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HYPERTENSION IN HEMODIALYSIS PATIENTS: Cardiac Consequences of Hypertension in Hemodialysis Patients
Author(s) -
Zoccali Carmine,
Benedetto Francesco Antonio,
Tripepi Giovanni,
Mallamaci Francesca
Publication year - 2004
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/j.0894-0959.2004.17331.x
Subject(s) - medicine , cardiology , left ventricular hypertrophy , heart failure , atrial fibrillation , coronary artery disease , dialysis , hemodialysis , kidney disease , end stage renal disease , population , sudden cardiac death , blood pressure , environmental health
Hypertension in end‐stage renal disease (ESRD) is an important risk factor for left ventricular hypertrophy (LVH), cardiac failure, coronary artery disease (CAD), and arrhythmia. LVH is generally considered an integrator of the long‐term effects of hypertension and other cardiovascular (CV) risk factors and represents the strongest predictor of adverse CV outcomes in ESRD patients. The risk of heart failure is higher in patients with a history of hypertensive renal disease than in those with other diagnoses. Both coronary heart disease (CHD) and LVH predict congestive heart failure, which is often the ultimate cause of death in patients with cardiac ischemia or LVH. A history of long‐standing hypertension is associated with ischemic heart disease both in cross‐sectional and prospective studies in ESRD. Atrial fibrillation and ventricular arrhythmias are highly prevalent in dialysis patients and are implicated in mortality and sudden death in this population. Despite the lack of evidence from randomized controlled trials, it appears reasonable that interventions aimed at curbing the high CV mortality of ESRD should be targeted to both hypertension and LVH.