Key result
Severe kidney dysfunction linked to ~80% higher CAD prevalence in hypertensive outpatients.
Why the study?
The clinical characteristics and quality of treatment of patients with arterial hypertension and chronic kidney disease in primary health care were not well described according to national guidelines.
Observational (n=43,133)
Yes
Absolute Event Rate: 72.5% vs 39.2%
p-value: p=<0.0001
In outpatients with arterial hypertension, decreased renal function is associated with a high burden of cardiovascular comorbidities and poor achievement of risk factor targets, highlighting the need for improved comprehensive management.
May warrant intensified comorbidity screening in hypertensive patients with reduced eGFR; leaves open whether targeted interventions improve outcomes.
Аim. To investigate the clinical characteristics and quality of treatment (according to the national guidelines) of patients with arterial hypertension (AH) and chronic kidney disease observed in primary health care. MATERIALS AND METHODS: The study was carried out on the basis of the AH registry data (n=43 133; 20052019 years). Glomerular filtration rate (eGFR) was calculated using the CKD-EPI formula; renal structure and albuminuria were not evaluated. The analysis was performed using the SPSS software (version 22; SPSS Inc). RESULTS: The creatinine level was assessed in 60% of patients, 23.6% of them had decreased eGFR60 ml/ min/1.73 m2. The incidence of co-morbid CVD and type 2 diabetes in patients with hypertension increased markedly with a decrease in eGFR (14 groups): the incidence of coronary artery disease increased 1.8 times (up to 72.5%), myocardial infarction 1.7 times (up to 20.6%), chronic heart failure 2 times (up to 84.0%), atrial fibrillation 10 times (up to 18.3%), history of stroke 3.7 times (up to 15.3%) and type 2 diabetes 2.4 times (up to 32.8%). Achievement of target goals of CV risk factors was not enough: systolic BP less than 50% of patients, triglycerides less than 7%, LDL-C in high and very high CVD risk patients less than 13%. CONCLUSION: Conducting timely assessment of renal function, drug therapy and lifestyle changes in patients with AH and decreased renal functional could prevent severe kidney damage, the development of CV complications, chronic renal failure and reduce mortality.
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Oschepkova et al. (2022) conducted an observational in Arterial hypertension and chronic kidney disease (n=43,133). Severely decreased estimated glomerular filtration rate (eGFR 15-29 ml/min/1.73 m2) vs. Preserved renal function (eGFR ≥ 90 ml/min/1.73 m2) was evaluated on Prevalence of coronary artery disease (p=<0.0001). In outpatients with arterial hypertension, severely decreased kidney function (eGFR 15-29 ml/min/1.73 m2) was associated with a 1.8-fold higher prevalence of coronary artery disease compared to those with normal kidney function (72.5% vs 39.2%).
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