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NDT Advance Access originally published online on December 29, 2005
Nephrology Dialysis Transplantation 2006 21(4):843-845; doi:10.1093/ndt/gfk025
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Editorial Comment

Blood pressure lowering or selection of antihypertensive agent: which is more important?

Luis M. Ruilope and Julian Segura

Hypertension Unit, Hospital 12 de Octubre, Madrid, Spain

Correspondence and offprint requests to: Dr Luis M. Ruilope, Hypertension Unit, Hospital 12 de Octubre, Av. Córdoba, s/n, 28041 Madrid, Spain. Email: ruilope@ad-hocbox.com

Keywords: Blood pressure; antihypertensive therapy; cardiovascular risk; renal insufficiency

The first 10% of the full text of this article appears below.

The relationship between an elevated blood pressure (BP) and cardiovascular (CV) and renal damage has been clearly established. It has remained a matter of debate, however, whether effects beyond BP control force the clinician to prefer certain class(es) of antihypertensive drug(s) beyond what nowadays are considered compelling indications for antihypertensive therapy.



   The ALLHAT study
 
After the publication of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) [1], those defending the idea that only BP control matters have argued that diuretics are the first-choice drugs and this stance has been supported by the Joint National Committee-7, in the absence of real arguments according to the definition of evidence-based medicine [2]. Among the many flaws in the ALLHAT study, we simply point out that probably two-thirds of the patients were on a diuretic before entering the trial; they were then selected as responders to this type of . . . [Full Text of this Article]



   The LIFE and ASCOT trials
 


   Renoprotection
 


   The evidence
 


   Conclusion
 

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