The African American Study of Kidney Disease: do these results indicate that 140/90 mm hg is good enough?

Abstract:

:Current national guidelines recommend aggressive lowering of blood pressure (< 130/80 mm Hg) in patients with chronic kidney disease (CKD). In this paper, we summarize recent clinical trial data evaluating the effect of lower blood pressure goals on renal outcomes. The epidemiologic data relating blood pressure to progression of kidney disease, the Modification of Diet in Renal Disease (MDRD) study (in patients with > 1 g proteinuria/d), and meta-analyses of angiotensin-converting enzyme (ACE) inhibitor clinical trials all support lower blood pressure goals in CKD patients, particularly those with proteinuria. The African American Study of Kidney Disease and Hypertension (AASK) supports lower blood pressure goals in terms of reduction of proteinuria, but demonstrates no additional benefit for clinical renal outcomes. Similarly, the second Ramipril Efficacy in Nephropathy study (REIN-2) shows that in patients with proteinuric nondiabetic renal disease who are receiving ACE inhibitors, a lower than usual blood pressure goal does not improve renal outcomes. However, there are limited clinical trial data evaluating the effects of low blood pressure on the increased cardiovascular risk seen in patients with CKD. Pending further clinical studies, current recommendations to target tight blood pressure control (< 130/80 mm Hg) in patients with CKD appear reasonable.

journal_name

Curr Hypertens Rep

authors

Rahman M,El-Meanawy A,Romanello J

doi

10.1007/s11906-005-0072-6

keywords:

subject

Has Abstract

pub_date

2005-10-01 00:00:00

pages

363-6

issue

5

eissn

1522-6417

issn

1534-3111

journal_volume

7

pub_type

杂志文章,评审
  • Hypertension in the Emergency Department.

    abstract::Hypertension is the leading risk factor for the global burden of disease, yet more than 20% of adults with hypertension are unaware of their condition. Underlying hypertension affects over 25% emergency department attendees, and the condition is more commonly encountered in emergency departments than in primary care s...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-016-0647-4

    authors: Chan SS,Graham CA,Rainer TH

    更新日期:2016-04-01 00:00:00

  • Impact of the 2017 American College of Cardiology/American Heart Association Blood Pressure Guidelines on the Next Blood Pressure Guidelines in Asia.

    abstract:PURPOSE OF REVIEW:To estimate the impact of the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines for high blood pressure (BP) on the next hypertension guidelines in Asia. RECENT FINDINGS:The 2017 ACC/AHA guidelines for high BP in adults changed the diagnostic threshold and the manage...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-019-0906-2

    authors: Nakagawa N,Hasebe N

    更新日期:2019-01-10 00:00:00

  • Angiotensin-receptor blocking agents and the peroxisome proliferator-activated receptor-gamma system.

    abstract::The metabolic syndrome leads to cardiovascular disease and type 2 diabetes mellitus, through multiple risks, such as insulin resistance, dyslipidemia, hyperinsulinemia, and hypertension. It also represents a disorder of partial genetic background as mutations of the peroxisome proliferator-activated receptor-gamma (PP...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-005-0019-y

    authors: Tuck ML

    更新日期:2005-08-01 00:00:00

  • Anti-Inflammatory Effects of Melatonin in Obesity and Hypertension.

    abstract:PURPOSE OF REVIEW:Here, we review the known relations between hypertension and obesity to inflammation and postulate the endogenous protective effect of melatonin and its potential as a therapeutic agent. We will describe the multiple effects of melatonin on blood pressure, adiposity, body weight, and focus on mitochon...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-018-0842-6

    authors: Prado NJ,Ferder L,Manucha W,Diez ER

    更新日期:2018-05-09 00:00:00

  • AT(2) receptor and tissue injury: therapeutic implications.

    abstract::The renin-angiotensin system (RAS) plays an important role in the initiation and progression of tissue injuries in the cardiovascular and nervous systems. The detrimental actions of the AT1 receptor (AT1R) in hypertension and vascular injury, myocardial infarction and brain ischemia are well established. In the past t...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-013-0416-6

    authors: Namsolleck P,Recarti C,Foulquier S,Steckelings UM,Unger T

    更新日期:2014-02-01 00:00:00

  • Using health information technology to improve hypertension management.

