What is the first-line treatment for hypertension in ADPKD?

What is the first-line treatment for hypertension in ADPKD?

• A. Calcium channel blockers
• B. Diuretics
• C. Beta blockers
• D. ACE inhibitors or ARBs

Answer: (D)

Hypertension in ADPKD often stems from activation of the renin-angiotensin-aldosterone system, so blocking this system not only lowers blood pressure but also protects kidney function. ACE inhibitors or ARBs reduce intraglomerular pressure and proteinuria, which helps slow CKD progression in these patients. This renoprotective effect makes these agents the preferred first-line choice for hypertension in ADPKD. Other classes like calcium channel blockers, diuretics, or beta blockers can be added if blood pressure targets aren’t reached or for other conditions, but they don’t offer the same early kidney protection as RAAS blockade. Start with an ACE inhibitor or ARB, and monitor kidney function and potassium after initiation.

Hypertension in ADPKD often stems from activation of the renin-angiotensin-aldosterone system, so blocking this system not only lowers blood pressure but also protects kidney function. ACE inhibitors or ARBs reduce intraglomerular pressure and proteinuria, which helps slow CKD progression in these patients. This renoprotective effect makes these agents the preferred first-line choice for hypertension in ADPKD. Other classes like calcium channel blockers, diuretics, or beta blockers can be added if blood pressure targets aren’t reached or for other conditions, but they don’t offer the same early kidney protection as RAAS blockade. Start with an ACE inhibitor or ARB, and monitor kidney function and potassium after initiation.