Titre du document / Document title

Preserving renal function in adults with Hypertension and diabetes : A consensus approach

Auteur(s) / Author(s)

National Kidney Foundation Hypertension and Diabetes Executive Committee Working Group, ETATS-UNIS
BAKRIS G. L. ; WILLIAMS M. ; DWORKIN L. ; ELLIOTT W. J. ; EPSTEIN M. ; TOTO R. ; TUTTLE K. ; DOUGLAS J. ; HSUEH W. ; SOWERS J. ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

National Kidney Foundation Hypertension and Diabetes Executive Committees Working Group, ETATS-UNIS

Résumé / Abstract

○ Over 11 million Americans have both diabetes and hypertension-comorbid diseases that strongly predispose people to both renal as well as cardiovascular (CV) injury. Hypertension substantially contributes to CV morbidity and mortality in people with diabetes. Diabetes is the most common cause of end-stage renal disease in the United States. Furthermore, hypertension and diabetes are particularly prevalent in certain populations, such as African-Americans and Native Americans. Since the 1994 Working Group Report on Hypertension and Diabetes, a large body of clinical trial data has affirmed the original blood pressure goal of less than 130/85 mmHg recommended to preserve renal function and reduce CV events in people with hypertension and diabetes. Data that are more recent have emerged, however, to support an even lower diastolic blood pressure goal, ie, 80 mmHg, in order to optimally preserve renal function and reduce CV events in people with diabetic nephropathy. A review of clinical trials indicates that more than 65% of people with diabetes and hypertension will require two or more different antihypertensive medications to achieve the new suggested target blood pressure of 130/80 mmHg. The purpose of this report Is to update the previous recommendations with a focus on level of blood pressure control, proteinuria reduction, and therapeutic approaches to achieve these goals. We provide an evidence-based approach, integrating data from the major clinical trials that were designed as randomized prospective, long-term studies that had as a primary endpoint either progression of diabetic nephropathy or reduction in CV events. This report also addresses socioeconomic and cultural barriers that hinder achievement of blood pressure goals. Lastly, the report discusses approaches to resolve cultural barriers, both physician- and patient-derived, that interfere with achievement of lower blood pressure goals.

Revue / Journal Title

American journal of kidney diseases   ISSN 0272-6386 

Source / Source

2000, vol. 36, n^o3, pp. 646-661 (97 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, Orlando, FL, ETATS-UNIS  (1981) (Revue)

Mots-clés anglais / English Keywords

Diabetes mellitus ; Association ; Hypertension ; Preservation ; Renal function ; Review ; Human ; Endocrinopathy ; Cardiovascular disease ;

Mots-clés français / French Keywords

Diabète ; Association ; Hypertension artérielle ; Préservation ; Fonction rénale ; Article synthèse ; Homme ; Endocrinopathie ; Appareil circulatoire pathologie ;

Mots-clés espagnols / Spanish Keywords

Diabetes ; Asociación ; Hipertensión arterial ; Preservación ; Función renal ; Artículo síntesis ; Hombre ; Endocrinopatía ; Aparato circulatorio patología ;

Localisation / Location

INIST-CNRS, Cote INIST : 19098, 35400009130387.0260