A Single-Center Report of Hypertension in Native American Kidney Transplant Recipients

Based on the current American Heart Association/American College of Cardiology definition [systolic blood pressure (SBP) >= 130 and/or diastolic BP(DBP) >= 80], hypertension affects 45% of the adult U.S. population. Post-kidney transplant (KT) hypertension has been associated with immunosuppression and worse graft outcomes. Hypertension data on Native American (NAm) KT recipients (KTR) is scarce. In our center, we serve a significant NAm population, and measure ambulatory blood pressure (AMBP) routinely in KTR at 4- and 12-months post-transplant. In a noninterventional, observational study we queried our transplant database for all NAm KTR who were transplanted at our center between years 2003 and 2023. Patients who had 4- and/or 12-months AMBP were included in our study. 262 NAm KTR met inclusion criteria. Average (sd) BP was 133.0 (15.0)/76.2 (9.7) and 134.1 (15.6)/76.5 (9.9) at 4- and 12-months respectively. Male gender (p = 0.03) and older donor age (p = 0.02) were associated with BP >= 130/80 at 4-months. Male gender (p = 0.05) and pre-transplant diabetes (p = 0.01) were associated with BP >= 130/80 at 12-months. About two-thirds of NAm KTR had uncontrolled hypertension at 4- and 12-months. The burden of hypertension, as measured by the gold standard AMBP monitoring is significant in NAm KTR, and therefore, attention to hypertension management is prudent in this minority patient population.