Hypertension Clinical Profile in Chinese Patients on Hemodialysis: A Multicenter, Retrospective, Cross-Sectional Study

Background: Hypertension prevalence exceeds 90% in hemodialysis (HD) patients. As a well-established cardiovascular risk factor, hypertension requires heightened attention and management in this population, where cardiovascular disease remains the leading cause of death. Currently, the absence of clinical practice guidelines for hypertension management in HD patients has resulted in substantial heterogeneity in clinical practices across centers. This study aims to investigate the current status of hypertension treatment and management in Chinese HD patients, providing foundational data to improve blood pressure (BP) control rates and reduce cardiovascular event incidence and mortality. Methods: This multicenter retrospective study evaluated hypertension management patterns at the hemodialysis center level in China. Centers providing over 100 MHD patients were recruited from diverse geographic regions. Data on BP control levels, target values, and antihypertensive medication regimens were collected for both the current period and three years prior. Results: A total of 68 HD centers across 20 provinces were included, with a median patient enrollment of 175 per center. The proportion of centers utilizing ABPM remained low (6.8% vs. 6.7% for historical and current data, respectively), while HBPM was employed by 37.4% and 35.9% of centers. All centers performed pre-HD BP measurements. Center-specific BP targets are detailed in Table 1. Based on individual center-defined diagnostic criteria, 74.6% of patients achieved "satisfactory" BP control. Recent pre- and post-dialysis systolic BP control patterns are summarized in Table 2. Antihypertensive medication remained largely consistent with patterns observed three years prior. Conclusion: Significant inter-center variability persists in BP management practices for Chinese HD patients, with minimal improvement observed over the past three years. These findings underscore the urgent need for standardized clinical practice guidelines to optimize BP management in this high-risk population.