Renovascular Hypertension: Comparison of Medical and Surgical Therapy

1979 ◽  
Vol 57 (s5) ◽  
pp. 445s-447s ◽  
Author(s):  
P. K. Whelton ◽  
A. P. Harris ◽  
R. P. Russell ◽  
P. C. Walsh ◽  
G. M. Williams ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Diastolic Blood Pressure ◽  
Renovascular Hypertension ◽  
Surgical Therapy ◽  
Antihypertensive Medication ◽  
Renovascular Disease ◽  
Significant Difference ◽  
Blood Pressures

1. Results of medical and surgical therapy were compared in 28 patients with hypertension and unilateral renovascular ischaemia. 2. Renal function remained normal in both groups throughout the study period. After 6 months of follow-up systolic and diastolic blood pressures were significantly lower in the surgically treated patients. After 12 months of follow-up there was no significant difference between the two groups in diastolic blood pressure and after 24 months of follow-up there was no significant difference between the two groups in either systolic or diastolic blood pressure. 3. Sixty per cent of surgically treated patients were cured 6 months after operation, but only 40% remained cured after 24 months of follow-up. 4. All patients cured at 6 months who subsequently required antihypertensive medication had arteriosclerotic renovascular disease.

Evaluating the Situational Specificity of Relaxation in Mild Essential Hypertension

1980 ◽  
Vol 51 (2) ◽  
pp. 667-674
Author(s):  
John E. Martin ◽  
Leonard H. Epstein
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Diastolic Blood Pressure ◽  
Systolic Pressure ◽  
Progressive Relaxation ◽  
Multiple Baseline ◽  
Self Monitoring ◽  
Situational Specificity ◽  
Blood Pressures

A multiple baseline across subject/settings design was employed to assess the specificity of the effects of progressive relaxation in two recently diagnosed, mild hypertensives. Relaxation was implemented successively across laboratory and home settings. In Subject 1, laboratory relaxation was associated with control over diastolic blood pressure, while in Subject 2, control over systolic pressure was observed. Improvements to normotensive levels were observed for both subjects, and the changes were maintained in both settings for Subject 2 at 6- and 12-mo. follow-up. Subject 1 discontinued her medications, relaxation, and self-monitoring of blood pressure, which was associated with an increase in blood pressure during treatment maintenance; however, at 6- and 12-mo. follow-up, both home and laboratory blood pressures were within normotensive range.

scholarly journals P1806OUTCOMES OF PEDIATRIC RENOVASCULAR HYPERTENSON: A SINGLE-CENTER EXPERIENCE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Jiwon Jung ◽  
Joo Hoon Lee ◽  
Kun suk Kim ◽  
Young Seo Park
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Blood Pressure Control ◽  
Antihypertensive Agents ◽  
Good Control ◽  
Pressure Control ◽  
Renovascular Disease ◽  
Antihypertensive Medications

