Abstract
BackgroundHypertension and chronic kidney disease (CKD) are common conditions and both are major risk factors for cardiovascular events. The objectives were 1) to study the prevalence of CKD in hypertensive patients and 2) to study the association of CKD with cardiac and vascular complications in a multicenter, nation-wide fashion.MethodsThis cross-sectional study evaluated patients aged 20 years or older who were diagnosed with hypertension and who had been treated for at least 12 months at 831 public hospitals in Thailand during the 2012 study period. Outcome measurements included calculated glomerular filtration rate (GFR) and cardiac and vascular complications that included coronary artery disease, stroke, peripheral arterial disease, heart failure, and atrial fibrillation. Multivariable modeling was conducted to determine independent factors associated with increased risk of cardiac and vascular complications.ResultsA total of 28770 patients were enrolled. Average age was 62.8 years and 37% were male. Prevalence of CKD stage 3 and 4–5 was 33.2 and 4.3%, respectively. Prevalence of cardiac and vascular complications was 10.5% (5% having coronary artery disease, 3.9% stroke, 1.7% heart failure, and 1.2% atrial fibrillation). CKD was an independent risk factor associated with each of the complications and overall cardiac and vascular complications with an adjusted Odds ratio of 1.4 for CKD stage 3 and 1.9 for CKD stage 4–5.ConclusionPrevalence of CKD stage 3–5 in hypertensive population was 37.5%. CKD is an independent risk factor for adverse cardiac and vascular outcome.
Highlights
Hypertension and chronic kidney disease (CKD) are common conditions and both are major risk factors for cardiovascular events
The secondary objectives were to: 1) study the prevalence of Chronic kidney disease (CKD) in hypertensive patients; and 2) study the prevalence of cardiac and vascular complications in patients with hypertension. Study population This cross-sectional survey was conducted in Thailand in 2012 to evaluate nation-wide standard of care and treatment outcome among hypertensive patients who were treated at public Thailand Ministry of Public Health (MoPH) hospitals in Thailand and private clinics in Bangkok that participate in the Thailand National Health Security Office (NHSO)’s program
Cardiac and vascular complications increased with age and men more than women (Fig. 2)
Summary
Hypertension and chronic kidney disease (CKD) are common conditions and both are major risk factors for cardiovascular events. Chronic kidney disease (CKD) is a leading cause of morbidity and mortality among patients around the world [1]. The GFRs of CKD stages 3, 4 and 5 are 30–60, 15–30 and < 15 ml/min respectively [4]. Prevalence of the different stages of CKD in Thailand was reported in 2 major studies namely the National Health Exam Survey (NHES) [5] and the Thai Screening and Early Evaluation of Kidney Disease (Thai SEEK) study [6]. Prevalence of CKD stages 3, 4, and 5 from the NHES studies was 8.1, Krittayaphong et al BMC Nephrology (2017) 18:115
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