Guiding Lights for Antihypertensive Treatment in Patients with Nondiabetic Chronic Renal Disease: Proteinuria and Blood Pressure Levels?
Authors: Cynthia D. Mulrow, Raymond R. Townsend
Journal: Annals of Internal Medicine (2003)

Editorials19 August 2003Guiding Lights for Antihypertensive Treatment in Patients with Nondiabetic Chronic Renal Disease: Proteinuria and Blood Pressure Levels?Cynthia D. Mulrow, MD, MSc, Deputy Editor and Raymond R. Townsend, MD, Associate EditorCynthia D. Mulrow, MD, MSc, Deputy EditorFrom University of Pennsylvania, Philadelphia, PA 19104.Search for more papers by this author and Raymond R. Townsend, MD, Associate EditorFrom University of Pennsylvania, Philadelphia, PA 19104.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-4-200308190-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In the United States, about 20 million adults have chronic kidney disease (1). Many also have hypertension, either as a cause or complication of the kidney disease. Recently released guidelines from the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) recommended aggressive treatment of hypertension to target blood pressure values less than 130/80 mm Hg in patients with chronic kidney disease (2). The guidelines defined chronic kidney disease as either reduced excretory function (estimated glomerular filtration rate < 60 mL/min per 1.73 m2, corresponding approximately to a creatinine level > 132.6 mol/L [>1.5 ...References1. Prevalence of chronic kidney disease and decreased kidney function in the adult U.S. population: third National Health and Nutrition Examination Survey. Am J Kidney Dis. 2003; 41(Suppl 2):S29-40. Google Scholar2. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, . The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560-72. 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[PMID: 12435255] CrossrefMedlineGoogle Scholar14. Hansson L, Zanchetti A, Carruthers SG, Dahlof B, Elmfeldt D, Julius S, . Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Lancet. 1998;351:1755-62. [PMID: 9635947] CrossrefMedlineGoogle Scholar15. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ. 1998; 317:703-13. [PMID: 9732337] Google Scholar16. Somes GW, Pahor M, Shorr RI, Cushman WC, Applegate WB. The role of diastolic blood pressure when treating isolated systolic hypertension. Arch Intern Med. 1999;159:2004-9. [PMID: 10510985] CrossrefMedlineGoogle Scholar17. Boutitie F, Gueyffier F, Pocock S, Fagard R, Boissel JP. 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[PMID: 12531578] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Cynthia D. Mulrow, MD, MSc, Deputy Editor; Raymond R. Townsend, MD, Associate EditorAffiliations: From University of Pennsylvania, Philadelphia, PA 19104.Disclosures: None disclosed.Corresponding Author: Customer Service, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.Current Author Addresses: Dr. Mulrow: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106-1572.Dr. Townsend: University of Pennsylvania, 210 White Building, 3400 Spruce Street, Philadelphia, PA 19104. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoProgression of Chronic Kidney Disease: The Role of Blood Pressure Control, Proteinuria, and Angiotensin-Converting Enzyme Inhibition: A Patient-Level Meta-Analysis Tazeen H. Jafar , Paul C. Stark , Christopher H. Schmid , Marcia Landa , Giuseppe Maschio , Paul E. de Jong , Dick de Zeeuw , Shahnaz Shahinfar , Robert Toto , and Andrew S. Levey , for the AIPRD Study Group* Metrics Cited byWhich Antihypertensive Agents in Chronic Kidney Disease?Andrew S. Levey, MD and Katrin Uhlig, MD, MSHypertensive nephrosclerosis: updateThe new American Guidelines 19 August 2003Volume 139, Issue 4Page: 296-298KeywordsACE inhibitorsBlood pressureCreatinineExcretionHypertensionProteinsProteinuriaRenal diseasesSystolic pressureUrine ePublished: 19 August 2003 Issue Published: 19 August 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...