المؤلفون: Campbell, Patricia¹ (AUTHOR) patriciam.campbell@southerntrust.hscni.net, Rutten, Frans H² (AUTHOR), Lee, Matthew MY³ (AUTHOR), Hawkins, Nathaniel M⁴ (AUTHOR), Petrie, Mark C³ (AUTHOR)

المصدر: Lancet. Mar2024, Vol. 403 Issue 10431, p1083-1092. 10p.

مصطلحات موضوعية: VENTRICULAR ejection fraction, SODIUM-glucose cotransporter 2 inhibitors, EPIDEMIOLOGICAL research, DRUG therapy, CLINICAL trials, HEART failure

مستخلص: Heart failure with preserved ejection fraction (HFpEF) is increasingly recognised and diagnosed in clinical practice, a trend driven by an ageing population and a rise in contributing comorbidities, such as obesity and diabetes. Representing at least half of all heart failure cases, HFpEF is recognised as a complex clinical syndrome. Its diagnosis and management are challenging due to its diverse pathophysiology, varied epidemiological patterns, and evolving diagnostic and treatment approaches. This Seminar synthesises the latest insights on HFpEF, integrating findings from recent clinical trials, epidemiological research, and the latest guideline recommendations. We delve into the definition, pathogenesis, epidemiology, diagnostic criteria, and management strategies (non-pharmacological and pharmacological) for HFpEF. We highlight ongoing clinical trials and future developments in the field. Specifically, this Seminar offers practical guidance tailored for primary care practitioners, generalists, and cardiologists who do not specialise in heart failure, simplifying the complexities in the diagnosis and management of HFpEF. We provide practical, evidence-based recommendations, emphasising the importance of addressing comorbidities and integrating the latest pharmacological treatments, such as SGLT2 inhibitors. [ABSTRACT FROM AUTHOR]

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المؤلفون: Imada, Tasuku^1,2 (AUTHOR), Katakami, Naoto² (AUTHOR) katakami@endmet.med.osaka-u.ac.jp, Watanabe, Hirotaka² (AUTHOR), Nishina, Shuhei¹ (AUTHOR), Sasaki, Shugo² (AUTHOR), Takahara, Mitsuyoshi³ (AUTHOR), Shimomura, Iichiro² (AUTHOR), Yamamoto, Tsunehiko¹ (AUTHOR)

المصدر: Journal of Diabetes Investigation. Jul2024, Vol. 15 Issue 7, p843-850. 8p.

مصطلحات موضوعية: *SODIUM-glucose cotransporters, *SODIUM-glucose cotransporter 2 inhibitors, *LDL cholesterol, *TYPE 2 diabetes, *JAPANESE people

مستخلص: Aims/Introduction: We aimed to evaluate factors that influence changes in blood low‐density lipoprotein cholesterol (LDL‐C) levels after treatment with sodium–glucose cotransporter 2 (SGLT2) inhibitors in Japanese patients with type 2 diabetes. Materials and Methods: We retrospectively analyzed clinical data of outpatients newly initiated on SGLT2 inhibitors (n = 176) and other oral antidiabetic drugs (n = 227). The patients were classified into four subgroups according to statin administration and baseline LDL‐C levels (<120 or ≥120 mg/dL). Clinical characteristics were compared among the subgroups. Multivariate analysis was carried out to identify factors contributing to changes in LDL‐C. Results: The median follow‐up period was 13.0 weeks (range 11.9–14.1 weeks, min 8 weeks, maximum 16 weeks) in the SGLT2i group, and 12.0 weeks (range 10.0–14.0 weeks, min 8 weeks, maximum 16 weeks) in the control group. Both groups showed a significant decrease in LDL‐C (SGLT2i group −3.8 ± 24.7 mg/dL, control group −3.4 ± 15.0 mg/dL). Multivariate regression analyses showed that in both groups, the change in LDL‐C depended on statin use and baseline LDL‐C levels. Stratified analyses showed that LDL‐C level was significantly decreased in statin users with baseline LDL‐C ≥120 mg/dL (from 148.9 ± 33.5 to 109.3 ± 17.9 mg/dL, P = 0.002), and significantly increased in statin non‐users with baseline LDL‐C <120 mg/dL (from 96.3 ± 27.3 to 104.7 ± 24.8 mg/dL, P = 0.002). These changes were more characteristic for SGLT2 inhibitors than for other oral antidiabetic drugs (P for interaction = 0.010 and <0.001, respectively). Conclusions: LDL‐C levels and statin medication at baseline influence changes in LDL‐C after SGLT2 inhibitors treatment in Japanese patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

