Document Detail


Antihypertensive therapy in renal patients - benefits and difficulties.
MedLine Citation:
PMID:  10529626     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
High blood pressure values, diastolic and systolic, are associated with decreased renal function. This is particularly true when the diastolic blood pressure is higher than 90 mm Hg. Several studies showed that lowering of the blood pressure within the range of normotension according to the WHO causes a reduction in the rate of progression to terminal renal failure. These studies have led to recommendations to aim at a target blood pressure of approximately 125/75 mm Hg in the treatment of patients with glomerular diseases and particularly diabetic nephropathy with proteinuria >1 g/day. In contrast to these results, blood pressure values corresponding to the recommendation (</=125/75 mm Hg) of the JNC VI (see text) were achieved in 15% of the patients only. It has also been shown that at any given level of an average 24-hour blood pressure, patients with an insufficient decrease of the blood pressure during nighttime have a higher risk to progress to terminal renal failure. Thus it is very important to lower the nighttime blood pressure and to detect nighttime blood pressure increases using ambulatory blood pressure measurements.
Authors:
V Schwenger; M Zeier; E Ritz
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Publication Detail:
Type:  Case Reports; Clinical Conference; Journal Article    
Journal Detail:
Title:  Nephron     Volume:  83     ISSN:  0028-2766     ISO Abbreviation:  Nephron     Publication Date:  1999  
Date Detail:
Created Date:  1999-12-20     Completed Date:  1999-12-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0331777     Medline TA:  Nephron     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  202-13     Citation Subset:  IM    
Affiliation:
Klinikum der Universität Heidelberg, Sektion Nephrologie, Heidelberg, Deutschland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiotensin-Converting Enzyme Inhibitors / administration & dosage
Antihypertensive Agents / administration & dosage*,  adverse effects
Blood Pressure / drug effects,  physiology
Blood Pressure Monitoring, Ambulatory
Captopril / administration & dosage,  adverse effects
Diuretics / administration & dosage,  adverse effects
Doxazosin / administration & dosage,  adverse effects
Humans
Hydrochlorothiazide / administration & dosage,  adverse effects
Hypertension, Renal / drug therapy*,  physiopathology
Kidney Failure, Chronic / complications*,  physiopathology
Kidney Glomerulus / blood supply*,  chemistry,  physiopathology
Male
Nitrendipine / administration & dosage,  adverse effects
Proteinuria / drug therapy,  physiopathology
Receptors, Angiotensin / antagonists & inhibitors
Renal Circulation / drug effects
Triamterene / administration & dosage,  adverse effects
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Diuretics; 0/Receptors, Angiotensin; 39562-70-4/Nitrendipine; 396-01-0/Triamterene; 58-93-5/Hydrochlorothiazide; 62571-86-2/Captopril; 74191-85-8/Doxazosin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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