单位:[1]Department of Nephrology, Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, State Key Laboratory of KidneyDiseases, Chinese PLA Institute of Nephrology, Beijing, China[2]Department of Nephrology, China-Japan Friendship Hospital, Beijing 100029, China[3]Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China[4]Department of Nephrology,Guangdong Provincial People’s Hospital, Guangzhou, Guangdong, China[5]Department of Nephrology, Zhongshan Hospital, Fudan University,Shanghai, China[6]Department of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China大连医科大学附属第一医院
Background: Hypertension is prevalent in chronic kidney disease (CKD), but the control of hypertension is suboptimal. We reported the prevalence and characteristics of resistant and undertreated hypertension based on a nationwide survey aiming to improve blood pressure (BP) control. Methods: Resistant hypertension (RH) was defined as BP above the target (<140/90 mm Hg) despite the use of 3 antihypertensive drugs or achieving the target BP by using >= 4 antihypertensive drugs. Undertreated hypertension was defined as uncontrolled hypertension (unCH) using <= 2 drugs. We compared the characteristics and antihypertensive treatment among different groups (including RH and unCH using <= 2 drugs). Multivariable logistic regression was used to detect factors associated with unCH using <= 2 drugs and RH. Results: 4,435 nondialysis CKD patients with hypertension were analyzed, and 36.9% of participants achieved controlled hypertension (CH) using <= 3 drugs, 11.1% met the criteria for RH, and 52% had unCH despite the use of <= 2 antihypertensive drugs. Participants with unCH using <= 2 drugs had low usage of renin-angiotensin system blockers (36.8%) and diuretics (5.5%), which was much lower than participants with CH using <= 3 drugs and RH (P< 0.05). After multivariable adjustment, obesity, advanced CKD stages, urinary protein level of >= 1.5 g/24 h, diabetes, and cardiovascular disease were associated with RH in CKD patients (P< 0.05). Conclusion: Compared with RH, undertreated hypertension contributes more to the unCH in Chinese CKD patients. It is important to ensure adequate antihypertensive treatment, including choosing antihypertensive drugs, that guidelines recommended.
基金:
National Key Technology RD ProgramNational Key Technology R&D Program [2013BAI09B05, 2015BAI12B06, 2011BAI10B00]; Beijing Science and Technology Project [D131100004713003, D171100002817002]; Key Program of National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81330019]; General Program of the National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81270794, 81670671]; Young Talent Project of Chinese PLA General Hospital
第一作者单位:[1]Department of Nephrology, Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, State Key Laboratory of KidneyDiseases, Chinese PLA Institute of Nephrology, Beijing, China
共同第一作者:
通讯作者:
通讯机构:[1]Department of Nephrology, Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, State Key Laboratory of KidneyDiseases, Chinese PLA Institute of Nephrology, Beijing, China[*1]28 Fuxing Road, Haidian District, Beijing 100853, China
推荐引用方式(GB/T 7714):
Zheng Ying,Tang Li,Chen Xiangmei,et al.Resistant and undertreated hypertension in patients with chronic kidney disease: data from the PATRIOTIC survey[J].CLINICAL and EXPERIMENTAL HYPERTENSION.2018,40(8):784-791.doi:10.1080/10641963.2018.1433193.
APA:
Zheng, Ying,Tang, Li,Chen, Xiangmei,Cai, Guangyan,Li, Wenge...&Lin, Hongli.(2018).Resistant and undertreated hypertension in patients with chronic kidney disease: data from the PATRIOTIC survey.CLINICAL and EXPERIMENTAL HYPERTENSION,40,(8)
MLA:
Zheng, Ying,et al."Resistant and undertreated hypertension in patients with chronic kidney disease: data from the PATRIOTIC survey".CLINICAL and EXPERIMENTAL HYPERTENSION 40..8(2018):784-791