A nationwide cross-sectional survey on prevalence, management and pharmacoepidemiology patterns on hypertension in Chinese patients with chronic kidney disease.

Wen Zhang,Peiju Mao,Jun Cen,Hong Cheng,Li Wang,Jian Liu,Changying Xing,Wei Shi,Dongsheng Jiang,Gang Xu,Rong Zhou,Nan Chen,Zhangsuo Liu,Jianshe Liu,Qinkai Chen,Chaoxing Huang,Mingxu Li,Yong Gu,Yanlin Zhang,Fu-Yuan Hong ,Lirong Gong ,Yuan Wang ,Ye-Ping Ren

doi:10.1038/srep38768

Abstract

Limited data are available on epidemiology and drug use in Chinese hypertensive patients with chronic kidney disease (CKD). We determined the prevalence; awareness, treatment, and control rates of hypertension; anti-hypertensive use, expenditure pattern; and factors associated with hypertension prevalence and control in Chinese patients with CKD. This was one of the largest cross-sectional surveys that enrolled 6079 CKD participants (mean age, 51.0 ± 16.37 years) with or without hypertension from 22 centres across China. The prevalence, awareness, and treatment rates were 71.2%, 95.4%, and 93.7%, respectively. Control rates 1 and 2 (Blood pressure, BP <140/90 and <130/80 mmHg) were 41.1% and 15.0%, respectively. Patients were treated mostly with monotherapy (37.7%) or 2-drug anti-hypertensive combination (38.7%). Factors associated with prevalence of hypertension included age; smoking; body mass index; physical exercise; family history of hypertension; hyperuricaemia; and CKD. Control rate was associated with CKD stage, BP monitoring at home, and use of drug combinations. Despite high rates of awareness and treatment, the control rates are low. CKD stages 4 and 5 adversely affect the control rate. The results suggest the immediate need of comprehensive controlling measures to improve the control of hypertension in Chinese patients with CKD.

Highlights

The prevalence of hypertension and chronic kidney disease (CKD) is constantly increasing in China and has seen multiple fold increase over the past 3 decades[17,18,19]
Since there are only a few studies that have determined the epidemiology and control of hypertension in Chinese patients with CKD; reliable information is necessary for the development of health policies in China, to prevent and control hypertension in patients with CKD
This is one of the largest nationwide survey that analysed the prevalence of hypertension, awareness of the disease, rates of treatment, control of hypertension; anti-hypertensive drug use and drug expenditure pattern; and factors associated with prevalence, awareness, treatment, and control rates of hypertension in patients with CKD in China

Summary

Introduction

In China, 2 studies reported the prevalence of hypertension in patients with CKD at 82.0% and 67.3%, respectively. Despite high awareness and treatment rates reported in these studies, the control rates for hypertension were relatively very low[11,12]. The control rate of hypertension is inversely associated with the CKD stage[13]. Patients with high-grade hypertension are at a higher risk of CKD progression[14] and other complications such as stroke, cardiovascular disease, and target organ damage (TOD)[15]. We determined the prevalence, awareness, control, and rate of reaching the target BP in hypertensive Chinese patients with CKD using a nationwide survey across China. We study evaluated the anti-hypertensive drug use situation, pattern of expenditure on drugs and factors associated with hypertension prevalence and control

Methods

Results

Conclusion