Ambulatory blood pressure phenotypes in adults taking antihypertensive medication With and Without CKD

Stanford E. Mwasongwe, Rikki M. Tanner, Bharat Poudel, Daniel N. Pugliese, Bessie A. Young, Marwah Abdalla, Solomon K. Musani, Orlando M. Gutiérrez, Adolfo Correa, Daichi Shimbo, Paul Muntner

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background and objectives Recent guidelines recommend out-of-clinic BP measurements. Design, setting, participants, & measurements We compared the prevalence of BP phenotypes between 561 black patients, With and Without CKD, taking antihypertensive medication Who underwent ambulatory BP monitoring at baseline (between 2000 and 2004) in the Jackson Heart Study. CKD Was defined as an albumin-to-creatinine ratio ≥30 mg/g or eGFR<60 ml/min per 1.73 m2. Sustained controlled BP Was defined by BP at goal both inside and outside of the clinic and sustained uncontrolled BP as BP above goal both inside and outside of the clinic. Masked uncontrolled hypertension Was defined by controlled clinic-measured BP With uncontrolled out-of-clinic BP. Results CKD Was associated With a higher multivariable-adjusted prevalence ratio for uncontrolled versus controlled clinic BP (prevalence ratio, 1.44; 95% CI, 1.02 to 2.02) and sustained uncontrolled BP versus sustained controlled BP (prevalence ratio, 1.66; 95% CI, 1.16 to 2.36). There Were no statistically significant differences in the prevalence of uncontrolled daytime or nighttime BP, nondipping BP, White-coat effect, and masked uncontrolled hypertension between participants With and Without CKD after multivariable adjustment. After multivariable adjustment, reduced eGFR Was associated With masked uncontrolled hypertension versus sustained controlled BP (prevalence ratio, 1.42; 95% CI, 1.00 to 2.00), Whereas albuminuria Was associated With uncontrolled clinic BP (prevalence ratio, 1.76; 95% CI, 1.20 to 2.60) and sustained uncontrolled BP versus sustained controlled BP (prevalence ratio, 2.02; 95% CI, 1.36 to 2.99). Conclusions The prevalence of BP phenotypes defined using ambulatory BP monitoring is high among adults With CKD taking antihypertensive medication.

Original languageEnglish (US)
Pages (from-to)501-510
Number of pages10
JournalClinical Journal of the American Society of Nephrology
Volume15
Issue number4
DOIs
StatePublished - Apr 7 2020
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

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