Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Use Among Hypertensive US Adults With Albuminuria
| Autor: | Chu, Chi D, Powe, Neil R, McCulloch, Charles E, Banerjee, Tanushree, Crews, Deidra C, Saran, Rajiv, Bragg-Gresham, Jennifer, Morgenstern, Hal, Pavkov, Meda E, Saydah, Sharon H, Tuot, Delphine S, Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Kidney Disease Clinical Sciences blood pressure Evaluation of treatments and therapeutic interventions Angiotensin-Converting Enzyme Inhibitors Middle Aged Cardiorespiratory Medicine and Haematology Cardiovascular albuminuria Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team Angiotensin Receptor Antagonists Cross-Sectional Studies Cardiovascular System & Hematology Clinical Research 6.1 Pharmaceuticals Hypertension Public Health and Health Services Humans Female guideline adherence Metabolic and endocrine |
| Zdroj: | Hypertension (Dallas, Tex. : 1979), vol 77, iss 1 |
| Popis: | Since 2003, US hypertension guidelines have recommended ACE (angiotensin-converting enzyme) inhibitors or ARBs (angiotensin receptor blockers) as first-line antihypertensive therapy in the presence of albuminuria (urine albumin/creatinine ratio ≥300 mg/g). To examine national trends in guideline-concordant ACE inhibitor/ARB utilization, we studied adults participating in the National Health and Nutrition Examination Surveys 2001 to 2018 with hypertension (defined by self-report of high blood pressure, systolic blood pressure ≥140 mm Hg or diastolic ≥90 mm Hg, or use of antihypertensive medications). Among 20 538 included adults, the prevalence of albuminuria ≥300 mg/g was 2.8% in 2001 to 2006, 2.8% in 2007 to 2012, and 3.2% in 2013 to 2018. Among those with albuminuria ≥300 mg/g, no consistent trends were observed for the proportion receiving ACE inhibitor/ARB treatment from 2001 to 2018 among persons with diabetes, without diabetes, or overall. In 2013 to 2018, ACE inhibitor/ARB usage in the setting of albuminuria ≥300 mg/g was 55.3% (95% CI, 46.8%-63.6%) among adults with diabetes and 33.4% (95% CI, 23.1%-45.5%) among those without diabetes. Based on US population counts, these estimates represent 1.6 million adults with albuminuria ≥300 mg/g currently not receiving ACE inhibitor/ARB therapy, nearly half of whom do not have diabetes. ACE inhibitor/ARB underutilization represents a significant gap in preventive care delivery for adults with hypertension and albuminuria that has not substantially changed over time. |
| Databáze: | OpenAIRE |
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