{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:55:54Z","timestamp":1791305754726,"version":"4.3.1"},"reference-count":105,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Optimal hypertension management requires not only stringent blood pressure control but also concomitant management of related cardiovascular, metabolic, and kidney comorbidities. Emerging evidence demonstrates that contemporary therapies improve albuminuria, estimated glomerular filtration rate trajectory, kidney outcomes, and cardiovascular outcomes, although the relative contributions of sustained blood pressure reduction and other biologic effects cannot always be separated. This review examines the impact of current and emerging treatment strategies across 3 core domains: blood pressure control, kidney function trajectory, and albuminuria reduction. Emphasis is placed on kidney function-based treatment selection, safety considerations including advanced disease, the role of targeted therapy in dysregulated aldosterone states, and evolving options for resistant hypertension. A risk- and clinical-characteristic-guided approach that integrates kidney stage, degree of albuminuria, and overall cardiovascular risk is proposed to move beyond uniform drug escalation toward personalized care. Early risk stratification, thoughtful sequencing, and structured monitoring are essential to translate therapeutic advances into sustained kidney and cardiovascular benefit.<\/jats:p>","DOI":"10.1093\/ajh\/hpag111","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:25:27Z","timestamp":1788780327000},"source":"Crossref","is-referenced-by-count":0,"title":["Antihypertensive pharmacotherapy in chronic kidney disease: integrating estimated glomerular filtration rate-based cutoffs, mechanistic insights, and emerging therapeutic pathways"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8157-7108","authenticated-orcid":false,"given":"Sriram","family":"Sriperumbuduri","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Virginia Commonwealth University , Richmond, VA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0224-6998","authenticated-orcid":false,"given":"Rachel W","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy & Outcomes Science, Virginia Commonwealth University School of Pharmacy , Richmond, VA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8741-1199","authenticated-orcid":false,"given":"Soyeb","family":"Aftab","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences , New Delhi,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0010-3416","authenticated-orcid":false,"given":"Swapnil","family":"Hiremath","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, University of Ottawa , Ottawa,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7560-9521","authenticated-orcid":false,"given":"Dave","family":"Dixon","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy & Outcomes Science, Virginia Commonwealth University School of Pharmacy , Richmond, VA,","place":["United States"]},{"name":"Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University School of Medicine , Richmond, VA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1919-1970","authenticated-orcid":false,"given":"Gaurav","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Virginia Commonwealth University , Richmond, VA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"2026100612263894300_hpag111-B1","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1111\/dom.70289","article-title":"Effects of SGLT2 inhibitors across the spectrum of albuminuria in cardiovascular-kidney-metabolic conditions: a pooled analysis of randomised trials","volume":"28","author":"Ferreira","year":"2026","journal-title":"Diabetes Obes Metab"},{"key":"2026100612263894300_hpag111-B2","doi-asserted-by":"publisher","first-page":"2055","DOI":"10.1681\/ASN.2014070688","article-title":"Drug-induced reduction in albuminuria is associated with subsequent renoprotection: a meta-analysis","volume":"26","author":"Heerspink","year":"2015","journal-title":"J Am Soc Nephrol"},{"key":"2026100612263894300_hpag111-B3","doi-asserted-by":"publisher","first-page":"1867","DOI":"10.1038\/s41591-023-02418-0","article-title":"A meta-analysis of GFR slope as a surrogate endpoint for kidney failure","volume":"29","author":"Inker","year":"2023","journal-title":"Nat Med"},{"key":"2026100612263894300_hpag111-B4","doi-asserted-by":"publisher","first-page":"8859678","DOI":"10.1155\/2024\/8859678","article-title":"Is eGFR slope a novel predictor of chronic complications of type 2 diabetes mellitus? 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