How Do I Manage Hypertension in Patients with Advanced Chronic Kidney Disease Not on Dialysis? Perspectives from Clinical Practice

References

• Levey AS, de Jong PE, Coresh J, et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO controversies conference report. Kidney Int. 2011;80(1):17–28. doi:10.1038/ki.2010.483
   PubMed Web of Science ®Google Scholar
• Levin A, Stevens PE. Summary of KDIGO 2012 CKD Guideline: behind the scenes, need for guidance, and a framework for moving forward. Kidney Int. 2014;85(1):49–61. doi:10.1038/ki.2013.444
   PubMed Web of Science ®Google Scholar
• Bikbov B, Purcell CA, Levey AS; Collaboration GBDCKD. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709–733. doi:10.1016/S0140-6736(20)30045-3
   PubMed Web of Science ®Google Scholar
• Hill NR, Fatoba ST, Oke JL, et al. Global prevalence of chronic kidney disease - a systematic review and meta-analysis. PLoS One. 2016;11(7):e0158765. doi:10.1371/journal.pone.0158765
   PubMed Web of Science ®Google Scholar
• Gansevoort RT, Correa-Rotter R, Hemmelgarn BR, et al. Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention. Lancet. 2013;382(9889):339–352. doi:10.1016/S0140-6736(13)60595-4
   PubMed Web of Science ®Google Scholar
• Bruck K, Stel VS, Gambaro G, et al. CKD prevalence varies across the european general population. J Am Soc Nephrol. 2016;27(7):2135–2147. doi:10.1681/ASN.2015050542
   PubMed Web of Science ®Google Scholar
• Report URDSAD. Chapter 1: CKD in the GEneral Population; 2019.
   Google Scholar
• Forni Ogna V, Ogna A, Ponte B, et al. Prevalence and determinants of chronic kidney disease in the Swiss population. Swiss Med Wkly. 2016;146:w14313. doi:10.4414/smw.2016.14313
   PubMed Web of Science ®Google Scholar
• Lamine F, Lalubin F, Pitteloud N, Burnier M, Zanchi A. Chronic kidney disease in type 2 diabetic patients followed-up by primary care physicians in Switzerland: prevalence and prescription of antidiabetic drugs. Swiss Med Wkly. 2016;146:w14282. doi:10.4414/smw.2016.14282
   PubMed Web of Science ®Google Scholar
• Hirst JA, Hill N, O’Callaghan CA, et al. Prevalence of chronic kidney disease in the community using data from OxRen: a UK population-based cohort study. Br J Gen Pract. 2020;70(693):e285–e293. doi:10.3399/bjgp20X708245
   PubMed Web of Science ®Google Scholar
• Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: the Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens. 2018;36(10):1953–2041. doi:10.1097/HJH.0000000000001940
   PubMed Web of Science ®Google Scholar
• Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296–1305. doi:10.1056/NEJMoa041031
   PubMed Web of Science ®Google Scholar
• Keith DS, Nichols GA, Gullion CM, Brown JB, Smith DH. Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch Intern Med. 2004;164(6):659–663. doi:10.1001/archinte.164.6.659
   PubMed Web of Science ®Google Scholar
• Chronic Kidney Disease PrognosisConsortium. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010;375(9731):2073–2081.
