Clinical studyPrevalence, treatment, and control of hypertension in chronic hemodialysis patients in the United States
Section snippets
Methods
This study is based on a large cohort of hemodialysis patients enrolled in a crossover, randomized, double-blind study of the safety and tolerability of sodium ferric gluconate in sucrose (Ferrlecit; Watson Pharma, Salt Lake City, Utah) versus placebo (6). Patients were enrolled at 69 centers in the United States between August 1999 and October 2000. Approval was obtained from the respective Institutional Review Boards.
Eligible patients were stable, adult chronic hemodialysis patients who had
Results
Patients in the sample were slightly younger (mean [± SD] age, 56 ± 15 years) compared with the U.S. dialysis population (Table 2). There were also more blacks and Hispanics. The average duration on dialysis was about 4 years. Less than 15% of patients were normotensive, and only 30% of those with hypertension had adequately controlled blood pressure (Table 3). The prevalence of hypertension was not affected by ethnicity (P >0.20) or sex (P >0.20) (Figure 1), but was increased in younger
Discussion
We found that hypertension, particularly systolic hypertension, was common in our sample of hemodialysis patients who comprised nearly 1.2% of the total hemodialysis population in the United States. Although the majority was treated, less than one third achieved adequate blood pressure control.
Blood pressure varies greatly during the interdialytic period, and routine measurements often overestimate blood pressure (10). We therefore used definitions of hypertension that have been validated in
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