Prevalence of CKD in diagnosed hypertension remained relatively the same 1999-2004 (29%) to 2011-2018 (28%). During this period, prevalence decreased among undiagnosed (23% to 15%) adults..
During the period 1999-2004 to 2011-2018, prevalence of CKD varied based on hypertension status. Among adults with diagnosed hypertension, prevalence decreased from 29.1% in 1999-2004 to 27.6% in 2011-2018. Prevalence among undiagnosed hypertensive adults decreased from 23.1% to 14.6%. Among those found to have pre-hypertension, the prevalence slightly decreased from 8.7% in 1999-2004 to 8.0% in 2011-2018.
The NHANES surveys are currently conducted every 2 years by the CDC's National Center for Health Statistics to examine disease prevalence and trends over time in different cross-sectional representative samples of noninstitutionalized U.S. civilian residents. The survey consists of a standardized in-home interview and a physical examination and blood and urine collection at a mobile examination center (MEC). Here we examined data from the 1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, and 2013-2014, 2015-2016, and 2017-2018 NHANES. CKD was diagnosed by laboratory testing and defined as an eGFR of ≥60 ml/min/1.73 m2 and the presence of albuminuria (first single measurement of albumin:creatinine ratio from random spot urine) or by eGFR alone for CKD stage 3 or 4 (stage 5 was excluded).
Hypertension is the second leading cause of CKD. Hypertensive disease accounts for 28% of incident ESRD in the United States (United States Renal Data System, 2011). Hypertension is associated with higher risk of cardiovascular outcomes in those with CKD. Additionally, treatment of hypertension in CKD, particularly by ACE inhibitors, has been shown to decrease proteinuria and disease progression (Sarafidis et al., 2008). Thus, assessing the prevalence of this risk factor and its control is essential to CKD surveillance. Self-reported hypertension was defined by answer of “yes” to the question “have you ever been told by a doctor or other health professional that you have hypertension, or high blood pressure?” Blood pressure measurements were taken by standardized protocol during the MEC and the average value (up to four measurements) was used. Hypertension medications were recorded from prescription bottles during the interview.
Estimated using CKD-EPI equation for calibrated creatinine: eGFR=141 x [min(calibrated serum creatinine in mg/dL) /κ, 1)]α x [max(calibrated serum creatinine in mg/dL/κ, 1)]-1.209 x 0.993age x (1.018 if female) x (1.159 if NH Black)
κ = 0.7 if female, and 0.9 if male
α = -0.329 if female, and -0.411 if male