351- Some medications used for other reasons in renal patients may transform hyper-
tension into RH (not a true RH). Cyclosporine, steroids (in renal transplant recip-
ients) and erythropoietin (in patients with renal anemia) are examples. GPs
should be aware of these and other drugs used in this highly comorbid patient
population. Over the counter medications, NSAIDs, antidepressants, oral contra-
ceptive pills, and a host of other potential culprits should be elucidated in patients
with RH. - While struggling to achieve target BP levels in patients with RH, GPs should
also aim at retarding the progression of kidney disease when selecting antihyper-
tensive medications. In this respect, rugs which have been shown to reduce pro-
teinuria and slow the progression of kidney disease such as ACE inhibitors and
ARBs should be constant components of the antihypertensive regimen.
Nondihydropyridine calcium channel blockers (CCB) should be chosen over
dihydropyridine CCBs owing to their more favorable effects on proteinuria [ 34 ].
Combined use of ACE inhibitor and ARB should be avoided particularly in
patients with moderate to severe renal disease.
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22 Resistant Hypertension and the General Practitioner (Monitoring and Treatment)