المؤلفون: Luo, Jinlan^1,2 (AUTHOR), Tu, Ling^1,2 (AUTHOR), Zhou, Chenchen³ (AUTHOR), Li, Gen⁴ (AUTHOR), Shi, Lili¹ (AUTHOR) m202176107@hust.edu.cn, Hu, Shuiqing^1,5 (AUTHOR) shuiqinghu@hust.edu.cn

المصدر: Sleep Medicine. Jul2024, Vol. 119, p480-487. 8p.

مصطلحات موضوعية: *INSOMNIA, *SODIUM-glucose cotransporter 2 inhibitors, *SLEEP duration, *FALSE discovery rate, *BLOOD proteins, *GLUCOSE transporters

مستخلص: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) initially emerged as oral antidiabetic medication but were subsequently discovered to exhibit pleiotropic actions. Insomnia is a prevalent and debilitating sleep disorder. To date, the causality between SGLT2 inhibitors and insomnia remains unclear. This study aims to evaluate the causality between SGLT2 inhibitors and insomnia and identify potential plasma protein mediators. Using a two-sample Mendelian Randomization (MR) analysis, we estimated the causality of SGLT2 inhibition on insomnia and sleep duration. Additionally, employing a two-step and proteome-wide MR analysis, we evaluated the causal link of SGLT2 inhibition on 4907 circulating proteins and the causality of SGLT2 inhibition-driven plasma proteins on insomnia. We applied a false discovery rate (FDR) correction for multiple comparisons. Furthermore, mediation analyses were used to identify plasma proteins that mediate the effects of SGLT2 inhibition on insomnia. SGLT2 inhibition was negatively correlated with insomnia (odds ratio [OR] = 0.791, 95 % confidence interval [CI] [0.715, 0.876], P = 5.579*10^-6) and positively correlated with sleep duration (β = 0.186, 95 % CI [0.059, 0.314], P = 0.004). Among the 4907 circulating proteins, diadenosine tetraphosphatase (Ap4A) was identified as being linked to both SGLT2 inhibition and insomnia. Mediation analysis indicated that the effect of SGLT2 inhibition on insomnia partially operates through Ap4A (β = −0.018, 95 % CI [−0.036, −0.005], P = 0.023), with a mediation proportion of 7.7 %. The study indicated a causality between SGLT2 inhibition and insomnia, with plasma Ap4A potentially serving as a mediator. • Few previous studies have explored the relationship between SGLT2 inhibition and insomnia. • Mendelian randomization made us able to evaluate the causality of SGLT2 inhibition on insomnia. • Genetically-predicted SGLT2 inhibition negatively correlated to insomnia. • Plasma AP4A level mediates the inhibitory effect of SGLT2 inhibition on insomnia. [ABSTRACT FROM AUTHOR]

المؤلفون: Yamato, Mayumi¹ (AUTHOR) m.yamato68@gmail.com, Kato, Nao¹ (AUTHOR), Yamada, Ken-ichi¹ (AUTHOR), Inoguchi, Toyoshi² (AUTHOR)

المصدر: Diabetes. Jul2024, Vol. 73 Issue 7, p1153-1166. 14p.

مصطلحات موضوعية: *DIABETIC retinopathy, *SODIUM-glucose cotransporter 2 inhibitors, *SODIUM-glucose cotransporters, *VASCULAR endothelial growth factors, *FLUORESCENCE angiography, *STREPTOZOTOCIN

