Target Blood Pressure Goals in Patients with Chronic Kidney Disease: Where Do We Stand in this Era of Evidence based Medicine?

Abstract

There is also a lot of emphasis in the last decade about BP measurement techniques. BP measurement by automated BP instruments or Abstract Chronic kidney disease (CKD) is highly prevalent globally and is strongly associated with cardiovascular disease (CVD). Hypertension affects the vast majority of patients with CKD and increases the risk of CVD, end-stage kidney disease, and mortality. Control of hypertension in CKD is very important in our clinical practice to slow the progression of CKD as well as to reduce CVD risk. Over the past 10 years, three major guidelines have dealt with blood pressure (BP) thresholds and targets for antihypertensive drug therapy in CKD patients: The 2012 Kidney Disease: Improving Global Outcomes Clinical Practice Guideline for the management of BP in CKD; the 2017 American College of Cardiology/American Heart Association 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High BP in Adults; and the 2018 European Society of Cardiology and the European Society of Hypertension guidelines for the Management of arterial hypertension. These guidelines do not offer a consensus on optimal BP targets and have varying recommendations for BP goals in patients with CKD. It may leave practicing physicians and patients in a dilemma. Therefore, it is necessary to understand the existing evidence used to create these guidelines to deliver personalized management and achieve BP targets in CKD.