Antihypertensive Therapy: Progression of Renal Injury

  • Matthew R. Weir
Part of the Atlas of Heart Diseases book series (AD)


Although traditional antihypertensive therapies are effective in controlling blood pressure (BP), deaths from hypertensive sequelae such as coronary artery disease and renal disease, although improved, have not been prevented [1,2]. Our ability to prevent hypertensive nephropathy through traditional methods of lowering BP may not be as effective as once thought, particularly in high-risk patients [3–6]. One reason for this may be the interaction between antihypertensive therapy and the age- and hypertension-induced decline in renal perfusion [7,8]. Depending on their mechanism of action, antihypertensive agents may impair renal blood flow (through plasma volume contraction or reduction in cardiac output) and may activate counter-regulatory neurohormonal mechanisms such as the renin-angiotensin-aldosterone system, which in turn may place the patient at increased risk for the development of glomerular hypertension or glomerular hypertrophy, despite an associated reduction in systemic BP [9–11].


Glomerular Filtration Rate Angiotensin Converting Enzyme Mean Arterial Pressure Renal Injury Antihypertensive Therapy 
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© Springer Science+Business Media New York 2001

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  • Matthew R. Weir

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