Resistant Hypertension and Chronic Kidney Disease: a Dangerous Liaison

Treatment-resistant hypertension is an increasingly recognised problem and is markedly over-represented in patients with chronic kidney disease (CKD). Recent evidence has clarified the heightened risk for both adverse renal and cardiovascular outcomes associated with resistant hypertension, even whe...

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Bibliographic Details
Published in:Current hypertension reports 2016-04, Vol.18 (5), p.36-36, Article 36
Main Authors: Wolley, Martin J, Stowasser, Michael
Format: Article
Language:English
Subjects:
Antihypertensive Agents - therapeutic use
Cardiology
Diuretics - therapeutic use
Family Medicine
General Practice
Humans
Hypertension
Hypertension - complications
Hypertension - drug therapy
Hypertension - epidemiology
Hypertension - physiopathology
Internal Medicine
Life Style
Medicine
Medicine & Public Health
Metabolic Diseases
Nephrology
Prevalence
Primary Care Medicine
Renal Insufficiency, Chronic - complications
Renal Insufficiency, Chronic - physiopathology
Resistant Hypertension (E Pimenta
Section Editor
Topical Collection on Resistant Hypertension
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Summary:Treatment-resistant hypertension is an increasingly recognised problem and is markedly over-represented in patients with chronic kidney disease (CKD). Recent evidence has clarified the heightened risk for both adverse renal and cardiovascular outcomes associated with resistant hypertension, even when blood pressure control is attained. The diagnosis of resistant hypertension in CKD is reliant on accurate blood pressure measurement, and out of office measurements are important due to the high prevalence of masked hypertension in these patients. Treatment strategies include careful dietary measures to restrict sodium intake, and a focus on improving adherence to antihypertensive medications. Medication choices should focus on a sensible foundation and then diuretic titration to combat the salt and volume retention inherent in CKD. In this review, we discuss the epidemiology, pathogenesis and consequences of resistant hypertension in CKD, and then review the optimal diagnostic and management strategies.
ISSN:1522-6417
1534-3111
DOI:10.1007/s11906-016-0641-x