مستخلص: The early pathogenetic mechanism of diabetic retinopathy (DR) and its treatment remain unclear. Therefore, we used streptozotocin-induced diabetic mice to investigate the early pathogenic alterations in DR and the protective effect of sodium–glucose cotransporter 2 (SGLT2) inhibitors against these alterations. Retinal vascular leakage was assessed by dextran fluorescence angiography. Retinal thickness and vascular leakage were increased 2 and 4 weeks after onset of diabetes, respectively. Immunostaining showed that morphological change of microglia (amoeboid form) was observed at 2 weeks. Subsequently, increased angiopoietin-2 expression, simultaneous loss of pericytes and endothelial cells, decreased vessel density, retinal hypoxia, and increased vascular endothelial growth factor (VEGF)-A/VEGF receptor system occurred at 4 weeks. SGLT2 inhibitors (luseogliflozin and ipragliflozin) had a significant protective effect on retinal vascular leakage and retinal thickness at a low dose that did not show glucose-lowering effects. Furthermore, both inhibitors at this dose attenuated microglia morphological changes and these early pathogenic alterations in DR. In vitro study showed both inhibitors attenuated the lipopolysaccharide-induced activation of primary microglia, along with morphological changes toward an inactive form, suggesting the direct inhibitory effect of SGLT2 inhibitors on microglia. In summary, SGLT2 inhibitors may directly prevent early pathogenic mechanisms, thereby potentially playing a role in preventing DR. Article Highlights: We used streptozotocin-induced diabetic mice to investigate the early pathogenic alterations in diabetic retinopathy (DR) and the protective effect of sodium–glucose cotransporter 2 inhibitors (SGLT2i) against these alterations. SGLT2i had a significant protective effect on retinal vascular leakage and retinal thickness at a low dose that did not show glucose-lowering effects. SGLT2i at this dose attenuated early pathogenic alterations, including microglia morphological changes, increased angiopoietin-2 expression, and decreased vessel density and hypoxia induced by diabetes. SGLT2i may break an early pathogenic vicious cycle and exert protective effects against DR. [ABSTRACT FROM AUTHOR]

المؤلفون: Bastawy, Nermeen¹ (AUTHOR), El-Mosallamy, Aliaa E. M. K.² (AUTHOR), Aljuaydi, Samira H.³ (AUTHOR), AbuBakr, Huda O.^3,4 (AUTHOR), Rasheed, Rabab Ahmed⁵ (AUTHOR) rabab.rasheed@ksiu.edu.eg, Sadek, A. S.^6,7 (AUTHOR), Khattab, R. T.⁶ (AUTHOR), Abualyamin, Wael Botros^8,9 (AUTHOR), Abdelaal, Shereen E.¹⁰ (AUTHOR), Boushra, Amy F.⁸ (AUTHOR)

المصدر: Pflügers Archiv: European Journal of Physiology. Jul2024, Vol. 476 Issue 7, p1125-1143. 19p.

مصطلحات موضوعية: *RATS, *SODIUM-glucose cotransporter 2 inhibitors, *GENE expression, *SODIUM-glucose cotransporters

مستخلص: Hyperthyroidism-induced cardiac disease is an evolving health, economic, and social problem affecting well-being. Sodium-glucose cotransporter protein 2 inhibitors (SGLT2-I) have been proven to be cardio-protective when administered in cases of heart failure. This study intended to investigate the potential therapeutic effect of SGLT2-I on hyperthyroidism-related cardiopulmonary injury, targeting the possible underlying mechanisms. The impact of the SGLT2-I, dapagliflozin (DAPA), (1 mg/kg/day, p.o) on LT4 (0.3 mg/kg/day, i.p)-induced cardiopulmonary injury was investigated in rats. The body weight, ECG, and serum hormones were evaluated. Also, redox balance, DNA fragmentation, inflammatory cytokines, and PCR quantification in heart and lung tissues were employed to investigate the effect of DAPA in experimentally induced hyperthyroid rats along with histological and immunohistochemical examination. Coadministration of DAPA with LT4 effectively restored all serum biomarkers to nearly average levels, improved ECG findings, and reinstated the redox balance. Also, DAPA could improve DNA fragmentation, elevate mtTFA, and lessen TNF-α and IGF-1 gene expression in both organs of treated animals. Furthermore, DAPA markedly improved the necro-inflammatory and fibrotic cardiopulmonary histological alterations and reduced the tissue immunohistochemical expression of TNF-α and caspase-3. Although further clinical and deep molecular studies are required before transposing to humans, our study emphasized DAPA's potential to relieve hyperthyroidism-induced cardiopulmonary injury in rats through its antioxidant, anti-inflammatory, and anti-apoptotic effects, as well as via antagonizing the sympathetic over activity. [ABSTRACT FROM AUTHOR]

