title: Blood pressure control in a Japanese population with chronic kidney disease: a baseline survey of a nationwide cohort.
abstract: BACKGROUND
  Hypertension is a key risk factor for adverse renal outcomes in chronic kidney disease (CKD), and strict blood pressure control is recommended to halt its progression. This study assessed blood pressure control in the Japanese CKD population.
  
  
  METHODS
  We used a nationwide database of 250,130 subjects (aged 20-88), including 45,845 CKD subjects (18.3%), participated in an annual health check, "The Specific Health Check and Guidance in Japan," and examined the relationship between CKD status and blood pressure. Blood pressures were measured in sitting position by trained staff, and target blood pressure for CKD subjects was defined as systolic (SBP)/diastolic blood pressure (DBP) <130/80 mm Hg.
  
  
  RESULTS
  In total population, CKD subjects had a higher prevalence of hypertension (58.0% vs. 41.8%, P < 0.001) and a higher proportion with antihypertensive medication (42.4% vs. 26.7%, P < 0.001), compared with non-CKD subjects. The proportion of subjects achieving target blood pressure was significantly lower among total CKD subjects than among total non-CKD subjects (34.6% vs. 43.8%, P ≤ 0.001). Among CKD subjects, these proportions were especially low in those with stage 4-5 (24.3-27.5%), those on antihypertensive medication (21.6%) and those with proteinuria ≥2± (21.3%). Logistic regression analysis showed that independent factors for high-blood pressure in CKD subjects were age, male gender, alcohol consumption, nonsmoking, diabetes, dyslipidemia, obesity, proteinuria, and antihypertensive medication.
  
  
  CONCLUSIONS
  Blood pressure control was inadequate in the majority of Japanese CKD subjects, despite antihypertensive treatment. More aggressive efforts to achieve target blood pressures among CKD subjects are recommended.
authors.affiliation: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan. kkonta@med.id.yamagata-u.ac.jp
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Konta
authors.forename: Ami
authors.initials: A
authors.lastname: Ikeda
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Ichikawa
authors.forename: Shouichi
authors.initials: S
authors.lastname: Fujimoto
authors.forename: Kunitoshi
authors.initials: K
authors.lastname: Iseki
authors.forename: Toshiki
authors.initials: T
authors.lastname: Moriyama
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Yamagata
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuruya
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yoshida
authors.forename: Koichi
authors.initials: K
authors.lastname: Asahi
authors.forename: Issei
authors.initials: I
authors.lastname: Kurahashi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D011507:Proteinuria / Q000453:epidemiology; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000453:epidemiology*; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents