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Am J Hypertens. 2017 Jun 1;30(6):610-616. doi: 10.1093/ajh/hpx017.

Blood Pressure Control During Chronic Kidney Disease Progression.

Lee S1, Oh HJ2,3, Lee EK1, Lee O1, Ha E3,4, Kim SJ5, Kang DH5, Choi KB5, Ryu DR3,5,6.

Author information

1
Department of Statistics, Ewha Womans University, Seoul, Korea.
2
Ewha Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.
3
Research Institute for Human Health Information, Ewha Womans University Mokdong Hospital, Seoul, Korea.
4
Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
5
Department of Internal Medicine, School of Medicine, Seoul, Korea.
6
Tissue Injury Defense Research Center, Ewha Womans University, Seoul, Korea.

Abstract

BACKGROUND:

Hypertension is a major cause of end-stage renal disease, and blood pressure (BP) control is crucial in patients with chronic kidney disease (CKD). However, it is generally inadequately controlled in CKD patients. We investigated the prevalence of CKD patients with inadequate BP control and its related factors, based on the CKD stage.

METHODS:

We analyzed the health examination sample cohort database, which consisted of the randomly selected participants among all the citizens who received the health examination provided by National Health Insurance Service of Korea in 2012 and 2013.

RESULTS:

There were 27,350 CKD patients (7.9%) out of a total of 345,044 participants. As CKD stage progressed, there were more patients with poorly controlled hypertension compared to those with well-controlled hypertension. In addition, systolic BP increased with CKD stage progression, while diastolic BP was not significantly different. Age, female, body mass index, increased pulse pressure, CKD stage, and levels of fasting glucose, total cholesterol, hemoglobin, and proteinuria were significant factors associated with poor control of BP in hypertensive CKD patients.

CONCLUSION:

The proportion of CKD patients with poorly controlled hypertension significantly increased as CKD progressed, mainly associated with the increase in pulse pressure. However, future investigation for causal relationship between poorly controlled hypertension and its related factors is needed.

KEYWORDS:

blood pressure; chronic kidney disease; hypertension; pulse pressure

PMID:
28338771
DOI:
10.1093/ajh/hpx017
[Indexed for MEDLINE]

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