TY - JOUR
T1 - The double challenge of resistant hypertension and chronic kidney disease
AU - Rossignol, Patrick
AU - Massy, Ziad A.
AU - Azizi, Michel
AU - Bakris, George
AU - Ritz, Eberhard
AU - Covic, Adrian
AU - Goldsmith, David
AU - Heine, Gunnar H.
AU - Jager, Kitty J.
AU - Kanbay, Mehmet
AU - Mallamaci, Francesca
AU - Ortiz, Alberto
AU - Vanholder, Raymond
AU - Wiecek, Andrzej
AU - Zoccali, Carmine
AU - London, Gérard Michel
AU - Stengel, Bénédicte
AU - Fouque, Denis
PY - 2015
Y1 - 2015
N2 - Resistant hypertension is defined as blood pressure above goal despite adherence to a combination of at least three optimally dosed antihypertensive medications, one of which is a diuretic. Chronic kidney disease is the most frequent of several patient factors or comorbidities associated with resistant hypertension. The prevalence of resistant hypertension is increased in patients with chronic kidney disease, while chronic kidney disease is associated with an impaired prognosis in patients with resistant hypertension. Recommended low-salt diet and triple antihypertensive drug regimens that include a diuretic, should be complemented by the sequential addition of other antihypertensive drugs. New therapeutic innovations for resistant hypertension, such as renal denervation and carotid barostimulation, are under investigation especially in patients with advanced chronic kidney disease. We discuss resistant hypertension in chronic kidney disease stages 3-5 (ie, patients with an estimated glomerular filtration rate below 60 mL/min per 1·73 m(2) and not on dialysis), in terms of worldwide epidemiology, outcomes, causes and pathophysiology, evidence-based treatment, and a call for action
AB - Resistant hypertension is defined as blood pressure above goal despite adherence to a combination of at least three optimally dosed antihypertensive medications, one of which is a diuretic. Chronic kidney disease is the most frequent of several patient factors or comorbidities associated with resistant hypertension. The prevalence of resistant hypertension is increased in patients with chronic kidney disease, while chronic kidney disease is associated with an impaired prognosis in patients with resistant hypertension. Recommended low-salt diet and triple antihypertensive drug regimens that include a diuretic, should be complemented by the sequential addition of other antihypertensive drugs. New therapeutic innovations for resistant hypertension, such as renal denervation and carotid barostimulation, are under investigation especially in patients with advanced chronic kidney disease. We discuss resistant hypertension in chronic kidney disease stages 3-5 (ie, patients with an estimated glomerular filtration rate below 60 mL/min per 1·73 m(2) and not on dialysis), in terms of worldwide epidemiology, outcomes, causes and pathophysiology, evidence-based treatment, and a call for action
U2 - https://doi.org/10.1016/S0140-6736(15)00418-3
DO - https://doi.org/10.1016/S0140-6736(15)00418-3
M3 - Review article
C2 - 26530623
SN - 0140-6736
VL - 386
SP - 1588
EP - 1598
JO - Lancet
JF - Lancet
IS - 10003
ER -