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

Publication ,  Journal Article
Tanner, RM; Calhoun, DA; Bell, EK; Bowling, CB; Gutiérrez, OM; Irvin, MR; Lackland, DT; Oparil, S; Warnock, D; Muntner, P
Published in: Clin J Am Soc Nephrol
September 2013

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.

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Published In

Clin J Am Soc Nephrol

DOI

EISSN

1555-905X

Publication Date

September 2013

Volume

8

Issue

9

Start / End Page

1583 / 1590

Location

United States

Related Subject Headings

  • Waist Circumference
  • Urology & Nephrology
  • United States
  • Stroke
  • Sex Factors
  • Renal Insufficiency, Chronic
  • Prevalence
  • Myocardial Infarction
  • Middle Aged
  • Male
 

Citation

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Tanner, R. M., Calhoun, D. A., Bell, E. K., Bowling, C. B., Gutiérrez, O. M., Irvin, M. R., … Muntner, P. (2013). Prevalence of apparent treatment-resistant hypertension among individuals with CKD. Clin J Am Soc Nephrol, 8(9), 1583–1590. https://doi.org/10.2215/CJN.00550113
Tanner, Rikki M., David A. Calhoun, Emmy K. Bell, C Barrett Bowling, Orlando M. Gutiérrez, Marguerite R. Irvin, Daniel T. Lackland, Suzanne Oparil, David Warnock, and Paul Muntner. “Prevalence of apparent treatment-resistant hypertension among individuals with CKD.Clin J Am Soc Nephrol 8, no. 9 (September 2013): 1583–90. https://doi.org/10.2215/CJN.00550113.
Tanner RM, Calhoun DA, Bell EK, Bowling CB, Gutiérrez OM, Irvin MR, et al. Prevalence of apparent treatment-resistant hypertension among individuals with CKD. Clin J Am Soc Nephrol. 2013 Sep;8(9):1583–90.
Tanner, Rikki M., et al. “Prevalence of apparent treatment-resistant hypertension among individuals with CKD.Clin J Am Soc Nephrol, vol. 8, no. 9, Sept. 2013, pp. 1583–90. Pubmed, doi:10.2215/CJN.00550113.
Tanner RM, Calhoun DA, Bell EK, Bowling CB, Gutiérrez OM, Irvin MR, Lackland DT, Oparil S, Warnock D, Muntner P. Prevalence of apparent treatment-resistant hypertension among individuals with CKD. Clin J Am Soc Nephrol. 2013 Sep;8(9):1583–1590.

Published In

Clin J Am Soc Nephrol

DOI

EISSN

1555-905X

Publication Date

September 2013

Volume

8

Issue

9

Start / End Page

1583 / 1590

Location

United States

Related Subject Headings

  • Waist Circumference
  • Urology & Nephrology
  • United States
  • Stroke
  • Sex Factors
  • Renal Insufficiency, Chronic
  • Prevalence
  • Myocardial Infarction
  • Middle Aged
  • Male