    abstract::High-quality medical care requires implementing evidence-based best practices, with continued monitoring to improve performance. Implementation science is beginning to identify approaches to developing, implementing, and evaluating quality improvement strategies across health care systems that lead to good outcomes fo...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-008-0038-6

    authors: Goldstein MK

    更新日期:2008-06-01 00:00:00

  • Statins and blood pressure regulation.

    abstract::Hypertension and high serum cholesterol levels are two of the most relevant risk factors for cardiovascular diseases. A combined increase in both risk factors has been reported in a significant proportion of patients with coronary artery disease. Statins are the most widely used drugs to treat hypercholesterolemia, an...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-001-0090-y

    authors: Borghi C,Veronesi M,Prandin MG,Dormi A,Ambrosioni E

    更新日期:2001-08-01 00:00:00

  • Resistant hypertension and the Birmingham Hypertension Square.

    abstract::Recent guidelines for the treatment of hypertension place great emphasis on tighter blood pressure control, especially in the presence of hypertensive target organ damage and diabetes. In order to achieve these treatment targets, more patients will require a combination of antihypertensive medications. However, resist...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-001-0039-1

    authors: Felmeden DC,Lip GY

    更新日期:2001-06-01 00:00:00

  • Integrative Physiological Aspects of Brain RAS in Hypertension.

    abstract:PURPOSE OF REVIEW:The renin-angiotensin system (RAS) plays an important role in modulating cardiovascular function and fluid homeostasis. While the systemic actions of the RAS are widely accepted, the role of the RAS in the brain, its regulation of cardiovascular function, and sympathetic outflow remain controversial. ...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-018-0810-1

    authors: de Morais SDB,Shanks J,Zucker IH

    更新日期:2018-02-26 00:00:00

  • Drug-Induced Hypertension: Focus on Mechanisms and Management.

    abstract:PURPOSE OF REVIEW:This review is intended to briefly describe the primary mechanistic pathways by which several common drugs can increase blood pressure. We also propose potential management strategies based on the underlying mechanisms responsible for the blood pressure elevation. RECENT FINDINGS:As hypertension is a...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-017-0736-z

    authors: Lovell AR,Ernst ME

    更新日期:2017-05-01 00:00:00

  • Hypertension after renal transplantation.

    abstract::With current immunosuppression, elevated blood pressure is found in almost 90% of renal graft recipients. Major causes of this are impairment of renal function (secondary to chronic allograft nephropathy or less frequently recurrence of primary renal disease), the use of calcineurin inhibitors as immunosuppressants, u...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-001-0063-1

    authors: Schwenger V,Zeier M,Ritz E

    更新日期:2001-10-01 00:00:00

  • The sympathetic nervous system in hypertension: back to the future?

    abstract::The seventeenth century London neuroanatomical school headed by Thomas Willis published the first images of the sympathetic nervous system. Nineteenth century European physiologists characterised these as the "pressor nerves". Von Euler's demonstration that the sympathetic transmitter was norepinephrine brought the fi...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-014-0519-8

    authors: Esler M

    更新日期:2015-02-01 00:00:00

  • Sodium intake and blood pressure in children.

    abstract::Elevation of blood pressure (BP) and the risk for progression to hypertension (HTN) is of increasing concern in children and adolescents. Indeed, it is increasingly recognized that target organ injury may begin with even low levels of BP elevation. Sodium intake has long been recognized as a modifiable risk factor for...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-013-0382-z

    authors: Hanevold CD

    更新日期:2013-10-01 00:00:00

  • Renin inhibitors: optimal strategy for renal protection.

    abstract::Diabetic nephropathy and hypertension are the major causes of chronic kidney disease. The renin system plays a key role in the control of blood pressure (BP), as well as in the regulation of renal and adrenal function. Chronic activation of the renin system can lead to organ damage, particularly renal damage; increasi...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-007-0076-5

    authors: Schmieder RE

    更新日期:2007-11-01 00:00:00

  • Inflammation as a Regulator of the Renin-Angiotensin System and Blood Pressure.

