Blood pressure control in hypertensive patients with chronic kidney disease
I read the article by Cha et al., who conducted a 1-year follow-up study to examine the blood pressure (BP) control and nocturnal patterns in 378 hypertensive patients with chronic kidney disease (CKD) and their effects on target organ damage. The survey was conducted twice at 1-year intervals. Percentages of patients at the time of enrollment and one year later (in parenthesis) were true controlled (16.5, 17.5%), white-coat (2.9, 0.4%), masked (50.0, 53.3%), and sustained uncontrolled (30.6, 28.8%) hypertension, respectively. Better BP control and dipping changes were associated with more stable CKD by changes in estimated glomerular filtration rate (eGFR) and proteinuria. In addition, masked hypertension and sustained uncontrolled hypertension were associated with higher incidence of cardiovascular–cerebrovascular events. I have some concerns about these findings.