المؤلفون: Porcari, Aldostefano^1,2,3 (AUTHOR), Cappelli, Francesco^4,5 (AUTHOR), Nitsche, Christian⁶ (AUTHOR), Tomasoni, Daniela⁷ (AUTHOR), Sinigiani, Giulio⁸ (AUTHOR), Longhi, Simone^3,9 (AUTHOR), Bordignon, Luca^2,3 (AUTHOR), Masri, Ahmad¹⁰ (AUTHOR), Serenelli, Matteo¹¹ (AUTHOR), Urey, Marcus¹² (AUTHOR), Musumeci, Beatrice¹³ (AUTHOR), Cipriani, Alberto⁸ (AUTHOR), Canepa, Marco^14,15 (AUTHOR), Badr-Eslam, Roza⁶ (AUTHOR), Kronberger, Christina⁶ (AUTHOR), Chimenti, Cristina¹⁶ (AUTHOR), Zampieri, Mattia^4,5 (AUTHOR), Allegro, Valentina^2,3 (AUTHOR), Razvi, Yousuf¹ (AUTHOR), Patel, Rishi¹ (AUTHOR)

المصدر: Journal of the American College of Cardiology (JACC). Jun2024, Vol. 83 Issue 24, p2411-2422. 12p.

مصطلحات موضوعية: *SODIUM-glucose cotransporter 2 inhibitors, *IVABRADINE, *BRAIN natriuretic factor, *TRANSTHYRETIN, *AMYLOID, *CARDIOMYOPATHIES, *VENTRICULAR ejection fraction

مستخلص: Transthyretin cardiomyopathy (ATTR-CM) was an exclusion criterion in randomized clinical trials of sodium-glucose cotransporter 2 inhibitors (SGLT2i). This study sought to assess the effectiveness and tolerability of SGLT2i in patients with ATTR-CM. Data of 2,356 consecutive ATTR-CM patients (2014-2022) were analyzed: 260 (11%) received SGLT2i. After comparing the groups according to the treatment, 14 variables were significantly different—age and N-terminal pro–B-type natriuretic peptide were included in the model. A propensity score reflecting the likelihood of being treated with SGLT2i for each patient was determined using 16 variables. The study comprised 220 patients treated with SGLT2i (age 77 ± 2 years; 82.3% wild-type ATTR-CM; left ventricular ejection fraction 45.8% ± 11%) and 220 propensity-matched control individuals. Adequacy of matching was verified (standardized differences: <0.10 between groups). Discontinuation rate for SGLT2i was 4.5%; at 12 months, SGLT2i treatment was associated with less worsening of NYHA functional class, N-terminal pro–B-type natriuretic peptide, estimated glomerular filtration rate, and fewer new initiations of loop diuretic agent therapy. Over 28 months (Q1-Q3: 18-45 months), SGLT2i therapy was associated with lower all-cause mortality (HR: 0.57; 95% CI: 0.37-0.89; P = 0.010), cardiovascular mortality (HR: 0.41; 95% CI: 0.24-0.71; P < 0.001), heart failure (HF) hospitalization (HR: 0.57; 95% CI: 0.36-0.91; P = 0.014), and the composite outcome of cardiovascular mortality and HF hospitalization (HR: 0.57; 95% CI: 0.38-0.84; P = 0.003). SGLT2i treatment in ATTR-CM patients was well tolerated and associated with favorable effects on HF symptoms, renal function, and diuretic agent requirement over time. SGLT2i treatment was associated with reduced risk of HF hospitalization and cardiovascular and all-cause mortality, regardless of the ejection fraction, despite the effect size being likely overestimated. In the absence of randomized trials, these data may inform clinicians regarding the use of SGLT2i in patients with ATTR-CM. [Display omitted] [ABSTRACT FROM AUTHOR]

المؤلفون: Guzmán-Carreras, Alicia¹ (AUTHOR), Vellisca-González, Andrea María¹ (AUTHOR), Molina-Puente, Juan Igor² (AUTHOR), García-Alonso, Rocío² (AUTHOR), Paz-Cabezas, Mateo³ (AUTHOR), Sánchez-Sauce, Beatriz⁴ (AUTHOR), Aguilar-Rodríguez, Fernando⁵ (AUTHOR) fernando.aguilar.rodriguez@gmail.com, Iguarán-Bermúdez, María Del Rosario¹ (AUTHOR), Andrès, Emmanuel⁶ (AUTHOR), Lorenzo-Villalba, Noel⁶ (AUTHOR) noellorenzo@gmail.com, Méndez-Bailón, Manuel¹ (AUTHOR)

المصدر: Journal of Clinical Medicine. Jun2024, Vol. 13 Issue 12, p3485. 14p.

