Clinical Hypertension最新文献

{"title":"Korea hypertension fact sheet 2022: analysis of nationwide population-based data with a special focus on hypertension in the elderly.","authors":"Hyeon Chang Kim,&nbsp;Hokyou Lee,&nbsp;Hyeok-Hee Lee,&nbsp;Gabin Lee,&nbsp;Eunji Kim,&nbsp;Moses Song,&nbsp;Jenny Moon,&nbsp;Yeeun Seo","doi":"10.1186/s40885-023-00243-8","DOIUrl":"https://doi.org/10.1186/s40885-023-00243-8","url":null,"abstract":"<p><strong>Background: </strong>The Korean Society of Hypertension has published the Korea Hypertension Fact Sheet 2022 to provide an overview of the magnitude and management status of hypertension and their recent trends.</p><p><strong>Methods: </strong>The Fact Sheets were based on the analyses of Korean adults aged 20 years or older of the 1998-2020 Korea National Health and Nutrition Examination Survey and the 2002-2020 National Health Insurance Big Data.</p><p><strong>Results: </strong>As of 2020, 29.4% of the adult population aged 20 or older in Korea, about 12.6 million people, have high blood pressure, of which 5.0 million (40%) are 65 years of age or older and 1.2 million (10%) are 80 years of age or older. Among those with hypertension, the awareness rate is 69%, the treatment rate is 65%, and the control rate is 47%. The number of people diagnosed with hypertension increased from 3.0 million in 2002 to 10.5 million in 2020. During the same period, the number of people using antihypertensive medication increased from 2.5 million to 9.9 million, and the number of people adherent to treatment increased from 0.6 million to 7.4 million. Among those treated for hypertension in 2020, 74% used angiotensin blockers, 61% used calcium channel blockers, 24% used diuretics, and 15% used beta blockers. Combination therapy with at least two classes of antihypertensive medication consisted of 60% of all antihypertensive prescriptions. The number of people with hypertension aged 65 or older is increasing very rapidly compared to those aged 20-64. Awareness and treatment rates of hypertension improved rapidly, especially in those aged 65 or older, but the rate of improvement slowed since 2012.</p><p><strong>Conclusions: </strong>In Korea, the level of hypertension management is improving, but the absolute number of people with hypertension, especially elderly hypertension, is increasing due to the rapid aging of the population. It is necessary to develop more efficient and target-specific policies to control blood pressure and prevent cardiovascular disease.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"29 1","pages":"22"},"PeriodicalIF":4.2,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10426053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10003460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term blood pressure variability as a potential therapeutic target for kidney disease.","authors":"Ye Eun Ko,&nbsp;Jong Hyun Jhee","doi":"10.1186/s40885-023-00248-3","DOIUrl":"10.1186/s40885-023-00248-3","url":null,"abstract":"<p><p>Short-term blood pressure variability (BPV) measured with ambulatory blood pressure (BP) monitoring has been demonstrated to be significant in predicting various clinical outcomes. Short-term BPV is distinguished from long-term BPV based on the time interval in which BP fluctuations are measured. Increased short-term BPV has been linked to detrimental effects on the microvascular structure and contributes to subclinical organ damage in the heart, blood vessels, and kidneys, regardless of the average 24-h BP levels. Short-term BPV can be defined by various measures, including calculated metrics (standard deviation, coefficient of variation, average real variability, weighted standard deviation, variability independent of the mean) or dipping patterns. Nevertheless, the additional role of short-term BPV beyond the predictive value of average 24-h BPs or established risk factors for cardiovascular disease and kidney disease remains unclear. In particular, longitudinal studies that evaluate the association between short-term BPV and kidney function impairment are limited and no conclusive data exist regarding which short-term BPV indicators most accurately reflect the prognosis of kidney disease. The issue of how to treat BPV in clinical practice is another concern that is frequently raised. This paper presents a review of the evidence for the prognostic role of short-term BPV in kidney outcomes. Additionally, this review discusses the remaining concerns about short-term BPV that need to be further investigated as an independent risk modifier.