title: Utilization patterns of antihypertensive drugs among the chronic kidney disease population in the United States: a cross-sectional analysis of the national health and nutrition examination survey.
abstract: OBJECTIVE
  Antihypertensive drugs are prescribed to patients with chronic kidney disease (CKD) for their cardioprotective and renoprotective effects. Nationally representative information on the use of antihypertensive drugs among CKD patients is limited. The purpose of this study was to assess the utilization patterns of antihypertensive drugs among the CKD population (stages I-IV) in the United States.
  
  
  METHODS
  We conducted a retrospective cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) panels from 2005-2006, 2007-2008, and 2009-2010. The estimated glomerular filtration rate was calculated and kidney damage was assessed to identify participants with CKD. The demographic and clinical characteristics of the participants with CKD were reported, as were the antihypertensive drugs they used.
  
  
  RESULTS
  A total weighted sample of 116,231,361 participants representative of the CKD population in the United States (stages I-IV) was identified. Less than one half of the participants with CKD in the NHANES were using antihypertensive drugs. β-blockers were the most commonly used and angiotensin II receptor blockers were the least used antihypertensive agents among participants with CKD. Age (≥70 years), awareness of hypertension or diabetes, and higher stage of CKD were associated with an increased likelihood of antihypertensive drug use among participants with CKD.
  
  
  CONCLUSIONS
  The results of our analyses suggest that antihypertensive drugs are underused in the CKD population, and the use of preferred agents (ie, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers) is low. Efforts should be directed toward emphasizing the importance of using antihypertensive drugs in the CKD population.
authors.affiliation: Harrison School of Pharmacy, Health Outcomes Research and Policy, Auburn, Alabama.
authors.forename: Kalyani B
authors.initials: KB
authors.lastname: Sonawane
authors.affiliation: Harrison School of Pharmacy, Health Outcomes Research and Policy, Auburn, Alabama.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Qian
authors.affiliation: Harrison School of Pharmacy, Health Outcomes Research and Policy, Auburn, Alabama. Electronic address: rah0019@auburn.edu.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Hansen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D010818:Practice Patterns, Physicians'; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents
keywords: antihypertensive drugs; chronic kidney disease; medications acting on the renin-angiotensin system