مصطلحات موضوعية: *HEART failure, *SODIUM-glucose cotransporter 2 inhibitors, *OLDER patients, *HEART failure patients, *ALDOSTERONE antagonists, *GLUCOSE transporters, *PROPENSITY score matching, *VENTRICULAR ejection fraction

مستخلص: Background/Objectives: Heart failure (HF) is a highly prevalent clinical syndrome with serious morbidity and mortality. Furthermore, acute heart failure (AHF) is the main cause of hospital admission in people aged 65 years or more. Sodium-glucose cotransporter type 2 inhibitors (SGLT2is) have been shown to improve the survival and quality of life in patients with HF regardless of left ventricular ejection fraction (LVEF). Our aims were to describe the characteristics of adults with multiple pathologies admitted with acute heart failure as the main diagnosis and of the population treated with SGLT2is, as well as to evaluate if their use was associated with lower readmission and mortality rates. Methods: A prospective study of patients from the PROFUND-IC registry who were admitted with AHF as the main diagnosis was conducted. Clinical and analytical characteristics were analyzed, as well as readmissions and mortality. Descriptive and bivariate analyses of the sample between those taking SGLT2is and those who were not were performed, using the chi-square test for qualitative variables and Welch's test for quantitative measures, as well as the Fisher and Wilcoxon tests as indicated for nonparametric tests. Kaplan–Meier curves were constructed to analyze the readmission and mortality of patients at 12 months based on SGLT2i treatment. Finally, a propensity score matching was performed, guaranteeing that the observed effect of the drug was not influenced by the differences in the characteristics between the groups. Results: There were 750 patients included: 58% were women, and the mean age was 84 years. Functional class II according to the NYHA scale predominated (54%), and the mean LVEF was 51%. SGLT2 inhibitors were prescribed to only 28% of patients. Most of the patients were men (48.6% vs. 39.8%, p = 0.029), they were younger (82 vs. 84 years, p = 0.002), and their LVEF was lower (48% vs. 52%, p < 0.001). Lower mortality was observed in the group treated with SGLT2is, both during baseline admission (2.4% vs. 6.9%, p = 0.017) and at the 12-month follow-up (6.2% vs. 13%, p = 0.023); as well as a lower readmission rate (23.8% vs. 38.9%, p < 0.001). After the propensity score matching, a decrease in the 12-month readmission rate continued to be observed in the group treated with SGLT2is (p = 0.03). Conclusions: SGLT2is use was associated with lower readmission rates at the 12-month follow-up in older adults with multiple pathologies admitted with acute heart failure. [ABSTRACT FROM AUTHOR]

المؤلفون: Li, Yunhao^1,2 (AUTHOR), Zhang, Zhanming³ (AUTHOR), Zhang, Zheming^1,4 (AUTHOR), Zheng, Ningning⁵ (AUTHOR), Ding, Xudong⁶ (AUTHOR) dingxd@sj-hospital.org

المصدر: Journal of Cellular Physiology. Jun2024, Vol. 239 Issue 6, p1-17. 17p.

مصطلحات موضوعية: *HOMEOSTASIS, *SODIUM-glucose cotransporter 2 inhibitors, *MITOCHONDRIAL DNA, *METABOLIC syndrome, *EMPAGLIFLOZIN, *MITOCHONDRIA, *CELL physiology

مستخلص: Metabolic syndrome (MetS) has a large clinical population nowadays, usually due to excessive energy intake and lack of exercise. During MetS, excess nutrients stress the mitochondria, resulting in relative hypoxia in tissues and organs, even when blood supply is not interrupted or reduced, making mitochondrial dysfunction a central pathogenesis of cardiovascular disease in the MetS. Sodium‐glucose cotransporter 2 inhibitors were designed as a hyperglycemic drug that acts on the renal tubules to block sugar reabsorption in primary urine. Recently they have been shown to have anti‐inflammatory and other protective effects on cardiomyocytes in MetS, and have also been recommended in the latest heart failure guidelines as a routine therapy. Among these inhibitors, empagliflozin shows better clinical promise due to less influence from glomerular filtration rate. This review focuses on the mitochondrial mechanisms of empagliflozin, which underlie the anti‐inflammatory and recover cellular functions in MetS cardiomyocytes, including stabilizing calcium concentration, mediating metabolic reprogramming, maintaining homeostasis of mitochondrial quantity and quality, stable mitochondrial DNA copy number, and repairing damaged mitochondrial DNA. [ABSTRACT FROM AUTHOR]

المؤلفون: Nakagaito, Masaki¹ (AUTHOR) mgaito128@gmail.com, Imamura, Teruhiko¹ (AUTHOR) teimamu@med.u-toyama.ac.jp, Ushijima, Ryuichi¹ (AUTHOR), Nakamura, Makiko¹ (AUTHOR), Kinugawa, Koichiro¹ (AUTHOR)

المصدر: Journal of Clinical Medicine. Jun2024, Vol. 13 Issue 11, p3196. 11p.

