TY - JOUR
T1 - Ambulatory blood pressure phenotypes in adults taking antihypertensive medication With and Without CKD
AU - Mwasongwe, Stanford E.
AU - Tanner, Rikki M.
AU - Poudel, Bharat
AU - Pugliese, Daniel N.
AU - Young, Bessie A.
AU - Abdalla, Marwah
AU - Musani, Solomon K.
AU - Gutiérrez, Orlando M.
AU - Correa, Adolfo
AU - Shimbo, Daichi
AU - Muntner, Paul
N1 - Publisher Copyright:
© 2020 by the American Society of Nephrology.
PY - 2020/4/7
Y1 - 2020/4/7
N2 - 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.
AB - 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.
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U2 - 10.2215/CJN.08840719
DO - 10.2215/CJN.08840719
M3 - Article
C2 - 32217635
AN - SCOPUS:85083003096
SN - 1555-9041
VL - 15
SP - 501
EP - 510
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 4
ER -