Key result
Taking renin-angiotensin system inhibitors was associated with a higher likelihood of blood pressure control to <140/90 mmHg in Chinese hypertensive CKD patients (PR 1.153; 95% CI 1.071-1.240).
Why the study?
Limited information was available on how antihypertensive drugs were used among Chinese patients with chronic kidney disease.
What are the patterns of antihypertensive drug utilization and their association with blood pressure control in Chinese patients with chronic kidney disease?
Cohort (n=2,213)
What are the patterns of antihypertensive drug utilization and their association with blood pressure control in Chinese patients with chronic kidney disease?
Relative Risk: 1.153 (95% CI 1.071–1.24)
In Chinese hypertensive CKD patients, combination therapy and diuretic use are insufficient, while RASI use is associated with better blood pressure control.
Insufficient combination therapy, diuretic, and advanced-stage RASI use observed in Chinese CKD hypertension; leaves open need for targeted practice audits and trials.
The utilization of antihypertensive drugs plays an important role in blood pressure control among chronic kidney disease (CKD) patients. Limited information was available on how antihypertensive drugs were used among Chinese CKD patients. In the present study, the utilization of antihypertensive drugs among a subgroup of hypertensive participants with a complete record of antihypertensive drug information from the Chinese Cohort Study of Chronic Kidney Disease was analyzed. Among 2213 subjects, 61.7% and 26.5% had their blood pressure controlled to <140/90 mmHg and <130/80 mmHg, respectively. In total, 38.5% were on monotherapy. Of those patients who received combination therapy, 57.8% were treated with a two-drug combination. Renin-angiotensin system inhibitors (RASIs) were the most commonly prescribed drugs (71.2%). Only 10.2% of the patients were prescribed diuretics. After multivariable adjustment, participants taking RASI were more likely to have their blood pressure controlled to <140/90 mmHg (prevalence ratio (PR) 1.153, 95% confidence interval (CI): 1.071-1.240). CKD stage 4 (PR 0.548, 95% CI: 0.434-0.692) was associated with RASIs treatment. Additionally, diabetes (PR 1.498, 95% CI: 1.120-2.004), albumin/creatinine ratio ≥300 mg/g (PR 1.547, 95% CI: 1.020-2.344), and CKD stage 4 (PR 2.022, 95% CI: 1.223-3.343) were associated with diuretic use. The results suggested that combination therapy, diuretics use in general, and utilization of RASIs in advanced CKD stage were insufficient in the current treatment of Chinese hypertensive CKD patients.
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Liu et al. (2019) conducted a cohort in Chronic kidney disease and hypertension (n=2,213). Renin-angiotensin system inhibitors (RASIs) vs. No RASI use was evaluated on Blood pressure controlled to <140/90 mmHg (PR 1.153, 95% CI 1.071-1.240). Taking renin-angiotensin system inhibitors was associated with a higher likelihood of blood pressure control to <140/90 mmHg in Chinese hypertensive CKD patients (PR 1.153; 95% CI 1.071-1.240).
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