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Management of Hypertension in Patients with Chronic Kidney Disease

  • Seyed Mehrdad HamrahianEmail author
Pediatric Hypertension (B Falkner, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Pediatric Hypertension

Abstract

Hypertension is the leading factor in the global burden of disease. It is the predominant modifiable risk factor for stroke, heart disease, and kidney failure. Chronic kidney disease (CKD) is both a common cause and sequel of uncontrolled hypertension. The pathophysiology of CKD-associated hypertension is complex and multi-factorial. This paper reviews the key pathogenic mechanisms of CKD-associated hypertension, the importance of standardized blood pressure (BP) measurement in establishing the diagnosis and management plus the significance of ambulatory BP monitoring for assessment of diurnal BP variation commonly seen in CKD. The optimal BP target in CKD remains a matter of discussion despite recent clinical trials. Medical therapy can be difficult and challenging. In addition to lifestyle modification and dietary salt restriction, treatment may need to be individualized based on co-morbidities. Combination of antihypertensive drugs, including appropriate diuretic choice and dose, is of great significance in hypertension management in CKD.

Keywords

Hypertension Chronic kidney disease Blood pressure Ambulatory blood pressure monitoring Resistant hypertension 

Notes

Compliance with Ethical Standards

Conflict of Interest

Dr. Hamrahian declares no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

  1. 1.
    World Health Organization. A global brief on hypertension: silent killer, global public health crisis. World health day 2013. Geneva: World Health Organization; 2013. p. 1–39.Google Scholar
  2. 2.
    Yoon SS, Fryar CD, Carroll MD. Hypertension prevalence and control among adults: United States, 2011–2014. NCHS data brief, no 220. Hyattsville, MD: National Center for Health Statistics. 2015.Google Scholar
  3. 3.
    Couser WG, Remuzzi G, Mendis S, Tonelli M. The contribution of chronic kidney disease to the global burden of major noncommunicable diseases. Kidney Int. 2011;80:1258–70.CrossRefPubMedGoogle Scholar
  4. 4.
    Muntner P, Anderson A, Charleston J, Chen Z, Ford V, Makos G, et al. Hypertension awareness, treatment, and control in adults with CKD: results from the chronic renal insufficiency cohort (CRIC) study. Am J Kidney Dis. 2010;55:441–51.CrossRefPubMedGoogle Scholar
  5. 5.
    Calhoun DA, Jones D, Textor S, Goff DC, Murphy TP, Toto RD, et al. Resistant hypertension: diagnosis, evaluation, and treatment. A scientific statement from the American Heart Association professional education committee of the Council for High Blood Pressure research. Hypertension. 2008;51:1403–19.CrossRefPubMedGoogle Scholar
  6. 6.
    De Nicola L, Gabbai FB, Agarwal R, Chiodini P, Borrelli S, Bellizzi V, et al. Prevalence and prognostic role of resistant hypertension in chronic kidney disease patients. J Am Coll Cardiol. 2013;61:2461–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Townsend RR, Taler SJ. Management of hypertension in chronic kidney disease. Nat Rev Nephrol. 2015;11:555–63.CrossRefPubMedGoogle Scholar
  8. 8.
    Drawz PE, Abdalla M, Rahman M. Blood pressure measurement: clinic, home, ambulatory, and beyond. Am J Kidney Dis. 2012;60:449–62.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Cohen DL, Huan Y, Townsend RR. Home blood pressure monitoring in CKD. Am J Kidney Dis. 2014;63:835–42.CrossRefPubMedGoogle Scholar
