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Recent advances in the treatment of hypertension with renal disease: peculiarities for the African descent population

Authors
Publication Date
Keywords
  • Hypertension
  • Treatment
  • African Population
  • Renal Disease
  • Human Health Sciences :: Urology & Nephrology [D27]
  • Sciences De La Santé Humaine :: Urologie & Néphrologie [D27]
Disciplines
  • Biology
  • Economics
  • Medicine

Abstract

Présentation PowerPoint Recent advances in the treatment of hypertension with renal disease: peculiarities for the African descent population JM KRZESINSKI Professor of Nephrology University of Liège Go, A. S. et al. N Engl J Med 2004 Age-Standardized Rates According to the Estimated GFR (MDRD) among 1,120,295 Adults Death from Any Cause (Panel A), Cardiovascular Events (Panel B), Hospitalization (Panel C) Incidence of ESRD (Klag et al JAMA 1997) • Black Americans have a 2-4 fold higher incidence of ESRD compared with Whites • When GFR is between 60-80 ml/min, the Black population presents higher systolic BP and diabetes mellitus prevalence, albuminuria and hyperuricemia (Peralta et al NDT 2010). • Higher death risk than W before ESRD! HTN nephrosclerosis in AA R Toto KI 2003 • Incidence of HTN is 5 times higher as cause of ESRD in AA compared to non AA • HTN is more severe, develops earlier and is more difficult to control in AA • Role of socioeconomic status and access to medical care, high salt intake, obesity, low nephron number, genetic predisposition? KI 2006 KI 2006 Whites AA Chromosome 22 Krzesinski J-M and Cohen E., Acta Clinica Belgica 2007, 62, 5-14. genes How to manage HTN with CKD: Dietary approach • Low salt diet • DASH diet (fruits, vegetables, fresh low fat dairy products) • Physical activity and low caloric diet • Low proteins (if proteinuria) and low lipids in the diet Role of sodium intake in the renal dysfunction progression Why is salt-sensitive HTA so common in Blacks? (Campese NDT 1996) How to manage HTN with CKD: Target BP and first line anti HTA drug • Target BP < 130/80 mmHg (or even lower) • RAS blocker must be the first choice! Hebert, L. A. et al. Hypertension 1997;30:428-435 Estimated mean chang

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