The American Journal of Medicine
Volume 121, Issue 4 , Pages 332-340, April 2008

Hypertension Awareness, Treatment, and Control in Chronic Kidney Disease

  • Pantelis A. Sarafidis, MD, PhD

      Affiliations

    • Hypertensive Diseases Unit, Section of Endocrinology, Diabetes, and Metabolism, University of Chicago-Pritzker School of Medicine, Chicago, Ill
    • ,
  • Suying Li, PhD

      Affiliations

    • Kidney Early Evaluation Program Data Coordinating Center, Minneapolis, Minn
    • ,
  • Shu-Cheng Chen, MS

      Affiliations

    • Kidney Early Evaluation Program Data Coordinating Center, Minneapolis, Minn
    • ,
  • Allan J. Collins, MD

      Affiliations

    • Kidney Early Evaluation Program Data Coordinating Center, Minneapolis, Minn
    • ,
  • Wendy W. Brown, MD, MPH

      Affiliations

    • West Side VA Medical Center, Chicago, Ill
    • ,
  • Michael J. Klag, MD, MPH

      Affiliations

    • Johns Hopkins General Hospital, Baltimore, Md.
    • ,
  • George L. Bakris, MD

      Affiliations

    • Hypertensive Diseases Unit, Section of Endocrinology, Diabetes, and Metabolism, University of Chicago-Pritzker School of Medicine, Chicago, Ill
    • Corresponding Author InformationRequests for reprints should be addressed to George L. Bakris, MD, Hypertensive Diseases Unit, Section of Endocrinology, Diabetes, and Metabolism, University of Chicago-Pritzker School of Medicine, 5841 S. Maryland Ave MC 1027, Chicago, IL 60637.

Abstract 

Background

Hypertension prevalence, awareness, treatment, and blood pressure control rates in the population with chronic kidney disease are limited. The objective of this study was to determine the state of blood pressure control in patients with chronic kidney disease.

Methods

This is a cross-sectional analysis of data of participants with chronic kidney disease from the Kidney Early Evaluation Program. The Kidney Early Evaluation Program is a national-based health screening program for individuals at high risk for kidney disease conducted in 49 states and the District of Columbia. Of 55,220 adults with kidney disease, 10,813 completed information for demographic and medical characteristics used in the analysis. Predictors of blood pressure control were assessed using multiple logistic regression analysis.

Results

Hypertension prevalence, awareness, and treatment proportions in the screened cohort were high (86.2%, 80.2%, and 70.0%, respectively), but blood pressure control rates were low (13.2%). These proportions increased with advancing stage of kidney disease. Elevated systolic blood pressure accounted for the majority of inadequate control. Male gender (odds ratio [OR] 0.86; 95% confidence interval [CI], 0.75-0.99), non-Hispanic black race (OR 0.76; 95% CI, 0.65-0.89), and body mass index of 30 kg/m2 or more (OR 0.83; 95% CI, 0.73-0.94) were inversely related with blood pressure control. Those with stage 3 kidney disease were more likely to have blood pressure at goal than those with stage 1 kidney disease (OR 2.08; 95% CI, 1.55-2.80).

Conclusion

We conclude that despite increased awareness and treatment of hypertension, control rates in these participants are poor. This poor control rate centers around elevated systolic pressure in people who are obese, non-Hispanic black, or male. These data suggest that those who are aware of their kidney disease are more likely to achieve blood pressure control.

Keywords: Awareness, Chronic kidney disease, Control, Hypertension, Treatment

 

 The authors declare no conflicts related to the present study.

PII: S0002-9343(08)00144-7

doi:10.1016/j.amjmed.2007.11.025

The American Journal of Medicine
Volume 121, Issue 4 , Pages 332-340, April 2008

Article Tools

* Image Usage & Resolution