1King Saud University, Riyadh, Saudi Arabia
2Security Forces Hospital, Riyadh, Saudi Arabia
Background: Despite the increasing burden of hypertension End-Stage Renal Disease and Cardiovascular disease, data is limited regarding prevalence and control of hypertension.
Aim: To examine distribution, treatment and outcome of blood pressure in Saudi DN patients.
Method: Retrospective study conducted between January 1989 and January 2004 on 503 DN patients with proteinuria in a tertiary, hospital in Riyadh, SA. Definitions of hypertension and its appropriate or inappropriate treatment were according to the seventh report of the Joint National Committee of the prevention, detection, evaluation and treatment of high blood pressure (JNC 7). Patients demographic, renal function, treatment, medication, and blood pressure were kept in record.
Results: 503 patients 269 (53.5%) males. age 64.5¡ 3/4 12.3 yrs. prevalence of hypertension was 409(81.3%) during first year and 447(88.9%) during last visit. isolated systolic hypertension was present in 97 (35.5%)patients. The patient had initial systolic blood pressure 136¡ 3/4 20 mmHg (100–200), diastolic blood pressure was 79.9¡ 3/4 10.6 (60–130). 136 patients were controlled, 372(74%) patients took medication during 1st year while 443(88.1%) patients during last year of follow up. ACE inhibitors were used by 254 (50.4%) of patients. Calcium Channel Blockers by 189(37.5%), ARB 72(14.3%), diuretics 44(8.7%), beta blocker by 3(0.6%) patients. Multiple drug therapy was given to 158(31.3%). Hypertension was controlled in 267 (53.1%) patients at last year of follow up. Comparing the outcome end points, patients with uncontrolled hypertension were having significantly higher incidence of of stroke p < 0.05. Higher incidence of myocardial infarction, retinopathy, proteinuria, hospitalization frequency and stay days in CCU were obtained in patients with uncontrolled hypertension. Patients as show in the table below.
Conclusion: Hypertension is common in Saudi DN patients. Isolated systolic hypertension was frequent. Higher incidences of complications were found in patients with uncontrolled blood pressure. Aggressive approach is warranted to minimize the complications and to achieve target blood pressure levels according to recommended guidelines of JNC7.