Kidney Function and Hypertension in Heart Failure: They Go Hand in Hand

Kidney Function and Hypertension in Heart Failure: They Go Hand in Hand Posted By:
...

We all have been educated numerous times about the need to control hypertension in all patients with that diagnosis. This is particularly in patients with heart failure (HF), where kidney function plays an important role in how well we can control blood pressure. Recently, a causal mediation analysis (using estimated glomerular filtration rate [eGFR] as the mediator) of the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Lower Heart Attack) trial data was performed to look at the relationship between blood pressure control, HF, and kidney function.

Within the data, there were more than 1700 incident HF events—with 1359 hospitalizations/fatal HF events. Analysis of this revealed that a relative change in eGFR was related to the effect of antihypertensive agents in HF. The authors concluded that the eGFR change was responsible for 50% of the effect of antihypertensive agents in HF on the risk difference scale. The drugs noted to be mediated by eGFR in the analysis were chlorthalidone and lisinopril, as compared with amlodipine and doxazosin.

The bottom line is that placing your patients on antihypertension medications and getting appropriate control can directly impact HF prevention: As the patient's renal function worsens due to lack of adequate blood pressure control, the greater their risk for incident symptomatic HF. As practitioners, we must work with our patients to help control comorbidities and, thus, mitigate some of the potentially harmful impacts of disease.

References
  • Khayyat-Kholghi M, et al. Worsening kidney function is the major mechanism of heart failure in hypertension: The ALLHAT study. JACC Heart Fail. 2021;9:100.

Share

Filed under: Cardiometabolic

Related
Phase III FLOW Trial Results Establishes Semaglutide’s Role in Treating T2D and CKD

Phase III FLOW Trial Results Establishes Semagluti ...

The highly anticipated results of the FLOW (Evaluate Renal Function with Semaglutide Once Weekly) tr ...

Filed under: Cardiometabolic, NPs & PAs


Continue Reading
The Gift of Time and Key Connection Between Diabetes Mellitus and Autoimmune Disorders

The Gift of Time and Key Connection Between Diabet ...

Are you aware that approximately 64,000 Americans are diagnosed with type 1 diabetes (T1D) each year ...

Filed under: Cardiometabolic


Continue Reading
The Importance of Shared Decision-making in Obesity

The Importance of Shared Decision-making in Obesit ...

Many areas of healthcare are starting to talk about the importance of shared decision-making (SDM), ...

Filed under: Cardiometabolic, NPs & PAs


Continue Reading
Addressing ASCVD Risk in HIV: An Update to the DHHS HIV Guidelines

Addressing ASCVD Risk in HIV: An Update to the DHH ...

The incidence of atherosclerotic cardiovascular disease (ASCVD) is estimated to be twice as high in ...

Filed under: Infectious Diseases, Preventive Medicine, Public Health, Cardiometabolic, NPs & PAs


Continue Reading
Understanding the Multifactorial Etiology of Obesity and the Metabolic Adaptations to Weight Loss

Understanding the Multifactorial Etiology of Obesi ...

Obesity Causes Overeating, Not the Other Way AroundOne of my favorite quotes from Dr Lee Kaplan is, ...

Filed under: Cardiometabolic, NPs & PAs


Continue Reading
Atrial Fibrillation: Optimizing Outcomes by Addressing Social Determinants of Health and Implicit Bias

Atrial Fibrillation: Optimizing Outcomes by Addres ...

Atrial fibrillation (AF) is the most common sustained arrhythmia diagnosed, and its prevalence is ex ...

Filed under: Cardiometabolic, NPs & PAs


Continue Reading