[Treatment of hypertension in chronic kidney disease]

Area of Science:

• Cardiology
• Nephrology
• Vascular Medicine

Background:

• Systemic arterial hypertension (SAH) is a complex cardiovascular syndrome with early indicators preceding elevated blood pressure (BP).
• SAH progression is linked to cardiovascular abnormalities, leading to end-organ damage and increased morbidity/mortality.
• Blood pressure is a biomarker, making individual BP patterns more critical than a single threshold for diagnosis and treatment.

Purpose of the Study:

• To highlight the importance of individual BP patterns over single thresholds in SAH.
• To discuss advancements in hypertension management for chronic kidney disease (CKD) patients, particularly those on dialysis.
• To emphasize the role of non-invasive BP monitoring in patient care.

Main Methods:

• Review of current understanding of SAH pathophysiology and its relation to end-organ damage.
• Analysis of the impact of non-invasive BP monitoring technologies on patient management.
• Examination of therapeutic strategies including RAAS blockade, dry weight monitoring, and lifestyle interventions.

Main Results:

• Non-invasive BP monitoring reconfigures diagnosis, circadian pattern assessment, surveillance, and treatment.
• Timely diagnosis and treatment can delay complications and the need for dialysis.
• RAAS blockade, dry weight management, and lifestyle modifications significantly impact morbidity and mortality in CKD patients.

Conclusions:

• Individualized BP monitoring and management are crucial for SAH.
• Advancements in hypertension care, especially for CKD patients, improve outcomes.
• Integrated therapeutic approaches reduce cardiovascular events and mortality.