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The Importance of Ambulatory and Home Monitoring Blood Pressure in Resistant Hypertension Associated with Chronic Kidney Disease

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Resistant Hypertension in Chronic Kidney Disease

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Abstract

Resistant hypertension (RH) is defined as blood pressure (BP) that remains above the target despite the use of ≥3 full-dose antihypertensive drugs including a diuretic or as BP at target with four or more drugs. In CKD, RH occurs in about one third of patients. Main determinants are sodium retention, increased activity of renin-angiotensin system, and sympathetic nervous system. To ensure correct diagnosis of RH, it is mandatory to exclude the “pseudoresistance,” a condition mainly caused by white coat hypertension, poor adherence to antihypertensive therapy, and inadequate diuretic therapy. Identification of CKD patients with RH is critical since these patients are exposed to a greater risk for renal and cardiovascular outcomes. Limiting dietary sodium intake is the cornerstone of treatment in RH due to its direct lowering BP effect but also because low sodium diet enhances the efficacy of other classes of antihypertensive drugs.

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Authors and Affiliations

  1. Division of Nephrology, Department of Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell’Invecchiamento, University of Campania “Luigi Vanvitelli”, Naples, Italy

    Silvio Borrelli, Luca De Nicola, Giuseppe Conte & Roberto Minutolo

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  1. Silvio Borrelli
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  2. Luca De Nicola
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  3. Giuseppe Conte
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  4. Roberto Minutolo
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Correspondence to Roberto Minutolo .

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Editors and Affiliations

  1. Grigore T. Popa University of Medicine, Iaşi, Romania

    Adrian Covic

  2. Department of Medicine, Division of Nephrology, University School of Medicine, Istanbul, Turkey

    Mehmet Kanbay

  3. Section of Nephrology, University of Illinois at Chicago College of Medicine/Advocate Christ Medical Center, Oak Lawn, Illinois, USA

    Edgar V. Lerma

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Borrelli, S., De Nicola, L., Conte, G., Minutolo, R. (2017). The Importance of Ambulatory and Home Monitoring Blood Pressure in Resistant Hypertension Associated with Chronic Kidney Disease. In: Covic, A., Kanbay, M., Lerma, E. (eds) Resistant Hypertension in Chronic Kidney Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-56827-0_4

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  • DOI: https://doi.org/10.1007/978-3-319-56827-0_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56825-6

  • Online ISBN: 978-3-319-56827-0

  • eBook Packages: MedicineMedicine (R0)

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