Treatment and Control of Hypertension Among Adults With Chronic Kidney Disease, 2011 to 2019

被引:1
作者
Martinez, Joshua D. [2 ]
Thomas, I-Chun [3 ]
Montez-Rath, Maria E. [2 ]
Pao, Alan C. [2 ]
Fung, Enrica [4 ]
Charu, Vivek [5 ,6 ]
Sim, John J. [8 ,9 ]
An, Jaejin [8 ,10 ]
Odden, Michelle C. [3 ,7 ]
Tamura, Manjula Kurella [1 ,2 ,3 ]
机构
[1] Vet Affairs Palo Alto Hlth Care Syst, 3801 Miranda Ave, Palo Alto, CA 94304 USA
[2] Stanford Univ, Sch Med, Dept Med, Div Nephrol, Stanford, CA USA
[3] VA Palo Alto Hlth Care Syst, Geriatr Res & Educ Clin Ctr, Palo Alto, CA USA
[4] Loma Linda Univ, Sch Med, Dept Med, Div Nephrol, Loma Linda, CA USA
[5] Stanford Univ, Sch Med, Dept Med, Quantitat Sci Unit, Stanford, CA USA
[6] Stanford Univ, Sch Med, Dept Pathol, Stanford, CA USA
[7] Stanford Univ, Sch Med, Dept Epidemiol & Populat Hlth, Stanford, CA USA
[8] Kaiser Permanente Bernard J Tyson Sch Med, Pasadena, CA USA
[9] Kaiser Permanente Angeles Med Ctr, Dept Med, Div Nephrol & Hypertens, Los Angeles, CA USA
[10] Kaiser Permanente Southern Calif, Res & Evaluat, Pasadena, CA USA
基金
美国国家卫生研究院;
关键词
blood pressure; health services; hypertension; renal insufficiency; chronic; BLOOD-PRESSURE CONTROL; US VETERANS; HEALTH; CARE; MANAGEMENT; MORTALITY; GUIDELINE; EVENTS; TRIAL;
D O I
10.1161/HYPERTENSIONAHA.123.21523
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
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 5% cross-sectional samples of adults with CKD between 2011 and 2019 in the Veterans Health Administration. We defined CKD as a sustained estimated glomerular filtration rate value <60 mL/min per 1.73 m(2) or a urine albumin-to-creatinine ratio >= 30 mg/g. The main outcomes were blood pressure (BP) control, defined as a systolic BP <140 mm Hg and a diastolic BP <90 mm Hg based on the mean of monthly BP measurements, and prescriptions for antihypertensive medications.RESULTS: The annual samples ranged between n=22 110 and n=33 039 individuals, with a mean age of 72 years, 96% of whom were men. Between 2011 and 2014, the age-adjusted proportion of adults with controlled BP declined from 78.0% to 72.2% (P value for linear trend, <0.001), reached a nadir of 71.0% in 2015, and then increased to 72.9% by 2019 (P value for linear trend, <0.001). Among adults with BP above goal, the age-adjusted proportion who did not receive antihypertensive treatment increased throughout the decade from 18.8% to 21.6%, and the age-adjusted proportion who received >= 3 antihypertensive medications decreased from 41.8% to 36.3%. Prescriptions for first-line antihypertensive agents also decreased.CONCLUSIONS: Among adults with CKD treated in the Veterans Health Administration, the proportion with controlled BP declined between 2011 and 2015 followed by a modest increase, coinciding with fewer prescriptions for antihypertensive medications.
引用
收藏
页码:2533 / 2543
页数:11
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