The prevalence of hypertension is high among patients undergoing dialysis. We extracted data of patients undergoing dialysis between 2012 and 2020 with recorded pre-dialysis systolic blood pressure (SBP) using a web-based national database in Japan. Following the 2019 Japanese Society of Hypertension guidelines, we classified SBP and assessed its trends over time based on sex, age, diabetes status, and the anti-hypertensive medication use. Using the 2020 database, we examined 336,759 Japanese patients undergoing dialysis (114,249 female; 222,510 male). The mean age was 69.4 ± 12.5 years, and the mean SBP was 152.3 ± 24.7 mm Hg. The prevalence rate of pre-dialysis hypertension was 70.2%, with 32.5%, 24.5%, and 13.2% of patients having grade I, grade II, and grade III hypertension, respectively. From 2014 to 2020, prevalence rate of pre-dialysis hypertension and absolute values of pre-dialysis SBP were higher in dialysis patients with diabetes than in those without diabetes across all age groups and sexes. Younger patients with diabetes or those on anti-hypertensive medication exhibited an SBP of approximately 160 mm Hg. Cerebrovascular death in patients with diabetes was associated with a higher rate of pre-dialysis hypertension than that in those without diabetes, and there was a significant difference in the prevalence of grade III hypertension between the two groups. In conclusion, the mean pre-dialysis SBP among patients undergoing dialysis remained high, and younger patients with diabetes or those receiving anti-hypertensive medications had poor blood pressure control. Optimal blood pressure management may be necessary to reduce the risk of cardiovascular mortality.

中文翻译：

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使用基于网络的国家数据库在日本接受透析的患者透析前血压水平的真实世界趋势

接受透析的患者中高血压的患病率很高。我们使用日本基于网络的国家数据库提取了 2012 年至 2020 年间接受透析的患者的数据，并记录了透析前收缩压 (SBP)。根据 2019 年日本高血压学会指南，我们对 SBP 进行了分类，并根据性别、年龄、糖尿病状况和抗高血压药物的使用情况评估了其随时间的变化趋势。使用 2020 年数据库，我们检查了 336,759 名接受透析的日本患者（114,249 名女性；222,510 名男性）。平均年龄为 69.4 ± 12.5 岁，平均收缩压为 152.3 ± 24.7 mm Hg。透析前高血压患病率为70.2%，其中I级、II级、III级高血压患者分别为32.5%、24.5%和13.2%。2014年至2020年，各年龄组和性别的糖尿病透析患者透析前高血压患病率和透析前收缩压绝对值均高于非糖尿病患者。年轻的糖尿病患者或正在服用抗高血压药物的患者的 SBP 约为 160 mm Hg。糖尿病患者脑血管死亡与非糖尿病患者相比，透析前高血压发生率较高，且两组间Ⅲ级高血压患病率存在​​显着差异。总之，透析患者的平均透析前收缩压仍然较高，年轻的糖尿病患者或接受抗高血压药物的患者血压控制较差。最佳血压管理对于降低心血管死亡风险可能是必要的。