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[Secondary hypertension].

H Kawabe1, I Saito

  • 1Health Center, Keio University.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|June 8, 2001
PubMed
Summary
This summary is machine-generated.

Control blood pressure to 130/85 mmHg or lower in patients with hypertension and chronic renal disease. Dietary sodium and protein reduction, along with specific antihypertensive drugs, aids renal function.

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Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Context:

  • Hypertension is a significant risk factor for chronic kidney disease (CKD).
  • Managing blood pressure (BP) and renal function is crucial in patients with renal insufficiency.
  • Renovascular hypertension and endocrine disorders present unique management challenges.

Purpose:

  • To outline optimal blood pressure targets and therapeutic strategies for patients with hypertension and chronic renal parenchymal disease.
  • To detail the role of dietary modifications and pharmacotherapy in managing renal insufficiency.
  • To review treatment approaches for specific hypertensive conditions like renovascular hypertension and endocrine-related hypertension.

Summary:

  • Recommended BP control is ≤130/85 mmHg (or ≤125/75 mmHg with proteinuria >1 g/day).

Related Experiment Videos

  • Dietary sodium (<7 g/day) and protein (<0.6-0.7 g/kg) reduction are vital for managing BP and renal function.
  • First-line antihypertensives include ACE inhibitors or long-acting calcium antagonists; beta-blockers, ACE inhibitors, and AII-receptor blockers are recommended for renovascular hypertension.
  • Surgical intervention is primary for renovascular hypertension and endocrine disorders (adenoma/tumor).
  • Specific agents like spironolactone, calcium antagonists, and alpha/beta blockers are used for idiopathic aldosteronism and pheochromocytoma.

    • Impact:

    • Provides evidence-based guidelines for optimizing hypertension management in CKD patients.
    • Highlights the importance of a multi-faceted approach including diet, medication, and surgical options.
    • Aims to improve renal outcomes and reduce cardiovascular complications in hypertensive individuals with kidney disease.