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Hypertension Awareness, Treatment, and Control in Adults With CKD: Results From the Chronic Renal Insufficiency Cohort (CRIC) Study
Open accessAbstract
Background A low rate of blood pressure control has been reported in patients with chronic kidney disease (CKD). These data were derived from population-based samples with a low rate of CKD awareness.Study design Cross-sectional.Setting & participants Data from the baseline visit of the Chronic Renal Insufficiency Cohort (CRIC) Study (n = 3,612) were analyzed. Participants with an estimated glomerular filtration rate of 20-70 mL/min/1.73 m(2) were identified from physician offices and review of laboratory databases.Outcomes Prevalence and awareness of hypertension, treatment patterns, control rates, and factors associated with hypertension control.Measurements Following a standardized protocol, blood pressure was measured 3 times by trained staff, and hypertension was defined as systolic blood pressure > or =140 mm Hg and/or diastolic blood pressure > or =90 mm Hg and/or self-reported antihypertensive medication use. Patients' awareness and treatment of hypertension were defined using self-report, and 2 levels of hypertension control were evaluated: systolic/diastolic blood pressure <140/90 and <130/80 mm Hg.Results The prevalence of hypertension was 85.7%, and 98.9% of CRIC participants were aware of this diagnosis and 98.3% were treated with medications, whereas 67.1% and 46.1% had hypertension controlled to <140/90 and <130/80 mm Hg, respectively. Of CRIC participants with hypertension, 15%, 25%, 26%, and 32% were using 1, 2, 3, and > or =4 antihypertensive medications, respectively. After multivariable adjustment, older patients, blacks, and those with higher urinary albumin excretion were less likely, whereas participants using angiotensin-converting enzyme inhibitors and angiotensin receptor blockers were more likely to have controlled their hypertension to <140/90 and <130/80 mm Hg.Limitations Data were derived from a single study visit.Conclusions Despite almost universal hypertension awareness and treatment in this cohort of patients with CKD, rates of hypertension control were suboptimal.
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“Difficulty controlling BP in late stages of CKD was also seen in CRIC (Chronic Renal Insufficiency Cohort), in which 88% of participants had stage 3 or 4 CKD.”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [303]
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Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., et al. (2018) · Hypertension · doi:10.1161/hyp.0000000000000065 · Cited by 7,391
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Metadata
- Authors
- Muntner, P., Anderson, A., Charleston, J., Chen, Z., Ford, V., Makos, G., O'Connor, A., Perumal, K., Rahman, M., Steigerwalt, S., Teal, V., Townsend, R., Weir, M., & Wright, J. T.
- Affiliations
- University of Alabama at Birmingham (US)
- University of Pennsylvania (US)
- University of Maryland, Baltimore (US)
- National Institutes of Health (US)
- University of Illinois Chicago (US)
- University Hospitals Cleveland Medical Center (US)
- St. John Medical Center (US)
- Case Western Reserve University (US)
- Corresponding author
- Muntner, Paul
- ORCID
- Venue
- American Journal of Kidney Diseases
- Publisher
- Elsevier BV
- Published
- 2010-03
- Volume
- 55
- Issue
- 3
- Pages
- 441-451
- ISSN
- 0272-6386 (ISSN-L)
- PMC
- PMC2866514
- OpenAlex
- W2096512601
- Cited by
- 423
- References
- 16
- Citations by year
- 2026: 10 · 2025: 34 · 2024: 32 · 2023: 45 · 2022: 34 · 2021: 35 · 2020: 33 · 2019: 40 · 2018: 32 · 2017: 23 · 2016: 20 · 2015: 19 · 2014: 13 · 2013: 16 · 2012: 17
- FWCI
- 7.55
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Kidney Diseases (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (5U01DK06102, U01DK060990, 5U01 DK60980, T32DK007785, T32DK060455, K01DK064860, U01DK060984, U01DK060902, U01DK060980, U01DK060963, U01DK061021, U01DK061028)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Keywords
- hypertension, chronic kidney disease, blood pressure control, hypertension awareness, antihypertensive medication use, ACE inhibitors, angiotensin receptor blockers, urinary albumin excretion, Chronic Renal Insufficiency Cohort Study, older adults, racial disparities
- MeSH terms
- Adult, Aged, Chronic Disease, Female, Humans, Hypertension, Kidney Diseases, Male, Middle Aged, Renal Insufficiency, Young Adult
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