Primary and secondary prevention of arterial hypertension: nephrologist's point of view

Authors

  • S. Andrulli Divisione di Nefrologia, Dialisi, Ospedale ‘Alessandro Manzoni’, Lecco
  • S. Mancuso Centro Emodialisi Mazarese, Mazara del Vallo (Trapani)
  • M.C. Bigi Divisione di Nefrologia, Dialisi, Ospedale ‘Alessandro Manzoni’, Lecco
  • A. Granata Divisione di Nefrologia e Dialisi, Ospedale ‘San Giovanni di Dio’, Agrigento
  • F. Logias Servizio di Dialisi, Ospedale ‘San Camillo’, Sorgono (Nuoro)
  • F. Floccari Divisione di Nefrologia e Dialisi, Ospedale ‘San Paolo’, Civitavecchia
  • L. Di Lullo Divisione di Nefrologia e Dialisi, Ospedale ‘L. Parodi-Delfno’, Colleferro (Roma)

DOI:

https://doi.org/10.33393/gcnd.2012.1112

Keywords:

Primary and secondary prevention, Arterial hypertension, Global cardiovascular risk, Drug compliance, Personalised therapy, Proteinuria

Abstract

Nephroangiosclerotic chronic kidney disease's primary and secondary prevention is actually based on blood pressure control and reduction of proteinuria. In proteinuric patients, blood pressure control has to be obtained by blocking renin–angiotensin axis, even in patients with moderate to severe chronic kidney disease. Combination therapy with angiotensin converting enzyme inhibitor (ACEi) drugs and angiotensin II receptor blockers (ARB) doesn't imply addictive protective effects. It could be tested in selected patients with proteinuria levels above 1 g/day. Combination therapy with ACEi and anti–aldosteronic agents seems to be promising but we need more multicentric trials.