Key result
Long-term standard stepped-care therapy for primary hypertension did not fully protect kidney function, with 17.5% of patients developing overt proteinuria over 9 years.
Why the study?
Does adequate control of blood pressure with standard stepped-care therapy prevent overt proteinuria in patients with primary hypertension?
Cohort (n=120)
Does adequate control of blood pressure with standard stepped-care therapy prevent overt proteinuria in patients with primary hypertension?
Long-term adequate blood pressure control does not fully protect against the development of overt proteinuria in primary hypertension, and elevated baseline uric acid may predict this poor renal outcome.
Answers are grounded in this paper and cite their sources.
Standard BP control may not fully prevent proteinuria; hypothesis-generating for uric acid prediction and alternative renoprotective strategies.
We analyzed the clinical course of 120 patients who were diagnosed as having primary hypertension and subsequently given standard stepped-care therapy (diuretic, beta-blocker and vasodilator) for 9 years. At the end of the follow-up period, 21 patients (17.5%) had developed overt proteinuria. The initial study showed no difference in systolic blood pressure, age, sex, serum creatinine and its clearance, glucose, cholesterol and triglycerides between these patients and those who had not become proteinuric, but uric acid levels and diastolic blood pressure were higher (both P less than 0.01). An adequate control of blood pressure was obtained and maintained in all patients, who had similar therapeutic needs. During the follow-up period, uric acid levels remained significantly elevated (P less than 0.01) in the proteinuric patients, while changes in serum glucose, cholesterol and triglycerides were similar in all patients. These results indicate that long-term treatment of primary hypertensives does not fully protect kidney function and that initially elevated uric acid levels could be a predictor of a poor prognosis.
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Ruilope et al. (1990) conducted a cohort in Primary hypertension (n=120). Standard stepped-care therapy (diuretic, beta-blocker and vasodilator) was evaluated on Development of overt proteinuria. Long-term standard stepped-care therapy for primary hypertension did not fully protect kidney function, with 17.5% of patients developing overt proteinuria over 9 years.
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