Debate from the 2012 ASH Annual Scientific Sessions: Should blood pressure be reduced in hemodialysis patients? pro position

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3 Citations (Scopus)

Abstract

Among chronic hemodialysis patients with hypertension, blood pressure should be lowered. Blood pressure reduction with antihypertensive drugs does not increase mortality; in contrast, meta-analysis of randomized trials suggests that treatment of hypertension in this high-risk population may, in fact, improve cardiovascular outcomes. The association of low blood pressure with increased mortality in longitudinal studies should not be considered as evidence against lowering blood pressure. Lowering blood pressure among hypertensive patients should primarily be done by sodium restriction and dry-weight reduction. Treatment is perhaps better directed to home blood pressure than pre- or post-dialysis blood pressure recordings. Although no firm data are available, it appears that treating home blood pressure to <140/90 mm Hg appears reasonable. Nonetheless, all blood pressure recordings during dialysis are important to ensure patient safety. Adequately designed and powered randomized trials are needed to examine the notion that blood pressure lowering and, if so, to what level of blood pressure will improve clinically meaningful outcomes among chronic dialysis patients.

Original languageEnglish
Pages (from-to)439-442
Number of pages4
JournalJournal of the American Society of Hypertension
Volume6
Issue number6
DOIs
StatePublished - Nov 2012

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Renal Dialysis
Blood Pressure
Dialysis
Hypertension
Mortality
Patient Safety
Hypotension
Antihypertensive Agents
Longitudinal Studies
Meta-Analysis
Weight Loss
Sodium
Therapeutics
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine

Cite this

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title = "Debate from the 2012 ASH Annual Scientific Sessions: Should blood pressure be reduced in hemodialysis patients? pro position",
abstract = "Among chronic hemodialysis patients with hypertension, blood pressure should be lowered. Blood pressure reduction with antihypertensive drugs does not increase mortality; in contrast, meta-analysis of randomized trials suggests that treatment of hypertension in this high-risk population may, in fact, improve cardiovascular outcomes. The association of low blood pressure with increased mortality in longitudinal studies should not be considered as evidence against lowering blood pressure. Lowering blood pressure among hypertensive patients should primarily be done by sodium restriction and dry-weight reduction. Treatment is perhaps better directed to home blood pressure than pre- or post-dialysis blood pressure recordings. Although no firm data are available, it appears that treating home blood pressure to <140/90 mm Hg appears reasonable. Nonetheless, all blood pressure recordings during dialysis are important to ensure patient safety. Adequately designed and powered randomized trials are needed to examine the notion that blood pressure lowering and, if so, to what level of blood pressure will improve clinically meaningful outcomes among chronic dialysis patients.",
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