Trends in Blood Pressure Control in US Adult CKD Patients from 1999 to 2018

Area of Science:

• Nephrology
• Cardiology
• Public Health

Background:

• Effective blood pressure (BP) control is vital for slowing chronic kidney disease (CKD) progression and preventing cardiovascular complications.
• Hypertension management in CKD patients significantly impacts survival rates.

Purpose of the Study:

• To analyze trends in BP control among adult CKD patients with hypertension in the United States.
• To identify factors associated with uncontrolled BP in this population over time.

Main Methods:

• Utilized National Health and Nutrition Examination Survey (NHANES) data from 1999-2000 to 2017-2018.
• Included 5,510 adult CKD patients with elevated BP or on antihypertensive medication.

Main Results:

• The prevalence of uncontrolled BP in adult CKD patients decreased from 72.9% (1999-2000) to 46.6% (2013-2014) but increased to 56.9% (2017-2018).
• CKD patients with higher albumin-creatinine rates (ACR) were more likely to be on medication but also more likely to have uncontrolled BP.
• Patients with eGFR ≥60 mL/min/1.73m² aware of their hypertension were less likely to take medication compared to those with eGFR 30-59 mL/min/1.73m².

Conclusions:

• BP control efforts in adult CKD patients require reinforcement, particularly for those with ACR ≥300 mg/g.
• Enhancing awareness and adherence to antihypertensive medication is crucial for CKD patients with eGFR ≥60 mL/min/1.73m².