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Kidney damage in 'benign' essential hypertension

P K Whelton1, J He, T V Perneger

  • 1Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA. pwhelton@mailhost.tcs.tulane.edu

Current Opinion in Nephrology and Hypertension
|March 1, 1997
PubMed
Summary

High blood pressure significantly predicts kidney damage and worsening renal disease. Systolic blood pressure elevation is a key risk factor, even within the normal range, emphasizing the need for blood pressure management in kidney patients.

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Area of Science:

  • Nephrology
  • Cardiology
  • Hypertension Research

Background:

  • Observational studies increasingly highlight hypertension as a critical independent predictor of renal damage.
  • Elevated blood pressure is linked to the progression of existing kidney disease, and increased morbidity and mortality in renal failure patients.

Purpose of the Study:

  • To review emerging evidence on the relationship between blood pressure and renal disease.
  • To discuss the role of systolic versus diastolic blood pressure in predicting renal risk.
  • To highlight the impact of angiotensin-converting enzyme inhibitors in renal insufficiency.

Main Methods:

  • Analysis of recent observational studies on blood pressure and renal outcomes.
  • Review of clinical trial data regarding antihypertensive treatments in renal insufficiency.

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  • Examination of newly published clinical guidelines for hypertension management in renal disease.

    • Main Results:

    • High blood pressure is an independent predictor of incident renal damage and progression of existing renal disease.
    • Systolic blood pressure elevation appears to be a stronger risk predictor than diastolic pressure.
    • A continuous, positive relationship exists between blood pressure and renal disease across the entire spectrum, including normotensive ranges.

    Conclusions:

    • Blood pressure management is crucial for preventing and managing renal disease.
    • Angiotensin-converting enzyme inhibitors show benefits in patients with renal insufficiency.
    • Ongoing trials and new guidelines offer valuable direction for clinical practice in managing hypertension in patients with kidney disease.