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Kidney Week

Abstract: TH-PO440

Applying the New Intensive Blood Pressure Categories to Non-Dialysis CKD Population from PATRIOTIC Survey

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Zheng, Ying, Chinese PLA General Hospital, Beijing, China
  • Zhang, Weiguang, Chinese PLA General Hospital, Beijing, China
  • Cai, Guangyan, Chinese PLA General Hospital, Beijing, China
  • Chen, Xiangmei, Chinese PLA General Hospital, Beijing, China
Background

The 2017 high blood pressure clinical practice guideline reported by the American College of Cardiology/American Heart Association put forward new categories of blood pressure (BP). This study aimed to assess the applicability of the new guideline in non-dialysis chronic kidney disease (CKD) population.

Methods

This is a nationwide, multicenter, cross-sectional study with a large sample. A total of 8927 non-dialysis CKD patients in 61 tertiary hospitals in all 31 provinces, municipalities, and autonomous regions of China (except Hong Kong, Macao, and Taiwan) were analyzed. The categories of BP were defined as normal BP (<120/80 mmHg), elevated BP (systolic BP 120–130 mmHg and diastolic BP <80 mmHg), and stages 1 (systolic BP 130–139 mmHg or diastolic BP 80–89 mmHg) and stage 2 (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg) hypertension. The prevalence and control of hypertension were estimated using a new definition, and the association between the main target organs’ injury and new categories of BP was analyzed.

Results

The prevalence, awareness, and treatment of hypertension in non-dialysis CKD patients were 79.8%, 72.4%, and 68.3%, respectively. Approximately 11.9% had BP <130/80 mmHg, and 6.6% had BP <120/80 mmHg. Subgroups via categories of BP had significant difference in age, sex, body mass index (BMI) categories, primary causes, and CKD stages (P <0.001). After multivariable adjustment, only stage 2 hypertension was associated with decreased renal function (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.9–3.0, P<0.001), cardiovascular disease (OR 2.0, 95% CI 1.3–3.1, P=0.001), and cerebrovascular disease (OR 2.7, 95% CI 1.2–5.8, P=0.015).

Conclusion

Using the new definition of hypertension, the higher prevalence and lower control of hypertension were shown in non-dialysis CKD participants. More studies are necessary to confirm the applicability of new categories of BP in CKD population because only stage 2 hypertension showed statistical association with the main target organs’ injury.