Blood Pressure in CKD: An Ethnic Gap

Chronic kidney disease patients in a public health care had higher rates of poor blood pressure than national estimates

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Ethnic minorities are more likely to develop kidney failure than whites. A team of California researchers wondered if poor blood pressure control played a role in this ethnic gap.

The researchers found that blood pressure among kidney disease patients in a San Francisco public health setting was 20 percent higher than national estimates.

This limited study also found Hispanic and Asian patients had slightly higher odds of uncontrolled blood pressure compared to their white counterparts. 

"Control your blood pressure."

Blood pressure control among patients with chronic kidney disease is not as good as it should be, said Delphine S. Tuot, MD, of the University of California San Francisco, and colleagues in background information to their study.

Little is known about blood pressure control among kidney disease patients from different ethnic backgrounds in the public health care system - a setting which cares for a much higher percentage of patients at higher risk of worsening kidney disease.

Dr. Tuot and colleagues set out to study uncontrolled blood pressure in adults with kidney disease in a public health setting.

The rate of uncontrolled blood pressure among kidney disease patients in the Community Health Network (CHN) - a healthcare system for San Francisco's uninsured and publicly insured residents - was 25.3 percent.

In comparison, national estimates from the National Health and Nutrition Examination Survey (NHANES) put the rate of uncontrolled blood pressure among kidney disease patients at 21.2 percent. 

Black patients in both the CHN and the NHANES had higher odds than whites of uncontrolled blood pressure, but with a smaller difference in the CHN.

According to Dr. Tuot, public healthcare systems like the CHN of San Francisco disproportionately care for at-risk patients, including racial and ethnic minorities. As such, these systems could serve on the front-line to lower the gaps in care by putting innovative programs into practice.

For their study, Dr. Tuot and colleagues looked at uncontrolled blood pressure in 6,618 adults with chronic kidney disease who received care in the CHN. Of these, 23 percent were white, 34 percent were black, 18 percent were Hispanic and 21 percent were Asian.

Compared to whites, the overall odds of uncontrolled blood pressure among kidney disease patients in the CHN were higher among:

  • Blacks, with an odds ratio of 1.11
  • Hispanics, with an odds ratio of 1.05
  • Asians, with an odds ratio of 1.04

An odds ratio explains the odds of an event happening in one group versus another. An odds ratio of more than 1.0 means that event happens more often in the first group than the second. In this case, the event was uncontrolled blood pressure.

While the odds of uncontrolled blood pressure were only slightly higher among ethnic minorities than whites, the findings are still significant.

"Continued efforts at improving blood pressure control should target integrated public delivery systems," the authors concluded.

The study was presented at the American Society of Nephrology's Annual Kidney Week and has yet to be published in a peer-reviewed journal. The research was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 

Reviewed by: 
Review Date: 
November 5, 2012
Last Updated:
June 11, 2013