Hypertension is both a cause and consequence of chronic kidney disease (CKD). According to
the Chinese national survey in 2007-2010, the prevalence of CKD was much higher in hypertensive patients
(18.9%, n=16,691) than in the overall population sample (10.8%, n=47,204). CKD in hypertension
confers risks to the kidneys as well as other organs. Probably because of high dietary salt intake, Asian
hypertensive patients with CKD show high prevalence of non-dipping and reversed dipping blood
pressure pattern, and may have even higher risks of cardiovascular disease. Therefore, out-of-office blood
pressure evaluation and comprehensive cardiovascular evaluations are required. Most of current
hypertension guidelines recommend intensive antihypertensive treatment in hypertensive patients with
CKD. This is probably of particular relevance for cardiovascular prevention in Asia, because stroke, as a
major complication of hypertension in Asia, is more closely related to blood pressure than coronary
events. Intensive blood pressure control to 130/80 mmHg is often required to prevent CKD progression
and cardiovascular complications. The inhibitors of the renin–angiotensin system (RAS) are recommended
as the first line antihypertensive medications in patients with a glomerular filtration rate higher than 30
ml/min/1.73 m², which may more efficaciously prevent end-stage renal disease and cardiovascular events.
Nonetheless, combination therapy of RAS inhibitors with other classes of antihypertensive drugs, such as
calcium-channel blockers, diuretics, etc, is required to control blood pressure to the target.