| Effectiveness of antihypertensive treatment in chronic renal failure: to what extent and with which drugs do patients treated by nephrologists achieve the recommended blood pressure? | |
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MedLine Citation:
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PMID: 15002005 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Adequate control of blood pressure (BP) is important to slow the progression of chronic renal failure (CRF). The Joint National Committee (JNC) VI recommends BP <130/85 mmHg, or <125/75 mmHg if urinary protein excretion exceeds 1 g/d. Angiotensin converting enzyme inhibitors (ACE-I) are considered as first-line agents. The current study is a survey of the degree of goal achievement and prescription patterns of antihypertensive (AHT) medication according to the JNC guidelines in clinical nephrology practice. All patients with CRF, not on renal replacement therapy, treated by nephrologists at the University Hospital of North-Norway were included in this retrospective cross-sectional study. Data on protein:creatinine ratio (PC ratio), BP and AHT drugs prescribed were extracted from the hospital's databases and medical records. A total of 144 patients were included. The patients' age was 62+/-16 years and the serum creatinine value was 210+/-92 micromol/l (mean+/-s.d.). In all, 74 patients (51%) had PC ratio < or =1, 36 (25%) >1, and for 34 (24%) PC ratio had not been measured; 23 (31%) of the patients with PC ratio < or =1 had BP < or =130/85 (139+/-21/78+/-12), and 5 (14%) of those with PC ratio >1 had BP < or =125/75 (145+/-22/85+/-14). Failure to achieve the goal was most commonly due to elevated SBP. In all, 55 % of the patients were prescribed ACE-I or angiotensin receptor blocker (ARB). In conclusion, the recommended BP goals may be difficult to achieve for a high proportion of patients in clinical practice due to difficulty in lowering SBP. There is a potential for improved treatment of hypertension in CRF patients, including increased prescription of ACE-I and ARB. |
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Authors:
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T Giverhaug; A Falck; B O Eriksen |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of human hypertension Volume: 18 ISSN: 0950-9240 ISO Abbreviation: J Hum Hypertens Publication Date: 2004 Sep |
Date Detail:
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Created Date: 2004-08-23 Completed Date: 2006-07-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8811625 Medline TA: J Hum Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 649-54 Citation Subset: IM |
Affiliation:
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Institute of Pharmacy, Faculty of Medicine, University of Tromsø, Norway. trudeg@farmasi.uit.no |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use Adult Aged Aged, 80 and over Angiotensin-Converting Enzyme Inhibitors / therapeutic use Antihypertensive Agents / therapeutic use* Biological Markers / blood Blood Pressure / drug effects* Creatinine / blood Diuretics / therapeutic use Drug Therapy, Combination Female Humans Hypertension, Renal / complications, drug therapy Kidney Failure, Chronic / drug therapy*, etiology Male Middle Aged Myocardial Contraction / drug effects Nephrology Norway Renin-Angiotensin System / drug effects Research Design Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Biological Markers; 0/Diuretics; 60-27-5/Creatinine |
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