Nephrol Dial Transplant (2001) 16: 475-478
© 2001 European Renal Association-European Dialysis and Transplant Association
Controversy
Controversy on optimal blood pressure on haemodialysis: lower is not always better
Manhes Hospital, Fleury-Mérogis, France
Blood pressure as a risk factor in the general population
In Western population the relationship between blood pressure (BP) levels and cardiovascular disease (CVD) is a continuous function. The evidence for this ‘linear’ relationship derives from prospective observational studies of the incidence of stroke and coronary heart disease and from the results of randomized trials on the effect of antihypertensive therapy [1–4]. Systolic (SBP) and diastolic BP (DBP) have been shown to be positively and continuously related to the risk of stroke across a wide range of BP values. No lower threshold of BP could be identified below which the risk of stroke did not continue to decline [5,6]. A meta-analysis of placebo-controlled, randomized trials of hypertensive subjects showed a 43% reduction in the incidence of stroke with pharmacological treatment [4]. Most studies found that the lowest treated DBPs, ranging from below 80 to below 85 mmHg, were associated with
Blood pressure as a risk factor in HD patients
Mechanisms responsible for BP characteristics in the general population
Blood pressure characteristics in patients in haemodialysis
Which therapeutic approach?
Notes
References
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