Controlling systolic blood pressure is difficult in patients with diabetic kidney disease exhibiting moderate‐to‐severe reductions in renal function
Open accessAbstract
This study compared the use of antihypertensive treatment and blood pressure (BP) controls between patients with diabetic kidney disease (DK+) and patients with non-diabetic kidney disease (DK-) exhibiting moderate-to-severe chronic renal failure who did not need renal replacement therapy. A cross-sectional survey included all renal patients with s-creatinine at ?200 micromol/l attending regular control sessions at six renal units in Norway. Of the 351 patients included, 73 (20.8%) were DK+. The proportion reaching a BP goal of <130/80 mmHg was similar in DK+ and DK- (14.1% vs 13.6%, p = 0.92), while 38% and 39% achieved a BP of <140/90 mmHg, respectively. The systolic BP goal was more difficult to achieve than the diastolic BP goal in DK+ patients (35% vs 15%) despite a mean of three different types of drugs being used. Loop diuretics and beta-adrenergic-receptor antagonists were the most frequently prescribed drugs, and the use of angiotensin-converting enzyme inhibitors or angiotensin-II-receptor antagonists declined when renal function deteriorated, from 80% to 0% and from 66% to 20% in the DK+ and DK- groups, respectively (p = 0.001). Thus, despite the use of multiple antihypertensive drugs, controlling BP - especially the systolic BP - is difficult in high-risk patients with chronic renal failure caused by diabetic kidney disease.
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Other data confirm that even when patients with chronic kidney disease were followed up in nephrology clinics, <15% had their blood pressure controlled to <130/80 mm Hg and <40% achieved a blood pressure of <140/90 mm Hg despite the use of 3 different antihypertensive agents.
“Other data confirm that even when patients with CKD were followed up in nephrology clinics, <15% had their BP controlled to <130/80 mm Hg and <40% achieved a BP of <140/90 mm Hg despite the use of 3 different antihypertensive agents.304”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [304]
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- Authors
- Grøn sælen, M., Katrine prøsch, L., Gudmundsdottir, H., Dyrbekk, D., Helge Hunderi, O., Arnesen, E., Paulsen, D., Skjønsberg, H., & Os, I.
- Affiliations
- Department of Pharmacotherapeutics, University of Oslo, Oslo
- Ullevål University Hospital, Oslo
- Sykehuset i Vestfold (NO)
- Østfold Hospital Trust (NO)
- Innlandet HF‐Elverum, Elverum
- Innlandet Hospital Trust (NO)
- Akershus University Hospital (NO)
- University of Oslo (NO)
- Oslo University Hospital (NO)
- ORCID
- Arnesen, Erik
- Venue
- Blood Pressure
- Publisher
- Informa UK Limited
- Published
- 2005-07
- Volume
- 14
- Issue
- 3
- Pages
- 170-176
- ISSN
- 0803-7051 (ISSN-L)
- 1651-1999
- OpenAlex
- W1990869576
- Cited by
- 17
- References
- 33
- Citations by year
- 2024: 1 · 2020: 1 · 2018: 1 · 2016: 1 · 2014: 1 · 2013: 4 · 2012: 1
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Blood Pressure (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Keywords
- diabetic nephropathy, systolic blood pressure control, antihypertensive therapy, chronic kidney disease, blood pressure targets, renin-angiotensin system blockade, ACE inhibitors, angiotensin receptor blockers, beta-blockers, loop diuretics, renal function decline
- MeSH terms
- Aged, Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents, Blood Pressure, Blood Pressure Determination, Cross-Sectional Studies, Diabetic Nephropathies, Health Surveys, Humans, Kidney, Kidney Failure, Chronic, Middle Aged, Norway, Risk Factors, Treatment Outcome, Angiotensin II Type 1 Receptor Blockers
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