Current Controversies over the Management of Elderly Hypertension with Impaired Renal Function.
10.5646/jksh.2011.17.4.148
- Author:
Moon Jae KIM
1
Author Information
1. Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea. nhkimj@inha.ac.kr
- Publication Type:Review
- Keywords:
Elderly hypertension;
Chronic kidney disease;
Blood pressure target
- MeSH:
Aged;
Aging;
Antihypertensive Agents;
Blood Pressure;
Cardiovascular Diseases;
Comorbidity;
Glomerular Filtration Rate;
Hospitalization;
Humans;
Hypertension;
Kidney;
Renal Insufficiency, Chronic;
Risk Factors
- From:Journal of the Korean Society of Hypertension
2011;17(4):148-155
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Both hypertension and aging impact renal function. Elderly patients are more likely to have chronic kidney disease (CKD), usually defined by estimated glomerular filtration rate 60 mL/min/1.73 m2. Multiple studies over the past two decades have shown that CKD is a powerful cardiovascular disease (CVD) risk factor. Reduced kidney function in elderly people is a marker for adverse outcomes. The major goals of lowering blood pressure (BP) in patients with CKD include reduction of mortality, CVD events and slowing progression. Main considerations in the management of hypertension include selection of a target BP and selection of agents used to attain the chosen target. Current clinical practice guidelines for BP targets and choice of anti-hypertensive agents in elderly patients with CKD are not specific. Older patients with CKD might experience increased mortality and hospitalizations in association with lower baseline BP values. This review outlines controversies in applying current guidelines for the management of BP to older patients with CKD. Because of the high burden of other comorbidities in older patients with CKD, strict adherence to guidelines for the management of hypertension may not always represent the most adequate approach.
