Renal Considerations in the Treatment of Hypertension.


eMediNexus    26 February 2018

A new article published in the American Journal of Hypertension cautioned against renal implications while implementing intensive blood pressure control strategies. The article discussed that although this approach confers cardiovascular benefit in patients with and without chronic kidney disease, the impact on renal disease progression varies based on the pattern of underlying renal injury. In the concurrence of proteinuria, stringent blood pressure control usually renders a protective effect on renal disease progression. However, in the absence of proteinuria, this benefit appears to be much less impressive. It was stated that thiazide diuretics are often utilized to achieve intensive blood pressure control; these drugs can cause hyponatremia and present with biochemical evidence imitating the syndrome of inappropriate antidiuretic hormone secretion. An altered prostaglandin transport may illustrate the unique susceptibility to this complication observed in some patients. Additionally, hyperkalemia is a complication of intensive blood pressure lowering, especially in cases with renin-angiotensin-aldosterone blockade. In inference, the authors stated that there are strategies and new drugs now available that can enable the use of these blockers while ensuring a normal plasma potassium concentration.

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