Hypertension Management in Chronic Kidney Disease: ACEIs/ARBs and Practical Issues (original) (raw)

In patients with CKD, hypertension is a common comorbid condition that increases the risk of progression of CKD and the risk of cardiovascular complications. Reduction of BP to less than 140/90 mmHg, slowing the progression of kidney disease and reducing cardiovascular disease (CVD) risk are goals of antihypertensive therapy. However, this BP goal is not attained by the majority of CKD patients. Stringent control of hypertension using a RAAS inhibitorbased treatment regimen is an evidence-based approach to slow the progression of CKD and reduce CVD risk. Most CKD patients require multiple antihypertensive drugs to reduce BP to target level. Clinical evidence indicates that initial fixed-dose RAAS inhibitor-based combination therapy is more effective and more efficient than stepped-care therapy or sequential monotherapy for lowering BP to target levels and reduces the risk of adverse events.