Journal
JOURNAL OF CLINICAL HYPERTENSION
Volume 19, Issue 11, Pages 1117-1124Publisher
WILEY
DOI: 10.1111/jch.13065
Keywords
blood pressure; chronic kidney disease; treatment-resistant hypertension
Categories
Funding
- National Heart, Lung, and Blood Institute [HHSN268201300046C, HHSN268201300047C, HHSN268201300048C, HHSN268201300049C, HHSN268201300050C]
- National Institute on Minority Health and Health Disparities
- National Institutes of Health [K24-HL125704]
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It is unclear whether black patients with chronic kidney disease (CKD) vs those without CKD who take antihypertensive medication have an increased risk for apparent treatment-resistant hypertension (aTRH). The authors analyzed 1741 Jackson Heart Study participants without aTRH taking antihypertensive medication at baseline. aTRH was defined as uncontrolled blood pressure while taking three antihypertensive medication classes or taking four or more antihypertensive medication classes, regardless of blood pressure level. CKD was defined as an albumin to creatinine ratio 30mg/g or estimated glomerular filtration rate <60mL/min/1.73m(2). Over 8years, 20.1% of participants without CKD and 30.5% with CKD developed aTRH. The multivariable-adjusted hazard ratio for aTRH comparing participants with CKD vs those without CKD was 1.45 (95% CI, 1.12-1.86). Participants with an albumin to creatinine ratio 30 vs <30mg/g (hazard ratio, 1.44; 95% CI, 1.04-2.00) and estimated glomerular filtration rate of 45 to 59mL/min/1.73m(2) and <45 vs 60mL/min/1.73m(2) (hazard ratio, 1.60 [95% CI, 1.16-2.20] and 2.05 [95% CI, 1.28-3.26], respectively) were more likely to develop aTRH.
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