Prevalence of apparent treatment-resistant hypertension among individuals with CKD.

Published

Journal Article

BACKGROUND AND OBJECTIVES: Apparent treatment-resistant hypertension is defined as systolic/diastolic BP ≥ 140/90 mmHg with concurrent use of three or more antihypertensive medication classes or use of four or more antihypertensive medication classes regardless of BP level. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The prevalence of apparent treatment-resistant hypertension among Reasons for Geographic and Racial Differences in Stroke study participants treated for hypertension (n=10,700) was determined by level of estimated GFR and albumin-to-creatinine ratio, and correlates of apparent treatment-resistant hypertension among those participants with CKD were evaluated. CKD was defined as an albumin-to-creatinine ratio ≥ 30 mg/g or estimated GFR<60 ml/min per 1.73 m(2). RESULTS: The prevalence of apparent treatment-resistant hypertension was 15.8%, 24.9%, and 33.4% for those participants with estimated GFR ≥ 60, 45-59, and <45 ml/min per 1.73 m(2), respectively, and 12.1%, 20.8%, 27.7%, and 48.3% for albumin-to-creatinine ratio<10, 10-29, 30-299, and ≥ 300 mg/g, respectively. The multivariable-adjusted prevalence ratios (95% confidence intervals) for apparent treatment-resistant hypertension were 1.25 (1.11 to 1.41) and 1.20 (1.04 to 1.37) for estimated GFR levels of 45-59 and <45 ml/min per 1.73 m(2), respectively, versus ≥ 60 ml/min per 1.73 m(2) and 1.54 (1.39 to 1.71), 1.76 (1.57 to 1.97), and 2.44 (2.12 to 2.81) for albumin-to-creatinine ratio levels of 10-29, 30-299, and ≥ 300 mg/g, respectively, versus albumin-to-creatinine ratio<10 mg/g. After multivariable adjustment, men, black race, larger waist circumference, diabetes, history of myocardial infarction or stroke, statin use, and lower estimated GFR and higher albumin-to-creatinine ratio levels were associated with apparent treatment-resistant hypertension among individuals with CKD. CONCLUSIONS: This study highlights the high prevalence of apparent treatment-resistant hypertension among individuals with CKD.

Full Text

Duke Authors

Cited Authors

  • Tanner, RM; Calhoun, DA; Bell, EK; Bowling, CB; Gutiérrez, OM; Irvin, MR; Lackland, DT; Oparil, S; Warnock, D; Muntner, P

Published Date

  • September 2013

Published In

Volume / Issue

  • 8 / 9

Start / End Page

  • 1583 - 1590

PubMed ID

  • 23868902

Pubmed Central ID

  • 23868902

Electronic International Standard Serial Number (EISSN)

  • 1555-905X

Digital Object Identifier (DOI)

  • 10.2215/CJN.00550113

Language

  • eng

Conference Location

  • United States