   PubMed Web of Science ®Google Scholar
• Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function–measured and estimated glomerular filtration rate. N Engl J Med. 2006;354(23):2473–2483. doi:10.1056/NEJMra054415
   PubMed Web of Science ®Google Scholar
• Carmena R, Ascaso JF, Redon J. Chronic kidney disease as a cardiovascular risk factor. J Hypertens. 2020;38(11):2110–2121. doi:10.1097/HJH.0000000000002506
   PubMed Web of Science ®Google Scholar
• Pogue V, Rahman M, Lipkowitz M, et al. Disparate estimates of hypertension control from ambulatory and clinic blood pressure measurements in hypertensive kidney disease. Hypertension. 2009;53(1):20–27. doi:10.1161/HYPERTENSIONAHA.108.115154
   PubMed Web of Science ®Google Scholar
• Agarwal R, Pappas MK, Sinha AD. Masked uncontrolled hypertension in CKD. J Am Soc Nephrol. 2016;27(3):924–932. doi:10.1681/ASN.2015030243
   PubMed Web of Science ®Google Scholar
• Drawz PE, Alper AB, Anderson AH, et al. Masked hypertension and elevated nighttime blood pressure in CKD: prevalence and association with target organ damage. Clin J Am Soc Nephrol. 2016;11(4):642–652. doi:10.2215/CJN.08530815
   PubMed Web of Science ®Google Scholar
• Georgianos PI, Agarwal R. Resistant hypertension in chronic kidney disease (CKD): prevalence, treatment particularities, and research agenda. Curr Hypertens Rep. 2020;22(10):84. doi:10.1007/s11906-020-01081-x
   PubMed Web of Science ®Google Scholar
• Lin CH, Lurie RC, Lyons OD. Sleep apnea and chronic kidney disease: a state-of-the-art review. Chest. 2020;157(3):673–685. doi:10.1016/j.chest.2019.09.004
   PubMed Web of Science ®Google Scholar
• Ogna A, Forni Ogna V, Haba Rubio J, et al. Sleep characteristics in early stages of chronic kidney disease in the HypnoLaus Cohort. Sleep. 2016;39(4):945–953. doi:10.5665/sleep.5660
   PubMed Web of Science ®Google Scholar
• Burnier M, Coltamai L, Maillard M, Bochud M. Renal sodium handling and nighttime blood pressure. Semin Nephrol. 2007;27(5):565–571. doi:10.1016/j.semnephrol.2007.07.007
   PubMed Web of Science ®Google Scholar
• Fukuda M, Munemura M, Usami T, et al. Nocturnal blood pressure is elevated with natriuresis and proteinuria as renal function deteriorates in nephropathy. Kidney Int. 2004;65(2):621–625. doi:10.1111/j.1523-1755.2004.00419.x
   PubMed Web of Science ®Google Scholar
• Cohen DL, Huan Y, Townsend RR. Ambulatory blood pressure in chronic kidney disease. Curr Hypertens Rep. 2013;15(3):160–166. doi:10.1007/s11906-013-0339-2
   PubMed Web of Science ®Google Scholar
• Agarwal R, Andersen MJ. Correlates of systolic hypertension in patients with chronic kidney disease. Hypertension. 2005;46(3):514–520. doi:10.1161/01.HYP.0000178102.85718.66
   PubMed Web of Science ®Google Scholar
• Peralta CA, Norris KC, Li S, et al. Blood pressure components and end-stage renal disease in persons with chronic kidney disease: the Kidney Early Evaluation Program (KEEP). Arch Intern Med. 2012;172(1):41–47. doi:10.1001/archinternmed.2011.619
   PubMedGoogle Scholar
• Sarafidis PA, Ruilope LM, Loutradis C, et al. Blood pressure variability increases with advancing chronic kidney disease stage: a cross-sectional analysis of 16 546 hypertensive patients. J Hypertens. 2018;36(5):1076–1085. doi:10.1097/HJH.0000000000001670
   PubMed Web of Science ®Google Scholar
• Whelton PK, Carey RM. The 2017 clinical practice guideline for high blood pressure. JAMA. 2017;318(21):2073–2074. doi:10.1001/jama.2017.18209
   PubMed Web of Science ®Google Scholar
• Wheeler DC, Becker GJ. Summary of KDIGO guideline. What do we really know about management of blood pressure in patients with chronic kidney disease? Kidney Int. 2013;83(3):377–383. doi:10.1038/ki.2012.425