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"29 1","pages":"23"},"PeriodicalIF":4.2,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10426225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10009654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and life style factors related to the nighttime blood pressure, nighttime dipping and their phenotypes in Korean hypertensive patients.","authors":"Byung Sik Kim,&nbsp;Ju Han Kim,&nbsp;Wan Kim,&nbsp;Woo Shik Kim,&nbsp;Sungha Park,&nbsp;Sang Jae Lee,&nbsp;Jang Young Kim,&nbsp;Eun Mi Lee,&nbsp;Sang Hyun Ihm,&nbsp;Wook Bum Pyun,&nbsp;Jeong-Hun Shin,&nbsp;Jinho Shin","doi":"10.1186/s40885-023-00241-w","DOIUrl":"https://doi.org/10.1186/s40885-023-00241-w","url":null,"abstract":"<p><strong>Background: </strong>Non-dipping or reverse dipping patterns are known to be associated with adverse cardiovascular prognosis among the general population and clinical cohort. Few large sized studies have explored factors including sleep duration and sleep quality related to nighttime blood pressure (BP) and nocturnal dipping patterns.</p><p><strong>Methods: </strong>Among 5,360 patients enrolled  in Korean multicenter nationwide prospective Registry of ambulatory BP monitoring (KORABP), 981 subjects with complete data on sleep duration, sleep quality assessed using a 4-point Likert scale, and clinical variables were included in the analysis. Phenotypes of nighttime BP pattern were categorized as extreme dipper, dipper, non-dipper, and reverse dipper. Hypertension was defined as a 24-h ambulatory BPs were 130/80 mmHg or higher.</p><p><strong>Results: </strong>Among 981 subjects, 221 were normotensive, 359 were untreated hypertensive, and 401 were treated hypertensive. Age of the participants were 53.87 ± 14.02 years and 47.1% were female. In overall patients, sleep duration was 431.99 ± 107.61 min, and one to four points of sleep quality were observed in 15.5%, 30.0%, 30.4%, and 24.2%, respectively. Of the 760 hypertensive patients, extreme dipper, dipper, non-dipper, and reverse dipper were observed in 58 (7.63%), 277 (36.45%), 325 (42.76%), and 100 (13.16%), respectively. In multiple linear regression analysis, sleep duration (β = 0.0105, p < 0.001) and sleep quality (β = -0.8093, p < 0.001) were associated with nighttime systolic BP and sleep quality was associated with extent of nighttime systolic BP dipping (β = 0.7622, p < 0.001) in hypertensive patients. In addition, sleep quality showed positive association with dipper pattern (odds ratio [OR] = 1.16, 95% confidence interval [CI] = 1.03-1.30) and showed negative association with reverse dipper pattern (OR = 0.73, 95% CI = 0.62-0.86) in multiple logistic regression analyses.</p><p><strong>Conclusion: </strong>When adjusted covariates, less sleep duration and poor sleep quality were positively associated with nighttime systolic BP. Additionally, sleep quality was the independent associated factor for dipper and reverse dipper phenotypes. The study also found that male sex, low estimated glomerular filtration rate, high ambulatory BP, low office BP, and poor sleep quality were associated with blunted nighttime SBP dipping.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"29 1","pages":"21"},"PeriodicalIF":4.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10391961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9928235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coffee intake and hypertension in Korean adults: results from KNHANES 2012-2016.","authors":"Surabhi Shah,&nbsp;In-Jeong Cho,&nbsp;Whanhee Lee,&nbsp;Wook Bum Pyun,&nbsp;Eunhee Ha","doi":"10.1186/s40885-023-00239-4","DOIUrl":"https://doi.org/10.1186/s40885-023-00239-4","url":null,"abstract":"<p><strong>Background: </strong>Coffee is the most popular and widely consumed drink in the world. Coffee consumption seems to have both benefits and risk with respect to hypertension; results from studies evaluating effect of frequency of coffee consumption on risk of hypertension are mixed and inconsistent. Hence, we investigated the association of coffee consumption and hypertension in Korean adults.