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Use of antihypertensive medications and mortality of patients with autosomal dominant polycystic kidney disease: a population-based study

Record type: Article

Background: This study aimed to estimate the association between antihypertensive therapy and mortality in patients with autosomal dominant polycystic kidney disease (ADPKD).

Study Design: Cohort study.

Setting & Participants: Participants with ADPKD from the UK General Practice Research Database older than 15 years between 1991 and 2008.

Predictors: Use of 5 major classes of antihypertensive drug.

Outcomes: Deaths, new renal replacement therapy events.

Measurements: Random-effects Poisson models were adjusted for age, sex, year of entry into the cohort, calendar year, prevalent coronary heart disease, stroke, diabetes, hyperlipidemia, and lipid-lowering therapy.

Results: From 1991-2008, there were 2,085 cases of ADPKD, with 1,877 contributing person-time for ages older than 15 years. In 1991, antihypertensive drugs were not prescribed for 68% of participants, which decreased to 38% by 2008. The proportion for which 1 class of antihypertensive drug was prescribed increased from 19% in 1991 to 24% in 2008; 2 classes, from 11% to 22%; 3 classes, from 2% to 11%; and 4 or 5 classes, from 1% to 5%. In 1991, drugs acting on the renin-angiotensin system were prescribed for only 7% of participants; by 2008, this had increased to 46%. There was evidence of a trend toward decreasing mortality as the number of antihypertensive drug classes prescribed in a year increased. For participants with 3 classes of drugs prescribed, the incident rate ratio was 0.11 (95% CI, 0.05-0.21; P < 0.001). Each annual increment in year of entry into the cohort was associated with a 6% (95% CI, 2%-10%; P = 0.008) decrease in mortality.

Limitations: Reported associations might be accounted for by unmeasured or incompletely measured confounders. These might include changes in other aspects of medical care for patients with ADPKD.

Conclusion: Increasing coverage and intensity of antihypertensive therapy is associated with decreasing mortality in people with ADPKD.

Full text not available from this repository.

Citation

Patch, Christine, Charlton, Judith, Roderick, Paul J. and Gulliford, Martin C. (2011) Use of antihypertensive medications and mortality of patients with autosomal dominant polycystic kidney disease: a population-based study American Journal of Kidney Diseases, 57, (6), pp. 856-862. (doi:10.1053/j.ajkd.2011.01.023). (PMID:21458899).

More information

Published date: June 2011
Keywords: polycystic kidney, autosomal dominant, hypertension, antihypertensive drugs, mortality, survival
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 191077
URI: http://eprints.soton.ac.uk/id/eprint/191077
ISSN: 0272-6386
PURE UUID: 0a0a93da-5f90-4f25-82a1-90ecd45d046c
ORCID for Paul J. Roderick: ORCID iD orcid.org/0000-0001-9475-6850

Catalogue record

Date deposited: 16 Jun 2011 10:54
Last modified: 18 Jul 2017 11:36

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