Improvement of Blood Pressure Control in Hypertensive Patients with Renal Diseases

Ohta, Yuko; Tsuruya, Kazuhiko; Fujii, Koji; Tokumoto, Masanori; Kanai, Hidetoshi; Matsumura, Kiyoshi; Tsuchihashi, Takuya; Hirakata, Hideki; Iida, Mitsuo

doi:10.1291/hypres.30.295

Cited by 2 publications

(3 citation statements)

References 31 publications

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“…However, the control status of BP in the hypertensive patients with DM/CKD remains inadequate. Several surveys have reported that the proportion of DM patients with controlled BP varied from 4% to 20% (12)(13)(14) and the proportion of CKD patients with controlled BP was 29% (15). Although BP control status in our hypertensive patients with multiple risk factors seems somewhat better than that seen in previous studies, strict goal BP levels were not achieved in a significant number of the patients.…”

Section: Discussioncontrasting

confidence: 56%

Clustering of Cardiovascular Risk Factors and Blood Pressure Control Status in Hypertensive Patients

et al. 2010

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Objective Hypertensive patients have multiple risk factors such as chronic kidney disease (CKD) and hyperuricemia in addition to components of metabolic syndrome. The morbidity of cardiovascular diseases is expected to increase synergistically by clustering of them. In the present study, we assessed the clustering of cardiovascular risk factors and blood pressure (BP) control status in hypertensive patients. Methods and Patients Subjects were 699 treated hypertensive patients (mean age: 65 ± 12 years; males 297, females 402) who had been followed at National Kyushu Medical Center, Fukuoka, Japan. We assessed the status of BP control and the presence of comorbidity including obesity, diabetes mellitus (DM), dyslipidemia, CKD and hyperuricemia. Results Average BP level and the number of antihypertensive drugs were 133 ± 11/74 ± 10 mmHg and 2.0 ± 1.1, respectively and the average number of cardiovascular risk factors was 1.5 ± 1.1. No comorbid risk factors were found in 18.7% of the patients. On the other hand, 34.2%, 28.9% and 18.2% of the patients had one, two or more than three risk factors, respectively. There were no significant differences in BP among these groups, while patients with three or more risk factors needed a greater number of antihypertensive drugs than those with other groups. Patients with three or more risk factors group showed significantly higher body mass index, serum LDL cholesterol, triglyceride, plasma glucose and serum uric acid levels compared to those with other groups (p<0.05, respectively). They also showed significantly lower serum HDL cholesterol and estimated GFR levels compared to those in other groups (p<0.05, respectively). Conclusion These results suggest that the majority of the treated hypertensive patients are complicated with additional cardiovascular risk factors and the patients with clustering risk factors required a greater number of antihypertensive drugs. Integrative management of BP as well as comorbid risk factors should be encouraged.

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Section: Discussioncontrasting

confidence: 56%

Clustering of Cardiovascular Risk Factors and Blood Pressure Control Status in Hypertensive Patients

et al. 2010

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“…Cependant, ce taux est très faible comparé au 42% retrouvés par Tonelli et al qui utilisaient la pression artérielle moyenne [19]. Ce faible taux pourrait être expliqué par la sévérité des chiffres tensionnelset de l'insuffisance rénale telle que retrouvés par Ohta Y et al au Japon [16], ainsi que la courte durée de l'étude. Nous n'avons pas retrouvé les autres facteurs de mauvais contrôle tensionnel décrits dans la littérature bien que certains facteurs de mauvais pronostics comme la protéinurie n'ont pas été recherchés [13,19].…”

Section: Discussionunclassified

“…Il s'agit d'une tâche difficile qui nécessite en plus des mesures hygiéno-diététiques, l'association le plus souvent d'au moins trois antihypertenseurs dépendant de la protéinurie et du stade de la MRC [7,8,12,13]. Ces associations médicamenteuses doivent privilégier les combinaisons fixes incluant les bloqueurs du système rénine angiotensine aldostérone (SRAA) qui ont prouvé leur efficacité dans la réduction de la progression de la MRC, de la protéinurie ainsi que de la morbimortalité globale et cardiovasculaire [5,7,8,[12][13][14][15][16][17]. Cependant, peu de données existent à notre connaissance en Afrique sur l'évaluation de l'HTA au cours de la MRC.…”

Section: Introductionunclassified

Sévérité et contrôle de l’hypertension artérielle au cours de la maladie rénale chronique au Cameroun

Kaze-Folefack,

Nono,

Halle

et al. 2013

Rev méd Madag

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Introduction. The association of hypertension with chronic kidney disease increases the morbidity and mortality. The aim of this study was to evaluate severity and control of hypertension among chronic kidney disease patients in Cameroon. Materials and methods. This was a cross sectional study on 97 medical files of patients suffering of hypertension and chronic kidney dis- ease at stages 3 to 5 not undergoing dialysis, in whom the treatment of hypertension was prescribed and followed during 8 weeks in outpa- tient nephrology clinics at Yaoundé general hospital. Results. The mean age of patients was 52.2±13.1 years with sex ratio 2:1. Severe hypertension occurred in 82 patients (84.6%) and 65 pa- tients (67%) had stage 4 to 5 chronic kidney disease. Renin angiotensin aldosterone blockers (89%), diuretics (80%) and calcium channel blockers (72%) were the main antihypertensive drugs. The mean number of antihypertensive drugs was 2.9±1.7 per patient and 70 patients (72.2%) were taking at least three antihypertensive drugs. At the end of the study, only 9 patients (9.3%) reached the target blood pressure value, and systolic and diastolic blood pressure reduction was respectively 36.3 mmHg and 19.4 mmHg. The severity of initial blood pressure value was statistically associated with poor control of blood pressure (p=0.004). Conclusion. Two third of patients at an advanced stage of chronic kidney disease were presenting with severe hypertension requiring the prescription of three antihypertensive drugs leading to poor short term control.

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Improvement of Blood Pressure Control in Hypertensive Patients with Renal Diseases

Cited by 2 publications

References 31 publications

Clustering of Cardiovascular Risk Factors and Blood Pressure Control Status in Hypertensive Patients

Clustering of Cardiovascular Risk Factors and Blood Pressure Control Status in Hypertensive Patients

Sévérité et contrôle de l’hypertension artérielle au cours de la maladie rénale chronique au Cameroun

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