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Hypertension and left ventricular hypertrophy in autosomal dominant polycystic kidney disease

Tevfik Ecder1, Robert W Schrier

  • 1Istanbul School of Medicine, Department of Internal Medicine, Istanbul, Turkey. stecder@hotmail.com

Expert Review of Cardiovascular Therapy
|May 21, 2004
PubMed

Insights

Aggressively controlling blood pressure in autosomal dominant polycystic kidney disease (ADPKD) patients is crucial. This approach helps reverse left ventricular hypertrophy and slow kidney disease progression, improving survival.

Area of Science:

  • Nephrology
  • Cardiology
  • Hypertension Research

Background:

  • Hypertension is prevalent in autosomal dominant polycystic kidney disease (ADPKD), impacting renal and patient survival.
  • Renin-angiotensin-aldosterone system (RAAS) activation, due to cyst expansion and ischemia, is implicated in ADPKD hypertension.
  • Left ventricular hypertrophy (LVH), a significant cardiovascular risk factor, is common in ADPKD patients.

Purpose of the Study:

  • To evaluate the impact of aggressive blood pressure control on left ventricular hypertrophy (LVH) in ADPKD patients.
  • To assess the role of aggressive blood pressure management in slowing renal disease progression in ADPKD.
  • To determine the optimal initial treatment strategy for hypertension in ADPKD.

Main Methods:

  • Analysis of prospective randomized trial data on blood pressure control in ADPKD.
  • Epidemiological assessment of blood pressure management and renal disease progression.
  • Review of treatment guidelines for hypertension in ADPKD.

Main Results:

  • Aggressive blood pressure control leads to optimal reversal of left ventricular hypertrophy (LVH) in ADPKD.
  • Evidence supports aggressive blood pressure control in slowing renal disease progression in ADPKD patients.
  • Blockade of the renin-angiotensin-aldosterone system (RAAS) is recommended as the initial treatment for ADPKD hypertension.

Conclusions:

  • Aggressive blood pressure control is vital for reducing cardiovascular morbidity and mortality in ADPKD.
  • Managing hypertension effectively is key to preserving renal function in ADPKD.
  • Targeting the renin-angiotensin-aldosterone system (RAAS) is the primary therapeutic strategy for ADPKD-related hypertension.

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