Hypertensive nephropathy primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nasrin Nikravangolsefid, MD-MPH [2]

Overview

Effective measures for primary prevention of Hypertensive nephropathy include detecting and controlling hypertension at the initial stages.

Primary Prevention

  • Effective measures for reducing blood pressure as primary prevention of Hypertensive nephropathy include:[1]
    • Lifestyle modification
      • Weight reduction
      • DASH diet
      • sodium intake restriction
      • Increase physical activity
    • Pharmacological therapy for hypertension
      • Among medications for controlling BP, Renin-angiotensin-aldosterone (RAAS) blockers such as ACEI or ARB play a significant role in preventing progression to ESRD by reducing proteinuria in hypertensive patients.
        • According to 2017 guidelines, the goal of BP is < 130/80 mmHg for patients with hypertension and CKD regardless of proteinuria.[2]



References

  1. Hart, Peter D; Bakris, George L (2010). "Hypertensive nephropathy: prevention and treatment recommendations". Expert Opinion on Pharmacotherapy. 11 (16): 2675–2686. doi:10.1517/14656566.2010.485612. ISSN 1465-6566.
  2. Whelton, Paul K.; Carey, Robert M.; Aronow, Wilbert S.; Casey, Donald E.; Collins, Karen J.; Dennison Himmelfarb, Cheryl; DePalma, Sondra M.; Gidding, Samuel; Jamerson, Kenneth A.; Jones, Daniel W.; MacLaughlin, Eric J.; Muntner, Paul; Ovbiagele, Bruce; Smith, Sidney C.; Spencer, Crystal C.; Stafford, Randall S.; Taler, Sandra J.; Thomas, Randal J.; Williams, Kim A.; Williamson, Jeff D.; Wright, Jackson T. (2018). "2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults". Journal of the American College of Cardiology. 71 (19): e127–e248. doi:10.1016/j.jacc.2017.11.006. ISSN 0735-1097.

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