Arch Intern Med. 1991 Jul;151(7):1280-7.
End-stage renal disease attributed to hypertension has increased annually for the last decade and will probably worsen through the year 2000. Patients with diabetic nephropathy and patients with hypertensive renal disease account for most new cases annually. Evidence reveals that all levels of untreated hypertension are associated with potentially declining renal function. Data from the Hypertension Detection and Follow-up Program and other studies show that antihypertensive treatment can prevent progressive renal failure. An ablation model demonstrates glomerular hyperfiltration as a possible mechanism for progressive renal failure. Human data on the renal effects of antihypertensive agents are limited and inconsistent. Despite the limitations, the Working Group on Hypertension and Chronic Renal Failure concludes that controlled hypertension to less than 140/90 mm Hg reduces the incidence of end-stage renal disease. Patients with established renal impairment may benefit from individualized treatment to 130/85 mm Hg or less.
在过去十年中，由高血压导致的终末期肾病每年都在增加，到2000年可能会恶化。糖尿病肾病患者和高血压肾病患者占每年新增病例的大多数。有证据表明，所有未治疗的高血压水平都与潜在的肾功能下降有关。高血压检测与随访项目及其他研究的数据表明，抗高血压治疗可以预防进行性肾衰竭。一种切除模型显示肾小球高滤过是进行性肾衰竭的一种可能机制。关于抗高血压药物对肾脏影响的人体数据有限且不一致。尽管存在这些局限性，高血压与慢性肾衰竭工作组得出结论，将血压控制在140/90 mmHg以下可降低终末期肾病的发病率。已出现肾功能损害的患者可能会从个体化治疗至130/85 mmHg或更低的血压水平中获益。
