News - Hypertension Week of August 24, 2003/ Vol. 2 No. 34

Study: Reducing Urinary Protein Key for Kidney Patients With Hypertension

Reducing urinary protein is important in preserving kidney function in patients suffering from kidney disease and hypertension, according to a study reported in the August 19 issue of the Annals of Internal Medicine.

Most patients with chronic kidney disease have high blood pressure and high levels of protein in their urine called proteinuria. Some blood pressure drugs such as angiotensin-converting enzyme (ACE) inhibitors prevent a worsening of kidney function by reducing both blood pressure and protein in urine.

The researchers sought to determine the levels of blood pressure and protein in urine that are associated with the lowest risk for worsening kidney disease.

They found that patients had less risk of worsening kidney function as long as the patients' systolic (upper number) blood pressure stayed between 110 to 129 points and their urine protein levels remained at less than one gram daily.

In an accompanying editorial, Drs. Cynthia Mulrow and Raymond Townsend, who are editors at the journal, said the findings add credence to the periodic measuring of proteinuria in all patients with hypertension.

Mulrow and Townsend said physicians should recognize that ACE inhibitors only partially reduce proteinuria in some patients and that it may be beneficial to combine an angiotensin-receptor blocker with an ACE inhibitor, even when systolic blood pressure is controlled to less than 130 points.

Other sources: Annals of Internal Medicine, 139:4: 244-52