Patterns of antihypertensive medication use in kidney transplant recipients

Abstract

Aim: This study analyzed the prevalence of hypertension and the pattern of antihypertensive treatment before and after kidney transplantation.

Patients and methods: The prevalence of hypertension and the class and daily dosage load of antihypertensive medications were analyzed in 116 patients before kidney transplantation and 1, 6, and 12 months after transplantation (67.2 % males, mean age 45.9 ± 11.4 years). Two patients died and eight had the allograft explanted, leaving 106 patients in the final analysis. Blood pressure (BP) was recorded on the day of transplantation and at every follow-up; it was considered uncontrolled at values > 130/80 mmHg.

Results: The prevalence of uncontrolled BP was significantly reduced after kidney transplantation (63.2 % before transplantation vs. 54.7, 41.5, and 25.5 % at the 1‑, 6‑, and 12-month follow-up, respectively, p < 0.001 for all). The number of prescribed antihypertensives did not change significantly during the follow-up (1.96 ± 1.03 before transplantation vs. 2.01 ± 0.88, 1.71 ± 0.78, and 1.73 ± 0.73 at the 1‑, 6‑, and 12-month follow-up, respectively, p > 0.05 for all). There was a significant decrease in antihypertensive drug load during the follow-up (1.08 ± 1.3 end of the study vs. 2.05 ± 2.32 before transplantation, p < 0.008). Before kidney transplantation, angiotensin-converting enzyme (ACE) inhibitors were most commonly prescribed (52.8 %), while after surgery β‑blockers gained prevalence (59.4-63.2 %). Mean arterial pressure decline correlated with an improvement of graft function.

Conclusion: The prevalence of uncontrolled BP and the antihypertensive drug dosage load reduced significantly after kidney transplantation. β‑blockers were used more frequently than ACE inhibitors after kidney transplantation.

Keywords: Angiotensin-converting enzyme inhibitors; Antihypertensive agents; Beta-blockers; Hypertension; Kidney transplantation.