Inadequate blood pressure control in vast majority of kidney allograft recipients and patients with coronary artery disease with and without comorbidities
J Malyszko, J Malyszko, H Bachorzewska-Gajewska, B Poniatowski, S Dobrzycki, M Mysliwiec
Ann Transplant 2009; 14(1): 49-49
Target blood pressure according to ESH/ESC guidelines should be lower
than 140/90 mm Hg in general population, while in patients with chronic
kidney disease-CKD or diabetes lower than 130/80 mm Hg. Hypertension is widely accepted risk factor for coronary artery disease, chronic heart failure or CKD. In kidney transplant recipient-Tx, prevalence of hypertension is 60-80%. The aim of the study was to assess the prevalence of achieved target blood pressure in 525 patients with coronary artery disease-CAD and 150 prevalent Tx. In CAD population 30% had diabetes and 33% had CKD. In 52% of the patients diabetes and/or CKD was diagnosed, in Tx population 15% had diabetes. Hypertension was diagnosed and treated in 72% in CAD and 90% in Tx. In CAD population without diabetes and CKD only 47% achieved target blood pressure, while in the population with CKD/and/or diabetes only 31%. Patients were treated with ACEi (72%), CCB (28%), diuretics (27%) and b-blockers (89%). In Tx more than 60% required 3 and more hypotensives. Only 40% Tx achieved target BP. In Tx most commonly used hypotensives were CCB (84%), b-blockers (68%), diuretics (51%), ACEi (38%), a-blockers (15%). Despite polytherapy the optimal blood pressure control was not achieved in majority of patients. CAD and Tx had a high prevalence of hypertension, thus they should be treated adequately. More efforts should be put to optimizing blood pressure control, particularly when other co-morbidities are present. Wide use of b-blockers and ACEi under using in Tx population should be noted.
Keywords: Kidney Transplantation