Capítulo 5: Hipertensión arterial: IECA-ARA-finerenona, ¿otros fármacos antihipertensivos?
DOI:
https://doi.org/10.47196/diab.v58i2Sup.788Palabras clave:
presión arterial, diabetes mellitus, enfermedad renalResumen
La hipertensión arterial (HTA) juega un rol capital en la enfermedad renal (ER), por lo cual la evaluación en forma precisa es esencial. La HTA puede acelerar la progresión de la ER, su presencia, por otro lado, puede dificultar el control adecuado de la presión arterial (PA) y esta combinación aumenta significativamente el riesgo de eventos CV en la población con ERC. La PA de consultorio (PAC) es necesaria, pero no suficiente en pacientes con ERC, por lo tanto, es recomendable complementar la evaluación con automonitoreo de la PA (AMPA), monitoreo domiciliario de la PA (MDPA) y monitoreo ambulatorio de la PA (MAPA), según disponibilidad.
Un escenario particular es el paciente en tratamiento sustitutivo (hemodiálisis) donde la PA (pre, intra y pos) no es adecuada para indicar tratamiento y no se relaciona con resultados CV. El MAPA de 44 horas es la recomendación para tomar conductas terapéuticas que modifiquen el pronóstico CV en este contexto.
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