Chronic kidney disease (CKD) is common. People with CKD have a wide range of comorbidities and, therefore, the majority of non-nephrologists will care for people with CKD. This paper aims to provide a brief overview of the diagnosis and management of CKD for the non-nephrologist.
The epidemiology of arterial hypertension and its treatment has been underlined by a huge research literature. Consistently raised arterial blood pressure in a clinic or home setting is a simple clinical observation that marks a predilection to a variety of fatal and non-fatal vascular disease events. Over the past 50 years tolerable, safe and effective primary and secondary medicines to offset a substantial amount of the associated morbidity and mortality risk of elevated blood pressure have emerged.
This review is based on presentations given at the Symposium of the High Blood Pressure Foundation supported by RCPE on 23 November 2011.National Institute for Health and Clinical Excellence guidance for the clinical management of hypertension, published last year, proposes a step change in UK clinical practice.1 Although broadly helpful, there are some concerns about its implementation. Ambulatory blood pressure monitoring for diagnosis of hypertension, though logical, will place an additional financial burden on primary care at a time of austerity.
Background: The prevalence of hypertension in a population is the sum of those individuals with a blood pressure (BP) exceeding 140/90 mm Hg plus those with normal BP on antihypertensive therapy (this is usually about 20–30% of the population). Rest normally reduces BP but the frequency and extent of the fall remains unclear.
Methods: This study analysed the results of 1,008 consecutive life assurance examinations in which BP was recorded twice, before and after a ten minute period of recumbent rest.
