Race and sex differences in hypertension control in CKD: results from the Kidney Early Evaluation Program (KEEP).
BACKGROUND
African American men with chronic kidney disease (CKD) progress to end-stage renal disease more rapidly than African American women or whites. Uncontrolled hypertension worsens CKD, and disparities in hypertension control may contribute to disparities in CKD progression.


METHODS
Cross-sectional.


METHODS
10,827 individuals with CKD and self-reported hypertension screened in the Kidney Early Evaluation Program.


METHODS
African American race, sex.


RESULTS
Hypertension control (blood pressure <130 mm Hg systolic and/or <80 mm Hg diastolic).


METHODS
Self-report, physical examination (blood pressure), laboratory data (serum creatinine, microalbuminuria by urine dipstick). We calculated estimated glomerular filtration rates by using the 4-variable isotope dilution mass spectrometry Modification of Diet in Renal Disease Study equation. We classified CKD as early (stages 1 to 2) or late (stages 3 to 5) based on estimated glomerular filtration rate and microalbuminuria.


RESULTS
In individuals with early CKD, African American women (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.14 to 1.88), white men (OR, 1.85; 95% CI, 1.39 to 2.46), and white women (OR, 1.69; 95% CI, 1.28 to 2.22) had greater odds of hypertension control (blood pressure <130/80 mm Hg) than African American men. In individuals with late CKD, white men (OR, 1.66; 95% CI, 1.10 to 2.52) and white women (OR, 1.67; 95% CI, 1.13 to 2.46) had greater odds of hypertension control than African American men. No differences were seen between African American men and women with late CKD.


CONCLUSIONS
No information for medication regimens.


CONCLUSIONS
African American men with CKD have poorly controlled hypertension compared with African American women and whites, particularly in the early stages of disease. Efforts to aggressively treat hypertension in this population may help narrow the race and sex disparities in progression to end-stage renal disease.
Duru
Obidiugwu Kenrik
OK
Division of General Internal Medicine/Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. kduru@mednet.ucla.edu
Li
Suying
S
Jurkovitz
Claudine
C
Bakris
George
G
Brown
Wendy
W
Chen
Shu-Cheng
SC
Collins
Allan
A
Klag
Michael
M
McCullough
Peter A
PA
McGill
Janet
J
Narva
Andrew
A
Pergola
Pablo
P
Singh
Ajay
A
Norris
Keith
K
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000419:Albuminuria / Q000209:etiology; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications* / Q000208:ethnology / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000208:ethnology / Q000209:etiology* / Q000503:physiopathology*; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D044465:White People / Q000706:statistics & numerical data*