[Arterial hypertension and the kidney]

Area of Science:

• Cardiology and Nephrology
• Hypertension Research
• Pharmacology

Context:

• Arterial hypertension is a leading global cause of cardiovascular mortality.
• Blood pressure exceeding 140/90 mmHg signifies significant cardiovascular risk requiring intervention.
• The pressure natriuresis relationship is a key long-term blood pressure regulatory mechanism, often disrupted in hypertension.

Purpose:

• To review the therapeutic strategies for arterial hypertension, particularly in patients with renal diseases.
• To highlight the role of thiazide diuretics in antihypertensive regimens.
• To evaluate the combined efficacy of thiazide diuretics with ACE inhibitors or ARBs for cardioprotection and nephroprotection.

Summary:

• While diagnostic and monitoring guidelines for hypertension are established, therapeutic strategies remain debated.
• Lifestyle modifications are foundational, but many patients with renal diseases necessitate combination drug therapy.
• Thiazide diuretics are recommended as a primary agent, with notable benefits when combined with ACE inhibitors or angiotensin receptor antagonists (ARBs).

Impact:

• This review emphasizes optimal therapeutic combinations for managing hypertension and its complications.
• The findings support enhanced cardioprotective and nephroprotective outcomes in hypertensive patients with kidney disease.
• Provides evidence-based recommendations for clinical practice in hypertension management.