Hypertension management in chronic kidney disease:adherence to intensive blood pressure control and long-term time in target range

ZHOU Shuwen; CAI Guangyan

doi:10.3969/j.issn.1674-3806.2025.12.01

Abstract：In recent years,several large-scale evidence-based medical researches published in top international journals have confirmed that intensive blood pressure control can effectively decrease the mortality of patients with hypertension and reduce their cardiovascular events.However,the impact of intensive blood pressure control on renal outcomes is controversial.Researches have shown that intensive blood pressure control may increase the risk of renal adverse events in the short term,but long-term observations have found that intensive blood pressure control has the effect of delaying the progression of nephropathy in patients with chronic kidney disease(CKD).Intensive blood pressure control has a more significant protective effect on the kidneys of CKD patients complicated with proteinuria and advanced CKD stages,suggesting that CKD patients with different clinical characteristics may obtain differential renal benefits from intensive blood pressure control strategies.Antihypertensive treatment should aim not only at achieving single-time target goal but also at maintaining long-term time in target range.For a long time,the rate of achieving blood pressure targets among CKD patients in China has been low,and the problem of hypertension resulting in the progression of kidney disease has not been effectively controlled.This paper elaborates on the comprehensive benefits of antihypertensive treatment for CKD patients.Based on the latest clinical research results and international guidelines,it emphasizes that efforts should not only be made to increase the rate of achieving blood pressure targets among CKD patients,but also to strive for intensive blood pressure control and achieving long-term time in target range.