Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hypertens. Nov 23, 2015; 5(4): 115-118
Published online Nov 23, 2015. doi: 10.5494/wjh.v5.i4.115
Kidney and cardiovascular risk in primary hypertension
Francesca Viazzi, Francesca Cappadona, Barbara Bonino, Roberto Pontremoli
Francesca Viazzi, Francesca Cappadona, Barbara Bonino, Roberto Pontremoli, Università degli Studi di Genova, IRCCS Azienda Ospedaliera Universitaria San Martino IST, 16132 Genova, Italy
Author contributions: All the authors equally contributed to this work.
Conflict-of-interest statement: The authors have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Roberto Pontremoli, MD, PhD, Università degli Studi di Genova, IRCCS Azienda Ospedaliera Universitaria San Martino IST, Largo Rosanna Benzi, 10, 16132 Genova, Italy. roberto.pontremoli@unige.it
Telephone: +39-10-3538932 Fax: +39-10-8561237
Received: June 18, 2015
Peer-review started: June 20, 2015
First decision: July 27, 2015
Revised: August 3, 2015
Accepted: September 10, 2015
Article in press: September 16, 2015
Published online: November 23, 2015
Processing time: 153 Days and 14.6 Hours
Abstract

In patients with primary hypertension, therapeutic strategies should be based on global cardiovascular risk profile rather than on the severity of blood pressure alone. Accurate assessment of concomitant risk factors and especially of the presence and extent of subclinical organ damage is of paramount importance in defining individual risk. Given the high prevalence of hypertension in the population at large, however, extensive diagnostic evaluation is often impractical or unfeasible in clinical practice. Low cost, easy to use markers of risk are needed to improve the clinical management of patients with hypertension. Early renal abnormalities such as a slight reduction in glomerular filtration rate and/or the presence of microalbuminuria are well known and powerful predictors of cardio-renal morbidity and mortality and provide a useful, low cost tools to optimize cardiovascular risk assessment. A greater use of these tests should therefore be implemented in clinical practice in order to optimize the management of hypertensive patients.

Keywords: Hypertension; Albuminuria; Cardiovascular risk; Glomerular filtration rate; Risk assessment; Kidney

Core tip: Accurate assessment of global cardiovascular risk, including the search for subclinical organ damage is key for devising effective therapeutic strategies in patients with primary hypertension but is often unfeasible for economic and logistic reasons given the very high prevalence of this condition. Early renal abnormalities such as slight reduction in glomerular filtration rate and/or the presence of microalbuminuria are well known and powerful predictors of cardio-renal morbidity and mortality and provide the useful, low cost tools to optimize cardiovascular risk assessment. A greater use of these tests should therefore be implemented in clinical practice in order to optimize the management of hypertensive patients.