仅有约1/3高血压肾病患者血压达标

阿姆斯特丹—根据一项大型全国研究的结果，80%的美国慢性肾病(CKD)患者合并高血压，但血压得到控制的病例仅占大约1/3。

尽管目前可以获取的抗高血压药物多种多样，但这仍是一个有明确未被满足医疗需求的领域，Panagiotis Mavros博士在欧洲心脏病学会(ESC)年会上说。

他展示的这项横断面研究包含在GE中心电子医疗记录数据库中识别的159,306例1-4期CKD患者。其中57%的患者为3期CKD，29%为2期CKD。在这一非常巨大的CKD患者群体中，大约43%的患者同时被诊断为糖尿病。80%的CKD患者有高血压，包括总体研究人群中10%既往未经诊断的高血压患者。在伴有高血压的CKD患者中，15%未接受抗高血压治疗，位于纽约州怀特豪斯的默克公司的Mavros博士说。

结果显示，在被诊断为高血压的患者中，仅有36%的血压控制于目标血压水平130/80 mmHg以下。在合并CKD并接受抗高血压治疗的患者中，73%接受联合治疗，通常联合使用3种不同种类的抗高血压药物。接受3种以上不同种类抗高血压药物治疗的患者倾向于CKD分期更晚。但不同CKD分期患者中，经治疗达到较好血压控制的患者比例无差异。

这项横断面研究是由默克公司资助的，Mavros博士是该公司的专职雇员。

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By: BRUCE JANCIN, Clinical Endocrinology News Digital Network

AMSTERDAM – Eighty percent of Americans with chronic kidney disease have comorbid hypertension, which is controlled in less than one-third of cases, according to a large national study.

This is an area of significant unmet medical need in spite of the wide availability of antihypertensive medications, Panagiotis Mavros, Ph.D., said at the annual congress of the European Society of Cardiology.

He presented a cross-sectional study involving 159,306 American adults with stage 1-4 chronic kidney disease (CKD) identified in the GE Centricity electronic medical record database. Fifty-seven percent were in stage 3 and 29% were in stage 2 CKD.

Roughly 43% of this very large group of CKD patients carried the diagnosis of diabetes mellitus. Eighty percent of the CKD population had hypertension, including 10% of the overall study population with previously undiagnosed hypertension. Among the CKD patients with hypertension, 15% were not being treated for it, said Dr. Mavros of Merck in Whitehouse Station, N.J.

Blood pressure was controlled to the target of less than 130/80 mm Hg in 36% of patients with diagnosed hypertension.

Seventy-three percent of treated hypertensive patients with CKD were on combination therapy, typically with three different classes of antihypertensive drugs. Patients on more than three different classes of antihypertensive medications tended to have more advanced CKD. However, the proportion of treated patients with good blood pressure control did not differ according to CKD stage.

This cross-sectional study was funded by Merck. Dr. Mavros is a full-time company employee.