</p><p><strong>Methods: </strong>Data from Korean National Health and Nutrition Examination Survey (KNHANES) 2012-2016 was obtained and 12,133 eligible participants were selected. The coffee consumption was attained using a food frequency questionnaire. Subsequently coffee intake was grouped into two categories: ≤2 and > 2 servings per day. Hypertension status was defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, use of antihypertensive drug treatment, or both. Multivariable logistic regression analysis was used to examine the association of coffee consumption and hypertension.</p><p><strong>Results: </strong>Logistic regression analysis showed that consumption of more than two servings of coffee a day was inversely associated with hypertension with odds ratio (OR) 0.84 (95% confidence interval [CI], 0.73-0.99). Similar results were seen in the propensity score-matched analysis (OR, 0.83; 95% CI, 0.69-0.98). Adults having age more than median value (OR, 0.76; 95% CI, 0.65-0.89) and normal cholesterol (OR, 0.84; 95% CI, 0.70-0.99) had significantly inverse association with hypertension, when coffee consumption was more than two servings daily.</p><p><strong>Conclusions: </strong>More than two servings of coffee intake per day was inversely associated with hypertension as compared to consumption of ≤ 2 servings coffee per day.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"29 1","pages":"20"},"PeriodicalIF":4.2,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10349480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9824042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative measurement of empathy and analysis of its correlation to clinical factors in korean patients with chronic diseases.","authors":"Ran Heo,&nbsp;Jinho Shin,&nbsp;Byung Sik Kim,&nbsp;Hyun-Jin Kim,&nbsp;Kye-Yeung Park,&nbsp;Hoon-Ki Park,&nbsp;Yu Mi Kim,&nbsp;Seon Young Hwang,&nbsp;Stewart W Mercer","doi":"10.1186/s40885-023-00246-5","DOIUrl":"https://doi.org/10.1186/s40885-023-00246-5","url":null,"abstract":"<p><strong>Background: </strong>Empathy is the core of the physician-patient relationship. The Consultation and Relational Empathy (CARE) measure is a useful tool for assessing patient-rated empathy. There have been scarce data on empathy in chronic disease patients in Korea. We aim to evaluate empathy using the Korean CARE measure in patients from various clinical environments and the factors influencing the degree of empathy in patients with chronic disease.</p><p><strong>Methods: </strong>Data were collected from patients with chronic diseases. Patients were from primary, secondary, and tertiary clinics. Characteristics of the patients, physicians, and disease status were collected. The difference in CARE score was studied according to the clinical factors.</p><p><strong>Results: </strong>A total of 162 patients with chronic diseases were included. About 60% of patients were male. The mean age was 62 years. They had an average number of 2.6 diseases. More than half of patients experienced overt cardiovascular disease. About half of them had a history of hospitalization due to cardiovascular disease. The overall average CARE score was 45.6 ± 7.0. The CARE score was not significantly different according to the characteristics of the patient, physician, or disease status. Regarding marital status, the CARE score was significantly lower for the small number of patients (n = 4, 2.5%) who refused to provide their marital status than for other groups. Except for four patients, there was no significant difference in the CARE score among married, unmarried, or divorced groups. This trend was maintained in hypertensive patients.</p><p><strong>Conclusions: </strong>The Korean CARE measure could assess patient-rated empathy in various clinical practices. The empathy of patients was high regardless of multiple factors.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"29 1","pages":"19"},"PeriodicalIF":4.2,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10349477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9824043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arterial hypertension in Leigh syndrome due to m.13513G > A is multicausal, requiring an extensive search to identify its pathphysiology.","authors":"Josef Finsterer","doi":"10.1186/s40885-023-00247-4","DOIUrl":"https://doi.org/10.1186/s40885-023-00247-4","url":null,"abstract":"","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"29 1","pages":"18"},"PeriodicalIF":4.