Document Detail

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?
MedLine Citation:
PMID:  15002005     Owner:  NLM     Status:  MEDLINE    
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.
T Giverhaug; A Falck; B O Eriksen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of human hypertension     Volume:  18     ISSN:  0950-9240     ISO Abbreviation:  J Hum Hypertens     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-23     Completed Date:  2006-07-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8811625     Medline TA:  J Hum Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  649-54     Citation Subset:  IM    
Institute of Pharmacy, Faculty of Medicine, University of Tromsø, Norway.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use
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
Hypertension, Renal / complications,  drug therapy
Kidney Failure, Chronic / drug therapy*,  etiology
Middle Aged
Myocardial Contraction / drug effects
Renin-Angiotensin System / drug effects
Research Design
Treatment Outcome
Reg. No./Substance:
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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