[A multi-center survey of hypertension and its treatment in patients with maintenance hemodialysis in Shanghai].
OBJECTIVE
To study the prevalence, treatment policy and control of hypertension in patients with maintenance hemodialysis, and to analyze the influencing factors of hypertension control.


METHODS
We studied the current status of 1382 patients with maintenance hemodialysis in 11 dialysis centers in Shanghai, among them 809 were male, and 573 were female. Hypertension was defined as systolic blood pressure (SBP)≥140 and/or diastolic blood pressure (DBP)≥90 mm Hg (1 mm Hg=0.133 kPa). Those who had a history of hypertension and requiring antihypertensive therapy were also diagnosed as hypertension though their blood pressure was within normal range during the survey. Hypertension control was defined as blood pressure<140/90 mm Hg before each dialysis session.


RESULTS
The prevalence of hypertension in the hemodialysis patients was 86.3%. The treatment rate and control rate in those patients were 96.8% and 25.5% respectively. More than half (50.4%) of patients were treated with only one kind of anti-hypertensive drug, and 34.4% with 2 kinds, 14.2% with 3 kinds, 1.0% with 4 kinds or more. Calcium channel blocker (CCB) was the most frequently prescribed drug (61.0%), followed by angiotensin II receptor blockers (56.4%), centrally acting anti-hypertensive agent (26.4%), beta blockers and alpha, beta-blockers (14.0%). The control rate of hypertension in those hemodialysis people was aggravated by the existence of coronary artery disease. The patients who need more kinds of antihypertensive agents have a poorer control rate of hypertension. The hypertension control rate elevated significantly with the adequate hemodialysis.


CONCLUSIONS
There is a very high prevalence of hypertension in maintenance hemodialysis patients. Although the treatment rate is high, the control rate is unsatisfactory. So the control of hypertension in hemodialysis patient is still a clinical challenge. Appropriate dialysis adequacy, reasonable use of erythropoietin, treatment of heart disease and judicious use of antihypertensive drugs may be helpful to improve the clinical outcome.
Lin
Jing
J
Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Ding
Xiao-qiang
XQ
Lin
Pan
P
Zou
Jian-zhou
JZ
Teng
Jie
J
Zhang
Jin-yuan
JY
Wang
Nian-song
NS
Zhou
Fu-jian
FJ
Shen
Pei-cheng
PC
He
Li-qun
LQ
Bao
Xiao-rong
XR
Xu
Shu-ren
SR
Yang
Huang
H
Zhang
Jing-hong
JH
Zhu
Kai-yuan
KY
Li
Xin-hua
XH
Jiang
Geng-ru
GR
Zhang
Wei
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis; D012307:Risk Factors; D055815:Young Adult