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9743804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges of managing hypertension in Pakistan - a review.","authors":"Adil Elahi,&nbsp;Arzina Aziz Ali,&nbsp;Aamir Hameed Khan,&nbsp;Zainab Samad,&nbsp;Hunaina Shahab,&nbsp;Namra Aziz,&nbsp;Aysha Almas","doi":"10.1186/s40885-023-00245-6","DOIUrl":"https://doi.org/10.1186/s40885-023-00245-6","url":null,"abstract":"<p><strong>Background: </strong>This review aims to describe existing evidence on the state of hypertension in Pakistan, including the prevalence, associated risk factors, preventive strategies, and challenges in the management of hypertension.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted electronically using PubMed and Google Scholar. Using specific screening methodology, 55 articles were selected to be included.</p><p><strong>Results: </strong>We found from this extensive review that several small studies report high prevalence of hypertension but there is a lack of population based prevalence of hypertension in Pakistan. Lifestyle risk factors such as obesity, unhealthy diet, decreased physical activity, low socioeconomic status, and lack of access to care were the main associated factors with hypertension. Lack of blood pressure monitoring practices and medication non-adherence were also linked to uncontrolled hypertension in Pakistan and were more evident in primary care setups. The evidence presented is essential for delineating the burden of the disease, hence allowing for better management of this underserved population.</p><p><strong>Conclusion: </strong>There is a need for updated surveys to depict the true prevalence and management of hypertension in Pakistan. Cost-effective implementation strategies and policies at the national level are needed for both prevention and control of hypertension.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"29 1","pages":"17"},"PeriodicalIF":4.2,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10268336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9692986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between D-dimer and long-term mortality in patients with acute severe hypertension visiting the emergency department.","authors":"Byung Sik Kim,&nbsp;Jeong-Hun Shin","doi":"10.1186/s40885-023-00244-7","DOIUrl":"https://doi.org/10.1186/s40885-023-00244-7","url":null,"abstract":"<p><strong>Objective: </strong>High levels of D-dimer, a marker of thrombotic events, are associated with poor outcomes in patients with various cardiovascular diseases. However, there has been no research on its prognostic implications in acute severe hypertension. This study investigated the association between D-dimer levels and long-term mortality in patients with severe acute hypertension who visited the emergency department.</p><p><strong>Design and method: </strong>This observational study included patients with acute severe hypertension who visited the emergency department between 2016 and 2019. Acute severe hypertension was defined as a systolic blood pressure ≥ 180 mmHg or a diastolic blood pressure ≥ 100 mmHg. Among the 10,219 patients, 4,127 who underwent D-dimer assay were analyzed. The patients were categorized into tertiles based on their D-dimer levels at the time of emergency department admission.</p><p><strong>Results: </strong>Among the 4,127 patients with acute severe hypertension, 3.1% in the first (lowest) tertile, 17.0% in the second tertile, and 43.2% in the third (highest) tertile died within 3 years. After the adjustment for confounding variables, the third tertile of the D-dimer group (hazard ratio, 6.440; 95% confidence interval, 4.628-8.961) and the second tertile of the D-dimer group (hazard ratio, 2.847; 95% confidence interval, 2.037-3.978) had a significantly higher risk of all-cause mortality over 3 years than the first tertile of the D-dimer group.</p><p><strong>Conclusions: </strong>D-dimer may be a useful marker for identifying the risk of mortality among patients with acute severe hypertension who visit the emergency department.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"29 1","pages":"16"},"PeriodicalIF":4.2,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10268450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9995527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility, credence, and usefulness of out-of-office cuffless blood pressure monitoring using smartwatch: a population survey.","authors":"Yongjun Jang,&nbsp;Jong-Mo Seo,&nbsp;Sang-Hyun Ihm,&nbsp;Hae Young Lee","doi":"10.1186/s40885-023-00242-9","DOIUrl":"https://doi.org/10.1186/s40885-023-00242-9","url":null,"abstract":"<p><strong>Background: </strong>Cuffless blood pressure (BP) measurement, enabled by recent advances in wearable devices, allows for BP monitoring in daily life. This study aims to evaluate the feasibility, cresdence, and usefulness of cuffless BP monitoring through a population survey.