   PubMed Web of Science ®Google Scholar
• Cheung AK, Chang TI, Cushman WC, et al. Blood pressure in chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2019;95(5):1027–1036. doi:10.1016/j.kint.2018.12.025
   PubMed Web of Science ®Google Scholar
• Garofalo C, Borrelli S, Provenzano M, et al. Dietary salt restriction in chronic kidney disease: a meta-analysis of randomized clinical trials. Nutrients. 2018;10(6):732. doi:10.3390/nu10060732
   PubMed Web of Science ®Google Scholar
• McMahon EJ, Campbell KL, Bauer JD, Mudge DW. Altered dietary salt intake for people with chronic kidney disease. Cochrane Database Syst Rev. 2015;2:Cd010070. doi:10.1002/14651858.CD010070.pub2
   PubMed Web of Science ®Google Scholar
• McMahon EJ, Bauer JD, Hawley CM, et al. A randomized trial of dietary sodium restriction in CKD. J Am Soc Nephrol. 2013;24(12):2096–2103. doi:10.1681/ASN.2013030285
   PubMed Web of Science ®Google Scholar
• Lambers Heerspink HJ, Holtkamp FA, Parving HH, et al. Moderation of dietary sodium potentiates the renal and cardiovascular protective effects of angiotensin receptor blockers. Kidney Int. 2012;82(3):330–337. doi:10.1038/ki.2012.74
   PubMed Web of Science ®Google Scholar
• Burnier M. Sodium intake and progression of chronic kidney disease-has time finally come to do the impossible: a prospective randomized controlled trial? Nephrol Dial Transplant. 2020. doi:10.1093/ndt/gfaa120
   Web of Science ®Google Scholar
• Aburto NJ, Hanson S, Gutierrez H, Hooper L, Elliott P, Cappuccio FP. Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses. BMJ. 2013;346:f1378. doi:10.1136/bmj.f1378
   PubMed Web of Science ®Google Scholar
• Burnier M. Should we eat more potassium to better control blood pressure in hypertension? Nephrol Dial Transplant. 2019;34(2):184–193. doi:10.1093/ndt/gfx340
   PubMed Web of Science ®Google Scholar
• Brenner BM, Cooper ME, de Zeeuw D, et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. 2001;345(12):861–869. doi:10.1056/NEJMoa011161
   PubMed Web of Science ®Google Scholar
• Hou FF, Zhang X, Zhang GH, et al. Efficacy and safety of benazepril for advanced chronic renal insufficiency. N Engl J Med. 2006;354(2):131–140. doi:10.1056/NEJMoa053107
   PubMed Web of Science ®Google Scholar
• Lewis EJ, Hunsicker LG, Clarke WR, et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med. 2001;345(12):851–860. doi:10.1056/NEJMoa011303
   PubMed Web of Science ®Google Scholar
• Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129–2200. doi:10.1093/eurheartj/ehw128
   PubMed Web of Science ®Google Scholar
• Taler SJ, Agarwal R, Bakris GL, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for management of blood pressure in CKD. Am J Kidney Dis. 2013;62(2):201–213. doi:10.1053/j.ajkd.2013.03.018
   PubMed Web of Science ®Google Scholar
• Schmidt M, Mansfield KE, Bhaskaran K, et al. Serum creatinine elevation after renin-angiotensin system blockade and long term cardiorenal risks: cohort study. BMJ. 2017;356:j791. doi:10.1136/bmj.j791
   PubMedGoogle Scholar
• Ahmed A, Jorna T, Bhandari S. Should we STOP angiotensin converting enzyme inhibitors/angiotensin receptor blockers in advanced kidney disease? Nephron. 2016;133(3):147–158. doi:10.1159/000447068
   PubMed Web of Science ®Google Scholar
• Burnier M. Renin-angiotensin system blockade in advanced kidney disease: stop or continue? Kidney Med. 2020;2(3):231–234. doi:10.1016/j.xkme.2020.04.002
   PubMedGoogle Scholar
• Epstein M, Reaven NL, Funk SE, McGaughey KJ, Oestreicher N, Knispel J. Evaluation of the treatment gap between clinical guidelines and the utilization of renin-angiotensin-aldosterone system inhibitors. Am J Manag Care. 2015;21(11 Suppl):S212–220.
