| Blood pressure control among persons without and with chronic kidney disease: US trends and risk factors 1999-2006. | |
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MedLine Citation:
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PMID: 19470881 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Recent guidelines recommending more aggressive blood pressure control in patients with chronic kidney disease have unknown impact. We assessed trends in and predictors of blood pressure control in 8829 adult National Health and Nutrition Examination Survey 1999-2006 participants with hypertension (self-report, measured blood pressure, or use of antihypertensive medications), without (n=7178) and with (n=1651) chronic kidney disease. Uncontrolled blood pressure was defined as follows: general definition, systolic blood pressure > or =140 mm Hg and diastolic blood pressure > or =90 mm Hg, and disease-specific definition, systolic blood pressure > or =130 mm Hg and diastolic blood pressure > or =85 mm Hg (1999-2002) and systolic blood pressure > or =130 mm Hg and diastolic blood pressure > or =80 mm Hg (2003-2006) for those with chronic kidney disease (estimated glomerular filtration rate: <60 mL/min per 1.73 m(2)) or diabetes mellitus (self-report). Proportions with uncontrolled blood pressure in 1999-2006 were greater in those with chronic kidney disease versus those without chronic kidney disease (51.5% versus 48.7% [general definition: P=0.122] and 68.8% versus 51.7% [disease-specific definition: P<0.001]). In those with chronic kidney disease, there were significant decreases in uncontrolled blood pressure over time (55.9% to 47.8% [general definition: P=0.011]). With adjustment for demographic, socioeconomic, and clinical variables, older age (P<0.001) and lack of antihypertensive treatment (P<0.001) were associated with uncontrolled blood pressure, regardless of chronic kidney disease status; nonwhite race (P=0.002) was associated in those without chronic kidney disease, whereas female sex (P=0.030) was associated in those with chronic kidney disease. Multiple medications (P<0.001) and angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (P=0.001) were associated with less uncontrolled blood pressure. Although some improvement has occurred over time, uncontrolled blood pressure remains highly prevalent, especially in subjects with chronic kidney disease and in nonwhites, older persons, and women. Therapy appears suboptimal. |
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Authors:
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Laura C Plantinga; Edgar R Miller; Lesley A Stevens; Rajiv Saran; Kassandra Messer; Nicole Flowers; Linda Geiss; Neil R Powe; |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2009-05-26 |
Journal Detail:
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Title: Hypertension Volume: 54 ISSN: 1524-4563 ISO Abbreviation: Hypertension Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-06-18 Completed Date: 2009-09-16 Revised Date: 2012-03-05 |
Medline Journal Info:
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Nlm Unique ID: 7906255 Medline TA: Hypertension Country: United States |
Other Details:
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Languages: eng Pagination: 47-56 Citation Subset: IM |
Affiliation:
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Departments of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. plantingal@medsfgh.ucsf.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Antihypertensive Agents / classification, therapeutic use Blood Pressure / drug effects, physiology* Body Mass Index Diastole Educational Status Female Health Surveys Humans Hypertension / complications, epidemiology, physiopathology* Income Kidney Failure, Chronic / complications, physiopathology* Male Middle Aged Prevalence Risk Factors Social Class Systole United States / epidemiology Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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K23 DK081017-01/DK/NIDDK NIH HHS; K23 DK081017-02/DK/NIDDK NIH HHS; K23 DK081017-04/DK/NIDDK NIH HHS; K23 DK081017-05/DK/NIDDK NIH HHS; K23DK081017-01/DK/NIDDK NIH HHS; K24 DK002643-09/DK/NIDDK NIH HHS; K24DK02643/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents |
| Investigator | |
Investigator/Affiliation:
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Neil Powe / ; Laura Plantinga / ; L Ebony Boulware / ; Josef Coresh / ; Edgar Miller / ; Andrew Levey / ; Lesley Stevens / ; Deidra Crews / ; April Lawner / ; Rajiv Saran / ; Elizabeth Hedgeman / ; Brenda Gillespie / ; William Herman / ; Friedrich Port / ; Bruce Robinson / ; Vahakn Shahinian / ; Jerry Yee / ; Eric Young / ; Meggy Yin / ; Desmond Williams / ; Sabitha Desari / ; Mark Eberhardt / ; Paul Eggers / ; Nicole Flowers / ; Linda Geiss / ; Sue Hailpern / ; Regina Jordan / ; Juanita Mondeshire / ; Bernice Moore / ; Gary Myers / ; Meda Pavkov / ; Nilka Rios-Burrows / ; Deborah Rolka / ; Sharon Saydah / ; Anton Schoolwerth / ; Rodolfo Valdez / ; Larry Waller / |
| Comments/Corrections | |
Comment In:
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Hypertension. 2009 Jul;54(1):25-6
[PMID:
19470874
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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