Abstract Background and Aims Renovascular disease is rare but important treatable cause of secondary hypertension in children. We aimed to evaluate the clinical presentations and long-term outcomes of pediatric patients with renovascular hypertension (RVH). Method We retrospectively reviewed medical records of patients with renovascular disease at our center between 1994 and 2019. Clinical courses including status of hypertension control with preservation of renal function during follow up were evaluated. Results 20 patients were diagnosed with RVH. 50 % (n = 10) were male, and median age at diagnosis was 10.1 (range 1.3 – 17.2) years, and median follow up period was 8.7 (range 0.1 – 24.6) years. 50 % (n = 10) presented with incidently detected high blood pressure (8 patients without symptoms, one with headache, and the other one with proteinuria), 25 % (n = 5) first admitted due to heart failure symptoms, and the rest (25 %, n = 5) presented with neurologic symptoms including seizure or paraplegia. Majority had no underlying disease except for 3 patients with Moyamoya disease. 80 % (n = 16) had unilateral renovascular stenosis. All patients showed elevated basal random renin activity (median 20.0, range 2.5 – 62.1 ng/ml/hr), and 45 % (n = 9) patients showed elevated basal random aldosterone level (median 822, range 266 – 2440 pg/ml). All patients needed antihypertensive medications for blood pressure control; 35 % (n = 7) of patients gained good control of blood pressure only with antihypertensive agents including angiotensin converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB), 40 % (n = 8) of patients who underwent percutaneous transluminal angioplasty all still needed antihypertensive agents including ACEI for blood pressure control. 20 % (n = 4) of the patients initially showed profoundly low relative function of involved kidney on diuretic scan, leading to nephrectomy. Three of these patients with nephrectomy successfully discontinued all antihypertensive agent gaining good control of blood pressure. The remaining one patient showed progressive deterioration of relative function on the involved side of kidney during 13 years, ended up with nephrectomy, but couldn’t discontinue ACEI. Glomerular filtration rate (GFR) was within normal range for all patients at diagnosis. For patients without nephrectomy, mean relative function of the involved kidney on diuretic scan was 33.5 ± 11.4 % at diagnosis. There was no significant change or deterioration of relative renal function during a mean follow up period of 10 ± 8 (median 11.5, range 0 – 19.5) years, although they all used ACEI/ARB. All patients including patients with nephrectomy showed normal GFR with a mean of 114.1 ± 19.5 ml/min/1.73 m2 at the last follow up. Conclusion Antihypertensive medications including ACEI and ARB were safely used with no further deterioration of the renal function of the involved side with or without angioplasty. Pediatric RVH is well managed with preserved renal function in long-term follow up.

scholarly journals The Effect of Dash Diet on the Blood Pressure of the Male Hypertensive Office Employees between 33-55 Years of Age

2020 ◽  
pp. 18-30
Author(s):  
Chetna Rai ◽  
Rupali Sengupta
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Nutrition Education ◽  
Dash Diet ◽  
Adherence Score ◽  
Significant Difference ◽  
Blood Pressures ◽  
Office Employees ◽  
Clinical Blood Pressure

Aims: To determine the effect of the DASH Diet on the Blood Pressure of the male hypertensive office employees between 33-55 years of age. Place and Duration of Study: The study was conducted at Abhitex International Company, Panipat, Haryana, India between November 2018 to January 2019. Methodology: The Clinical blood pressure of the office employees of Abhitex International company, Panipat, between the age group of 35 to 55 years was recorded, following the international guidelines given by American Heart Association(AHA) and American College of Cardiology. Purposive sampling was done and the employees who had clinical blood pressure above 120/80 mm Hg were considered as the samples for the study. The dietary pattern of the samples was evaluated by checking the adherence to the DASH diet which was done through a questionnaire and 3 days 24-hour diet recall. Dietary adherence was assessed using a scoring scheme adopted by Folsom and colleagues. Samples were made aware of the DASH Diet and post one month the adherence to DASH Diet was again checked and the change in the clinical blood pressure was observed. Results: There were 50 study participants. The mean age of the participants was 41.5 years. The average Systolic blood pressure of the 50 participants in the pre-test was 149.3 mm of Hg and average diastolic blood pressure was 89.58 mm of Hg. Pre Nutrition Education Program, the total mean DASH adherence score was 4.3 out of 10 but post NEP and after following DASH Diet, the adherence score for the DASH Diet improved and resulted in 6.7 which indicated that the samples adhered more to the DASH Diet post NEP. There were reductions in systolic (149.30±18.98 mmHg to 146.12±14.85 mmHg) and diastolic (89.58±8.76 mmHg to 86.28±4.76 mmHg) blood pressures when the subjects adhered towards the DASH Diet. A significant difference at p=0.05(p=0.039*) in the pre and post-systolic blood pressure was observed in the study. A similar trend was also noticed in the pre and post-diastolic blood pressure which showed a highly significant difference at p=0.05(p=0.002**). Conclusion: It was concluded from the study that the improvement in the DASH Diet adherence score was associated with a reduction in the Clinical blood pressure. There was a reduction in systolic (149.30±18.98 mmHg to 146.12±14.85 mmHg) and diastolic (89.58±8.76 mmHg to 86.28±4.76 mmHg) blood pressures with an improvement of DASH Adherence Score (4.3±1.27 to 6.7±1.19).

