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Title: Considerable international variation exists in blood pressure control and antihypertensive prescription patterns in chronic kidney disease
Authors: Natalia Alencar de Pinho
Adeera Levin
Masafumi Fukagawa
Wendy E. Hoy
Roberto Pecoits-Filho
Helmut Reichel
Bruce Robinson
Chagriya Kitiyakara
Jinwei Wang
Kai Uwe Eckardt
Vivekanand Jha
Kook Hwan Oh
Laura Sola
Susanne Eder
Martin de Borst
Maarten Taal
Harold I. Feldman
Bénédicte Stengel
Ognjenka Djurdjev
Mila Tang
Naohiki Fujii
Shoichi Maruyama
Takahiro Imaizumi
Jianzhen Zhang
Zaimin Wang
Helen G. Healy
Ziad A. Massy
Christian Combe
Maurice Laville
Roberto Pecoits Filho
Antonio Lopes
Ronald Pisoni
Brian Bieber
Charlotte Tu
Pornpen Sangthawan
Warangkana Pichaiwong
Pinkaew Klyprayong
Paula Orlandi
Raymond Townsend
Alan Go
Luxia Zhang
Vivek Kumar
Ashok Kumar Yadav
Seema Baid-Agrawal
Curie Ahn
Dong Wan Chae
Seung Hyeok Han
Pablo G. Rios
Liliana Gadola
Veronica Lamadrid
Johannes Leierer
Julia Kerschbaum
Martin H. de Borst
Frans J. Van Ittersum
Jan A. Van den Brand
Maarten A. De Jong
Maarten W. Taal
Adam Shardlow
University of Queensland
Tokai University School of Medicine
University of New South Wales (UNSW) Australia
Charité – Universitätsmedizin Berlin
Université Paris-Sud
Pontificia Universidade Catolica do Parana
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
University of Nottingham
Peking University
The University of British Columbia
Medizinische Universitat Innsbruck
University of Groningen, University Medical Center Groningen
University of Pennsylvania Perelman School of Medicine
Friedrich-Alexander-Universität Erlangen-Nürnberg
Seoul National University College of Medicine
Centro de Diálisis Peritoneal
Arbor Research Collaborative for Health
Nephrological Center
Keywords: Medicine
Issue Date: 1-Oct-2019
Citation: Kidney International. Vol.96, No.4 (2019), 983-994
Abstract: © 2019 International Society of Nephrology Although blood pressure control is a major goal in chronic kidney disease, no worldwide overview of either its achievement or antihypertensive prescriptions is currently available. To evaluate this we compared crude prevalence of uncontrolled blood pressure among 17 cohort studies, including 34 602 individuals with estimated glomerular filtration rate under 60 ml/min/1.73 m2 and treated hypertension across four continents, and estimated observed to expected prevalence ratios, adjusted for potential confounders. Crude prevalence of blood pressure of 140/90 mm Hg or more varied from 28% to 61% and of blood pressure of 130/80 or more from 54% to 84%. Adjusted prevalence ratios indicated poorer hypertension control than expected in cohorts from European countries, India, and Uruguay, and better control in patients from North American and high-income Asian countries. Four antihypertensive drug classes or more were prescribed to more than 30% of participants in North American and some European cohorts, but this practice was less common elsewhere. Renin angiotensin-aldosterone system inhibitors were the most common antihypertensive drugs, prescribed for 54% to 91% of cohort participants. Differences for other drug classes were much stronger, ranging from 11% to 79% for diuretics, 22% to 70% for beta-blockers, and 27% to 75% for calcium-channel blockers. The confounders studied explain only a part of the international variation in blood pressure control among individuals with chronic kidney disease. Thus, considerable heterogeneity in prescription patterns worldwide calls for further investigation into the impact of different approaches on patient outcomes.
ISSN: 15231755
Appears in Collections:Scopus 2019

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