Kidney Week

Abstract: TH-PO243

Trends in Hypertension Recognition, Treatment, and Control Between 2011 and 2019 Among Adults with CKD in the Veterans Health Administration

Session Information

• Hypertension and CVD: Clinical - I
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1601 Hypertension and CVD: Basic

Authors

• Martinez, Joshua Daniel, Stanford University, Stanford, California, United States

Joshua Daniel Martinez,

• Thomas, I-Chun, VA Palo Alto Health Care System, Palo Alto, California, United States

I-Chun Thomas,

• Montez-Rath, Maria E., VA Palo Alto Health Care System, Palo Alto, California, United States

Maria E. Montez-Rath,

• Pao, Alan C., VA Palo Alto Health Care System, Palo Alto, California, United States

Alan C. Pao,

• Fung, Enrica, Stanford University, Stanford, California, United States

Enrica Fung,

• Charu, Vivek, Stanford University, Stanford, California, United States

Vivek Charu,

• Sim, John J., Kaiser Permanente Southern California, Pasadena, California, United States

John J. Sim,

• An, Jaejin, Kaiser Permanente Southern California, Pasadena, California, United States

Jaejin An,

• Odden, Michelle, Stanford University, Stanford, California, United States

Michelle Odden,

• Tamura, Manjula, VA Palo Alto Health Care System, Palo Alto, California, United States

Manjula Tamura,

Background

Hypertension frequently accompanies chronic kidney disease (CKD) as etiology and sequela. We examined contemporary trends in hypertension treatment and control in a national sample of adults with CKD.

Methods

We evaluated serial 5% cross-sectional samples of adults with CKD between 2011 and 2019 in the Veterans Health Administration (VA). We defined CKD as a sustained estimated glomerular filtration rate (eGFR) value <60 ml/min/1.73m² or a urine albumin-creatinine ratio (UACR) ≥30 mg/g.

Results

We examined 238,748 adults with a mean age of 72 years, 96% of whom were male. The age-adjusted proportion of adults with controlled BP declined from 78.0% in 2011 to 72.9% in 2019 (p-value for linear trend <0.001). Between 2011 and 2019, among adults with BP above goal, the age-adjusted proportion with a diagnosis of hypertension declined from 97.1% to 94.3% (p-value for linear trend <0.001), the age-adjusted proportion who did not receive antihypertensive treatment increased from 18.8% to 21.6% (p-value for linear trend <0.001), while the age-adjusted proportion who received three or more antihypertensive medications decreased from 41.8% to 36.3% (p-value for linear trend <0.001). The age-adjusted proportion of adults who received angiotensin converting enzyme inhibitors or angiotensin receptor blockers declined from 65.0% to 59.7% (p-value for linear trend <0.001); the age-adjusted proportion of adults who received thiazide-type diuretics declined from 24.1% to 20.0% (p-value for linear trend <0.001).

Conclusion

Among adults with CKD treated in the VA, the proportion with controlled BP has declined over time, coinciding with fewer prescriptions for antihypertensive medications.

Funding

• NIDDK Support