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CKD and Hypertension: State-of-the-Art Management

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Dr Deodatta Chafekar    11 January 2018

According to new guidelines from the American College of Cardiology/American Heart Association (ACC/AHA), published in Hypertension and simultaneously presented at the 2017 American Heart Association Scientific Sessions held from November 11-15 in Anaheim, California. Hypertension is now defined as a BP of ≥130/80 mmHg. Guideline recommends Adults with hypertension and CKD should be treated to a BP goal of <130/80 mmHg.

Most patients with CKD will require two or more antihypertensive agents to achieve these targets. With the exception of use of ARBs or ACEIs in CKD patients with high levels of urinary albumin or protein excretion, there is no strong evidence to support the preferential use of any particular agent(s) in controlling BP in CKD.3

Among the many antihypertensive agents, (ARBs) are the most tolerated and have well-known renoprotective effects. Azilsartan, a newly introduced sartan, appears to be more efficacious in reducing BP, as compared to the maximum doses of three other ARBs (valsartan, olmesartan and candesartan) with a similar safety and tolerability profile along with possible renoprotection.4

Thus, azilsartan could be a new sartan for achieving intensive BP control in CKD patients.

References

  1. Judd E, et al. Adv Chronic Kidney Dis. 2015;22(2):116-22. 2SPRINT Research Group. N Engl J Med. 2015; 373(22):2103-16. 3KDIGO. Kidney Int Suppl. (2011). 2012;2(5):347-356. 4De Caterina AR, et al. Vasc Health Risk Manag. 2012;8:299-305.

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