Blood Pressure Control During Chronic Kidney Disease Progression.
BACKGROUND
Hypertension is a major cause of end-stage renal disease, and blood pressure (BP) control is crucial in patients with chronic kidney disease (CKD). However, it is generally inadequately controlled in CKD patients. We investigated the prevalence of CKD patients with inadequate BP control and its related factors, based on the CKD stage.


METHODS
We analyzed the health examination sample cohort database, which consisted of the randomly selected participants among all the citizens who received the health examination provided by National Health Insurance Service of Korea in 2012 and 2013.


RESULTS
There were 27,350 CKD patients (7.9%) out of a total of 345,044 participants. As CKD stage progressed, there were more patients with poorly controlled hypertension compared to those with well-controlled hypertension. In addition, systolic BP increased with CKD stage progression, while diastolic BP was not significantly different. Age, female, body mass index, increased pulse pressure, CKD stage, and levels of fasting glucose, total cholesterol, hemoglobin, and proteinuria were significant factors associated with poor control of BP in hypertensive CKD patients.


CONCLUSIONS
The proportion of CKD patients with poorly controlled hypertension significantly increased as CKD progressed, mainly associated with the increase in pulse pressure. However, future investigation for causal relationship between poorly controlled hypertension and its related factors is needed.
Department of Statistics, Ewha Womans University, Seoul, Korea.
Seulbi
S
Lee
Ewha Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.|Research Institute for Human Health Information, Ewha Womans University Mokdong Hospital, Seoul, Korea.
Hyung Jung
HJ
Oh
Department of Statistics, Ewha Womans University, Seoul, Korea.
Eun-Kyung
EK
Lee
Department of Statistics, Ewha Womans University, Seoul, Korea.
Oesook
O
Lee
Research Institute for Human Health Information, Ewha Womans University Mokdong Hospital, Seoul, Korea.|Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
Eunhee
E
Ha
Department of Internal Medicine, School of Medicine, Seoul, Korea.
Seung-Jung
SJ
Kim
Department of Internal Medicine, School of Medicine, Seoul, Korea.
Duk-Hee
DH
Kang
Department of Internal Medicine, School of Medicine, Seoul, Korea.
Kyu Bok
KB
Choi
Research Institute for Human Health Information, Ewha Womans University Mokdong Hospital, Seoul, Korea.|Department of Internal Medicine, School of Medicine, Seoul, Korea.|Tissue Injury Defense Research Center, Ewha Womans University, Seoul, Korea.
Dong-Ryeol
DR
Ryu
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D000959:Antihypertensive Agents
blood pressure; chronic kidney disease; hypertension; pulse pressure