Effects of antihypertensive drugs on various aspects of renal function

Abstract

This paper reviews the effects of antihypertensive drugs on various aspects of renal function such as renal hemodynamics, sodium excretion and microalbuminuria. The discussion also includes the renin-angiotensin system. It is concluded that most agents reduce renal vascular resistance, at least in patients who respond with a drop in blood pressure. Microalbuminuria usually also falls, although this effect may be variable. Changes in renin and sodium excretion depend upon the type of drug used. With the present state of knowledge, it is not possible to define which type of treatment is most beneficial for the kidney in the long term.

ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly

“…378 Obese patients with hypertension are also characterized by a circadian rhythm that does not show the expected BP drop during sleep time (nondipping), and they respond to mental stress with a higher increase in total peripheral resistance and smaller increase in heart rate, stroke volume, and cardiac output than lean patients with hypertension. 379 In the LIFE study, the association of Cornell ECG voltage criteria with greater body mass supported the known association of anatomic LVH with obesity 380 and showed obese, elderly patients with hypertension had similar cardiac changes previously described in younger patients: LVH with a high prevalence of geometric abnormalities, especially eccentric hypertrophy. 381…”