   PubMed Web of Science ®Google Scholar
• Weir MR, Bakris GL, Bushinsky DA, et al. Patiromer in patients with kidney disease and hyperkalemia receiving RAAS inhibitors. N Engl J Med. 2015;372(3):211–221. doi:10.1056/NEJMoa1410853
   PubMed Web of Science ®Google Scholar
• Sinha AD, Agarwal R. Thiazides are useful agents in CKD. J Am Soc Hypertens. 2016;10(4):288–289. doi:10.1016/j.jash.2016.02.006
   PubMed Web of Science ®Google Scholar
• Dussol B, Moussi-Frances J, Morange S, Somma-Delpero C, Mundler O, Berland Y. A pilot study comparing furosemide and hydrochlorothiazide in patients with hypertension and stage 4 or 5 chronic kidney disease. J Clin Hypertens (Greenwich). 2012;14(1):32–37. doi:10.1111/j.1751-7176.2011.00564.x
   PubMed Web of Science ®Google Scholar
• Bovee DM, Visser WJ, Middel I, et al. A randomized trial of distal diuretics versus dietary sodium restriction for hypertension in chronic kidney disease. J Am Soc Nephrol. 2020;31(3):650–662. doi:10.1681/ASN.2019090905
   PubMed Web of Science ®Google Scholar
• Wright JT Jr., Bakris G, Greene T, et al. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA. 2002;288(19):2421–2431. doi:10.1001/jama.288.19.2421
   PubMed Web of Science ®Google Scholar
• Burnier M. Renal protection with calcium antagonists: the role of lercanidipine. Curr Med Res Opin. 2013;29(12):1727–1735. doi:10.1185/03007995.2013.842891
   PubMed Web of Science ®Google Scholar
• Zanchi A, Brunner HR, Waeber B, Burnier M. Renal haemodynamic and protective effects of calcium antagonists in hypertension. J Hypertens. 1995;13(12 Pt 1):1363–1375. doi:10.1097/00004872-199512000-00002
   PubMed Web of Science ®Google Scholar
• Bakris GL, Sarafidis PA, Weir MR, et al. Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomised controlled trial. Lancet. 2010;375(9721):1173–1181. doi:10.1016/S0140-6736(09)62100-0
   PubMed Web of Science ®Google Scholar
• Jamerson K, Weber MA, Bakris GL, et al. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med. 2008;359(23):2417–2428. doi:10.1056/NEJMoa0806182
   PubMed Web of Science ®Google Scholar
• Flack JM, Sica DA, Bakris G, et al. Management of high blood pressure in Blacks: an update of the International Society on Hypertension in Blacks consensus statement. Hypertension. 2010;56(5):780–800. doi:10.1161/HYPERTENSIONAHA.110.152892
   PubMed Web of Science ®Google Scholar
• Ojji DB, Mayosi B, Francis V, et al. Comparison of dual therapies for lowering blood pressure in Black Africans. N Engl J Med. 2019;380(25):2429–2439. doi:10.1056/NEJMoa1901113
   PubMed Web of Science ®Google Scholar
• Penne EL, Neumann J, Klein IH, Oey PL, Bots ML, Blankestijn PJ. Sympathetic hyperactivity and clinical outcome in chronic kidney disease patients during standard treatment. J Nephrol. 2009;22(2):208–215.
   PubMed Web of Science ®Google Scholar
• Converse RL Jr., Jacobsen TN, Toto RD, et al. Sympathetic overactivity in patients with chronic renal failure. N Engl J Med. 1992;327(27):1912–1918. doi:10.1056/NEJM199212313272704
   PubMed Web of Science ®Google Scholar
• Briet M, Schiffrin EL. Aldosterone: effects on the kidney and cardiovascular system. Nat Rev Nephrol. 2010;6(5):261–273. doi:10.1038/nrneph.2010.30
   PubMed Web of Science ®Google Scholar
• Currie G, Taylor AH, Fujita T, et al. Effect of mineralocorticoid receptor antagonists on proteinuria and progression of chronic kidney disease: a systematic review and meta-analysis. BMC Nephrol. 2016;17(1):127.
