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Treatment of hypertension in Italian nephrology out-patient clinics: the THIN Study

Domenico Russo1, Michele Andreucci, Antonella De Blasio

  • 1Department of Nephrology, University of Naples School of Medicine "Federico II", 80024 Cardito, Napoli, Italy. domenicorusso51@hotmail.com

Seminars in Nephrology
|November 22, 2005
PubMed

Insights

Nephrologists improved blood pressure control in hypertensive patients, especially those with essential hypertension. However, better strategies are needed for patients with chronic kidney disease and diabetes.

Area of Science:

  • Nephrology
  • Cardiology
  • Hypertension Management

Background:

  • Optimal blood pressure control is vital for preventing cardiovascular events in hypertensive patients.
  • A small percentage of patients achieve well-controlled blood pressure under various specialists.
  • Nephrology out-patient clinics manage complex hypertension cases.

Purpose of the Study:

  • To evaluate blood pressure control targets achieved in Italian nephrology out-patient clinics.
  • To identify factors influencing blood pressure normalization in hypertensive patients managed by nephrologists.

Main Methods:

  • A questionnaire-based survey was distributed to Italian nephrology out-patient clinics.
  • Data collected included patient clinical characteristics, lifestyle, biochemistry, blood pressure, and antihypertensive medications.
  • Data from 1,632 patients were analyzed.

Main Results:

  • The most frequent causes of hypertension were essential hypertension (26%), renal insufficiency (16%), and diabetes (10%).
  • At admission, 98% had systolic BP >140 mmHg and 95% had diastolic BP >90 mmHg.
  • At the last visit, normalized blood pressure was achieved in 38% (systolic) and 75% (diastolic) of patients.
  • Higher normalization rates were observed in essential hypertension compared to secondary hypertension (renal insufficiency, diabetes).

Conclusions:

  • Nephrologists demonstrate improvement in managing essential hypertension.
  • More effective strategies are required for hypertension management in patients with reduced renal function and diabetes.
  • Multidisciplinary approaches may be necessary for complex hypertensive patients.

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