</p><p><strong>Methods: </strong>During the \"Daily BP Measurement with Your Galaxy Watch\" campaign held by the Korean Society of Hypertension, participants were asked to share their experiences with cuffless BP measurement using a smartwatch application through an online survey. The questionnaire included questions about age, underlying medical conditions, smartwatch utilization, experience with BP calibration, the reliability of BP values measured by a smartwatch, and willingness to use the BP monitoring function in the future.</p><p><strong>Results: </strong>A total of 1071 participants responded to the survey. The largest age group (decile) was 50-59 years old (33.3%), followed by 40-49 years old (29.9%). Although nearly half of the participants (47.5%) had no chronic diseases, 40.1% reported having hypertension. BP monitoring was the most frequently utilized smartwatch function (95.8%), followed by heart rate measurement (87.1%). 31.8% of participants reported that BP values measured by the smartphone application were \"very accurate and helpful,\" while 63.5% rated them as \"slightly lower (44.4%)\" or \"higher (19.1%)\" compared to the standard home BP monitoring device. 93% of the participants reported utilizing the BP monitoring function at least once a week. Regarding the BP calibration process, most participants (93.9%) calibrated the BP measurement application themselves, and 50.8% rated the difficulty level as \"very easy.\"</p><p><strong>Conclusion: </strong>Cuffless BP measurement using a smartwatch application was feasible in the general population, including the self-calibration process. However, the satisfaction level in terms of accuracy is still modest, indicating a need for further development.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"29 1","pages":"15"},"PeriodicalIF":4.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10234022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9568764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic roles of thiazides and loop diuretics in blood pressure control and renal protection against chronic kidney disease.","authors":"Wonji Jo,&nbsp;Eun Sil Koh,&nbsp;Sungjin Chung","doi":"10.1186/s40885-023-00238-5","DOIUrl":"https://doi.org/10.1186/s40885-023-00238-5","url":null,"abstract":"<p><p>Fluid overload secondary to loss of functional nephron mass can elevate blood pressure, which is characteristic of hypertension shown in chronic kidney disease (CKD). Therefore, it is logical to use diuretics at appropriate dose to lower blood pressure in patients with CKD and hypertension. Despite the theoretical background on the use of diuretics in CKD, there have been no definitive data on the effectiveness or safety of diuretics as first-line therapy for the management of hypertension in patients with CKD. Results from some clinical trials have demonstrated that diuretics would not lower blood pressure. They could even worsen electrolyte imbalance and kidney function when they are administered in patients with CKD. Major clinical practice guidelines on management of blood pressure or CKD have stated that evidence for benefits of thiazide diuretics is not conclusive yet in patients with advanced CKD, although loop diuretics are often effective for volume control at lower glomerular filtration rate. Recently, evidence for diuretics as effective blood pressure lowering agents in patients with advanced CKD is increasing. Renoprotective effect of thiazide or loop diuretics might represent a consequence of their influence on blood pressure or their ability to potentiate the effect of renin-angiotensin system blockade by making intraglomerular pressure more renin-angiotensin system-dependent, although their direct benefit on renal function remains controversial. This review summarizes recent data on the possible role of diuretics in lowering blood pressure, slowing the progression of kidney disease, and reducing cardiovascular risk in CKD patients.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"29 1","pages":"14"},"PeriodicalIF":4.2,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10184374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9476671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}