scholarly journals Reduction in hsCRP levels is associated with decreased incidence of cardiovascular events in Japanese hypertensive women but not in men

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Shokei Kim-Mitsuyama ◽  
Hirofumi Soejima ◽  
Osamu Yasuda ◽  
Koichi Node ◽  
Hideaki Jinnouchi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Events ◽  
Significant Interaction ◽  
Antihypertensive Medication ◽  
Substantial Reduction ◽  
Cardiovascular Outcomes ◽  
Antihypertensive Medications ◽  
Significant Difference ◽  
Baseline Characteristics

Abstract To test our hypothesis that the magnitude of reduction in hsCRP achieved by antihypertensive medications may predict the benefit for cardiovascular outcomes in hypertensive individuals, we performed subanalysis of the ATTEMPT-CVD study. The hypertensive participants enrolled in the ATTMEPT-CVD study were categorized into two groups according to whether achieved reduction in hsCRP levels at 6 months after initiation of antihypertensive medications from baseline was equal to or greater than 40% (responder group) or less than 40% (non-responder group). Baseline characteristics and blood pressure during follow-up period were similar between the groups. For women, the incidence of cardiovascular events was significantly less in responder group than non-responder group (P < 0.0221). However, for men, there was no significant difference between the groups regarding incident cardiovascular events (P = 0.2434). There was a significant interaction (P = 0.0187) between sexes for incident cardiovascular events. Our results provide the evidence suggesting that substantial reduction (40% or greater reduction) in hsCRP on antihypertensive medication predicts the benefit for cardiovascular outcomes in hypertensive women but it does not in hypertensive men. The magnitude of achieved reduction in hsCRP by antihypertensive medications seems to be a useful indicator of successful treatment in Japanese hypertensive women. This trial was registered with ClinicalTrials.gov, number NCT01075698.

The Significance of Renal Function in Response to Cardiac Resynchronisation Therapy – The Piece of a Much Larger Puzzle

2020 ◽  
Vol 18 ◽  
Author(s):  
Agnieszka Dębska-Kozłowska ◽  
Izabela Warchoł ◽  
Marcin Książczyk ◽  
Andrzej Lubiński
Keyword(s):  
Renal Function ◽  
Nyha Class ◽  
Heart Association ◽  
Cardiac Resynchronisation Therapy ◽  
Study Groups ◽  
Creatinine Concentration ◽  
Significant Difference ◽  
Cardiac Resynchronisation ◽  
Resynchronisation Therapy

Background: Although cardiac resynchronisation therapy (CRT) is an important player in the treatment of heart failure (HF) patients, the proportion of CRT patients with no improvement in either echocardiographic or clinical parameters remains consistently high and accounts for about 30% despite meeting CRT implantation criteria. Furthermore, in patients suffering from HF, renal dysfunction accounts for as many as 30-60%. Accordingly, CRT may improve renal function inducing a systemic haemodynamic benefit leading to increased renal blood flow. Objectives: The aim of the present study was to evaluate the importance of renal function in response to resynchronisation therapy during a 12-month follow-up period. Materials and methods: The study consisted of 46 HF patients qualified for implantation of cardiac resynchronisation therapy defibrillator (CRT-D). A CRT responder is defined as a person without chronic HF exacerbations during observation whose physical efficiency has improved owing to New York Heart Association (NYHA) class improvement ≥1. Results: A statistically significant difference was noted between responders and non-responders regarding creatinine level at the 3rd month (p=0.04) and, particularly, at the 12th month (p=0.02) of follow-up (100±23 vs 139±78 μmol/l). Moreover, there was a remarkable difference between both study groups with regard to GFR CKD-EPI (glomerular filtration rate (GFR) assessed using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula) at the 6th (p=0.03) and 12th month (p=0.01) of follow-up. The reference values for initial creatinine concentrations (101 μmol/l) as well as GFR CKD-EPI (63 ml/min/1.73m2 ) were empirically evaluated to predict favourable therapeutic CRT response. Conclusions: Predictive value of GFR CKD-EPI and creatinine concentration for a positive response to CRT were found relevant.

