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Suboptimal blood pressure control in chronic kidney disease stage 3: baseline data from a cohort study in primary

Simon D S Fraser1, Paul J Roderick, Natasha J McIntyre

  • 1Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, South Academic Block, Southampton General Hospital, Tremona Road, Southampton, Hampshire SO16 6YD, UK. s.fraser@soton.ac.uk

BMC Family Practice
|June 27, 2013
PubMed

Insights

Poor blood pressure (BP) control is common in chronic kidney disease (CKD) patients, especially those with diabetes or albuminuria. Improving BP management in CKD may require combination therapy and addressing adherence.

Area of Science:

  • Nephrology
  • Cardiology
  • Public Health

Background:

  • Poorly controlled hypertension is a significant risk factor for mortality and disease progression in chronic kidney disease (CKD).
  • CKD stage 3 management, including blood pressure (BP) control, primarily occurs in primary care settings in the UK.
  • Effective BP management is crucial for improving patient outcomes in CKD.

Purpose of the Study:

  • To investigate the associations of BP control in individuals diagnosed with CKD stage 3.
  • To assess BP control rates against established guidelines in a primary care setting.

Main Methods:

  • 1,741 patients with CKD stage 3 were recruited from 32 general practices.
  • BP control was evaluated using NICE, KDOQI, and KDIGO guidelines.
  • Logistic regression analysis identified factors associated with BP control.

Main Results:

  • Hypertension prevalence was 88%; achievement rates for NICE, KDOQI, and KDIGO BP targets were 58.1%, 35.9%, and 60.2%, respectively.
  • Patients with diabetes and/or albuminuria had lower BP control rates.
  • Older age, diabetes, and albuminuria were negatively associated with achieving BP targets.

Conclusions:

  • Suboptimal BP control is prevalent in hypertensive CKD patients, particularly those with diabetes and albuminuria.
  • There is a need to improve BP control strategies in CKD management.
  • Combination antihypertensive therapy, alongside adherence and side effect considerations, may enhance BP control.
Abstract

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