Treated primary hypertension resulted in renal function deterioration in 15% of patients, with black patients twice as likely as white patients to experience creatinine elevations (23% vs 11%).
Cohort (n=94)
We analyzed the clinical courses of 94 patients with treated primary hypertension and initially normal serum creatinine concentrations (less than or equal to 133 mumol per liter less than or equal to 1.5 mg per deciliter) who were followed for a mean (+/- SD) of 58 +/- 34 months (range, 12 to 174) to determine the frequency with which renal function deteriorated and the factors associated with deterioration. Fourteen patients (15 percent) had an increase in serum creatinine concentrations (greater than or equal to 35 mumol per liter greater than or equal to 0.4 mg per deciliter); in 16 percent of the 61 patients with apparently good control of blood pressure, the serum creatinine concentration rose 59 +/- 33 mumol per liter (0.67 +/- 0.38 mg per deciliter). Despite good control of diastolic blood pressure (less than or equal to 90 mm Hg), black patients were twice as likely as white patients to have elevations in serum creatinine (23 percent vs. 11 percent). Stepwise discriminant function analysis showed that a significant rise in the serum creatinine concentration was most likely to occur in association with older age, black race, a higher number of missed office visits, and employment as a laborer. We conclude that although renal function was preserved in 85 percent of patients with treated hypertension, it may deteriorate in some patients despite good blood-pressure control. Our observations may partly explain why hypertension, particularly among black persons, remains a leading cause of renal disease in the United States.
Rostand et al. (Thu,) conducted a cohort in Treated primary hypertension (n=94). Treated primary hypertension was evaluated on Increase in serum creatinine concentrations (≥0.4 mg/dL). Treated primary hypertension resulted in renal function deterioration in 15% of patients, with black patients twice as likely as white patients to experience creatinine elevations (23% vs 11%).