Myocardial work analysis in screening of familial dilated cardiomyopathy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Triantafyllou ◽  
R Monteiro ◽  
A Protonotarios ◽  
T Gossios ◽  
P Elliott ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Dilated Cardiomyopathy ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Systemic Hypertension ◽  
Work Efficiency ◽  
Work Analysis ◽  
Significant Difference ◽  
Global Work

Abstract Introduction Early detection of affected family relatives of patients with dilated cardiomyopathy (DCM) is essential in order to guide follow up, outcomes and initiate early treatment. Myocardial work analysis is a novel method which integrated strain imaging and blood pressure and has the potential to identify patients with subclinical disease. Purpose We analysed myocardial work in family relatives of DCM patients with positive genotype but negative phenotype in order to identify whether myocardial work can identify early changes. Methods Seventy-four family relatives of DCM patients attending for screening were examined. All individuals were asymptomatic with either positive (45/74, G+) or negative (29/74, G-) genotype and no echocardiographic evidence of left ventricular dilatation or systolic impairment. Non-invasive myocardial work analysis using two-dimensional (2D) speckle tracking echocardiography was analysed. Global longitudinal strain (GLS) was measured by the same vendor specific software used for myocardial work analysis. Left ventricular (LV) ejection fraction (EF) was measured with the Simpson's biplane method. The peak systolic arm cuff blood pressure (BP) measurement at the time of echocardiography was used for the myocardial work study. Results In total we included 74 individuals (37±15 years old, 50.7% women) with mean systolic and diastolic BP of 121.3±14 and 73.2±10 mmHg respectively, mean EF was 58±5% and mean GLS at 18.4±2.5%. G+ individuals had pathogenic and very likely pathogenic mutations in 8 different genes (TTN, BAG3, DSP, FLNC, LMNA, DMD, RBM20, TPM1). There was no difference in age, systemic hypertension, diabetes or medical treatment between the 2 groups. No significant difference was found among G+ and G- individuals in mean systolic and diastolic BP (121.2±14.7 vs 121.2±15.2 mmHg), mean EF (57.3±5 vs 59.1±4%), GLS (−18.2±1.5 vs −18.6±2.9%), mean global work index (1818±403 vs 1928±295 mmHg%) and global constructive work (2192±464 vs 2260±318 mmHg%). However, we found significant reduction of the global work efficiency (GWE) with a GWE of 94.4±2.7% in the G+ versus 95.9±1.6% in the G- individuals (p 0.02). Moreover, the global wasted work (GWW) was increased in the G+ with a GWW of 111±58 mmHg% versus 82±41 mmHg% in the G- individuals (p 0.03). Conclusion DCM gene carriers show, early on, decreased myocardial work efficiency and increased wasted work compared to unaffected family members, which appears to be earlier than other parameters such as EF and GLS. Myocardial work analysis could potentially recognize individuals showing early cardiac involvement and guide closer follow up and early initiation of treatment. Funding Acknowledgement Type of funding source: None

scholarly journals The relationship between diastolic blood pressure and the risk of cardiovascular events in patients with atrial fibrillation: the Fushimi AF registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Ikeda ◽  
M Iguchi ◽  
H Ogawa ◽  
Y Aono ◽  
K Doi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Cardiovascular Events ◽  
Left Ventricular ◽  
Cox Proportional Hazards ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
The Impact

