Race and Sex Differences in Hypertension Control in CKD: Results From the Kidney Early Evaluation Program (KEEP)

Obidiugwu Kenrik Duru; Suying Li; Claudine Jurkovitz; George Bakris; Wendy Brown; Shu Cheng Chen; Allan Collins; Michael Klag; Peter A. McCullough; Janet McGill; Andrew Narva; Pablo Pergola; Ajay Singh; Keith Norris

doi:10.1053/j.ajkd.2007.09.023

Race and Sex Differences in Hypertension Control in CKD: Results From the Kidney Early Evaluation Program (KEEP)

Obidiugwu Kenrik Duru, Suying Li, Claudine Jurkovitz, George Bakris, Wendy Brown, Shu Cheng Chen, Allan Collins, Michael Klag, Peter A. McCullough, Janet McGill, Andrew Narva, Pablo Pergola, Ajay Singh, Keith Norris

Medicine - Renal and Hypertension Division

Research output: Contribution to journal › Article › peer-review

52 Scopus citations

Abstract

Background: African American men with chronic kidney disease (CKD) progress to end-stage renal disease more rapidly than African American women or whites. Uncontrolled hypertension worsens CKD, and disparities in hypertension control may contribute to disparities in CKD progression. Study Design: Cross-sectional. Setting & Participants: 10,827 individuals with CKD and self-reported hypertension screened in the Kidney Early Evaluation Program. Predictors: African American race, sex. Outcomes: Hypertension control (blood pressure <130 mm Hg systolic and/or <80 mm Hg diastolic). Measurements: Self-report, physical examination (blood pressure), laboratory data (serum creatinine, microalbuminuria by urine dipstick). We calculated estimated glomerular filtration rates by using the 4-variable isotope dilution mass spectrometry Modification of Diet in Renal Disease Study equation. We classified CKD as early (stages 1 to 2) or late (stages 3 to 5) based on estimated glomerular filtration rate and microalbuminuria. Results: In individuals with early CKD, African American women (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.14 to 1.88), white men (OR, 1.85; 95% CI, 1.39 to 2.46), and white women (OR, 1.69; 95% CI, 1.28 to 2.22) had greater odds of hypertension control (blood pressure <130/80 mm Hg) than African American men. In individuals with late CKD, white men (OR, 1.66; 95% CI, 1.10 to 2.52) and white women (OR, 1.67; 95% CI, 1.13 to 2.46) had greater odds of hypertension control than African American men. No differences were seen between African American men and women with late CKD. Limitations: No information for medication regimens. Conclusions: African American men with CKD have poorly controlled hypertension compared with African American women and whites, particularly in the early stages of disease. Efforts to aggressively treat hypertension in this population may help narrow the race and sex disparities in progression to end-stage renal disease.

Original language	English (US)
Pages (from-to)	192-198
Number of pages	7
Journal	American Journal of Kidney Diseases
Volume	51
Issue number	2
DOIs	https://doi.org/10.1053/j.ajkd.2007.09.023
State	Published - Feb 2008

Bibliographical note

Funding Information:
Support: The KEEP study received unrestricted educational grants from several industry sponsors, including Amgen, Abbott Laboratories, Genzyme, Novartis, and OrthoBiotech. KEEP also received assistance and materials from Siemens Diagnostics, LifeScan, Inc, and Ocean Spray Cranberries. Drs Duru and Norris received funding from Grant U54RR019234 from the National Center for Research Resources, a component of the National Institutes of Health. Dr Duru received support from the UCLA/DREW Project EXPORT, National Center on Minority Health and Health Disparities (Grant P20MD000148/ P20MD000182).

Keywords

Hypertension
chronic kidney disease
ethnic groups
sex

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1053/j.ajkd.2007.09.023

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Duru, O. K., Li, S., Jurkovitz, C., Bakris, G., Brown, W., Chen, S. C., Collins, A., Klag, M., McCullough, P. A., McGill, J., Narva, A., Pergola, P., Singh, A., & Norris, K. (2008). Race and Sex Differences in Hypertension Control in CKD: Results From the Kidney Early Evaluation Program (KEEP). American Journal of Kidney Diseases, 51(2), 192-198. https://doi.org/10.1053/j.ajkd.2007.09.023

