Recent progress of the elucidation of the central pathways contributing to the genesis of neurogenic hypertension may participate the next generation

of therapeutic strategies for hypertensive patients with increased SNA. Future research will be needed to search for more advanced treatment strategies and to determine the appropriate indications of these treatment strategies. NAKAMURA SATOKO, KAWANO YUHEI Division of Hypertension and Nephrology, National Cerebral and Cardiovascular Center, Japan Recently, chronic kidney disease (CKD) has become a major public health problem and a risk factor for all-cause mortality and cardiovascular disease (CVD). CVD is the leading cause of morbidity and mortality in patients with CKD. The increased risk of CVD begins during the earlier stages of CKD. Although patients with CKD have a very high prevalence of traditional CVD risk PD0325901 factors such as diabetes and hypertension, they are also exposed to other non-traditional, uremia-related risk factors such as abnormal calcium-phosphorus metabolism and inflammation. Although some of the burden of CVD in CKD may be due to atherosclerosis, it is apparent that patients with CKD also have a high prevalence of arteriosclerosis and disorders

of left ventricular structure and function. Proteinuria has been shown to be an independent risk factor for CVD outcomes in the Framingham and other observational studies. We observed the microalbuminuria was associated with CVD outcomes and kidney dysfunction in the Japanese elderly Resveratrol hypertensive patients without previous cardiovascular complications. There are several reasons STAT inhibitor why microalbuminuria may be an independent risk factor for CVD. Microalbuminuria may represent an early stage

of kidney disease, with an associated risk of subsequent CKD progression and development of macroalbuminuria. Microalbuminuria may also reflect systemic endothelial damage, inflammation and/or abnormalities in the coagulation and fibrinolytic systems. Hypertension is both a cause and a result of kidney disease. In the United States, about 70 to 80 % of patients with stage 1 to 4 CKD have hypertension, and the prevalence of hypertension increases as GFR declines. In a cohort study of urban Japanese population (the Suita Study) shows that subjects with CKD (8.9% for men and 11.3% for women) were older and had higher prevalence of hypertension (41.1% for men and 42.6% for women). In this cohort study, CKD was a risk factor for stroke and myocardial infarction. The association between blood pressure and the incidence of CVD was closer in subjects with CKD compared to those without CKD. Therefore, to prevent CVD, it may be necessary to control blood pressure by lifestyle modification and proper clinical treatment for subjects with CKD. Recent studies indicated that the decreased kidney function was associated with the incidence of coronary artery disease, heart failure, cerebral vascular disease and cardiovascular mortality.