Abstract Background Hypertension is one of the major risk factors of cardiovascular events in patients with atrial fibrillation (AF). However, relationship between diastolic blood pressure (DBP) and cardiovascular events in AF patients remains unclear. Methods The Fushimi AF Registry is a community-based prospective survey of AF patients in Japan. Follow-up data were available in 4,466 patients, and 4,429 patients with available data of DBP were examined. We divided the patients into three groups; G1 (DBP&lt;70 mmHg, n=1,946), G2 (70≤DBP&lt;80, n=1,321) and G3 (80≤DBP, n=1,162), and compared the clinical background and outcomes between groups. Results The proportion of female was grater in G1 group, and the patients in G1 group were older and had higher prevalence of heart failure (HF), diabetes mellitus (DM), chronic kidney disease (CKD). Prescription of beta blockers was higher in G1 group, but that of renin-angiotensin system-inhibitors and calcium channel blocker was comparable. During the median follow-up of 1,589 days, in Kaplan-Meier analysis, the incidence rates of cardiovascular events (composite of cardiac death, ischemic stroke and systemic embolism, major bleeding and HF hospitalization during follow up) were higher in G1 group and G3 group than G2 group (Figure 1). When we divided the patients based on the systolic blood pressure (SBP) at baseline (≥130 mmHg or &lt;130 mmHg), the incidence of rates of cardiovascular events were comparable among groups. Multivariate Cox proportional hazards regression analysis including female gender, age (≥75 years), higher SBP (≥130 mmHg), DM, pre-existing HF, CKD, low left ventricular ejection fraction (&lt;40%) and DBP (G1, G2, G3) revealed that DBP was an independent determinant of cardiovascular events (G1 group vs. G2 group; hazard ratio (HR): 1.40, 95% confidence intervals (CI): 1.19–1.64, G3 group vs. G2 group; HR: 1.23, 95% CI: 1.01–1.49). When we examined the impact of DBP according to 10 mmHg increment, patients with very low DBP (&lt;60 mmHg) (HR: 1.50,95% CI:1.24–1.80) and very high DBP (≥90 mmHg) (HR: 1.51,95% CI:1.15–1.98) had higher incidence of cardiovascular events than patients with DBP of 70–79 mmHg (Figure 2). However, when we examined the impact of SBP according to 20 mmHg increment, SBP at baseline was not associated with the incidence of cardiovascular events (Figure 3). Conclusion In Japanese patients with AF, DBP exhibited J curve association with higher incidence of cardiovascular events. Funding Acknowledgement Type of funding source: None

Abstract P606: Hemodynamic Predictors of Multiple Recurrent Strokes in the Patients With Prior Lacunar Stroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Adam H de Havenon ◽  
Alexandra Kvernland ◽  
Alen Delic ◽  
Ka-ho Wong ◽  
Nazanin Sheibani ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Failure Time ◽  
Recurrent Stroke ◽  
Cox Proportional Hazards Model ◽  
Lacunar Stroke ◽  
Blood Pressures ◽  
Recurrent Strokes ◽  
The Mean

Background: Recurrent stroke has higher morbidity and mortality than incident stroke. We evaluated hemodynamic risk factors for multiple recurrent strokes. Methods: We included patients in the SPS3 trial. The primary predictor was the top tertile, compared to the bottom tertile, of the mean systolic blood pressure (mSBP) and blood pressure variability represented as standard deviation (sdSBP) using blood pressures from day 30 of the trial to the end of follow-up. We excluded blood pressures from the first 30 days to reduce confounding from the trial’s intervention. We fit a logistic regression model to ≥2 recurrent strokes from day 30 to the end of follow-up and, to accurately analyze the multiple failure-time data, we ordered the multiple failure events to the Prentice, Williams and Peterson extension of the Cox proportional-hazards model. Results: We included 2,882 patients, of which 223 had a recurrent stroke and 41/223 had ≥2 recurrent strokes for a total of 272 strokes. The mean (SD) number of blood pressure readings was 78.0 (37.4). The etiology of the 272 strokes was 161 (59.2%) lacunar, 22 (8.1%) intracranial atherosclerosis, 10 (3.7%) extracranial atherosclerosis, 24 (8.8%) cardioembolic, and 55 (20.2%) cryptogenic or other. In both unadjusted and adjusted logistic regression models and PWP Cox models, the top tertile of sdSBP was consistently predictive of multiple recurrent strokes, while mSBP was not (Tables 1/2). Conclusions: We found that in patients with an index lacunar stroke, higher SBP variability, but not mean SBP, was predictive of multiple recurrent strokes of varying mechanisms.

