind randomized clinical trials in humans with hypertensive nephrosclerosis. Importantly, minoxidil is still relied on for aggressive control of blood pressure in many patients with hypertensive nephrosclerosis.

UR - http://www.scopus.com/inward/record.url?scp=0028438526&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028438526&partnerID=8YFLogxK

M3 - Article

C2 - 7922253

AN - SCOPUS:0028438526

VL - 3

SP - 279

EP - 285

JO - Current Opinion in Nephrology and Hypertension

JF - Current Opinion in Nephrology and Hypertension

SN - 1062-4821

IS - 3

ER -