TY - JOUR
T1 - Variations in 24-hour BP profiles in cohorts of patients with kidney disease around the world
T2 - The I-DARE study
AU - CRIC Study Investigators
AU - Drawz, Paul E.
AU - Brown, Roland
AU - De Nicola, Luca
AU - Fujii, Naohiko
AU - Gabbai, Francis B.
AU - Gassman, Jennifer
AU - He, Jiang
AU - Iimuro, Satoshi
AU - Lash, James
AU - Minutolo, Roberto
AU - Phillips, Robert A.
AU - Rudser, Kyle
AU - Ruilope, Luis
AU - Steigerwalt, Susan
AU - Townsend, Raymond R.
AU - Xie, Dawei
AU - Rahman, Mahboob
N1 - Publisher Copyright:
© 2018 by the American Society of Nephrology.
PY - 2018/9/7
Y1 - 2018/9/7
N2 - Background and objectives Ambulatory BP is increasingly recognized as a better measure of the risk for adverse outcomes related to hypertension, an important comorbidity in patients with CKD. Varying definitions of white-coat and masked hypertension have made it difficult to evaluate differences in prevalence of these BP patterns across CKD cohorts. Design, setting, participants, & measurements The International Database of Ambulatory BP in Renal Patients collaborative group established a large database of demographic, clinical, and ambulatory BP data from patients with CKD from cohorts in Italy, Spain, the Chronic Renal Insufficiency Cohort (CRIC) and the African American Study of Kidney Disease and Hypertension Cohort Study (AASK) in the United States, and the CKD Japan Cohort (CKD-JAC). Participants (n=7518) with CKD were included in the present analyses. Cutoffs for defining controlled BP were 140/90 mm Hg for clinic and 130/80 mm Hg for 24-hour ambulatory BP. Results Among those with controlled clinic BP, compared with CKD-JAC, AASK participants were more likely to have masked hypertension (prevalence ratio [PR], 1.21; 95% confidence interval [95% CI], 1.04 to 1.41) whereas CRIC (PR, 0.82; 0.72 to 0.94), Italian (PR, 0.73; 0.56 to 0.95), and Spanish participants (PR, 0.75; 0.64 to 0.88) were less likely. Among those with elevated clinic BP, AASK participants were more likely to have sustained hypertension (PR, 1.22; 95% CI, 1.13 to 1.32) whereas Italian (PR, 0.78; 0.70 to 0.87) and Spanish participants (PR, 0.89; 0.82 to 0.96) were less likely, although CRIC participants had similar prevalence as CKD-JAC. Prevalence of masked and sustained hypertension was elevated in males, patients with diabetes, participants on four or more antihyper-tensives, and those with moderate-to-severe proteinuria. Conclusions In a large, multinational database, the prevalence of masked and sustained hypertension varied across cohorts independent of important comorbidities.
AB - Background and objectives Ambulatory BP is increasingly recognized as a better measure of the risk for adverse outcomes related to hypertension, an important comorbidity in patients with CKD. Varying definitions of white-coat and masked hypertension have made it difficult to evaluate differences in prevalence of these BP patterns across CKD cohorts. Design, setting, participants, & measurements The International Database of Ambulatory BP in Renal Patients collaborative group established a large database of demographic, clinical, and ambulatory BP data from patients with CKD from cohorts in Italy, Spain, the Chronic Renal Insufficiency Cohort (CRIC) and the African American Study of Kidney Disease and Hypertension Cohort Study (AASK) in the United States, and the CKD Japan Cohort (CKD-JAC). Participants (n=7518) with CKD were included in the present analyses. Cutoffs for defining controlled BP were 140/90 mm Hg for clinic and 130/80 mm Hg for 24-hour ambulatory BP. Results Among those with controlled clinic BP, compared with CKD-JAC, AASK participants were more likely to have masked hypertension (prevalence ratio [PR], 1.21; 95% confidence interval [95% CI], 1.04 to 1.41) whereas CRIC (PR, 0.82; 0.72 to 0.94), Italian (PR, 0.73; 0.56 to 0.95), and Spanish participants (PR, 0.75; 0.64 to 0.88) were less likely. Among those with elevated clinic BP, AASK participants were more likely to have sustained hypertension (PR, 1.22; 95% CI, 1.13 to 1.32) whereas Italian (PR, 0.78; 0.70 to 0.87) and Spanish participants (PR, 0.89; 0.82 to 0.96) were less likely, although CRIC participants had similar prevalence as CKD-JAC. Prevalence of masked and sustained hypertension was elevated in males, patients with diabetes, participants on four or more antihyper-tensives, and those with moderate-to-severe proteinuria. Conclusions In a large, multinational database, the prevalence of masked and sustained hypertension varied across cohorts independent of important comorbidities.
UR - http://www.scopus.com/inward/record.url?scp=85053306889&partnerID=8YFLogxK
U2 - 10.2215/CJN.13181117
DO - 10.2215/CJN.13181117
M3 - Article
C2 - 29976600
AN - SCOPUS:85053306889
SN - 1555-9041
VL - 13
SP - 1348
EP - 1357
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 9
ER -