Abstract: FR-PO559

Global Variation in Blood Pressure Control and Anti-Hypertensive Therapy in CKD Patients with Hypertension

Session Information

Category: Hypertension

  • 1104 Hypertension: Clinical and Translational - Salt and Hypertension

Authors

  • Alencar de Pinho, Natalia, CESP INSERM, VILLEJUIF, France
  • Oh, Kook-Hwan, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Sola, Laura, CASMU-IAMPP, Montevideo, Uruguay
  • Mayer, Gert J., Medical University Innsbruck, Innsbruck, Austria
  • De Borst, Martin H., University Medical Center Groningen, Groningen, Netherlands
  • Taal, Maarten W., None, Derby, United Kingdom
  • Stengel, Benedicte, Inserm ? CESP, Villejuif, France
  • Levin, Adeera, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
  • Fukagawa, Masafumi, Tokai University School of Medicine, Isehara, KANAGAWA, Japan
  • Hoy, Wendy E., The University of Queensland, Brisbane, Queensland, Australia
  • Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Feldman, Harold I., University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Zhang, Luxia, Peking University Institute of Nephrology, Beijing, China
  • Eckardt, Kai-Uwe, University of Erlangen-Nuremberg, Erlangen, Germany
  • Jha, Vivekanand, George Institute for Global Health, New Delhi, India

Group or Team Name

  • ISN iNET-CKD
Background

Rates of blood pressure (BP) control in patients with CKD vary considerably worldwide. How differences in patient characteristics and antiHT treatment regimens relate to patterns of BP control is uncertain.

Methods

We used data from 14 studies participating in iNET-CKD, including 34,901 patients with eGFR <60 ml/min/1.73m2 and HT (defined as either BP ≥140/90 mmHg or antiHT drug use) to compare the prevalence of uncontrolled BP (≥140/90) across 16 countries using adjusted observed to expected prevalence ratios (PR).

Results

Rates of uncontrolled BP varied from 28% to 61% (Figure 1). After adjusting for age, gender, DM, and GFR, prevalence ratios remained higher in cohorts from continental Europe, India, and Uruguay. AntiHT use varied from 54% to 87% for RAAS inhibitors, 11% to 76% for diuretics, 26% to 75% for Ca channel blockers, and 22% to 68% for beta-blockers. In 8 out of 15 studies, >50% of patients with uncontrolled BP received <3 antiHT drugs. The number of prescribed antiHT classes was higher in cohorts from North America and Germany.

Conclusion

Global variation in BP control is only partly explained by patient characteristics. Heterogeneity of antiHT treatment practices may also play a role and would be potentially modifiable.