  10. 10.
    Niiranen TJ, Hänninen MR, Johansson J, Reunanen A, Jula AM. Home measured blood pressure is a stronger predictor of cardiovascular risk than office blood pressure: the Finn-home study. Hypertension. 2010;55:1346–51.CrossRefPubMedGoogle Scholar
  11. 11.
    Myers MG, Godwin M, Daves M, et al. Measurement of blood pressure in the office: recognizing the problem and proposing the solution. Hypertension. 2010;55:195–200.CrossRefPubMedGoogle Scholar
  12. 12.
    Agarwal R, Andersen MJ. Prognostic importance of ambulatory blood pressure recordings in patients with chronic kidney disease. Kidney Int. 2006;69:1175–80.CrossRefPubMedGoogle Scholar
  13. 13.
    Kanno A, Kikuya M, Asayama K, Satoh M, Inoue R, Hosaka M, et al. Night-time blood pressure is associated with the development of chronic kidney disease in a general population: the Ohasama study. J Hypertens. 2013;31:2410–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Ciobanu AO, Gherghinescu CL, Dulgheru R, Magda S, Dragoi Galrinho R, Florescu M, et al. The impact of blood pressure variability on subclinical ventricular, renal and vascular dysfunction, in patients with hypertension and diabetes. Maedica (Buchar). 2013;8:129–36.Google Scholar
  15. 15.
    Mojón A, Ayala DE, Piñeiro L, Otero A, Crespo JJ, Moyá A, et al. Comparison of ambulatory blood pressure parameters of hypertensive patients with and without chronic kidney disease. Chronobiol Int. 2013;30:145–58.CrossRefPubMedGoogle Scholar
  16. 16.
    Agarwal R. Hypertension diagnosis and prognosis in chronic kidney disease with out-of-office blood pressure monitoring. Curr Opin Nephrol Hypertens. 2006;15:309–13.CrossRefPubMedGoogle Scholar
  17. 17.
    Agarwal R, Pappas MK, Sinha AD. Masked uncontrolled hypertension in CKD. J Am Soc Nephrol. 2016;27:924–32.CrossRefPubMedGoogle Scholar
  18. 18.
    Fagard RH, Cornelissen VA. Incidence of cardiovascular events in white-coat, masked and sustained hypertension versus true normotension: a meta-analysis. J Hypertens. 2007;25:2193–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Koomans HA, Roos JC, Boer P, Geyskes GG, Mees EJ. Salt sensitivity of blood pressure in chronic renal failure. Evidence for renal control of body fluid distribution in man. Hypertension. 1982;4:190–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Pimenta E, Gaddam KK, Oparil S, Aban I, Husain S, Dell'Italia LJ, et al. Effects of dietary sodium reduction on blood pressure in subjects with resistant hypertension: results from a randomized trial. Hypertension. 2009;54:475–81.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Briet M, Boutouyrie P, Laurent S, London GM. Arterial stiffness and pulse pressure in CKD and ESRD. Kidney Int. 2012;82:388–400.CrossRefPubMedGoogle Scholar
  22. 22.
    Hovater MB, Sanders PW. Effect of dietary salt on regulation of TGF-beta in the kidney. Semin Nephrol. 2012;32:269–76.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Luft FC, Weinberger MH. Review of salt restriction and the response to antihypertensive drugs: satellite symposium on calcium antagonists. Hypertension. 1988;11:I-229–32.CrossRefGoogle Scholar
  24. 24.
    Kwakernaak AJ, Krikken JA, Binnenmars SH, Visser FW, Hemmelder MH, Woittiez AJ, et al. Effects of sodium restriction and hydrochlorothiazide on RAAS blockade efficacy in diabetic nephropathy: a randomised clinical trial. Lancet Diabetes Endocrinol. 2014;2:385–95.CrossRefPubMedGoogle Scholar
  25. 25.