   PubMed Web of Science ®Google Scholar
• Chung EY, Ruospo M, Natale P, et al. Aldosterone antagonists in addition to renin angiotensin system antagonists for preventing the progression of chronic kidney disease. Cochrane Database Syst Rev. 2020;10:Cd007004. doi:10.1002/14651858.CD007004.pub4
   PubMedGoogle Scholar
• Williams B, MacDonald TM, Morant S, et al. Spironolactone versus placebo, bisoprolol, and doxazosin to determine the optimal treatment for drug-resistant hypertension (PATHWAY-2): a randomised, double-blind, crossover trial. Lancet. 2015;386(10008):2059–2068. doi:10.1016/S0140-6736(15)00257-3
   PubMed Web of Science ®Google Scholar
• Bakris GL, Agarwal R, Anker SD, et al. Effect of Finerenone on chronic kidney disease outcomes in type 2 diabetes. N Engl J Med. 2020;383(23):2219–2229. doi:10.1056/NEJMoa2025845
   PubMed Web of Science ®Google Scholar
• Vonend O, Marsalek P, Russ H, Wulkow R, Oberhauser V, Rump LC. Moxonidine treatment of hypertensive patients with advanced renal failure. J Hypertens. 2003;21(9):1709–1717. doi:10.1097/00004872-200309000-00021
   PubMed Web of Science ®Google Scholar
• Barzilay J, Grimm R, Cushman W, Bertoni AG, Basile J. Getting to goal blood pressure: why reserpine deserves a second look. J Clin Hypertens (Greenwich). 2007;9(8):591–594. doi:10.1111/j.1524-6175.2007.07229.x
   PubMedGoogle Scholar
• Siddiqui M, Bhatt H, Judd EK, Oparil S, Calhoun DA. Reserpine substantially lowers blood pressure in patients with refractory hypertension: a Proof-of-Concept Study. Am J Hypertens. 2020;33(8):741–747. doi:10.1093/ajh/hpaa042
   PubMed Web of Science ®Google Scholar
• Krieger EM, Drager LF, Giorgi DMA, et al. Spironolactone versus clonidine as a fourth-drug therapy for resistant hypertension. Hypertension. 2018;71(4):681–690. doi:10.1161/HYPERTENSIONAHA.117.10662
   PubMed Web of Science ®Google Scholar
• Kristensen SL, Rorth R, Jhund PS, et al. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet Diabetes Endocrinol. 2019;7(10):776–785. doi:10.1016/S2213-8587(19)30249-9
   PubMed Web of Science ®Google Scholar
• Zelniker TA, Wiviott SD, Raz I, et al. SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet. 2019;393(10166):31–39. doi:10.1016/S0140-6736(18)32590-X
   PubMed Web of Science ®Google Scholar
• Dekkers CCJ, Wheeler DC, Sjöström CD, Stefansson BV, Cain V, Heerspink HJL. Effects of the sodium-glucose co-transporter 2 inhibitor dapagliflozin in patients with type 2 diabetes and Stages 3b-4 chronic kidney disease. Nephrol Dial Transplant. 2018;33(11):2005–2011. doi:10.1093/ndt/gfx350
   PubMed Web of Science ®Google Scholar
• Mancia G, Cannon CP, Tikkanen I, et al. Impact of empagliflozin on blood pressure in patients with type 2 diabetes mellitus and hypertension by background antihypertensive medication. Hypertension. 2016;68(6):1355–1364. doi:10.1161/HYPERTENSIONAHA.116.07703
   PubMed Web of Science ®Google Scholar
• Heerspink HJL, Stefansson BV, Chertow GM, et al. Rationale and protocol of the Dapagliflozin And Prevention of Adverse outcomes in Chronic Kidney Disease (DAPA-CKD) randomized controlled trial. Nephrol Dial Transplant. 2020;35(2):274–282. doi:10.1093/ndt/gfz290
