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Blood pressure targets in CKD.

Raymond R Townsend1

  • 1Renal Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

Advances in Chronic Kidney Disease
|February 24, 2015
PubMed
Summary

The 2014 hypertension guidelines recommend specific blood pressure goals for patients with chronic kidney disease (CKD). Evidence supports a goal of <140/90 mmHg, with some suggesting <130/80 mmHg for those with proteinuria.

Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • The 2014 Guidelines for the Management of Hypertension in Adults sparked debate regarding recommendations and evidence.
  • This review focuses on recommendations for treatment goals and agents in hypertensive patients with chronic kidney disease (CKD).

Purpose of the Study:

  • To critically review the evidence supporting the 2014 guideline recommendations on blood pressure targets and therapeutic agents for hypertensive patients with CKD.
  • To present the author's perspective on the data underpinning these specific recommendations.

Main Methods:

  • Literature review of studies cited in the 2014 hypertension guidelines.
  • Analysis of evidence related to treatment goals (Recommendation 4) and agent selection (Recommendation 8) for CKD patients.
Keywords:
Blood pressure targetChronic kidney diseaseGuideline

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Main Results:

  • A general consensus exists for a blood pressure goal of <140/90 mmHg in CKD.
  • Some guidelines suggest a stricter goal of <130/80 mmHg for CKD patients with significant proteinuria.

Conclusions:

  • The author reviews the evidence for specific 2014 hypertension guideline recommendations concerning CKD management.
  • The article highlights consensus and differing opinions on optimal blood pressure targets in hypertensive CKD patients.