    Boudville N, Ward S, Benaroia M, House AA. Increased sodium intake correlates with greater use of antihypertensive agents by subjects with chronic kidney disease. Am J Hypertens. 2005;18:1300–5.CrossRefPubMedGoogle Scholar
  26. 26.
    Klein IH, Ligtenberg G, Neumann J, Oey PL, Koomans HA, Blankestijn PJ. Sympathetic nerve activity is inappropriately increased in chronic renal disease. J Am Soc Nephrol. 2003;14:3239–44.CrossRefPubMedGoogle Scholar
  27. 27.
    Davis JO, Freeman RH. Mechanisms regulating renin release. Physiol Rev. 1976;56:1–56.PubMedGoogle Scholar
  28. 28.
    Bidani AK, Polichnowski AJ, Loutzenhiser R, Griffin KA. Renal microvascular dysfunction, hypertension and CKD progression. Curr Opin Nephrol Hypertens. 2013;22:1–9.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Svenningsen P, Friis UG, Versland JB, Buhl KB, Møller Frederiksen B, Andersen H, et al. Mechanisms of renal NaCl retention in proteinuric disease. Acta Physiol (Oxf). 2013;207:536–45.CrossRefGoogle Scholar
  30. 30.
    Buhl KB, Friis UG, Svenningsen P, Gulaveerasingam A, Ovesen P, Frederiksen-Møller B, et al. Urinary plasmin activates collecting duct ENaC current in preeclampsia. Hypertension. 2012;60:1346–51.CrossRefPubMedGoogle Scholar
  31. 31.
    Hall JE. The kidney, hypertension, and obesity. Hypertension. 2003;41:625–33.CrossRefPubMedGoogle Scholar
  32. 32.
    Ehrhart-Bornstein M, Lamounier-Zepter V, Schraven A, Langenbach J, Willenberg HS, Barthel A, et al. Human adipocytes secrete mineralocorticoid-releasing factors. Proc Natl Acad Sci U S A. 2003;100:14211–6.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    LeLorier J, Bombardier C, Burgess E, Moist L, Wright N, Cartier P, et al. Practical considerations for the use of nonsteroidal anti-inflammatory drugs and cyclo‑oxygenase‑2 inhibitors in hypertension and kidney disease. Can J Cardiol. 2002;18:1301–8.PubMedGoogle Scholar
  34. 34.
    Conlin PR, Moore TJ, Swartz SL, Barr E, Gazdick L, Fletcher C, et al. Effect of indomethacin on blood pressure lowering by captopril and losartan in hypertensive patients. Hypertension. 2000;36:461–5.CrossRefPubMedGoogle Scholar
  35. 35.
    Johnson AG, Nguyen TV, Day RO. Do nonsteroidal anti-inflammatory drugs affect blood pressure? A Meta-Analysis Ann Intern Med. 1994;121:289–300.CrossRefPubMedGoogle Scholar
  36. 36.
    Mansoor GA. Herbs and alternative therapies in the hypertension clinic. Am J Hypertens. 2001;14:971–5.CrossRefPubMedGoogle Scholar
  37. 37.
    Burnier M, Wuerzner G, Struijker-Boudier H, Urquhart J. Measuring, analyzing, and managing drug adherence in resistant hypertension. Hypertension. 2013;62:218–25.CrossRefPubMedGoogle Scholar
  38. 38.
    Rimoldi SF, Scherrer U, Messerli FH. Secondary arterial hypertension: when, who, and how to screen? Eur Heart J. 2014;35:1245–54.CrossRefPubMedGoogle Scholar
  39. 39.
    James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507–20.CrossRefPubMedGoogle Scholar
  40. 40.
    SPRINT Research Group, Wright JT Jr, Williamson JD, Whelton PK, Snyder JK, Sink KM, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373:2103–16.CrossRefGoogle Scholar
  41. 41.
    McCullough PA, Steigerwalt S, Tolia K, Chen SC, Li S, Norris KC, et al. Cardiovascular disease in chronic kidney disease: data from the kidney early evaluation Program (KEEP). Curr Diab Rep. 2011;11:47–55.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Whaley-Connell AT, Sowers JR, Stevens LA, McFarlane SI, Shlipak MG, Norris KC, et al. CKD in the United States: kidney early evaluation program (KEEP) and National Health and Nutrition Examination Survey (NHANES) 1999-2004. Am J Kidney Dis. 2008;51:S13–20.CrossRefPubMedGoogle Scholar