Use of Multiple Visits to Increase Blood Pressure Tracking Correlations in Childhood

PEDIATRICS ◽  
1991 ◽  
Vol 87 (5) ◽  
pp. 708-711
Author(s):  
Matthew W. Gillman ◽  
Bernard Rosner ◽  
Denis A. Evans ◽  
Laurel A. Smith ◽  
James O. Taylor ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Correlation Coefficient ◽  
Diastolic Pressure ◽  
Pearson Correlation ◽  
Systolic Pressure ◽  
Pearson Correlation Coefficient ◽  
Increase Blood Pressure ◽  
Multiple Visit

Previous studies of childhood blood pressure have shown tracking correlations, which estimate the magnitude of association between initial and subsequent measurements, to be lower than corresponding adult values. Inasmuch as this disparity could arise from failing to account for a larger week-to-week variability in children, blood pressure was measured for 4 successive years, on four weekly visits in each year, and with three measurements at each visit, using a random-zero sphygmomanometer, in a cohort of 333 schoolchildren aged 8 through 15 at entry. Ninety percent of subjects had measurements in 1 or more years of follow-up. For all follow-up periods (1, 2, and 3 years from baseline), the Pearson correlation coefficient (r) for both systolic and diastolic blood pressure rose substantially with the number of weekly visits used to calculate each subject's yearly blood pressure (P &lt; .0001). For systolic pressure, the 3-year r values for 1, 2, 3, and 4 visits were .45, .55, .64, and .69, respectively. For diastolic pressure (Korotkoff phase 4), the corresponding values were .28, .41, .47, and .54. These higher multiple-visit estimates of tracking approximate published adult values and raise the possibility that prediction of adult blood pressure from childhood measurements may be improved by averaging readings from multiple weekly visits.

The Relationship Between Blood Pressure Variability And Renal Progression In Hypertensive Patients With Chronic Kidney Disease

2021 ◽  
Vol 6 (14) ◽  
pp. 80-88
Author(s):  
Huseyin Duru ◽  
Ekrem KARA
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Blood Pressure Measurement ◽  
Rapid Progression ◽  
Night Time ◽  
Hypertensive Patients ◽  
Significant Difference ◽  
Renal Progression

Objective: To evaluate the effect of 24 hour systolic blood pressure (SBP) and diastolic blood pressure (DBP) variability (BPV) on renal progression in hypertensive patients with chronic kidney disease (CKD) Methods: A total 59 hypertensive patients (mean age: 54.2±14.6 years, 50.8% male) with CKD who underwent 24 hours ambulatory blood pressure measurement (ABPM) were included. Data on SBP, DBP, BPV coefficients (VC) for SBP (SBP-CV) and DBP (DBP-CV) were recorded. A decrease in e-GFR of <5 ml/min/year was considered as normal renal progression and a decrease in ≥5 ml/min/year was considered as rapid renal progression. Results: Overall, 40.6% of the patients had uncontrolled HT, while 45.8% had non-dipper pattern. Mean±SD daytime and night-time SBP and SBP-VC values were 135.3±17.9 mmHg, 128.6±23.0 mmHg, 11.7±2.8 and 9.5±3.6, respectively. Mean±SD daytime and nigh-time DBP and DBP-VC values were 84.5±13.4 mmHg, 77.2±16.1 mmHg, 13.8±3.8 and 12.0±3.7, respectively. Rapid renal progression was detected in 25.4% of patients with no significant difference in daytime, night-time and total SBP, SBP-VC, DBP and DBP-VC values between patients with rapid vs. natural renal progression. The regression analysis adjusted for age, gender, presence of DM, baseline e-GFR and dipping status revealed no significant impact of SBP-VC and DBP-VC in predicting rapid progression (p> 0.05). Conclusion: In conclusion, our finding revealed no significant association between BPV and renal progression in hypertensive patients with CKD. Larger scale prospective, randomized controlled trials with longer follow-up are needed to clarify this issue.

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