Renal Participation in Cardiovascular Risk in Essential Hypertension

The possibility that the kidney plays a relevant role in the origin of essential hypertension in humans has been amply debated 1–3. However, it has also been shown that the kidney suffers the consequences of sustained elevated blood pressure in the absence of therapy 4. Nephrosclerosis together with diabetic nephropathy are the most common causes of end-stage renal disease 5. A review of the literature published in the last decade transmits the picture that, with an "adequate" blood pressure control with standard antihypertensive therapy, the kidney is well protected and very few patients will suffer the consequences of blood pressure increments 6, 7. The aim of this short review is to present the evidence supporting the existence of mild renal insufficiency in hypertensive patients, but also to show the association of this disorder with a very significant increment in global cardiovascular risk.