Several nontraditional factors, such hyperhomocysteinemia, oxidant stress, dyslipidemia, and elevated inflammatory markers, are associated with atherosclerosis. Most of the traditional CVD risk factors, such as older age, diabetes, systolic hypertension, left ventricular hypertrophy, and low HDL cholesterol, are highly prevalent in CKD. ( 4) demonstrated that reduced estimated GFR <60 ml/min per 1.73 m 2 independently predicts the risk for death and cardiovascular events in individuals with or without known CVD. The task force recommended that patients with CKD be considered in the highest risk group. This report showed that there was a high prevalence of CVD in CKD and that mortality as a result of CVD was 10 to 30 times higher in dialysis patients than in the general population. In 1998, the National Kidney Foundation Task Force issued a report that emphasized the high risk for CVD in CKD ( 3). CVD in CKD is treatable and potentially preventable, and CKD seems to be a risk factor for CVD ( 2). However, cardiovascular disease (CVD) also frequently is associated with CKD, which is important because individuals with CKD are more likely to die of CVD than to develop ESRD ( 1).
ESRD that requires treatment with dialysis or transplantation is the most visible outcome of CKD. There is a rising incidence and prevalence of ESRD, with poor outcome and high cost. The purpose of this review is to show the importance of PP on cardiovascular risk in patients with CKD, including kidney transplant recipients.Ĭhronic kidney disease (CKD) is a worldwide public health problem. Several studies have shown that PP is a reliable prognostic factor for mortality and CVD in patients who have CKD and are on hemodialysis and in renal transplant patients. The burden of hypertension is present at all stages of CKD. Most of the traditional CVD risk factors are highly prevalent in CKD, and several nontraditional factors also are associated with atherosclerosis in CKD. This holds true for all stages of kidney disease, including ESRD that requires renal replacement therapy. The progression of kidney disease and its associated cardiovascular complications are the major causes of morbidity and mortality. Chronic kidney disease (CKD) is a major public health problem. Increasingly, PP is recognized as an independent predictor of myocardial infarction, congestive heart failure, and cardiovascular death, even in hypertensive patients who undergo successful antihypertensive drug therapy, especially in older individuals. PP reflects stiffness of the large arteries and increases with age. Systolic BP seems to be a more important factor than diastolic BP on cardiovascular and all-cause mortality in older patients. Recently published prospective studies have focus on systolic and pulse pressure (PP). Heart-smart strategies include getting regular exercise, not smoking, limiting alcohol and reducing the amount of salt in the diet.Epidemiologic studies have emphasized the close relationship between high BP and cardiovascular disease (CVD).
Following a healthy lifestyle is also important. Treating high blood pressure usually reduces pulse pressure.
The greater the pulse pressure, the stiffer and more damaged the blood vessels are thought to be. High blood pressure or fatty deposits on the walls of the arteries (atherosclerosis) can make the arteries stiff. Stiffness of the body's largest artery (aorta) is the leading cause of increased pulse pressure in older adults. A pulse pressure greater than 60 is considered a risk factor for cardiovascular disease, especially for older adults. Measuring pulse pressure may help a health care provider predict the risk of a heart event, including a heart attack or stroke. Generally, a pulse pressure greater than 40 mm Hg is unhealthy. For example, if the resting blood pressure is 120/80 millimeters of mercury (mm Hg), the pulse pressure is 40 - which is considered a healthy pulse pressure.
The top number (systolic) minus the bottom number (diastolic) is the pulse pressure.
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