Considerable international variation exists in blood pressure control and antihypertensive prescription patterns in chronic kidney disease.

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  • Additional Information
    • Corporate Authors:
      International Network of Chronic Kidney Disease cohort studies (iNET-CKD)
    • Source:
      Publisher: Elsevier Country of Publication: United States NLM ID: 0323470 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1523-1755 (Electronic) Linking ISSN: 00852538 NLM ISO Abbreviation: Kidney Int Subsets: MEDLINE
    • Publication Information:
      Publication: 2016- : New York : Elsevier
      Original Publication: New York, Springer-Verlag.
    • Subject Terms:
      Antihypertensive Agents/*therapeutic use ; Drug Prescriptions/*statistics & numerical data ; Hypertension/*prevention & control ; Practice Patterns, Physicians'/*statistics & numerical data ; Renal Insufficiency, Chronic/*complications; Adult ; Aged ; Aged, 80 and over ; Antihypertensive Agents/standards ; Asia/epidemiology ; Blood Pressure/drug effects ; Blood Pressure/physiology ; Europe/epidemiology ; Female ; Glomerular Filtration Rate/physiology ; Humans ; Hypertension/epidemiology ; India/epidemiology ; Male ; Middle Aged ; North America/epidemiology ; Practice Guidelines as Topic ; Practice Patterns, Physicians'/standards ; Prevalence ; Renal Insufficiency, Chronic/drug therapy ; Renal Insufficiency, Chronic/physiopathology ; Urology/standards ; Urology/statistics & numerical data ; Uruguay/epidemiology
    • Abstract:
      Although blood pressure control is a major goal in chronic kidney disease, no worldwide overview of either its achievement or antihypertensive prescriptions is currently available. To evaluate this we compared crude prevalence of uncontrolled blood pressure among 17 cohort studies, including 34 602 individuals with estimated glomerular filtration rate under 60 ml/min/1.73 m 2 and treated hypertension across four continents, and estimated observed to expected prevalence ratios, adjusted for potential confounders. Crude prevalence of blood pressure of 140/90 mm Hg or more varied from 28% to 61% and of blood pressure of 130/80 or more from 54% to 84%. Adjusted prevalence ratios indicated poorer hypertension control than expected in cohorts from European countries, India, and Uruguay, and better control in patients from North American and high-income Asian countries. Four antihypertensive drug classes or more were prescribed to more than 30% of participants in North American and some European cohorts, but this practice was less common elsewhere. Renin angiotensin-aldosterone system inhibitors were the most common antihypertensive drugs, prescribed for 54% to 91% of cohort participants. Differences for other drug classes were much stronger, ranging from 11% to 79% for diuretics, 22% to 70% for beta-blockers, and 27% to 75% for calcium-channel blockers. The confounders studied explain only a part of the international variation in blood pressure control among individuals with chronic kidney disease. Thus, considerable heterogeneity in prescription patterns worldwide calls for further investigation into the impact of different approaches on patient outcomes.
      (Copyright © 2019 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)
    • Comments:
      Comment in: Kidney Int. 2019 Oct;96(4):820-822. (PMID: 31543151)
    • Grant Information:
      U01 DK060990 United States DK NIDDK NIH HHS; U01 DK060984 United States DK NIDDK NIH HHS; U01 DK061022 United States DK NIDDK NIH HHS; U01 DK061021 United States DK NIDDK NIH HHS; U01 DK061028 United States DK NIDDK NIH HHS; U01 DK060980 United States DK NIDDK NIH HHS; U01 DK060963 United States DK NIDDK NIH HHS; U01 DK060902 United States DK NIDDK NIH HHS; UL1 TR000003 United States TR NCATS NIH HHS; UL1 TR000424 United States TR NCATS NIH HHS; UL1 TR000439 United States TR NCATS NIH HHS; UL1 TR000433 United States TR NCATS NIH HHS; UL1 RR029879 United States RR NCRR NIH HHS; P20 GM109036 United States GM NIGMS NIH HHS; UL1 RR024131 United States RR NCRR NIH HHS
    • Contributed Indexing:
      Investigator: A Levin; O Djurdjev; M Tang; M Fukagawa; N Fujii; S Maruyama; T Imaizumi; WE Hoy; J Zhang; Z Wang; HG Healy; N Alencar de Pinho; B Stengel; ZA Massy; C Combe; M Laville; RP Filho; A Lopes; H Reichel; B Robinson; R Pisoni; B Bieber; C Tu; C Kitiyakara; P Sangthawan; W Pichaiwong; P Klyprayong; HI Feldman; P Orlandi; R Townsend; A Go; J Wang; L Zhang; KU Eckardt; V Jha; V Kumar; AK Yadav; S Baid-Agrawal; KH Oh; C Ahn; DW Chae; SH Han; L Sola; PG Rios; L Gadola; V Lamadrid; S Eder; J Leierer; J Kerschbaum; MH de Borst; FJ Van Ittersum; JA Van den Brand; MA De Jong; MW Taal; A Shardlow
      Keywords: antihypertensive treatment; chronic kidney disease; hypertension control; international health
    • Accession Number:
      0 (Antihypertensive Agents)
    • Publication Date:
      Date Created: 20190731 Date Completed: 20201014 Latest Revision: 20201014
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/j.kint.2019.04.032
    • Accession Number:
      31358344