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Related Experiment Videos

Long-term renal function in primary hypertension. An epidemiological and pathophysiological study.

A Siewert-Delle1

  • 1Department of Nephrology and the Hypertension Clinic, Sahlgrenska University Hospital, Göteborg University, Sweden.

Scandinavian Journal of Urology and Nephrology. Supplementum
|June 1, 1999
PubMed
Summary

Preterm birth may increase adult hypertension risk. Good blood pressure control protects kidneys, but intensive treatment is needed to normalize renal blood flow and resistance in hypertensive individuals.

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Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Epidemiology

Background:

  • Birth factors may influence adult cardiovascular health.
  • Long-term consequences of primary hypertension on renal function are not fully understood.
  • The impact of intensified blood pressure management on renal hemodynamics requires further investigation.

Purpose of the Study:

  • To investigate the influence of birth factors on adult blood pressure.
  • To examine long-term renal function and hemodynamic changes in primary hypertension.
  • To assess the effects of intensified blood pressure control on renal parameters and urinary albumin excretion.

Main Methods:

  • Analysis of birth variables in relation to adult blood pressure in a cohort born in 1926-27.
  • 14-year follow-up of renal function, hemodynamics, and urinary albumin excretion in normotensive and hypertensive men.

Related Experiment Videos

  • Investigation of intensified blood pressure control (DBP ≤ 85 mmHg) using felodipine or ramipril in hypertensive patients.
  • 20-year assessment of serum creatinine levels in hypertensive men from the Primary Prevention Study to evaluate end-stage renal disease risk.

    • Main Results:

    • Preterm birth (gestational age < 38 weeks) was associated with an increased risk of adult hypertension.
    • Good long-term blood pressure control (DBP ≤ 90 mmHg) preserved glomerular filtration rate and reduced proteinuria but did not normalize renal blood flow or vascular resistance.
    • Intensified blood pressure control to DBP ≤ 85 mmHg with felodipine normalized renal blood flow and vascular resistance.
    • Ramipril treatment lowered blood pressure and urinary albumin excretion but did not fully normalize renal hemodynamics.
    • No hypertensive patients in the Primary Prevention Study developed end-stage renal disease within 20 years with good blood pressure control.

    Conclusions:

    • Preterm birth is a potential risk factor for adult hypertension.
    • Effective blood pressure management is crucial for protecting kidney function in hypertensive individuals.
    • Intensified antihypertensive therapy, particularly with felodipine, can restore normal renal hemodynamics in primary hypertension.
    • Patients with non-malignant primary hypertension and good blood pressure control are unlikely to develop progressive kidney decline or end-stage renal disease.