P-448: Renal failure incidence rates within countries are associated with hypertension treatment, not hypertension prevalence

• Published in: American journal of hypertension Vol. 17; no. S1; pp. 197A - 198A
• Main Authors: Hawkins, Ralph G., Houston, Mark C.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.05.2004
• Subjects: Hypertension Prevalence; Regression Analysis; Renal Failure
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/j.amjhyper.2004.03.522

Reports originating from national public health surveys have identified that hypertension prevalence, treatment and control rates vary among countries. National renal failure registries also identify different rates of end-stage renal failure amongst these countries. We analyzed these reported results to find associations between renal failure incidence and concurrently measured hypertension characteristics in these countries. A review of hypertension prevalence, treatment and control in 8 countries has recently been published. National renal failure registries have reported renal failure incidence rates in each of these countries for the year concurrent with or consecutive to each hypertension survey. Regression analysis was done for renal failure incidence for each population compared with hypertension prevalence, treatment, control and lack of control for each corresponding population. Independent linear regression analyses of total spending for antihypertensive medications and renal failure incidence were performed for Canada and the US. Linear regression analysis did not identify a relationship between hypertension prevalence or hypertension control and renal failure among the 10 populations examined. However, a strong curvilinear correlation exists between the proportion of the population treated for hypertension and renal failure within the population (correlation coefficient 0.99, p-value less than 0.0001). A direct correlation also exists between total spending for all antihypertensive medication categories and renal failure incidence rates in both Canada (r=0.87948, p=0.0006) and the US (r=0.9058, p=0.0005). Multinational data suggest that higher penetrance of hypertension treatment within a country is associated with higher incidence rates of renal failure concurrently existing within that country when compared with other countries with lower proportions of treated population. Trends of American and Canadian spending on antihypertensive medications over time correlate directly with renal failure incidence in those countries. Together, these data imply that conventional treatment of hypertension has failed to arrest the rising incidence of renal failure and may in fact be contributory to the epidemic rise observed in incident rates in these countries. The relationship of ESRD to specific antihypertensive drug categories will require examination. Am J Hypertens (2004) 17, 197A–198A; doi: 10.1016/j.amjhyper.2004.03.522