  43. 43.
    Klahr S, Levey AS, Beck GJ, Caggiula AW, Hunsicker L, Kusek JW, et al. The effects of dietary protein restriction and blood-pressure control on the progression of chronic renal disease. Modification of Diet in Renal Disease study group. N Engl J Med. 1994;330:877–84.CrossRefPubMedGoogle Scholar
  44. 44.
    Wright JT Jr, Bakris G, Greene T, Agodoa LY, Appel LJ, Charleston J, et al. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA. 2002;288:2421–31.CrossRefPubMedGoogle Scholar
  45. 45.
    Ruggenenti P, Perna A, Loriga G, Ganeva M, Ene-Iordache B, Turturro M, et al. Blood-pressure control for renoprotection in patients with non-diabetic chronic renal disease (REIN‑2): multicentre, randomised controlled trial. Lancet. 2005;365:939–46.CrossRefPubMedGoogle Scholar
  46. 46.
    Cushman WC, Evans GW, Byington RP, Goff DC Jr, Grimm RH Jr, Cutler JA, et al. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010;362:1575–85.CrossRefPubMedGoogle Scholar
  47. 47.
    Margolis KL, O’Connor PJ, Morgan TM, et al. Outcomes of combined cardiovascular risk factor management strategies in type 2 diabetes: the ACCORD randomized trial. Diabetes Care. 2014;37(6):1721–8.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Upadhyay A, Earley A, Haynes SM, Uhlig K. Systematic review: blood pressure target in chronic kidney disease and proteinuria as an effect modifier. Ann Intern Med. 2011;154:541–8.CrossRefPubMedGoogle Scholar
  49. 49.
    Drawz PE, Pajewski NM, Bates JT, et al. Effect of intensive versus standard clinic-based hypertension management on ambulatory blood pressure. Results from the SPRINT (systolic blood pressure intervention trial) ambulatory blood pressure study. Hypertension. 2017;69.Google Scholar
  50. 50.
    Kjeldsen SE, Lund-Johansen P, Nilsson PM, Mancia G. Unattended blood pressure measurements in the systolic blood pressure intervention trial: implications for entry and achieved blood pressure values compared with other trials. Hypertension. 2016;67:808–12.CrossRefPubMedGoogle Scholar
  51. 51.
    Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int Suppl. 2012;2:337–414.CrossRefGoogle Scholar
  52. 52.
    National Institute for Health and Care Excellence. Chronic kidney disease http://www.nice.org.uk/guidance/cg182/evidence/cg182-chronic-kidney-disease.
  53. 53.
    Dasgupta K, Quinn RR, Zarnke KB, Rabi DM, Ravani P, Daskalopoulou SS, et al. The 2014 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol. 2014;30:485–501.CrossRefPubMedGoogle Scholar
  54. 54.
    Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31:1281–357.CrossRefPubMedGoogle Scholar
  55. 55.
    Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG, et al. Clinical practice guidelines for the management of hypertension in the community a statement by the American Society of Hypertension and the International Society of Hypertension. J Hypertens. 2014;32:3–15.CrossRefPubMedGoogle Scholar
  56. 56.
    American Diabetes Association. Standards of medical care in diabetes. Chapter 8 ‘cardiovascular disease and risk management’. Diabetes Care. 2016;39(Suppl. 1):S60–71.Google Scholar
  57. 57.
    Leung AA, Nerenberg K, Daskalopoulou SS, et al. Hypertension Canada’s 2016 Canadian Hypertension Education Program guidelines for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol. 2016;32(5):569–88.CrossRefPubMedGoogle Scholar
