Abstract
A 70-YEAR-OLD white woman has a 15-year history of hypertension that is currently being treated with a calcium channel blocker. She has no other medical problems. On physical examination, her blood pressure is 150/90 mm Hg. Blood tests show a serum creatinine level of 1.7 mg/dL (150 μmol/L) and an estimated glomerular filtration rate (GFR) of 37 mL/min/1.73 m2. Her serum low-density lipoprotein cholesterol level is 130 mg/dL (3.36 mmol/L). Urine studies show a bland urinalysis and spot protein-creatinine ratio of 1,500 mg/g. Is this patient at high risk for the development of cardiovascular disease (CVD)? If so, how should this patient be treated to reduce the risk for CVD and slow the progression of chronic kidney disease (CKD)?
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