Current opinion in nephrology and hypertension
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During the past 12 months additional evidence has emerged from observational studies indicating that high blood pressure is an important independent predictor of incident renal damage, progression of existing renal disease, and morbidity and mortality in patients with renal failure. Several of these studies suggest that elevation of systolic blood pressure is a stronger predictor of risk than a corresponding increase in diastolic blood pressure. ⋯ Ongoing trials should help clarify optimal choice of antihypertensive medications and goals for reduction of blood pressure in prevention of renal disease. In the interim, two new guidelines for management of hypertension in patients with existing renal disease provide helpful guidance for the clinician.