K008: Clinical and therapeutic evaluation of nondiabetic hypertensive patients with chronic renal failure derived to a hypertension unit

Abstract

In order to evaluate the severity of hypertension (HBP) associated to chronic renal failure (CRF) and its therapeutic management in our setting, we examined the ethiologic, clinic and therapeutic characteristics of a group of 312 (219–70.20% men) non diabetic hypertensive patients with CRF (Crs > 1.4 mg/dl) with an average age of 56.1 ± 12 years old, serum creatinine 1.92 ± 0.46 mgdl, IMC: 29.79 ± 6 and average BP (treated) of 164.4 ± 26/98.3 ± 15 mmHg. The patients were summitted from: general practice (53.21%), specialists (39.10%) and the emergency room (7.69%). The determinants for referral to our service were: severe hypertension (43.58%), CRF (42.95%), or HBP complicated with cerebrovascular disease or ischaemic heart disease (IHD) (21.16%). Ethiologic diagnosis (%): nephroangiosclerosis (47.8), ischaemic nephropathy (8.01), polycystic disease (6.73%), glomerulonephritis (8.01), obstructive uropathy (7.69), interstitial nephropathy (8.65). Associated risk factors (%): hypercholesterolemie (25), mixed dyslipidemie (15.6), hypertriglyceridemie (2.5), obesity (20.6), hyperuricemic (6.25), smoking (20). Cardiovascular complications (%): cerebrovascular disease (13.75), IHD (13.75), heart failure (8.75), arrythmias (3.75), peripheral arteriopathie (6.25). Patients with BP under 140/90 mmHg: 6.25%, <130/85:3.75%, DBP < 90: 30%, DBP < 85:21.35%. Antihypertensive drugs (%): diuretics: 42.5, betablockers: 25.63, calcium channel blockers: 28.75, ACE inhibitors: 46.88; angiotensin receptor antagonists: 1.25; alphablockers: 8.75. Treatment status (%): not treated: 10.25, monotherapy: 36.2; bitherapy: 32.37; three drugs: 15.29; four or more: 2.56%. Statins: 15% of the hypercholesterolemic patients. In conclusions: Hypertension plus CRF is a common cause of consultation, being nephroangiosclerosis the most frequent aethiology. Although these patients have a very high cardiovascular risk, they are often poorly controlled and insufficiently treated.

Hypertension, chronic renal failure, cardiovascular risk