Key result
Antihypertensive treatment in renal transplant recipients intensified between 2001 and 2014, with beta-blockers assuming a dominant role and target blood pressure achieved in 46% to 60% of patients.
Why the study?
What are the trends in antihypertensive medication use and blood pressure control among renal transplant recipients over time?
Cross-Sectional (n=1,874)
No
What are the trends in antihypertensive medication use and blood pressure control among renal transplant recipients over time?
Despite an increase in the number of antihypertensive agents used over time, blood pressure control (<140/90 mmHg) in renal transplant recipients remains suboptimal and fluctuated between 46% and 60%.
BP control remains suboptimal in renal transplant recipients despite intensified therapy; leaves open the need for optimized regimens in prospective studies.
BACKGROUND/AIMS: This retrospective study analysed hypertension management and adherence to blood pressure (BP) targets among renal transplant recipients (RTRs) under specialized care in the Outpatient Transplantation Unit in the Department of Nephrology, Transplantology and Internal Medicine at Gdansk University Hospital. METHODS: Medical records of 101, 316, 639 and 818 RTRs diagnosed with hypertension, who received outpatient care in 2001, 2006, 2011 and 2014, respectively were analysed in four independent cross-sectional surveys. All RTRs received antihypertensive regimens. RESULTS: The overall most commonly used antihypertensive agents were beta-blockers (BB) (range 66.3-82.5%) followed by calcium channel blockers (CCB) (range 52.8-64.2%). Whilst a significant, upward tendency of BB usage (p<0.01) was observed, CCB usage (p<0.001) displayed a downward tendency as a first line therapy in the subsequent years. The average number of antihypertensive agents used per patient increased significantly from 2.24±1.03 in 2001 to 2.55±1.25 in 2014 (p<0.05). The most frequently used combination of hypotensive therapy consisted of two or three antihypertensive drugs depending on the survey. The most common two drug combination consisted of BB and CCB followed by BB accompanied by angiotensin converting enzyme inhibitors. A significant, upward tendency in the use of four (p<0.001) and five (p<0.05) antihypertensive drugs simultaneously, was observed in subsequent years. The target values of BP i.e. <140/90 mmHg were accomplished in 47, 58, 60 and 46% of RTRs in subsequent years. In a secondary - stratified analysis of data from 2014, younger patients (p<0.05), patients with better graft function (p<0.001), patients treated with a higher number of antihypertensive agents (p<0.001) and those not treated with BB (p<0.01) were shown to reach the BP target of below 140/90 mmHg more often. CONCLUSION: The study showed intensification of hypertension treatment in RTRs in subsequent years with BB assuming a dominant role.
No takes yet. Share an insight, caveat, or question.
Kuźmiuk-Glembin et al. (2018) conducted a cross-sectional in Hypertension in renal transplant recipients (n=1,874). Antihypertensive therapy was evaluated on Achievement of target blood pressure <140/90 mmHg. Antihypertensive treatment in renal transplant recipients intensified between 2001 and 2014, with beta-blockers assuming a dominant role and target blood pressure achieved in 46% to 60% of patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: