Sarafidis Pantelis A, Li Suying, Chen Shu-Cheng, Collins Allan J, Brown Wendy W, Klag Michael J, Bakris George L
Hypertensive Diseases Unit, Section of Endocrinology, Diabetes, and Metabolism, University of Chicago-Pritzker School of Medicine, Chicago, IL 60637, USA.
Am J Med. 2008 Apr;121(4):332-40. doi: 10.1016/j.amjmed.2007.11.025.
Hypertension prevalence, awareness, treatment, and blood pressure control rates in the population with chronic kidney disease are limited. The objective of this study was to determine the state of blood pressure control in patients with chronic kidney disease.
This is a cross-sectional analysis of data of participants with chronic kidney disease from the Kidney Early Evaluation Program. The Kidney Early Evaluation Program is a national-based health screening program for individuals at high risk for kidney disease conducted in 49 states and the District of Columbia. Of 55,220 adults with kidney disease, 10,813 completed information for demographic and medical characteristics used in the analysis. Predictors of blood pressure control were assessed using multiple logistic regression analysis.
Hypertension prevalence, awareness, and treatment proportions in the screened cohort were high (86.2%, 80.2%, and 70.0%, respectively), but blood pressure control rates were low (13.2%). These proportions increased with advancing stage of kidney disease. Elevated systolic blood pressure accounted for the majority of inadequate control. Male gender (odds ratio [OR] 0.86; 95% confidence interval [CI], 0.75-0.99), non-Hispanic black race (OR 0.76; 95% CI, 0.65-0.89), and body mass index of 30 kg/m(2) or more (OR 0.83; 95% CI, 0.73-0.94) were inversely related with blood pressure control. Those with stage 3 kidney disease were more likely to have blood pressure at goal than those with stage 1 kidney disease (OR 2.08; 95% CI, 1.55-2.80).
We conclude that despite increased awareness and treatment of hypertension, control rates in these participants are poor. This poor control rate centers around elevated systolic pressure in people who are obese, non-Hispanic black, or male. These data suggest that those who are aware of their kidney disease are more likely to achieve blood pressure control.
慢性肾脏病患者人群中的高血压患病率、知晓率、治疗率及血压控制率均有限。本研究的目的是确定慢性肾脏病患者的血压控制状况。
这是一项对来自肾脏早期评估项目的慢性肾脏病参与者数据的横断面分析。肾脏早期评估项目是一项针对肾病高危个体的全国性健康筛查项目，在49个州和哥伦比亚特区开展。在55220名患有肾病的成年人中，10813人完成了用于分析的人口统计学和医学特征信息。使用多因素逻辑回归分析评估血压控制的预测因素。
筛查队列中的高血压患病率、知晓率和治疗比例较高（分别为86.2%、80.2%和70.0%），但血压控制率较低（13.2%）。这些比例随着肾病分期的进展而增加。收缩压升高是控制不佳的主要原因。男性（比值比[OR]0.86；95%置信区间[CI]，0.75 - 0.99）、非西班牙裔黑人种族（OR 0.76；95% CI，0.65 - 0.89）以及体重指数为30 kg/m²或更高（OR 0.83；95% CI，0.73 - 0.94）与血压控制呈负相关。与1期肾病患者相比，3期肾病患者更有可能血压达标（OR 2.08；95% CI，1.55 - 2.80）。
我们得出结论，尽管高血压的知晓率和治疗率有所提高，但这些参与者的控制率仍较差。这种较差的控制率集中在肥胖、非西班牙裔黑人或男性人群的收缩压升高上。这些数据表明，知晓自己患有肾病的人更有可能实现血压控制。
