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Initiating Early Combination Therapy in Patients with Hypertension and Associated Chronic Kidney Disease: A Narrative Review


Affiliations
1 Manager, Medical Services, Emcure Pharmaceuticals Ltd., Pune., India
2 Apollo Main Hospital, Greams Lane, 21, Greams Road, Thousand Lights, Chennai, Tamil Nadu, India
3 Asian Institute of Gastroenterology, Hyderabad, Telangana, India
4 All India Institute of Medical Sciences, Sri Aurobindo Marg, Ansari Nagar, New Delhi, India
5 Emcure Pharmaceuticals Ltd., Pune, India
 

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Hypertension and chronic kidney disease (CKD) are inter-related. Hypertension is both a cause and the consequence of CKD and both these conditions are independent risk factors for cardiovascular disease (CVD). Blood pressure control remains suboptimal in patients with CKD. This needs to be addressed on an urgent basis in order to prevent kidney damage.Combination anti-hypertensive treatment is the need of the hour in CKD patients with hypertension. Hence, the present narrative review was carried out to explore the significance of early combination therapy in the management of patients with hypertension and CKD. A PubMed search was conducted with the search terms ‘hypertension’, ‘chronic kidney disease’ and ‘combination therapy’ for randomized controlled trials, reviews and systematic reviews, published between 2010 and 2020. Abstracts were screened and relevant articles were selected. A search was then conducted on Google Scholar with the same search terms and relevant articles were selected. In a backward chronological search, the reference lists of all the selected articles were checked and more articles relevant to the topic were selected. The selected papers were used to evaluate the role of early combination therapy in patients with hypertension and CKD. Data suggest that combination therapy is needed to manage hypertensive patients with CKD and is indicated in patients with SBP ≥ 20 mmHg or DBP ≥ 10 mmHg above the goal. Initial combination therapy can therefore be considered for patients with hypertension and CKD.


Keywords

Blood pressure, hypertension, CKD, antihypertensive, combination therapy
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  • Initiating Early Combination Therapy in Patients with Hypertension and Associated Chronic Kidney Disease: A Narrative Review

Abstract Views: 114  |  PDF Views: 79

Authors

Girish Deshmukh
Manager, Medical Services, Emcure Pharmaceuticals Ltd., Pune., India
N K Narayanan
Apollo Main Hospital, Greams Lane, 21, Greams Road, Thousand Lights, Chennai, Tamil Nadu, India
Mohasin Aslam
Asian Institute of Gastroenterology, Hyderabad, Telangana, India
Sachin Chittawar
All India Institute of Medical Sciences, Sri Aurobindo Marg, Ansari Nagar, New Delhi, India
Shreya Lal
Emcure Pharmaceuticals Ltd., Pune, India
Sanket Newale
Emcure Pharmaceuticals Ltd., Pune, India

Abstract


Hypertension and chronic kidney disease (CKD) are inter-related. Hypertension is both a cause and the consequence of CKD and both these conditions are independent risk factors for cardiovascular disease (CVD). Blood pressure control remains suboptimal in patients with CKD. This needs to be addressed on an urgent basis in order to prevent kidney damage.Combination anti-hypertensive treatment is the need of the hour in CKD patients with hypertension. Hence, the present narrative review was carried out to explore the significance of early combination therapy in the management of patients with hypertension and CKD. A PubMed search was conducted with the search terms ‘hypertension’, ‘chronic kidney disease’ and ‘combination therapy’ for randomized controlled trials, reviews and systematic reviews, published between 2010 and 2020. Abstracts were screened and relevant articles were selected. A search was then conducted on Google Scholar with the same search terms and relevant articles were selected. In a backward chronological search, the reference lists of all the selected articles were checked and more articles relevant to the topic were selected. The selected papers were used to evaluate the role of early combination therapy in patients with hypertension and CKD. Data suggest that combination therapy is needed to manage hypertensive patients with CKD and is indicated in patients with SBP ≥ 20 mmHg or DBP ≥ 10 mmHg above the goal. Initial combination therapy can therefore be considered for patients with hypertension and CKD.


Keywords


Blood pressure, hypertension, CKD, antihypertensive, combination therapy

References