  58. 58.
    Aucott L, Poobalan A, Smith WC, Avenell A, Jung R, Broom J. Effects of weight loss in overweight/obese individuals and long-term hypertension outcomes: a systematic review. Hypertension. 2005;45:1035–41.CrossRefPubMedGoogle Scholar
  59. 59.
    Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 2002;136:493–503.CrossRefPubMedGoogle Scholar
  60. 60.
    Aguilera MT, de la Sierra A, Coca A, Estruch R, Fernandez-Sola J, Urbano-Marquez A. Effect of alcohol abstinence on blood pressure: assessment by 24-hour ambulatory blood pressure monitoring. Hypertension. 1999;33:653–7.CrossRefPubMedGoogle Scholar
  61. 61.
    Singer DR, Markandu ND, Sugden AL, Miller MA, MacGregor GA. Sodium restriction in hypertensive patients treated with a converting enzyme inhibitor and a thiazide. Hypertension. 1991;17:798–803.CrossRefPubMedGoogle Scholar
  62. 62.
    Kwakernaak AJ, Krikken JA, Binnenmars SH, Visser FW, Hemmelder MH, Woittiez AJ, et al. Effects of sodium restriction and hydrochlorothiazide on RAAS blockade efficacy in diabetic nephropathy: a randomised clinical trial. Lancet Diabetes Endocrinol. 2014;2:385–95.CrossRefPubMedGoogle Scholar
  63. 63.
    Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH collaborative research group. N Engl J Med. 1997;336:1117–24.CrossRefPubMedGoogle Scholar
  64. 64.
    Dahlof B, Sever PS, Poulter NR, Wedel H, Beevers DG, Caulfield M, et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomized controlled trial. Lancet. 2005;366:895–906.CrossRefPubMedGoogle Scholar
  65. 65.
    Patel A, MacMahon S, Chalmers J, Neal B, Woodward M, Billot L, et al. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomized controlled trial. Lancet. 2007;370:829–40.CrossRefPubMedGoogle Scholar
  66. 66.
    Chalmers J, Arima H, Woodward M, Mancia G, Poulter N, Hirakawa Y, et al. Effects of combination of perindopril, indapamide, and calcium channel blockers in patients with type 2 diabetes mellitus: results from the action in diabetes and vascular disease: Preterax and Diamicron controlled evaluation (ADVANCE) trial. Hypertension. 2014;63:259–64.CrossRefPubMedGoogle Scholar
  67. 67.
    Tamargo J, Segura J, Ruilope LM. Diuretics in the treatment of hypertension. Part 1: thiazide and thiazide-like diuretics. Expert Opin Pharmacother. 2014;15:527–47.CrossRefPubMedGoogle Scholar
  68. 68.
    Tamargo J, Segura J, Ruilope LM. Diuretics in the treatment of hypertension. Part 2: loop diuretics and potassium-sparing agents. Expert Opin Pharmacother. 2014;15:605–21.CrossRefPubMedGoogle Scholar
  69. 69.
    Ernst ME, Carter BL, Goerdt CJ, Steffensmeier JJ, Phillips BB, Zimmerman MB, et al. Comparative antihypertensive effects of hydrochlorothiazide and chlorthalidone on ambulatory and office blood pressure. Hypertension. 2006;47:352–8.CrossRefPubMedGoogle Scholar
  70. 70.
    Cirillo M, Marcarelli F, Mele AA, Romano M, Lombardi C, Bilancio G. Parallel-group 8-week study on chlorthalidone effects in hypertensives with low kidney function. Hypertension. 2014;63:692–7.CrossRefPubMedGoogle Scholar
  71. 71.
    Shankar SS, Brater DC. Loop diuretics: from the Na-K-2Cl transporter to clinical use. Am J Physiol Renal Physiol. 2003;284:F11–21.CrossRefPubMedGoogle Scholar
  72. 72.
    Izzo JL. Value of combined thiazide-loop diuretic therapy in chronic kidney disease: heart failure and reninangiotensin-aldosterone blockade. J Clin Hypertens. 2012;14:344.CrossRefGoogle Scholar
  73. 73.
