Why the study?
End-stage renal disease attributed to hypertension has increased annually and untreated hypertension at all levels is associated with declining renal function, necessitating evaluation of antihypertensive treatment effects.
Does antihypertensive treatment to specific blood pressure targets prevent progressive renal failure and end-stage renal disease in patients with hypertension?
Does antihypertensive treatment to specific blood pressure targets prevent progressive renal failure and end-stage renal disease in patients with hypertension?
This working group report recommends strict blood pressure control (<140/90 mm Hg generally, ≤130/85 mm Hg in renal impairment) to prevent progression to end-stage renal disease.
Supports stricter BP targets to prevent ESRD; reinforces guideline-directed hypertension management.
End-stage renal disease attributed to hypertension has increased annually for the last decade and will probably worsen through the year 2000. Patients with diabetic nephropathy and patients with hypertensive renal disease account for most new cases annually. Evidence reveals that all levels of untreated hypertension are associated with potentially declining renal function. Data from the Hypertension Detection and Follow-up Program and other studies show that antihypertensive treatment can prevent progressive renal failure. An ablation model demonstrates glomerular hyperfiltration as a possible mechanism for progressive renal failure. Human data on the renal effects of antihypertensive agents are limited and inconsistent. Despite the limitations, the Working Group on Hypertension and Chronic Renal Failure concludes that controlled hypertension to less than 140/90 mm Hg reduces the incidence of end-stage renal disease. Patients with established renal impairment may benefit from individualized treatment to 130/85 mm Hg or less.
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A 1991 study conducted a review in Hypertension and Chronic Renal Failure. Antihypertensive treatment (blood pressure control <140/90 mm Hg) vs. Untreated hypertension was evaluated on Incidence of end-stage renal disease. Controlling hypertension to less than 140/90 mm Hg reduces the incidence of end-stage renal disease, while patients with established renal impairment may benefit from targets of 130/85 mm Hg or less.
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