Global Cardiovascular Risk Assessment in the Management of Primary Hypertension: The Role of the Kidney

Abstract

The knowledge of each patient's global risk profile is a prerequisite for effective therapeutic strategies in primary hypertension. Detecting the presence of subclinical organ damage at the cardiac, vascular, and renal levels is key for stratifying cardiovascular risk and may also be helpful in choosing antihypertensive agents and in monitoring the effectiveness of treatment. A systematic, in-depth search for subclinical organ damage, however, may be difficult to carry out because of logistic and economic problems related to the high prevalence of hypertension in the population. Renal abnormalities such as microalbuminuria and reduction in glomerular filtration rate have proven to be powerful predictors of cardiovascular and renal outcome. Thanks to their relatively low cost and wide applicability, more widespread use of these tests in the diagnostic workup will help detect subsets of patients at greater risk for whom additional preventive and therapeutic treatment is advisable.

Defect of Septum Atrio-Ventricular Complete in Newborn. Clinical Evolution Report of a Case

“…In the meta-analysis, which includes more than 700 patients, there is undeniable evidence of the beneficial effect of treatment that reduces the level of MK in the blood on the rate of progression of CKD. Decreased MC content on the background of therapy with xanthine oxidase inhibitors in individuals with renal dysfunction promoted the growth of GFR and decreased plasma creatinine level [18]. In turn, the positive effect of the normalization of MK indices on renal function in patients receiving xanthine oxidase inhibitors was accompanied by a reduction in the risk of developing MTR [16,19].…”

Association Between Plasma Homocysteine and Microalbuminuria in Untreated Patients with Essential Hypertension: a Case-Control Study

“…In recent reports, MAU was determined based on the albumin to creatinine ratio in the first urine void in the morning, preferably from two non-consecutive urine collections. Due to the low cost and convenience, the determination of MAU using this method has been shown to be sufficiently accurate and has been widely adopted in clinical practice [22]. The prevalence of microalbuminuria has been reported to vary from 5% to 30% in patients with primary hypertension [23], with higher values in the presence of diabetes [24].…”

Assessment of microalbuminuria in hypertensive patients with established coronary artery disease

“…The task force categorized microalbuminuria assessment as reasonable in adults with hypertension or diabetes. Thanks to its relatively low cost and wide applicability, more widespread use of this test in the diagnostic workup will help detect subsets of patients at greater risk for whom additional preventive and therapeutic treatment is advisable (36).…”