Duru, OK, Li, S, Jurkovitz, C, Bakris, G, Brown, W, Chen, SC, Collins, A, Klag, M, McCullough, PA, McGill, J, Narva, A, Pergola, P, Singh, A & Norris, K 2008, 'Race and Sex Differences in Hypertension Control in CKD: Results From the Kidney Early Evaluation Program (KEEP)', American Journal of Kidney Diseases, vol. 51, no. 2, pp. 192-198. https://doi.org/10.1053/j.ajkd.2007.09.023

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title = "Race and Sex Differences in Hypertension Control in CKD: Results From the Kidney Early Evaluation Program (KEEP)",

abstract = "Background: African American men with chronic kidney disease (CKD) progress to end-stage renal disease more rapidly than African American women or whites. Uncontrolled hypertension worsens CKD, and disparities in hypertension control may contribute to disparities in CKD progression. Study Design: Cross-sectional. Setting & Participants: 10,827 individuals with CKD and self-reported hypertension screened in the Kidney Early Evaluation Program. Predictors: African American race, sex. Outcomes: Hypertension control (blood pressure <130 mm Hg systolic and/or <80 mm Hg diastolic). Measurements: Self-report, physical examination (blood pressure), laboratory data (serum creatinine, microalbuminuria by urine dipstick). We calculated estimated glomerular filtration rates by using the 4-variable isotope dilution mass spectrometry Modification of Diet in Renal Disease Study equation. We classified CKD as early (stages 1 to 2) or late (stages 3 to 5) based on estimated glomerular filtration rate and microalbuminuria. Results: In individuals with early CKD, African American women (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.14 to 1.88), white men (OR, 1.85; 95% CI, 1.39 to 2.46), and white women (OR, 1.69; 95% CI, 1.28 to 2.22) had greater odds of hypertension control (blood pressure <130/80 mm Hg) than African American men. In individuals with late CKD, white men (OR, 1.66; 95% CI, 1.10 to 2.52) and white women (OR, 1.67; 95% CI, 1.13 to 2.46) had greater odds of hypertension control than African American men. No differences were seen between African American men and women with late CKD. Limitations: No information for medication regimens. Conclusions: African American men with CKD have poorly controlled hypertension compared with African American women and whites, particularly in the early stages of disease. Efforts to aggressively treat hypertension in this population may help narrow the race and sex disparities in progression to end-stage renal disease.",

keywords = "Hypertension, chronic kidney disease, ethnic groups, sex",

author = "Duru, {Obidiugwu Kenrik} and Suying Li and Claudine Jurkovitz and George Bakris and Wendy Brown and Chen, {Shu Cheng} and Allan Collins and Michael Klag and McCullough, {Peter A.} and Janet McGill and Andrew Narva and Pablo Pergola and Ajay Singh and Keith Norris",

note = "Funding Information: Support: The KEEP study received unrestricted educational grants from several industry sponsors, including Amgen, Abbott Laboratories, Genzyme, Novartis, and OrthoBiotech. KEEP also received assistance and materials from Siemens Diagnostics, LifeScan, Inc, and Ocean Spray Cranberries. Drs Duru and Norris received funding from Grant U54RR019234 from the National Center for Research Resources, a component of the National Institutes of Health. Dr Duru received support from the UCLA/DREW Project EXPORT, National Center on Minority Health and Health Disparities (Grant P20MD000148/ P20MD000182). ",

year = "2008",

month = feb,

doi = "10.1053/j.ajkd.2007.09.023",

language = "English (US)",

volume = "51",

pages = "192--198",

journal = "American Journal of Kidney Diseases",

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publisher = "W.B. Saunders",

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TY - JOUR

T1 - Race and Sex Differences in Hypertension Control in CKD

T2 - Results From the Kidney Early Evaluation Program (KEEP)

AU - Duru, Obidiugwu Kenrik

AU - Li, Suying

AU - Jurkovitz, Claudine

AU - Bakris, George

AU - Brown, Wendy

AU - Chen, Shu Cheng

AU - Collins, Allan

AU - Klag, Michael

AU - McCullough, Peter A.

