TY - JOUR
T1 - Race and Sex Differences in Hypertension Control in CKD
T2 - Results From the Kidney Early Evaluation Program (KEEP)
AU - Duru, Obidiugwu Kenrik
AU - Li, Suying
AU - Jurkovitz, Claudine
AU - Bakris, George
AU - Brown, Wendy
AU - Chen, Shu Cheng
AU - Collins, Allan
AU - Klag, Michael
AU - McCullough, Peter A.
AU - McGill, Janet
AU - Narva, Andrew
AU - Pergola, Pablo
AU - Singh, Ajay
AU - Norris, Keith
N1 - Funding Information:
Support: The KEEP study received unrestricted educational grants from several industry sponsors, including Amgen, Abbott Laboratories, Genzyme, Novartis, and OrthoBiotech. KEEP also received assistance and materials from Siemens Diagnostics, LifeScan, Inc, and Ocean Spray Cranberries. Drs Duru and Norris received funding from Grant U54RR019234 from the National Center for Research Resources, a component of the National Institutes of Health. Dr Duru received support from the UCLA/DREW Project EXPORT, National Center on Minority Health and Health Disparities (Grant P20MD000148/ P20MD000182).
PY - 2008/2
Y1 - 2008/2
N2 - Background: African American men with chronic kidney disease (CKD) progress to end-stage renal disease more rapidly than African American women or whites. Uncontrolled hypertension worsens CKD, and disparities in hypertension control may contribute to disparities in CKD progression. Study Design: Cross-sectional. Setting & Participants: 10,827 individuals with CKD and self-reported hypertension screened in the Kidney Early Evaluation Program. Predictors: African American race, sex. Outcomes: Hypertension control (blood pressure <130 mm Hg systolic and/or <80 mm Hg diastolic). Measurements: Self-report, physical examination (blood pressure), laboratory data (serum creatinine, microalbuminuria by urine dipstick). We calculated estimated glomerular filtration rates by using the 4-variable isotope dilution mass spectrometry Modification of Diet in Renal Disease Study equation. We classified CKD as early (stages 1 to 2) or late (stages 3 to 5) based on estimated glomerular filtration rate and microalbuminuria. Results: In individuals with early CKD, African American women (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.14 to 1.88), white men (OR, 1.85; 95% CI, 1.39 to 2.46), and white women (OR, 1.69; 95% CI, 1.28 to 2.22) had greater odds of hypertension control (blood pressure <130/80 mm Hg) than African American men. In individuals with late CKD, white men (OR, 1.66; 95% CI, 1.10 to 2.52) and white women (OR, 1.67; 95% CI, 1.13 to 2.46) had greater odds of hypertension control than African American men. No differences were seen between African American men and women with late CKD. Limitations: No information for medication regimens. Conclusions: African American men with CKD have poorly controlled hypertension compared with African American women and whites, particularly in the early stages of disease. Efforts to aggressively treat hypertension in this population may help narrow the race and sex disparities in progression to end-stage renal disease.
AB - Background: African American men with chronic kidney disease (CKD) progress to end-stage renal disease more rapidly than African American women or whites. Uncontrolled hypertension worsens CKD, and disparities in hypertension control may contribute to disparities in CKD progression. Study Design: Cross-sectional. Setting & Participants: 10,827 individuals with CKD and self-reported hypertension screened in the Kidney Early Evaluation Program. Predictors: African American race, sex. Outcomes: Hypertension control (blood pressure <130 mm Hg systolic and/or <80 mm Hg diastolic). Measurements: Self-report, physical examination (blood pressure), laboratory data (serum creatinine, microalbuminuria by urine dipstick). We calculated estimated glomerular filtration rates by using the 4-variable isotope dilution mass spectrometry Modification of Diet in Renal Disease Study equation. We classified CKD as early (stages 1 to 2) or late (stages 3 to 5) based on estimated glomerular filtration rate and microalbuminuria. Results: In individuals with early CKD, African American women (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.14 to 1.88), white men (OR, 1.85; 95% CI, 1.39 to 2.46), and white women (OR, 1.69; 95% CI, 1.28 to 2.22) had greater odds of hypertension control (blood pressure <130/80 mm Hg) than African American men. In individuals with late CKD, white men (OR, 1.66; 95% CI, 1.10 to 2.52) and white women (OR, 1.67; 95% CI, 1.13 to 2.46) had greater odds of hypertension control than African American men. No differences were seen between African American men and women with late CKD. Limitations: No information for medication regimens. Conclusions: African American men with CKD have poorly controlled hypertension compared with African American women and whites, particularly in the early stages of disease. Efforts to aggressively treat hypertension in this population may help narrow the race and sex disparities in progression to end-stage renal disease.
KW - Hypertension
KW - chronic kidney disease
KW - ethnic groups
KW - sex
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U2 - 10.1053/j.ajkd.2007.09.023
DO - 10.1053/j.ajkd.2007.09.023
M3 - Article
C2 - 18215697
AN - SCOPUS:38349046800
SN - 0272-6386
VL - 51
SP - 192
EP - 198
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 2
ER -