    abstract:PURPOSE OF REVIEW:Mechanisms facilitating progression of hypertension via cross stimulation of the renin-angiotensin system (RAS) and inflammation have been proposed. Accordingly, we review and update evidence for regulation of RAS components by pro-inflammatory factors. RECENT FINDINGS:Angiotensin II (Ang II), which ...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-018-0900-0

    authors: Satou R,Penrose H,Navar LG

    更新日期:2018-10-05 00:00:00

  • Angiotensin-converting enzyme 2: possible role in hypertension and kidney disease.

    abstract::The discovery of angiotensin-converting enzyme (ACE) 2 adds a new level of complexity to the understanding of the renin-angiotensin system. The high catalytic efficiency of ACE2 for the generation of angiotensin (ANG)-1-7 from ANG II suggests an important role of ACE2 in preventing ANG II accumulation, while at the sa...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-008-0014-1

    authors: Wysocki J,González-Pacheco FR,Batlle D

    更新日期:2008-02-01 00:00:00

  • Modulation of pressure-natriuresis by renal medullary reactive oxygen species and nitric oxide.

    abstract::The renal pressure-natriuresis mechanism is the dominant controller of body fluid balance and long-term arterial pressure. In recent years, it has become clear that the balance of reactive oxygen and nitrogen species within the renal medullary region is a key determinant of the set point of the renal pressure-natriure...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-010-0094-6

    authors: O'Connor PM,Cowley AW Jr

    更新日期:2010-04-01 00:00:00

  • Prevalence and diagnosis of primary aldosteronism.

    abstract::Primary aldosteronism (PA) is a common cause of arterial hypertension: in the PA Prevalence in Hypertensives (PAPY) Study, the prevalence of PA was 11.2% in consecutive referred hypertensive patients. When adrenal vein sampling (AVS) is available, two thirds of the cases can be attributed to a tumor and one third of c...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-010-0134-2

    authors: Rossi GP

    更新日期:2010-10-01 00:00:00

  • Role of Paced Breathing for Treatment of Hypertension.

    abstract:PURPOSE OF REVIEW:Hypertension remains to be a major contributor to global morbidity and mortality. Despite a plethora of pharmacological options available, an abundance of patients have uncontrolled blood pressure thus creating the need for additional strategies, including non-pharmacologic approaches. In this review,...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-017-0742-1

    authors: Cernes R,Zimlichman R

    更新日期:2017-06-01 00:00:00

  • Pathophysiology of obesity hypertension.

    abstract::Excess weight gain is a major cause of essential hypertension, and abnormal kidney function appears to be a cause as well as a consequence of obesity hypertension. Excess renal sodium reabsorption and a hypertensive shift of pressure natriuresis play a major role in mediating increased blood pressure associated with w...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-000-0073-4

    authors: Hall JE

    更新日期:2000-04-01 00:00:00

  • The role of the sympathetic nervous system in obesity-related hypertension.

    abstract::Obesity is recognized as a major health problem throughout the world. Excess weight is a major cause of increased blood pressure in most patients with essential hypertension and greatly increases the risk for diabetes, cardiovascular diseases, and end-stage renal disease. Although the mechanisms by which obesity raise...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-009-0036-3

    authors: da Silva AA,do Carmo J,Dubinion J,Hall JE

    更新日期:2009-06-01 00:00:00

  • Mechanisms and consequences of inflammatory signaling in the myocardium.

    abstract::To further understand chronic heart disease, such as heart failure and cardiomyopathy, we must fully define signaling pathways within the myocardium. Recent studies suggest that some forms of heart disease are associated with a chronic low-grade inflammation that promotes adverse ventricular remodeling and correlates ...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-012-0309-0

    authors: Ahn J,Kim J

    更新日期:2012-12-01 00:00:00

  • Immune mechanisms in hypertension.

