The 2018 ESC/ESH hypertension guidelines: Should nephrologists always stop at the lower boundary?

Journal of Nephrology
Gianpaolo ReboldiPaolo Verdecchia

Abstract

In patients with chronic kidney disease (CKD), hypertension is a major challenge because of its high prevalence, the consequent increase in cardiovascular morbidity and mortality, and the risk it confers specifically to the progression of kidney disease. Hence, establishing evidence-based blood pressure targets and treatment strategies is a clinical priority of paramount importance. Over the last few years, different guidelines have advocated different blood pressure treatment thresholds and goals in CKD patients, including a target < 140/90 mmHg and a more intensive target-lower than 130/80 mmHg-in the presence of albuminuria ≥ 300 mg/daily. Aim of this article is to critically appraise the evidence base of the freshly released 2018 ESC/ESH European Guidelines, which recommend to lower systolic BP to a range 130 to < 140 mmHg in patients with diabetic or non-diabetic CKD, also in view of the 2017 US guidelines, which favor a more intensive strategy with a BP target lower than 130/80 mmHg.

References

Jun 3, 2005·Journal of the American Society of Nephrology : JASN·Tomas BerlUNKNOWN Collaborative Study Group
Dec 18, 2007·Journal of Clinical Epidemiology·Jørn WetterslevChristian Gluud
Apr 3, 2009·Clinical Journal of the American Society of Nephrology : CJASN·Rajiv Agarwal
Mar 17, 2010·The New England Journal of Medicine·William C CushmanFaramarz Ismail-Beigi
Aug 16, 2011·Kidney International·Keng T Woo, Choong M Chan
Jun 27, 2013·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Jicheng LvVlado Perkovic
Aug 12, 2014·Journal of the American College of Cardiology·John J SimSteven J Jacobsen
Apr 6, 2017·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Pavel S RoshanovMichael Walsh
Jun 24, 2017·Journal of the American Society of Nephrology : JASN·Alfred K CheungUNKNOWN SPRINT Research Group
Apr 25, 2018·The Lancet. Diabetes & Endocrinology·Giuseppe Mancia
Jun 15, 2018·Nature Reviews. Nephrology·Maria Luisa S Sequeira-Lopez, R Ariel Gomez
Jul 29, 2018·The Lancet. Diabetes & Endocrinology·João Sérgio NevesMiguel Bigotte Vieira
Aug 31, 2018·European Heart Journal·Bryan WilliamsUNKNOWN ESC Scientific Document Group

❮ Previous
Next ❯

Citations

Jan 24, 2019·Journal of Nephrology·Roberto MinutoloUNKNOWN Collaborative Study Group on the Conservative Treatment of CKD of the Italian Society of Nephrology
Jun 26, 2020·Expert Opinion on Pharmacotherapy·Fabio AngeliGianpaolo Reboldi
Apr 30, 2019·Heart Asia·Fabio AngeliPaolo Verdecchia
May 31, 2019·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Anna PisanoCarmine Zoccali
Mar 7, 2020·Journal of Hypertension·Fabio AngeliPaolo Verdecchia
Mar 26, 2021·Journal of Nephrology·Arnaud DelezireCécile Vigneau
Nov 7, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Lorenzo SignoriniGiovanni Gambaro

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.