مصطلحات موضوعية: *HEART failure patients, *SODIUM-glucose cotransporter 2 inhibitors, *SODIUM-glucose cotransporters, *MEDICAL care costs, *TREATMENT effectiveness, *PATIENT readmissions

مستخلص: Background: The clinical impact of the withdrawal of sodium–glucose cotransporter 2 inhibitors (SGLT2i) on all-cause readmission in patients with heart failure remains unknown. Methods: We enrolled a total of 212 consecutive patients who were hospitalized for heart failure and received SGLT2i during their index hospitalization between February 2016 and July 2022. Of these patients, 51 terminated SGLT2i during or after their index hospitalization. We evaluated the prognostic impact of the withdrawal of SGLT2i on the primary outcome, which was defined as the all-cause readmission rate/times. Results: Over a median of 23.2 months, all-cause readmission occurred in 38 out of 51 patients (74.5%) withdrawn from SGLT2i and 93 out of 161 patients (57.8%) with continuation of SGLT2i (p = 0.099). The incidence of all-cause readmissions per year was 0.97 [0–1.50] in patients withdrawn from SGLT2i and 0.50 [0–1.03] in patients with continuation of SGLT2i (p = 0.030). There was no significant difference in total medical costs (62,906 [502–187,246] versus 29,236 [7920–180,305] JPY per month, p = 0.866) between both patient groups. Conclusions: Termination of SGLT2i may be associated with incremental all-cause readmission and no benefit in reducing total medical costs. [ABSTRACT FROM AUTHOR]

المؤلفون: Sarafidis, Pantelis¹ (AUTHOR) psarafidis11@yahoo.gr, Schmieder, Roland² (AUTHOR), Burnier, Michel³ (AUTHOR), Persu, Alexandre⁴ (AUTHOR), Januszewicz, Andrzej⁵ (AUTHOR), Halimi, Jean-Michel⁶ (AUTHOR), Arici, Mustafa⁷ (AUTHOR), Ortiz, Alberto⁸ (AUTHOR), Wanner, Christoph⁹ (AUTHOR), Mancia, Giuseppe¹⁰ (AUTHOR), Kreutz, Reinhold¹¹ (AUTHOR)

المصدر: Nephrology Dialysis Transplantation. Jun2024, Vol. 39 Issue 6, p929-943. 15p.

مصطلحات موضوعية: *SODIUM-glucose cotransporter 2 inhibitors, *HYPERTENSION, *TYPE 2 diabetes, *BLOOD pressure, *CHRONIC kidney failure

مستخلص: In June 2023, the European Society of Hypertension (ESH) presented and published the new 2023 ESH Guidelines for the Management of Arterial Hypertension, a document that was endorsed by the European Renal Association (ERA). Following the evolution of evidence in recent years, several novel recommendations relevant to the management of hypertension in patients with chronic kidney disease (CKD) appeared in these Guidelines. These include recommendations for target office blood pressure (BP) <130/80 mmHg in most and against target office BP <120/70 mmHg in all patients with CKD; recommendations for use of spironolactone or chlorthalidone for patients with resistant hypertension with estimated glomerular filtration rate (eGFR) higher or lower than 30 mL/min/1.73 m2, respectively; use of a sodium-glucose cotransporter 2 inhibitor for patients with CKD and estimated eGFR ≥20 mL/min/1.73 m2; use of finerenone for patients with CKD, type 2 diabetes mellitus, albuminuria, eGFR ≥25 mL/min/1.73 m2 and serum potassium <5.0 mmol/L; and revascularization in patients with atherosclerotic renovascular disease and secondary hypertension or high-risk phenotypes if stenosis ≥70% is present. The present report is a synopsis of sections of the ESH Guidelines that are relevant to the daily clinical practice of nephrologists, prepared by experts from ESH and ERA. The sections summarized are those referring to the role of CKD in hypertension staging and cardiovascular risk stratification, the evaluation of hypertension-mediated kidney damage and the overall management of hypertension in patients with CKD. [ABSTRACT FROM AUTHOR]