   PubMed Web of Science ®Google Scholar
• Heerspink HJL, Stefansson BV, Correa-Rotter R, et al. Dapagliflozin in patients with chronic kidney disease. N Engl J Med. 2020;383(15):1436–1446. doi:10.1056/NEJMoa2024816
   PubMed Web of Science ®Google Scholar
• Fernandez-Fernandez B, Sarafidis P, Kanbay M, et al. SGLT2 inhibitors for non-diabetic kidney disease: drugs to treat CKD that also improve glycaemia. Clin Kidney J. 2020;13(5):728–733. doi:10.1093/ckj/sfaa198
   PubMed Web of Science ®Google Scholar
• Packer M, Anker SD, Butler J, et al. Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med. 2020;383(15):1413–1424. doi:10.1056/NEJMoa2022190
   PubMed Web of Science ®Google Scholar
• Stavropoulos K, Patoulias D, Imprialos K, et al. Efficacy and safety of renal denervation for the management of arterial hypertension: A systematic review and meta-analysis of randomized, sham-controlled, catheter-based trials. J Clin Hypertens (Greenwich). 2020;22(4):572–584. doi:10.1111/jch.13827
   PubMed Web of Science ®Google Scholar
• Bohm M, Kario K, Kandzari DE, et al. Efficacy of catheter-based renal denervation in the absence of antihypertensive medications (SPYRAL HTN-OFF MED Pivotal): a multicentre, randomised, sham-controlled trial. Lancet. 2020;395(10234):1444–1451.
   PubMed Web of Science ®Google Scholar
• Singh RR, Denton KM. Renal Denervation. Hypertension. 2018;72(3):528–536. doi:10.1161/HYPERTENSIONAHA.118.10265
   PubMed Web of Science ®Google Scholar
• Hering D, Mahfoud F, Walton AS, et al. Renal denervation in moderate to severe CKD. J Am Soc Nephrol. 2012;23(7):1250–1257. doi:10.1681/ASN.2011111062
   PubMed Web of Science ®Google Scholar
• Veelken R, Schmieder RE. Renal denervation–implications for chronic kidney disease. Nat Rev Nephrol. 2014;10(6):305–313. doi:10.1038/nrneph.2014.59
   PubMed Web of Science ®Google Scholar
• Burnier M, Pruijm M, Wuerzner G, Santschi V. Drug adherence in chronic kidney diseases and dialysis. Nephrol Dial Transplant. 2015;30(1):39–44. doi:10.1093/ndt/gfu015
   PubMed Web of Science ®Google Scholar
• Schmitt KE, Edie CF, Laflam P, Simbartl LA, Thakar CV. Adherence to antihypertensive agents and blood pressure control in chronic kidney disease. Am J Nephrol. 2010;32(6):541–548. doi:10.1159/000321688
   PubMed Web of Science ®Google Scholar
• KDIGO Clinical Practice. Guideline for the management of blood pressure in chronic kidney disease. Kidney Int Supple. 2012;2(5):372–376.
   Web of Science ®Google Scholar
• Boffa RJ, Constanti M, Floyd CN, Wierzbicki AS. Hypertension in adults: summary of updated NICE guidance. BMJ. 2019;367:l5310. doi:10.1136/bmj.l5310
   PubMedGoogle Scholar
• Rabi DM, McBrien KA, Sapir-Pichhadze R, et al. Hypertension Canada’s 2020 comprehensive guidelines for the prevention, diagnosis, risk assessment, and treatment of hypertension in adults and children. Can J Cardiol. 2020;36(5):596–624. doi:10.1016/j.cjca.2020.02.086
   PubMed Web of Science ®Google Scholar