Improvement of awareness, treatment and control of hypertension among chronic kidney disease patients in China from 1999 to 2005

Abstract

Controlling hypertension is important to protect renal function and prevent cardiovascular disease in chronic kidney disease (CKD) patients. However, data on hypertension awareness, treatment and control among CKD patients are limited. Two nationwide surveys were conducted in China in 1999-2000 and 2004-2005 among, respectively, 1328 and 1244 adult, non-dialysis, hypertensive CKD patients, to assess the status of hypertension awareness, treatment and control and associated factors. A standard questionnaire was adopted, and blood pressure (BP) was measured by trained staff according to a standard protocol in both surveys. Compared with the data from 1999-2000, the data from 2004-2005 showed increased awareness (87.2 vs. 75.7%, P<0.001), treatment (85.9 vs. 80.4%, P=0.001) and control (30.0 vs. 21.1%, P<0.001, by the general threshold of BP<140/90 mm Hg; 7.7 vs. 5.9%, P=0.075, by an optimal threshold of BP<130/80 mm Hg) of hypertension. The odds ratios for general BP control were 1.4 (95% confidence index (CI), 1.1-1.7) for female gender, 1.1 (95% CI, 1.0-1.1) for high estimated glomerular filtration rate, 1.3 (95% CI, 1.1-1.6) for treatment in a local hospital, 2.8 (95% CI, 2.0-3.9) for hypertension awareness and 1.7 (95% CI, 1.4-1.9) for combined treatment. General physicians from local hospitals made greater contributions to the total improvement. Lack of treatment was mainly due to patients not recognizing the necessity for it. This is the first report of hypertension awareness, treatment and control among hypertensive CKD patients from a developing country. Improvement of awareness and general control of hypertension were demonstrated. Education of both physicians and patients regarding optimal BP control should be reinforced in the future.