Epidemiology of arterial hypertension in renal transplant patients:: changes over the last decade

Background. Arterial hypertension is a common clinical problem in renal transplantation, with important consequences on graft and patient survival. Patients and methods. A total of 3365 adult patients transplanted in 1990 (N = 824), 1994 (N = 1075) and 1998 (N = 1466) with a functioning graft after the first year were included. In this study, arterial hypertension was defined as systolic blood pressure (SBP) greater than or equal to140 mmHg and/or diastolic blood pressure (DBP) greater than or equal to90 mmHg and/or treatment with antihypertensive drugs. The use of angiotensin converting enzyme (ACE) inhibitors or angiotensin II (ATII) receptor blockers during the first year was recorded. Results. The prevalence of hypertension showed a progressive and significant increase during follow-up after renal transplantation in the three periods analysed, although SBP and DBP were lower in patients who underwent transplantation in 1998. The presence of arterial hypertension at 1 year was significantly associated with recipient gender (male), donor age ( <60 years), immunosuppressive therapy (cyclosporine), serum creatinine and year of transplantation. Arterial hypertension was not associated with graft survival and cardiovascular mortality. The prevalence and severity of hypertension was significantly lower in patients treated with tacrolimus vs cyclosporine. The use of ACE inhibitors or ATII receptor blockers has increased in the recent years. Conclusions. Arterial hypertension remained a common problem in renal transplantation, although in recent years the intensity of the control seems satisfactory. The use of ACE inhibitors or ATII receptor blockers has increased significantly in the last years.