Document Detail


Current understanding of optimal blood pressure goals in dialysis patients.
MedLine Citation:
PMID:  16965729     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The hemodialysis population is associated with a very low survival rate, with myocardial infarctions and strokes accounting for most of the increased mortality. Recent observational studies demonstrate a paradoxical relationship between increasing blood pressure and increasing mortality. Hypertension treated with antihypertensive medications unequivocally reduces cerebrovascular risk, but demonstration of a survival benefit for cardiovascular mortality has proven more difficult to demonstrate. Increased pulse pressure is caused by inadequate dialysis treatment that increases arterial wall stiffness and afterload, and decreases coronary perfusion. The disproportionate representation of diastolic dysfunction and coronary artery atherosclerosis may explain why increased pulse pressure is associated with higher cardiovascular risk for the dialysis population. Optimum blood pressure control has not been established, due to a lack of prospective studies targeting blood pressure reduction. Opinion-based recommendations are offered, but goals should be individualized based on a complete assessment of prevailing comorbidities and should target normalization of the pulse pressure.
Authors:
Paul Light
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current hypertension reports     Volume:  8     ISSN:  1522-6417     ISO Abbreviation:  Curr. Hypertens. Rep.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-12     Completed Date:  2007-01-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100888982     Medline TA:  Curr Hypertens Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  413-9     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Room N3W143, University of Maryland School of Medicine, 22 S. Greene Street, Baltimore, MD 21201, USA. plight@medicine.umaryland.edu
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / adverse effects,  therapeutic use*
Blood Pressure / drug effects
Coronary Circulation / drug effects
Humans
Hypertension / complications,  drug therapy*,  mortality
Myocardial Infarction / mortality,  prevention & control*
Reference Values
Renal Dialysis* / adverse effects
Risk Factors
Stroke / mortality,  prevention & control*
Survival Analysis
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

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


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