Management of Hypertension in Patients With Diabetic Kidney Disease: Summary of the Joint Association of British Clinical Diabetologists and UK Kidney Association (ABCD-UKKA) Guideline 2021

Peridialytic, Intradialytic, and Interdialytic Blood Pressure Measurement in Hemodialysis Patients

Can We Study Hypertension in Patients on Dialysis? Yes We Can

Hypertension in Hemodialysis Patients: The Role of Antihypertensive Medications

Ambulatory Blood Pressure Monitoring: Profiles in Chronic Kidney Disease Patients and Utility in Management.

Clinical Value of Ambulatory Blood Pressure Monitoring in CKD

Section 15: Management of Heart Failure in Special Populations

Prevention of cardiovascular events in end-stage renal disease: Results of a randomized trial of fosinopril and implications for future studies

Aggressive blood pressure reduction and renin–angiotensin system blockade in chronic kidney disease: time for re-evaluation?

ACE inhibitors in hemodialysis patients: Does survival improve?

Complications of Progression of CKD

Ischemic brain injury in hemodialysis patients: which is more dangerous, hypertension or intradialytic hypotension?

Section 5: Management of Asymptomatic Patients with Reduced Left Ventricular Ejection Fraction

Blood Pressure Goals: How Low Is Safe in CKD?

To the Editor: We read with interest the paper by Sega et al regarding the prognostic value of ambulatory, home, and office blood pressure in the PAMELA population.1 However, we find that the main conclusions of the report may be driven by the lack of adjustment for confounders. The relationships between level of blood pressure and risk were not adjusted for age, which may have a major influence on risk over a long time span. There is indeed a relation between age and blood pressure,2 and therefore, these results may be biased. The comparisons of the various blood pressures were also not adjusted for potential confounders, with the argument that “no adjustment for age, sex, and other cardiovascular risk factors was made because comparisons between the predictive value of various blood pressure values involved the same sample.” However, it has been shown in a general Belgian population that the within-subject differences between office and ambulatory blood pressure measurements increased with older age and greater body mass index.3 In addition, in the Danish MONICA population, the within-subject differences between office and ambulatory blood pressure measurements increased with older age, diagnosis of hypertension, male gender, and presence of diabetes.4 So, to assess the true prognostic value of office blood pressure versus that of ambulatory blood pressure, it is mandatory to explore whether adjustments for other relevant cardiovascular risk factors would change the results. Recently, it was shown in the Danish MONICA population that ambulatory blood pressure was a much better predictor of all-cause mortality and cardiovascular mortality than office blood pressure, taking other relevant risk factors into account.5 Accordingly, to make the results from previous studies comparable to the PAMELA study, we would like to know the results of adjusted analyses. Until that time, the conclusion that …

Renin-Angiotensin System Blockade in Advanced Kidney Disease: Stop or Continue?