Cardiovascular Disease and the Kidney: An Epidemiologic Overview
- 1 January 1999
- journal article
- review article
- Published by Wolters Kluwer Health in Journal of Cardiovascular Pharmacology
- Vol. 33, S1-S6
- https://doi.org/10.1097/00005344-199900001-00001
Abstract
Essential hypertension and congestive heart failure (CHF) are examples of cardiovascular disorders that may cause renal failure, although sometimes a primary kidney defect may lead to hypertension. Renal damage in malignant and severe hypertension is dramatic, extensive, and rapidly progressive, although nephrosclerotic damage, which develops slowly and appears late in hypertension, is a rare cause of morbidity because mild to moderate hypertension is now the most common form. However, the incidence of end-stage renal failure associated with hypertension is markedly increasing, perhaps because of underdiagnosis of renal damage in hypertension, insufficient lowering of blood pressure in clinical practice, or inability of antihypertensive drugs to lower blood pressure sufficiently to preserve the kidney, a goal that may need specific drugs that act, for example, on the renin-angiotensin system (RAS). Renal vasoconstriction and reduction of renal blood flow are early companions of cardiac insufficiency and may be involved in the development of sodium and water retention. Profound reduction of cardiac output and arterial hypotension in severe CHF may lead to acute renal failure. Chronic renal insufficiency is associated with elevated cardiovascular morbidity and mortality. Renal impairment is often caused by a disease process, such as diabetes mellitus, that involves both the cardiovascular system and the kidney. When the primary disease is renal, possible reasons for an association include renal-dependent increase in blood pressure, activation of the RAS, overproduction of other vasoactive substances of renal origin, and electrolyte imbalances leading to fatal arrhythmias.Keywords
This publication has 34 references indexed in Scilit:
- History of hypertension in patients treated for end-stage renal diseaseJournal Of Hypertension, 1997
- Does antihypertensive therapy protect the kidney in essential hypertensionJournal Of Hypertension, 1996
- Nephritic Urinary Sediment: Not only in Proliferative Glomerulonephritis but also in Malignant HypertensionNephron, 1995
- Epidemiology and prevention of blood pressure-related renal diseaseJournal Of Hypertension, 1992
- Hypertension as a Causative Diagnosis of Patients Entering End-Stage Renal Disease Programs in the United States From 1980 to 1986American Journal of Kidney Diseases, 1991
- The association of blood pressure levels and change in renal function in hypertensive and nonhypertensive subjectsArchives of Internal Medicine, 1990
- Prognostic value of serum creatinine and effect of treatment of hypertension on renal function. Results from the hypertension detection and follow-up program. The Hypertension Detection and Follow-up Program Cooperative Group.Hypertension, 1989
- Hypertension as a risk factor for renal disease. Review of clinical and epidemiological evidence.Hypertension, 1989
- Association between blood pressure and the rate of decline in renal function with ageKidney International, 1984
- Hypertensive vascular disease; description and natural historyJournal of Chronic Diseases, 1955