Arterial hypertension affects the majority of patients with end-stage renal disease treated with dialysis and its control is mostly inadequate.[1, 2] In these patients, the optimal blood pressure (BP) target has not been established and studies on mortality and hypertension have yielded conflicting results.[3, 4] While some studies failed to show that hypertension influences the survival of patients, others have suggested the presence of a “J” curve or a more complex relationship between BP and mortality.[5-7] These conflicting results have been ascribed to the differences in the modality of BP measurement or to the presence of comorbid conditions.[8, 9] Important confounding variables, such as those related to dialytic treatment or to antihypertensive therapy often have not been taken into consideration. Furthermore, most studies come mainly from North America or Japan and there are no long-term studies in large numbers of patients from Europe.
The purpose of this study was to investigate the relationship between BP and antihypertensive treatment with all-cause mortality in a large population of Italian dialysis patients.