To the Editor.—
In his review of the management of hypertension (233:990, 1975), Dr Maronde implies that hypertension should not be treated vigorously in patients with advanced renal disease. This is contrary to several recent articles in the literature.1-6 There seems to be a general consensus that hypertension in those with advanced renal disease should be treated vigorously, most authors maintaining that the pressure should be normalized. This may result in some temporary decrease in renal function, but the end result is that the renal function stabilizes and often improves. I would like to know why Dr Maronde advises continued conservatism in the management of hypertension of advanced renal disease.
Rubinoff H. Hypertension and Renal Disease. JAMA. 1976;235(12):1212. doi:10.1001/jama.1976.03260380016013