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Optimal blood pressure target and measurement in patients with chronic kidney disease.
- Source :
-
The Korean journal of internal medicine [Korean J Intern Med] 2019 Nov; Vol. 34 (6), pp. 1181-1187. Date of Electronic Publication: 2019 Jun 17. - Publication Year :
- 2019
-
Abstract
- The prevalence rates of hypertension and chronic kidney disease (CKD) are increasing with the aging of the population. Hypertension and CKD are closely related, and hypertension with accompanying CKD is difficult to control. This difficulty controlling blood pressure (BP) can be explained by changes in diurnal variation in BP, such as non-dipping and reverse dipping patterns, increased pulse pressure, and BP variability in CKD patients resulting in a high frequency of nocturnal hypertension or masked hypertension. CKD patients with uncontrolled or nocturnal hypertension are at increased risk for cardiovascular disease, progression of CKD, and all-cause death. Recent studies have shown that intensive reduction of systolic BP below 120 mmHg is seems to favor in CKD patients regardless of the presence or absence of diabetes. As BP control is difficult in patients with CKD, appropriate measurement of BP is important. Automated BP monitoring could reduce the so-called "white coat effect" (spike in BP) that may be triggered by measurement in a clinical setting. Moreover, out-of-office BP monitoring at home or ambulatory BP monitoring for 24 hours may provide critical information regarding diurnal BP variability and nocturnal BP in patients with CKD.
- Subjects :
- Antihypertensive Agents therapeutic use
Blood Pressure Determination
Circadian Rhythm
Humans
Hypertension diagnosis
Hypertension drug therapy
Hypertension epidemiology
Predictive Value of Tests
Renal Insufficiency, Chronic diagnosis
Renal Insufficiency, Chronic epidemiology
Renal Insufficiency, Chronic therapy
Risk Factors
Time Factors
Treatment Outcome
Blood Pressure drug effects
Hypertension physiopathology
Renal Insufficiency, Chronic physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 2005-6648
- Volume :
- 34
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Korean journal of internal medicine
- Publication Type :
- Academic Journal
- Accession number :
- 31189302
- Full Text :
- https://doi.org/10.3904/kjim.2019.164