Document Detail


Hypertension awareness, treatment, and control in adults with CKD: results from the Chronic Renal Insufficiency Cohort (CRIC) Study.
MedLine Citation:
PMID:  19962808     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A low rate of blood pressure control has been reported in patients with chronic kidney disease (CKD). These data were derived from population-based samples with a low rate of CKD awareness.
STUDY DESIGN: Cross-sectional.
SETTING & PARTICIPANTS: Data from the baseline visit of the Chronic Renal Insufficiency Cohort (CRIC) Study (n = 3,612) were analyzed. Participants with an estimated glomerular filtration rate of 20-70 mL/min/1.73 m(2) were identified from physician offices and review of laboratory databases.
OUTCOMES: Prevalence and awareness of hypertension, treatment patterns, control rates, and factors associated with hypertension control.
MEASUREMENTS: Following a standardized protocol, blood pressure was measured 3 times by trained staff, and hypertension was defined as systolic blood pressure > or =140 mm Hg and/or diastolic blood pressure > or =90 mm Hg and/or self-reported antihypertensive medication use. Patients' awareness and treatment of hypertension were defined using self-report, and 2 levels of hypertension control were evaluated: systolic/diastolic blood pressure <140/90 and <130/80 mm Hg.
RESULTS: The prevalence of hypertension was 85.7%, and 98.9% of CRIC participants were aware of this diagnosis and 98.3% were treated with medications, whereas 67.1% and 46.1% had hypertension controlled to <140/90 and <130/80 mm Hg, respectively. Of CRIC participants with hypertension, 15%, 25%, 26%, and 32% were using 1, 2, 3, and > or =4 antihypertensive medications, respectively. After multivariable adjustment, older patients, blacks, and those with higher urinary albumin excretion were less likely, whereas participants using angiotensin-converting enzyme inhibitors and angiotensin receptor blockers were more likely to have controlled their hypertension to <140/90 and <130/80 mm Hg.
LIMITATIONS: Data were derived from a single study visit.
CONCLUSIONS: Despite almost universal hypertension awareness and treatment in this cohort of patients with CKD, rates of hypertension control were suboptimal.
Authors:
Paul Muntner; Amanda Anderson; Jeanne Charleston; Zhen Chen; Virginia Ford; Gail Makos; Andrew O'Connor; Kalyani Perumal; Mahboob Rahman; Susan Steigerwalt; Valerie Teal; Raymond Townsend; Matthew Weir; Jackson T Wright;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-12-05
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  55     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-01     Completed Date:  2010-03-29     Revised Date:  2013-02-11    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  441-51     Citation Subset:  IM    
Copyright Information:
Copyright 2010 National Kidney Foundation, Inc. All rights reserved.
Affiliation:
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA. pmuntner@uab.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Chronic Disease
Female
Humans
Hypertension / complications*,  drug therapy*,  prevention & control
Kidney Diseases / complications*
Male
Middle Aged
Renal Insufficiency / complications*
Young Adult
Grant Support
ID/Acronym/Agency:
5U01DK-06102/DK/NIDDK NIH HHS; 5U01DK060902/DK/NIDDK NIH HHS; 5U01DK060963/DK/NIDDK NIH HHS; 5U01DK060984/DK/NIDDK NIH HHS; 5U01DK060990/DK/NIDDK NIH HHS; 5U01DK061021/DK/NIDDK NIH HHS; 5U01DK061028/DK/NIDDK NIH HHS; 5U01DK60980/DK/NIDDK NIH HHS; K01 DK064860/DK/NIDDK NIH HHS; K01 DK064860-04/DK/NIDDK NIH HHS; UL1 RR024989/RR/NCRR NIH HHS
Comments/Corrections
Comment In:
Am J Kidney Dis. 2010 Mar;55(3):415-8   [PMID:  20189048 ]

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