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Hypertension in dialysis patients: a cross-sectional analysis
M Tozawa1, K Iseki, K Fukiyama
1Third Department of Internal Medicine, University of The Ryukyus, Okinawa, Japan.
Insights
Blood pressure control is inadequate in chronic dialysis patients, even with antihypertensive medication. This study found higher blood pressure in medicated patients, indicating a need for improved hypertension management strategies in dialysis populations.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Clinical Hypertension
Background:
- Hypertension is a prevalent comorbidity in patients undergoing chronic dialysis.
- Effective blood pressure management is crucial for reducing cardiovascular risk in this population.
Purpose of the Study:
- To assess the current status of blood pressure control among hemodialysis patients in Okinawa, Japan.
- To identify factors associated with blood pressure levels in this cohort.
Main Methods:
- Cross-sectional study of 1,243 hemodialysis patients in January 1991.
- Data collected on 18 variables, including demographics, dialysis parameters, blood chemistry, and predialysis blood pressure.
- Statistical analysis using stepwise regression and univariate analysis to identify predictors of blood pressure.
Main Results:
- Patients on antihypertensive medication had significantly higher systolic and diastolic blood pressures compared to non-medicated patients.
- Antihypertensive medication use was positively associated with both systolic and diastolic blood pressure.
- No significant difference in 4-year mortality rates was observed between medicated and non-medicated groups.
Conclusions:
- Hypertension appears inadequately controlled in this cohort of chronic dialysis patients.
- Widespread use of antihypertensive medications did not correlate with better blood pressure control.
- Further research is needed to optimize hypertension management strategies for dialysis patients.
Abstract:
To clarify the current status of blood pressure control in chronic dialysis patients, we investigated a large group of patients undergoing dialysis in Okinawa, Japan. A set of cross-sectional data of 18 variables, including age, antihypertensive medication, dose of dialysis, blood chemistry findings and predialysis blood pressure, were obtained in 1,243 patients (524 females, 719 males) aged 14 to 93 years who were on hemodialysis in January 1991. Systolic and diastolic blood pressures in patients taking antihypertensive medication (160.8 +/- 0.8/84.6 +/- 0.5 mmHg, mean +/- SEM) were significantly (P < 0.0001) higher than in those were not taking antihypertensive medication (141.3 +/- 0.8/76.9 +/- 0.5). Stepwise regression and univariate analysis methods were used to determine the independent predictors of blood pressure. Antihypertensive medication was positively associated with systolic and diastolic blood pressure. However, the mortality rate of the two groups during the following four years did not differ (antihypertensive-medicated group 23.1% vs. non-medicated group 20.9%). In conclusion, hypertension does not appear to be adequately controlled in our dialysis patients, despite the widespread use of antihypertensive medications.