    Anderson S, Brenner BM. Therapeutic benefit of converting-enzyme inhibition in progressive renal disease. Am J Hypertens. 1988;1:380S–3S.CrossRefPubMedGoogle Scholar
  74. 74.
    Holtkamp FA, de Zeeuw D, Thomas MC, Cooper ME, de Graeff PA, Hillege HJ, et al. An acute fall in estimated glomerular filtration rate during treatment with losartan predicts a slower decrease in long-term renal function. Kidney Int. 2011;80:282–7.CrossRefPubMedGoogle Scholar
  75. 75.
    ONTARGET Investigators, Yusuf S, Teo KK, Pogue J, Dyal L, Copland I, et al. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med. 2008;358:1547–59.CrossRefGoogle Scholar
  76. 76.
    Fried LF, Emanuele N, Zhang JH, Brophy M, Conner TA, Duckworth W, et al. Combined angiotensin inhibition for the treatment of diabetic nephropathy. N Engl J Med. 2013;369:1892–903.CrossRefPubMedGoogle Scholar
  77. 77.
    Bakris GL, Weir MR, Secic M, Campbell B, Weis-McNulty A. Differential effects of calcium antagonist subclasses on markers of nephropathy progression. Kidney Int. 2004;65:1991–2002.CrossRefPubMedGoogle Scholar
  78. 78.
    Bakris GL, Sarafidis PA, Weir MR, Dahlöf B, Pitt B, Jamerson K, et al. Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomised controlled trial. Lancet. 2010;375:1173–81.CrossRefPubMedGoogle Scholar
  79. 79.
    Weir MR, Bakris GL, Weber MA, Dahlof B, Devereux RB, Kjeldsen SE, et al. Renal outcomes in hypertensive black patients at high cardiovascular risk. Kidney Int. 2012;81:568–76.CrossRefPubMedGoogle Scholar
  80. 80.
    Eide IK, Torjesen PA, Drolsum A, Babovic A, Lilledahl NP. Low-renin status in therapy-resistant hypertension: a clue to efficient treatment. J Hypertens. 2004;22:2217–26.CrossRefPubMedGoogle Scholar
  81. 81.
    Williams B, MacDonald TM, Morant S, Webb DJ, Sever P, McInnes G, et al. Spironolactone versus placebo, bisoprolol, and doxazosin to determine the optimal treatment for drug-resistant hypertension (PATHWAY-2): a randomised, double-blind, crossover trial. Lancet. 2015;386:2059–68.CrossRefPubMedPubMedCentralGoogle Scholar
  82. 82.
    Nishizaka MK, Zaman MA, Calhoun DA. Efficacy of low-dose spironolactone in subjects with resistant hypertension. Am J Hypertens. 2003;16:925–30.CrossRefPubMedGoogle Scholar
  83. 83.
    Rosendorff C, Lackland DT, Allison M, Aronow WS, Black HR, Blumenthal RS, et al. Treatment of hypertension in patients with coronary artery disease: a scientific statement from the American Heart Association, American College of Cardiology, and American Society of Hypertension. Hypertension. 2015;65:1372–407.CrossRefPubMedGoogle Scholar
  84. 84.
    Hermida RC, Diana E, Ayala DE, Mojón A, Fernández JR. Bedtime dosing of antihypertensive medications reduces cardiovascular risk in CKD. J Am Soc Nephrol. 2011;22:2313–21.CrossRefPubMedPubMedCentralGoogle Scholar
  85. 85.
    Hermida RC, Ayala DE, Mojon A, Fernandez JR. Decreasing sleep-time blood pressure determined by ambulatory monitoring reduces cardiovascular risk. J Am Coll Cardiol. 2011;58:1165–73.CrossRefPubMedGoogle Scholar
  86. 86.
    Ogedegbe G, Schoenthaler A. A systematic review of the effects of home blood pressure monitoring on medication adherence. J Clin Hypertens. 2006;8:174–80.CrossRefGoogle Scholar

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© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Division of Nephrology, Department of Medicine, Sidney Kimmel School of MedicineThomas Jefferson UniversityPhiladelphiaUSA

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