Hypertension Control in Adults With CKD in China: Baseline Results From the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE)

BACKGROUND: Hypertension contributes to increased morbidity and mortality in the chronic kidney disease (CKD) population. Studies on blood pressure control in CKD patients in China are limited. In this study, we aimed to describe the status of blood pressure control in Chinese CKD patients based on the first national prospective CKD cohort data. METHODS: A subgroup of Chinese Cohort Study of Chronic Kidney Disease participants with hypertension at baseline was included in the present study. Uncontrolled blood pressure was defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg. Defined daily doses (DDDs) are used as a standard measurement of drug utilization in this population. Factors associated with uncontrolled blood pressure were analyzed using multivariable logistic regression. RESULTS: There were 2,251 hypertensive CKD subjects among 2,873 predialysis CKD participants. The awareness, treatment, and control rates of hypertension were 80.7%, 95.6%, and 57.1%, respectively. Factors independently associated with uncontrolled blood pressure were overweight, obesity, albuminuria, decreased estimated glomerular filtration rate (eGFR), and diabetes. Over 50% of study subjects were prescribed 2 or more antihypertensive medications and only 7% were prescribed diuretics. Uncontrolled hypertensive patients were prescribed less antihypertensive medication than controlled hypertensives (DDD 1.3 [1.0-2.3] vs. 2.0 [1.0-3.1], P < 0.001). CONCLUSIONS: Hypertension control was suboptimal among hypertensive CKD patients in China, especially among those overweight or with obesity, albuminuria, lower eGFR, and diabetes. Patients with uncontrolled hypertension should undergo treatment regimen evaluation to select the appropriate dosage and type of antihypertensive medications.