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Epidemiology and prevention of blood pressure-related renal disease
P K Whelton1, T V Perneger, F L Brancati
1Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University School of Hygiene, Baltimore, Maryland.
Aim:
To examine the relationship between blood pressure and end-stage renal disease.
Method:
Review of recent reports on blood pressure in relation to renal function.
Background:
The incidence and prevalence of treated end-stage renal disease are increasing progressively in economically developed countries. To combat this problem, the treatment of established end-stage renal disease must be complemented by strategies to treat and prevent risk factors for the development of renal failure.
Results:
Severe hypertension and malignant hypertension are well accepted as risk factors for renal insufficiency. Recent reports suggest a strong relationship between blood pressure and renal function, throughout the entire range of blood pressure. Most blood pressure-related renal disease can probably be attributed to mild hypertension or a high normal blood pressure.
Conclusions:
Additional clinical trials are needed to assess the value of different antihypertensive drugs and different levels of blood pressure control in preserving renal function in subjects at risk of blood pressure-related renal disease. Primary prevention of hypertension may be an important complement to the treatment of established hypertension in reducing the burden of renal disease in the community.