Indicator Details: Blood Pressure Treatment and Control Among Adults with CKDa
Data Sources
 
Stratification and Year Choices:

  Source
  • CRIC

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Published literature or one-time analysis, ongoing surveillance not available Published literature or one-time analysis, ongoing surveillance not available

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Footnotes:
a Treated, self-reported use of antihypertensive medications; Controlled, blood pressure below guideline-recommended thresholds. Adapted from Muntner et al. (2010).




While 98% of adult cohort study enrollees with CKD reported using antihypertensive medications, only 67% had controlled blood pressure (<140/90 mmHg); using more recent CKD-specific guidelines for control (<130/80), the percentage controlled was only 46%.
Chart Explanation: Overall, nearly all (98%) CRIC participants with hypertension reported being treated with antihypertensive medications. Despite this, only 67% were controlled by general JNC-VI guidelines (<140/90 mmHg; Chobanian et al., 2003). Using the more stringent CKD-specific guidelines for control recommended in this report (<130/80 mmHg), only 46% were controlled.
The Chronic Renal Insufficiency Cohort (CRIC) study is a cohort study of 3,612 individuals 21-74 years of age with CKD of varying severity, recruited from 13 sites across the United States in 2003-2007. CRIC was designed to study consequences of CKD with a particular focus on cardiovascular illness like myocardial infarction (heart attack) and stroke. As with all cohort studies, participants may not be representative of all those who live in the communities from which they are recruited.

Analyses for this measure were performed in 3,612 adults with CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study. Baseline blood pressure and self-reported use of antihypertensive medications were used to define treatment and control. Complete methods can be found in Muntner et al. (2010).
FieldData
Description of MeasureBlood pressure treatment and control among adults with CKD
Data SourceCRIC prospective observational cohort study
Type of Data SourcePrivate
Data SetCRIC summarized data
Health Care System DataNo
Regional or National?National
Demographic GroupAdults (21-74 years old) with mild to severe CKD who are treated throughout 13 sites in 7 U.S. centers
NumeratorEnrolled adults reporting treatment or having controlled blood pressure
DenominatorEnrolled adults with hypertension measurements
Definition of CKDEstimated GFR of 20-70 (ages 21-44); 20-60 (ages 45-64) and 20-50 (ages 65+) ml/min/1.73 m² (for entry into study)
Glomerular filtration rateEstimated, MDRD Study equation
Primary Data Source IndicatorBlood pressure
Primary Indicator Method of MeasurementAverage of 3 measurements in sitting position after 5 minutes of quiet rest according to standard protocol
Secondary (1) VariableAntihypertensive treatment
Secondary (1) Indicator Method of MeasurementSelf-report
Frequency of Measurement (Primary)Once (baseline)
U.S. Region Covered by Primary VariableSeven urban centers throughout the United States (Baltimore, MD; Philadelphia, PA; Cleveland, OH; Detroit, MI; Chicago, IL; New Orleans, LA; Oakland, CA)
Period Currently Available2003–2007
Pending DataNone for baseline; further visits scheduled
Additional Data Items of InterestStage of CKD, stratification variables of interest (age, gender, race/ethnicity), diabetes, labs
Limitations of IndicatorCross-sectional analyses and possibly “healthy cohort” effect
Analytical ConsiderationsData summarized by CRIC investigators (see Muntner et al.); as with all cohort studies, selection bias and possible confounding
References and Sources:
  • Muntner P, Anderson A, Charleston J, et al. Hypertension awareness, treatment, and control in adults with CKD: results from the Chronic Renal Insufficiency Cohort (CRIC) study. Am. J. Kidney Dis. 2010;55(3):441-451.
    http://www.ncbi.nlm.nih.gov/pubmed/19962808
Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd