Hypertension awareness, treatment, and control in adults with CKD: results from the Chronic Renal Insufficiency Cohort (CRIC) Study.
BACKGROUND
A low rate of blood pressure control has been reported in patients with chronic kidney disease (CKD). These data were derived from population-based samples with a low rate of CKD awareness.


METHODS
Cross-sectional.


METHODS
Data from the baseline visit of the Chronic Renal Insufficiency Cohort (CRIC) Study (n = 3,612) were analyzed. Participants with an estimated glomerular filtration rate of 20-70 mL/min/1.73 m(2) were identified from physician offices and review of laboratory databases.


RESULTS
Prevalence and awareness of hypertension, treatment patterns, control rates, and factors associated with hypertension control.


METHODS
Following a standardized protocol, blood pressure was measured 3 times by trained staff, and hypertension was defined as systolic blood pressure > or =140 mm Hg and/or diastolic blood pressure > or =90 mm Hg and/or self-reported antihypertensive medication use. Patients' awareness and treatment of hypertension were defined using self-report, and 2 levels of hypertension control were evaluated: systolic/diastolic blood pressure <140/90 and <130/80 mm Hg.


RESULTS
The prevalence of hypertension was 85.7%, and 98.9% of CRIC participants were aware of this diagnosis and 98.3% were treated with medications, whereas 67.1% and 46.1% had hypertension controlled to <140/90 and <130/80 mm Hg, respectively. Of CRIC participants with hypertension, 15%, 25%, 26%, and 32% were using 1, 2, 3, and > or =4 antihypertensive medications, respectively. After multivariable adjustment, older patients, blacks, and those with higher urinary albumin excretion were less likely, whereas participants using angiotensin-converting enzyme inhibitors and angiotensin receptor blockers were more likely to have controlled their hypertension to <140/90 and <130/80 mm Hg.


CONCLUSIONS
Data were derived from a single study visit.


CONCLUSIONS
Despite almost universal hypertension awareness and treatment in this cohort of patients with CKD, rates of hypertension control were suboptimal.
Muntner
Paul
P
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA. pmuntner@uab.edu
Anderson
Amanda
A
Charleston
Jeanne
J
Chen
Zhen
Z
Ford
Virginia
V
Makos
Gail
G
O'Connor
Andrew
A
Perumal
Kalyani
K
Rahman
Mahboob
M
Steigerwalt
Susan
S
Teal
Valerie
V
Townsend
Raymond
R
Weir
Matthew
M
Wright
Jackson T
JT
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy* / Q000517:prevention & control; D007674:Kidney Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000150:complications*; D055815:Young Adult