慢性肾脏病患者的高血压知晓率、治疗率和控制率：慢性肾功能不全队列研究（CRIC）的结果。
Hypertension awareness, treatment, and control in adults with CKD: results from the Chronic Renal Insufficiency Cohort (CRIC) Study.
机构信息
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
出版信息
Am J Kidney Dis. 2010 Mar;55(3):441-51. doi: 10.1053/j.ajkd.2009.09.014. Epub 2009 Dec 5.
BACKGROUND
A low rate of blood pressure control has been reported in patients with chronic kidney disease (CKD). These data were derived from population-based samples with a low rate of CKD awareness.
STUDY DESIGN
Cross-sectional.
SETTING & PARTICIPANTS: Data from the baseline visit of the Chronic Renal Insufficiency Cohort (CRIC) Study (n = 3,612) were analyzed. Participants with an estimated glomerular filtration rate of 20-70 mL/min/1.73 m(2) were identified from physician offices and review of laboratory databases.
OUTCOMES
Prevalence and awareness of hypertension, treatment patterns, control rates, and factors associated with hypertension control.
MEASUREMENTS
Following a standardized protocol, blood pressure was measured 3 times by trained staff, and hypertension was defined as systolic blood pressure > or =140 mm Hg and/or diastolic blood pressure > or =90 mm Hg and/or self-reported antihypertensive medication use. Patients' awareness and treatment of hypertension were defined using self-report, and 2 levels of hypertension control were evaluated: systolic/diastolic blood pressure <140/90 and <130/80 mm Hg.
RESULTS
The prevalence of hypertension was 85.7%, and 98.9% of CRIC participants were aware of this diagnosis and 98.3% were treated with medications, whereas 67.1% and 46.1% had hypertension controlled to <140/90 and <130/80 mm Hg, respectively. Of CRIC participants with hypertension, 15%, 25%, 26%, and 32% were using 1, 2, 3, and > or =4 antihypertensive medications, respectively. After multivariable adjustment, older patients, blacks, and those with higher urinary albumin excretion were less likely, whereas participants using angiotensin-converting enzyme inhibitors and angiotensin receptor blockers were more likely to have controlled their hypertension to <140/90 and <130/80 mm Hg.
LIMITATIONS
Data were derived from a single study visit.
CONCLUSIONS
Despite almost universal hypertension awareness and treatment in this cohort of patients with CKD, rates of hypertension control were suboptimal.
背景
慢性肾脏病（CKD）患者的血压控制率较低。这些数据来源于基于人群的样本，其中 CKD 的知晓率较低。
研究设计
横断面研究。
设置和参与者
分析了慢性肾功能不全队列（CRIC）研究基线访视的数据（n = 3612）。从医生办公室和实验室数据库的回顾中确定肾小球滤过率估计值为 20-70 mL/min/1.73 m2 的参与者。
结局
高血压的患病率和知晓率、治疗模式、控制率以及与高血压控制相关的因素。
测量
按照标准化方案，由经过培训的工作人员测量血压 3 次，高血压定义为收缩压> =140 mm Hg 和/或舒张压> =90 mm Hg 和/或自我报告使用抗高血压药物。使用自我报告定义患者的高血压知晓率和治疗率，评估 2 个高血压控制水平：收缩压/舒张压<140/90 和<130/80 mm Hg。
结果
高血压的患病率为 85.7%，CRIC 参与者中 98.9%知晓该诊断，98.3%接受药物治疗，而 67.1%和 46.1%的患者血压控制在<140/90 和<130/80 mm Hg 以下。在有高血压的 CRIC 参与者中，分别有 15%、25%、26%和 32%的人使用 1、2、3 和>或=4 种降压药物。经过多变量调整，年龄较大、黑人以及尿白蛋白排泄量较高的患者，血压控制到<140/90 和<130/80 mm Hg 的可能性较低，而使用血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂的患者血压控制到<140/90 和<130/80 mm Hg 的可能性较高。
局限性
数据来自单次研究访问。
结论
尽管该 CKD 患者队列中几乎普遍存在高血压的知晓率和治疗率，但血压控制率仍不理想。
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