Key result
~65% of hypertensive hemodialysis patients fail to reach BP targets, though females show better control.
Why the study?
Hypertension is common among hemodialysis patients and controlling blood pressure is essential to reduce cardiovascular risk and mortality, but hypertension prevalence and control rates needed assessment.
Cross-Sectional (n=390)
Yes
A high prevalence of uncontrolled hypertension (64.9%) was observed among hemodialysis patients in Palestine, highlighting the need for individualized dialysis and better adherence to pharmacological and non-pharmacological interventions.
Uncontrolled hypertension is common in Palestinian hemodialysis patients; cross-sectional data leaves open optimal management strategies.
Background: Hypertension (NTN) is very common among the hemodialysis (HD) population, and controlling high blood pressure (BP) is essential to decrease the risk of cardiovascular diseases and mortality in HD patients. This study aimed to assess the prevalence of hypertension among HD patients, the percentage of patients who reached predialysis and post-dialysis recommended goals of BP, and to find any possible association between controlled HTN and some socio-demographic and clinical factors. Method: The study was a cross-sectional observational at three hemodialysis units in the south of Palestine. The minimum calculated sample size was 308, so all adult hemodialysis patients who met the inclusion criteria in the selected units were included. Controlled NTN was defined as predialysis BP of ˂140/90 mmHg and post-dialysis BP of ˂130/80 mmHg according to KDOQI Clinical Practice Guidelines Results: A total of 390 patients participated in the study; 203 males (52.1%), mean age ±SD was 52.4±16.2, diabetes mellitus (DM) was the leading cause of ESRD (43.3%) followed by uncontrolled HTN (29.2%). The average duration of hemodialysis therapy ±SD was 37.47±37.57 months. Of the 390 patients, 356 (91.3%) had HTN, and 231 (64.9%) patients with HTN did not achieve the predialysis and post-dialysis BP target goals of less than 140/90 and 130/80, respectively. There was a significant association between control of BP and gender only, as 59.2% of patients who achieved the target BP goals were female (p-value = 0.002). Patients have prescribed 2875 medication orders of 53 different medications with a mean of 7.37±2.38; calcium carbonate was the most frequently prescribed medication (67.4%), followed by amlodipine (64.6%) and aspirin (56.7%). Amlodipine was the most prescribed antihypertensive medication. Conclusion: The study showed a very high rate of HTN among HD patients. The control of BP was inferior as the majority of patients did not achieve the target blood pressure goals. It is recommended to individualize HD session duration and frequency to meet patients' needs, in addition to counseling patients about the appropriate non-pharmacological interventions such as sodium restriction and being adherent to antihypertensive medication dose and timing.
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Al-Ramahi et al. (2023) conducted a cross-sectional in Hypertension in hemodialysis patients (n=390). Hemodialysis was evaluated on Prevalence of hypertension. Among 390 hemodialysis patients, 91.3% had hypertension, and 64.9% of those failed to achieve target blood pressure goals, with females significantly more likely to achieve control (P=0.002).
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