Nephrol Dial Transplant (1999) 14: 2075-2077
© 1999 European Renal Association-European Dialysis and Transplant Association
Editorial Comments
How good are nephrologists at controlling blood pressure in renal patients?
Division of Nephrology, University Hospital, Verona, Italy
Correspondence and offprint requests to: Giuseppe Maschio, MD, Divisione Nefrologia, Ospedale Civile Maggiore, I-37126 Verona, Italy.
`It is easier to split an atom than a prejudice' (A. Einstein)
High blood pressure (BP) levels are unequivocally associated with increased risks of major cardiovascular events and stroke [1]. Significant progress in the control of hypertension over the years has also led to a true explosion of morbidity and mortality trials in hypertensive patients [2]. These studies have shown a significant reduction in the incidence of cardiovascular and cerebrovascular events. This has been obtained, almost without exception, with combinations of antihypertensive agents.
Despite the impressive results of the trials, most investigators document, even today, that BP continues to be poorly controlled in too many hypertensive patients [3,4]. This is not a new problem and the failure to control BP in many treated patients was observed several years ago (Table 1
). It has been repeatedly confirmed that approximately 20–40% of patients fail to achieve
Is the lack of aggressiveness in the pharmacologic treatment of patients with essential hypertension also seen in those with renal disease?
Error 1: hypertension does not cause progressive renal disease
Error 2: strict blood pressure control results in underperfusion of vital organs including the kidney
References
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