Blood pressure and antihypertensive medication profile in a multiethnic Asian population of stable chronic kidney disease patients

作者：Teo Boon Wee^*; Chua Horng Ruey; Wong Weng Kin; Haroon Sabrina; Subramanian Srinivas; Loh Ping Tyug; Sethi Sunil; Lau Titus

来源：Singapore Medical Journal, 2016, 57(5): 267-273.

DOI：10.11622/smedj.2016089

• Asian
• blood pressure
• chronic renal failure
• hypertension
• medication

INTRODUCTION Clinical practice guidelines recommend different blood pressure (BP) goals for chronic kidney disease (CKD) patients. Usage of antihypertensive medication and attainment of BP targets in Asian CKD patients remain unclear. This study describes the profile of antihypertensive agents used and BP components in a multiethnic Asian population with stable CKD.
METHODS Stable CKD outpatients with variability of serum creatinine levels < 20%, taken > 3 months apart, were recruited. Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using automated manometers, according to practice guidelines. Serum creatinine was assayed and the estimated glomerular filtration rate (GFR) calculated using the CKD Epidemiology Collaboration equation. BP and antihypertensive medication profile was examined using univariate analyses.
RESULTS 613 patients (55.1% male; 74.7% Chinese, 6.4% Indian, 11.4% Malay; 35.7% diabetes mellitus) with a mean age of 57.8 +/- 14.5 years were recruited. Mean SBP was 139 +/- 20 mmHg, DBP was 74 +/- 11 mmHg, serum creatinine was 166 +/- 115 mu mol/L and GFR was 53 +/- 32 mL/min/1.73 m(2). At a lower GFR, SBP increased (p < 0.001), whereas DBP decreased (p = 0.0052). Mean SBP increased in tandem with the number of antihypertensive agents used (p < 0.001), while mean DBP decreased when >= 3 antihypertensive agents were used (p = 0.0020).
CONCLUSION Different targets are recommended for each BP component in CKD patients. A majority of patients cannot attain SBP targets and/or exceed DBP targets. Research into monitoring and treatment methods is required to better define BP targets in CKD patients.

• 出版日期2016-5