Open AccessAntihypertensive treatment and renal protection: Is there a J‐curve relationship?
Author(s) -
Viazzi Francesca,
Leoncini Giovanna,
Grassi Guido,
Pontremoli Roberto
Publication year - 2018
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.13396
Subject(s) - medicine , renal function , proteinuria , blood pressure , kidney disease , cohort , disease , kidney , cardiology , risk factor , urology , intensive care medicine
A bidirectional relationship between hypertension and kidney disease, with one exacerbating the effect of the other, is well established. Elevated blood pressure (BP) is a well‐recognized, modifiable risk factor for cardiovascular (CV) disease as well as for development and progression of chronic kidney disease and, therefore, the identification of optimal BP target is a key issue in the management of renal patients. Recent large trials and real life cohort studies have indicated that below a definite BP value renal protection seems to plateau and too low levels may even be associated with a paradoxical increase in renal morbidity, thus reviving the debate about the so called BP ‐renal function J‐curve relationship. Existing evidence supports a systolic target around 130 mm Hg to combine both renal and CV protection and possibly lower levels in the presence of overt proteinuria.