Revisiting resistant hypertension in kidney disease.
Curr Opin Nephrol Hypertens
; 33(5): 465-473, 2024 Sep 01.
Article
en En
| MEDLINE
| ID: mdl-38726750
ABSTRACT
PURPOSE OF REVIEW As compared to controlled or uncontrolled hypertension, resistant hypertension in patients with chronic kidney disease (CKD) poses a significantly increased healthcare burden due to greater target end-organ damage including cardiovascular disease and CKD progression. Patients with CKD have two to three times higher risk of developing resistant hypertension. True resistant hypertension needs to be distinguished from apparent treatment resistant hypertension (aTRH); however, it is usually not possible in epidemiological studies. Moreover, impact of contemporary guidelines changes in the target blood pressure (BP) goal to less than 130/80âmmHg remains to be determined. RECENT FINDINGS:
Up to half of patients with CKD meet aTRH criteria using 2017âACC/AHA target BP less than 130/80âmmHg. Excess sodium retention in extracellular and tissue compartment remains the cornerstone cause of resistance to the treatment in CKD. Maximizing and optimizing the diuretic regimen in addition to dietary sodium restriction plays a critical role in these patients. Management requires a trustworthy provider-patient relationship facilitating identification and intervention for the barriers restricting the uptake of lifestyle modifications and medications. Recently, renal denervation has been approved and many other novel agents are on the horizon for treatment of true resistant hypertension associated with CKD.SUMMARY:
This review discusses the latest in the pathophysiology, definition, identification and treatment strategies of resistant hypertension in individuals with CKD. Further investigations are required to identify the prevalence, future implication and treatment outcome data for true resistant hypertension associated with CKD.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Resistencia a Medicamentos
/
Insuficiencia Renal Crónica
/
Hipertensión
/
Antihipertensivos
Límite:
Humans
Idioma:
En
Revista:
Curr Opin Nephrol Hypertens
Asunto de la revista:
ANGIOLOGIA
/
NEFROLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Reino Unido