Ischemic heart disease after renal transplantation

Dramatic improvements in renal allograft survival over the last 10 years have shifted the focus of posttransplant management from short-term considerations to reduction of deaths due to IHD (and other causes) over the long term. A growing body of evidence suggests that the high incidence of IHD after renal transplantation is in large part due to the high prevalence of traditional risk factors such as hypertension and hyperlipidemia. It is neither feasible nor necessary to demonstrate that treating risk factors like elevated blood pressure and LDL cholesterol is justified in reducing morbidity and mortality from IHD. Recent data suggest that the incidence of IHD is declining in some centers [16], likely because of the use of new medications that effectively reduce factors for IHD. Further emphasis on managing these risk factors, along with additional studies to identify new prevention strategies, are needed if progress in reducing this major cause of death in transplant patients is to continue.