Barriers to blood pressure control and angiotensin enzyme inhibitor use in Canadian patients with chronic renal insufficiency
Key result
Among 304 patients with chronic renal insufficiency, 42.1% achieved target blood pressure control and 64.5% were prescribed ACEI/ARB therapy.
Population
304 consecutive patients with chronic renal insufficiency seen at follow-up in four nephrology clinics…
Design
Cohort
Authors
Discussion
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Member takes
Implication
Suboptimal BP control and ACEI/ARB use persist in CKD clinics; leaves open effective implementation strategies.
Key Points
- The aim is to describe the use of angiotensin-converting enzyme inhibitors and blood pressure control in chronic renal insufficiency patients while identifying barriers to these strategies.
- Prospective study conducted with 304 chronic renal insufficiency patients across four nephrology clinics in Canada.
- Blood pressure control and antihypertensive medication use were recorded, with a questionnaire administered to nephrologists.
- Data on patient demographics, renal function, and barriers to medication use were collected.
- 42.1% of patients achieved blood pressure control per guidelines, with 28.3% having increased antihypertensive medication.
- 35.5% of patients were not prescribed ACE inhibitors or ARBs, with 31% citing previous ACEI failure due to side effects.
- Miscommunication with primary physicians and medication costs were not significant barriers identified.
Study Design
Type
Observational (n=304)
Multicenter
Yes
Structured PICO
P
Population
304 consecutive patients with chronic renal insufficiency seen at follow-up in four nephrology clinics across Canada.
E
Exposure
Guideline-directed medical therapy including blood pressure control and angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB).
O
Outcome
Achievement of target blood pressure control and use of ACEI/ARB, along with barriers to their implementation.
Despite established guidelines, only about 40% of patients with chronic renal insufficiency achieve target blood pressure and 64% receive ACEI/ARB therapy in Canadian nephrology clinics, highlighting a significant gap in optimal medical management.
Cite This Study
Marcello Tonelli (2002) conducted an observational in chronic renal insufficiency (n=304). Blood pressure control and ACEI/ARB therapy was evaluated on Achievement of target blood pressure control. Among 304 patients with chronic renal insufficiency, 42.1% achieved target blood pressure control and 64.5% were prescribed ACEI/ARB therapy.