AU - McGill, Janet

AU - Narva, Andrew

AU - Pergola, Pablo

AU - Singh, Ajay

AU - Norris, Keith

N1 - Funding Information: Support: The KEEP study received unrestricted educational grants from several industry sponsors, including Amgen, Abbott Laboratories, Genzyme, Novartis, and OrthoBiotech. KEEP also received assistance and materials from Siemens Diagnostics, LifeScan, Inc, and Ocean Spray Cranberries. Drs Duru and Norris received funding from Grant U54RR019234 from the National Center for Research Resources, a component of the National Institutes of Health. Dr Duru received support from the UCLA/DREW Project EXPORT, National Center on Minority Health and Health Disparities (Grant P20MD000148/ P20MD000182).

PY - 2008/2

Y1 - 2008/2

N2 - Background: African American men with chronic kidney disease (CKD) progress to end-stage renal disease more rapidly than African American women or whites. Uncontrolled hypertension worsens CKD, and disparities in hypertension control may contribute to disparities in CKD progression. Study Design: Cross-sectional. Setting & Participants: 10,827 individuals with CKD and self-reported hypertension screened in the Kidney Early Evaluation Program. Predictors: African American race, sex. Outcomes: Hypertension control (blood pressure <130 mm Hg systolic and/or <80 mm Hg diastolic). Measurements: Self-report, physical examination (blood pressure), laboratory data (serum creatinine, microalbuminuria by urine dipstick). We calculated estimated glomerular filtration rates by using the 4-variable isotope dilution mass spectrometry Modification of Diet in Renal Disease Study equation. We classified CKD as early (stages 1 to 2) or late (stages 3 to 5) based on estimated glomerular filtration rate and microalbuminuria. Results: In individuals with early CKD, African American women (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.14 to 1.88), white men (OR, 1.85; 95% CI, 1.39 to 2.46), and white women (OR, 1.69; 95% CI, 1.28 to 2.22) had greater odds of hypertension control (blood pressure <130/80 mm Hg) than African American men. In individuals with late CKD, white men (OR, 1.66; 95% CI, 1.10 to 2.52) and white women (OR, 1.67; 95% CI, 1.13 to 2.46) had greater odds of hypertension control than African American men. No differences were seen between African American men and women with late CKD. Limitations: No information for medication regimens. Conclusions: African American men with CKD have poorly controlled hypertension compared with African American women and whites, particularly in the early stages of disease. Efforts to aggressively treat hypertension in this population may help narrow the race and sex disparities in progression to end-stage renal disease.

AB - Background: African American men with chronic kidney disease (CKD) progress to end-stage renal disease more rapidly than African American women or whites. Uncontrolled hypertension worsens CKD, and disparities in hypertension control may contribute to disparities in CKD progression. Study Design: Cross-sectional. Setting & Participants: 10,827 individuals with CKD and self-reported hypertension screened in the Kidney Early Evaluation Program. Predictors: African American race, sex. Outcomes: Hypertension control (blood pressure <130 mm Hg systolic and/or <80 mm Hg diastolic). Measurements: Self-report, physical examination (blood pressure), laboratory data (serum creatinine, microalbuminuria by urine dipstick). We calculated estimated glomerular filtration rates by using the 4-variable isotope dilution mass spectrometry Modification of Diet in Renal Disease Study equation. We classified CKD as early (stages 1 to 2) or late (stages 3 to 5) based on estimated glomerular filtration rate and microalbuminuria. Results: In individuals with early CKD, African American women (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.14 to 1.88), white men (OR, 1.85; 95% CI, 1.39 to 2.46), and white women (OR, 1.69; 95% CI, 1.28 to 2.22) had greater odds of hypertension control (blood pressure <130/80 mm Hg) than African American men. In individuals with late CKD, white men (OR, 1.66; 95% CI, 1.10 to 2.52) and white women (OR, 1.67; 95% CI, 1.13 to 2.46) had greater odds of hypertension control than African American men. No differences were seen between African American men and women with late CKD. Limitations: No information for medication regimens. Conclusions: African American men with CKD have poorly controlled hypertension compared with African American women and whites, particularly in the early stages of disease. Efforts to aggressively treat hypertension in this population may help narrow the race and sex disparities in progression to end-stage renal disease.

KW - Hypertension

KW - chronic kidney disease

KW - ethnic groups

KW - sex

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Race and Sex Differences in Hypertension Control in CKD: Results From the Kidney Early Evaluation Program (KEEP)

Abstract

Bibliographical note

Keywords

UN SDGs

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