187Table 12.1Target blood pressure (BP) in chronic kidney disease and definition of resistant hypertensionTarget BP in chronic kidney diseaseTarget BP in chronic kidney disease with pathological albuminuria/proteinuriaTarget BP in elderly personsDefinition of resistant hypertensionKDIGO≤
140/90≤
130/80No specific targetsn. a.CHEP<140/90 in nondiabetic<130/80 in DMAs in chronic kidney diseaseAge≥
80 years:Systolic BP <150bn. a.JNC 8<140/90As in chronic kidney diseaseAge≥
60 years:<140/90 if DM and/or chronic kidney diseasen. a.JNC 7<130/80As in chronic kidney diseaseNo specific targetsFailure to achieve goal BP in patients who are adhering to full doses of an appropriate three-drug regimen that includes a diureticISH/ASH<140/90As in chronic kidney diseaseaAge≥
80 years:<140/90 if DM and/or chronic kidney diseaseBP≥
140/90 mmHg with use of three drugs(ACEi or ARB/CCB/diuretic) in full or maximally tolerated dosesNICE<140/90 in nondiabetic<130/80 in DM<130/80Age≥
80 years:<150/90bBP >140/90 mmHg after treatment with the optimal or best tolerated doses of an ACE inhibitor or an ARB plus a CCB plus a diureticNHFA<130/80<125/75No specific targetsn. a.ESC/ESHSystolic BP <140Systolic BP <130Age≥
80 years:<150/90bBP≥
140/90 mmHg with appropriate lifestylemeasures and three drugs (a diuretic and two other drugs belonging to different classes, not necessarily including a MRA) at adequate dosesAdapted from [6 ]; with permission. BP expressed in mmHgn. a.not addressed,BPblood pressure,DMdiabetes mellitus,ACEangiotensin-converting enzyme,ARBangiotensin receptor blocker,CCBcalcium channelblocker,MRAmineralocorticoid receptor antagonistNote that BP targets apply to seated office BP measurementsaISH/ASH generally recommend a < 140/90 mmHg BP target for chronic kidney disease but acknowledge that “some experts still recommend less than 130/80 mmHg” in albuminuriabNo specific recommendations are given for elderly persons with chronic kidney disease and/or DM12 Resistant Hypertension in Elderly People with Chronic Kidney Disease