    abstract::Inflammation plays an important role in the pathogenesis of hypertension. Innate and adaptive immune response may contribute to this process. The mechanisms implicating immune response in hypertension are still elusive. To date, the evidence originates in three major areas of data: cytokine production, central nervous...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-011-0224-9

    authors: Leibowitz A,Schiffrin EL

    更新日期:2011-12-01 00:00:00

  • Angiotensin II and progressive renal insufficiency.

    abstract::The inhibition of angiotensin II through angiotensin converting enzyme inhibitors or angiotensin receptor blockers has become the foundation of medical treatment of progressive chronic renal disease. Although these drugs provide a significant improvement over earlier treatments, they only slow the progression of renal...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-002-0071-9

    authors: Gaedeke J,Noble NA,Border WA

    更新日期:2002-10-01 00:00:00

  • Comparison Between Automated Office Blood Pressure Measurements and Manual Office Blood Pressure Measurements-Implications in Individual Patients: a Systematic Review and Meta-analysis.

    abstract:PURPOSE OF REVIEW:Automated office blood pressure (AOBP) measurements may provide more accurate estimation of blood pressure (BP) than manual office blood pressure (MOBP) measurements. This systematic review investigated the diagnostic performance of AOBP and MOBP using ambulatory blood pressure measurement (ABPM) as r...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-020-01118-1

    authors: Bo Y,Kwok KO,Chu KK,Leung EY,Yu CP,Wong SY,Lee EK

    更新日期:2021-01-15 00:00:00

  • Antihypertensive treatment and new-onset diabetes mellitus.

    abstract::The various antihypertensive regimens have varying effects on glucose metabolism and the development of diabetes mellitus. Recent large hypertension trials have shown great differences in the development of new-onset diabetes among antihypertensive drug therapies. The incidence of diabetes is unchanged or increased by...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-005-0029-9

    authors: Aksnes TA,Reims HM,Kjeldsen SE,Mancia G

    更新日期:2005-08-01 00:00:00

  • Glutathione-S-transferase M1 and T1 null genotypes are associated with hypertension risk: a systematic review and meta-analysis of 12 studies.

    abstract::Oxidative stress is known to be implicated in the pathogenesis of essential hypertension. Glutathione-S-transferase (GST) enzymes are key components of cellular defense against oxidative stress. The present study aimed to clarify the association between polymorphisms in GST and risk of essential hypertension using a m...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,meta分析,评审

    doi:10.1007/s11906-014-0432-1

    authors: Eslami S,Sahebkar A

    更新日期:2014-06-01 00:00:00

  • Neuroprotective mechanisms of the ACE2-angiotensin-(1-7)-Mas axis in stroke.

    abstract::The discovery of beneficial neuroprotective effects of the angiotensin converting enzyme 2-angiotensin-(1-7)-Mas axis [ACE2-Ang-(1-7)-Mas] in ischemic and hemorrhagic stroke has spurred interest in a more complete characterization of its mechanisms of action. Here, we summarize findings that describe the protective ro...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-014-0512-2

    authors: Bennion DM,Haltigan E,Regenhardt RW,Steckelings UM,Sumners C

    更新日期:2015-02-01 00:00:00

  • The salt paradox and its possible implications in managing hypertensive diabetic patients.

    abstract::Diabetes mellitus is one of the leading causes of end-stage renal disease. The pathogenesis of diabetic nephropathy is still poorly understood, but glomerular injury has been ascribed, at least in part, to glomerular hyperfiltration, which occurs early in the course of diabetes mellitus. Therefore, a better understand...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-005-0089-x

    authors: Vallon V,Blantz R,Thomson S

    更新日期:2005-04-01 00:00:00

  • Pathophysiology of hypertension in the absence of nitric oxide/cyclic GMP signaling.

    abstract::The nitric oxide (NO)-cyclic guanosine monophosphate (cGMP) signaling system is a well-characterized modulator of cardiovascular function, in general, and blood pressure, in particular. The availability of mice mutant for key enzymes in the NO-cGMP signaling system facilitated the identification of interactions with o...

    journal_title:Current hypertension reports

    pub_type: 杂志文章

    doi:10.1007/s11906-012-0320-5

    authors: Thoonen R,Sips PY,Bloch KD,Buys ES

    更新日期:2013-02-01 00:00:00