Chronic kidney disease and global cardiovascular risk in essential hypertension

Area of Science:

• Nephrology
• Cardiology
• Hypertension Management

Background:

• Recent guidelines highlight chronic kidney disease (CKD) relevance in hypertensive patient risk stratification.
• Altered renal function indices are independent predictors of cardiovascular (CV) morbidity and mortality.
• Essential hypertension with mild renal function alterations is linked to elevated CV morbidity and mortality.

Purpose of the Study:

• To emphasize the mandatory determination of microalbuminuria and estimated glomerular filtration rate for adequate global CV risk evaluation in hypertensive patients.
• To underscore the independent predictive value of renal function indices for CV outcomes.
• To advocate for an integrated therapeutic approach for hypertensive patients with CKD.

Main Methods:

• Review of recent guidelines and literature.
• Analysis of the role of microalbuminuria and estimated glomerular filtration rate (eGFR) in risk assessment.
• Evaluation of the impact of altered renal function on cardiovascular outcomes.

Main Results:

• Microalbuminuria and eGFR estimation are mandatory for comprehensive CV risk assessment in hypertension.
• Indices of altered renal function (microalbuminuria, elevated creatinine, decreased creatinine clearance, proteinuria) independently predict CV morbidity and mortality.
• Clustering of risk factors contributes to high CV morbidity/mortality in hypertensive patients with mild renal dysfunction.

Conclusions:

• The increased prevalence of CKD necessitates recognizing its significance in both general and hypertensive populations.
• An integrative therapeutic strategy is required to simultaneously protect renal and cardiovascular systems in hypertensive patients.
• Early identification and management of CKD are essential for improving cardiovascular outcomes in hypertensive individuals.