Kidney Week

Abstract: TH-PO1006

Prevalence of Antihypertensive Use in CKD

Session Information

• CKD Epidemiology, Risk Factors, Prevention - I
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Tangri, Navdeep, University of Manitoba, Winnipeg, Manitoba, Canada

Navdeep Tangri,

• Kushner, Pamela R., University of California Irvine, Irvine, California, United States

Pamela R. Kushner,

• Barone, Salvatore, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Maryland, United States

Salvatore Barone,

• Arnold, Matthew, BioPharmaceuticals Medical, AstraZeneca, Cambridge, United Kingdom

Matthew Arnold,

• Chen, Hungta (tony), BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Maryland, United States

Hungta (tony) Chen,

• Wittbrodt, Eric T., BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Maryland, United States

Eric T. Wittbrodt,

Background

Treatment-resistant hypertension (TRH) is a comorbidity of concern in patients with chronic kidney disease (CKD) and elevates the risk of cardiovascular events. The aim of this analysis was to identify the prevalence of antihypertensive medication (AHM) use in patients with persistent TRH concurrent with CKD, overall and stratified by CKD stage.

Methods

The study cohort was comprised of adults with CKD in the US TriNetX database between 2008 and 2020. CKD index was defined as the second of two consecutive eGFR measurements <75 ml/min/m² between 91-730 days apart or ICD-9/10 code of CKD or dialysis. Patients with >1 systolic blood pressure (SBP) >130 mm Hg within 6 months before or any time after index were included, and of these, TRH was defined as taking >3 AHM classes. The number of AHM prescribed 0 to >4 were described overall and by CKD stage. A sensitivity analysis using SBP >140 mm Hg was also performed.

Results

In the cohort with CKD and SBP >130 mm Hg (N = 109,385), mean (SD) age was 64 (13) years, 57% were female, and 77% were White and 20% were Black. Median (IQR) SBP measurements was 3 (1,5). Proportion of patients with TRH was 18.6% overall, and by CKD stage was 13.8% (S1 and 2), 21.5% (S3), 35.7% (S4), and 37.5% (S5). These proportions were modestly increased in the sensitivity analysis.

Conclusion

In a large real-world cohort, TRH was detected in nearly 1 in 5 individuals with CKD, and no AHM use was observed in nearly half of CKD patients with elevated SBP. An opportunity clearly exists for improved management of TRH in order to avoid adverse clinical outcomes in this high-risk population.

Funding

• Commercial Support – AstraZeneca