Blood Pressure and Angiotention Converting Enzyme Inhibitor Use in Hypertensive Patients with Cronic Renal Insufficiency

Control of hypertention in patients with cronic renal failure rduce the risk of progression to end stage renal disease and development of cardiovascular disease. In particular, use of ACE inhibitors has been associated with a delayed loss of renal funtion, although, it is curently unknown if this property is being utilised by prescribing physicians.

We conclude that achieved BP control among hypertensive CRI (chdonic renal insufficiency) subject, thoug no worse than that among those without CRI, remained suboptimal. Patient with a CrCI (creatinin clearence) 21 to 40 mL/min - a population that should be targeted for ACE inhibitor treatment-were actualy less likely to be prescribed ACE inhibitors0. Our data identify areas in which the care of patients with CRI can be improved. Education concerning the importance of agressive BP lowering and apropriate ACE inhibitors use, as well as earlier referal to njephrologist for-co management of CRI patients, may improve the care of the large number of ambulatory patients with reduce renal function.