The real world trends in blood pressure of dialysis patients in japan using the web-based database

Objective: Hypertension is common in dialysis patients, which is frequent as well as poorly controlled. Blood pressure (BP) has a J curve relationship with cardiovascular disease and survival in dialysis patients; however, optimal BP is not well defined. We wanted to learn about the clinical characteristics of Japanese patients undergoing dialysis and the prevalence of cardiovascular death based on systolic blood pressure (SBP) using the Web based Analysis of Dialysis Data Archives (WADDA) system database. Design and Methods: We enrolled the patients undergoing dialysis who were recorded pre dialysis SBP from 2012 to 2020 using WADDA system 2.1. According to the Japanese Society of Hypertension guidelines 2019 (JSH 2019), we classified SBP and evaluated their trends over time by gender and age. Moreover, we evaluated the association between SBP and cardiovascular death. Results: Using the 2020 database, we looked at 336,759 Japanese patients undergoing dialysis (222,510 men and 114,249 women). The mean age was 69.4 ± 12.5 years, the mean dialysis history was 7.4 ± 7.7 years, and the mean pre dialysis SBP was 152.3 ± 24.7 mmHg. Among these patients, 72% had hypertension, 56.4% had diabetes, 28.9% had ischemic heart disease, and 25.4% had cerebrovascular disease. From 2012 to 2020, there was no change in the percentage of hypertension in each age group. The rate of grade II and III hypertension was predominantly male in the younger population (the twenties to fifties), but it shifted to females in the older population (over sixties). This gender disparity was more pronounced in the grade III hypertension group. Patients with cerebrovascular death had higher rates of hypertension (60.7 percent [gradeI; 26.2%, gradeII; 17.3%, gradeIII; 17.3%]) than those with heart failure death (32.9 percent [gradeI; 18.3%, gradeII; 8.4%, gradeIII; 6.2%]). Conclusion: Using the WADDA system, we summarized recent trends in BP of Japanese dialysis patients. We discovered that the rate of hypertension in patients undergoing dialysis has remained high (around 70%) and has not changed over the last decade. Furthermore, we discovered higher rates of hypertension, particularly in younger males, implying that optimal BP management for these populations may reduce cerebrovascular mortality.