Current strategies for management of hypertensive renal disease

The incidence of hypertensive end-stage renal disease continues to increase annually. To reduce this incidence, it is necessary to control systolic an d diastolic hypertension. Reversible causes should always be sought in any hypertensive patient who develops renal insufficiency. Blood pressure shoul d be reduced to 130/85 mm Hg, and in African Americans with hypertensive re nal failure, reducing the blood pressure to 120/75 mm Hg may be beneficial. Any antihypertensive treatment regimen that effectively lowers blood press ure mill help slow progressive renal failure. Whenever possible, an angiote nsin-converting enzyme inhibitor should be part of the treatment, since the se drugs have been shown to be renoprotective beyond their antihypertensive effect in certain renal disease categories.