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高血压既是慢性肾脏病(CKD)的原因也是CKD的结果。根据我国一项调查,高血压患者CKD患病率高于普通人群。高血压患者中CKD是肾脏及其他重要脏器的危险因素。可能是高盐膳食的原因,高血压合并CKD患者夜间血压不下降或升高的患病率高,并可能有更高的心血管病风险。因此,需要进行诊室外血压评估及全面心血管评估。目前大部分高血压指南推荐高血压合并CKD患者积极降血压治疗。这对亚洲人心血管病的预防更为重要,因为在亚洲,脑卒中与血压更相关,是高血压的主要并发症。预防CKD进展及心血管并发症通常需要强化降压,将血压控制到130/80mm Hg。肾素血管紧张素系统(RAS)阻断剂被推荐作为估算的肾小球滤过率>30mL/(min·1.73m~2)患者的一线降压药物,可预防终末期肾病及心血管事件。然而,将血压控制达标通常需要RAS阻断剂与其他类降压药(如钙拮抗剂、利尿剂等)联合治疗。
Hypertension is both a cause of chronic kidney disease (CKD) and a result of CKD. According to a survey in China, the prevalence of CKD in hypertensive patients is higher than that in the general population. CKD in hypertensive patients is a risk factor for kidney and other important organs. May be the cause of high-salt diet, high blood pressure with CKD patients with no decline or increase in nocturnal blood pressure prevalence and may have a higher risk of cardiovascular disease. Therefore, outpatient BPP and comprehensive cardiovascular assessment are required. Currently, most hypertensive guidelines recommend that patients with hypertension and CKD be active in lowering blood pressure. This is even more important for the prevention of cardiovascular disease in Asia, as stroke is more associated with blood pressure in Asia and is a major complication of hypertension. Preventing CKD progression and cardiovascular complications usually require an intensified lowering of blood pressure to control blood pressure to 130/80 mm Hg. Renin-angiotensin system (RAS) blockers are recommended as first-line antihypertensive drugs in patients with an estimated glomerular filtration rate> 30 mL / (min · 1.73 m 2) to prevent end-stage renal disease and cardiovascular events . However, achieving blood pressure control usually requires the combination of RAS blockers and other classes of antihypertensive drugs (such as calcium antagonists, diuretics, etc.).