Table 2.
Additive interaction between Apparent Treatment Resistant Hypertension and both race and eGFR for the association with incident ESKD among hypertensive Veterans in the Million Veteran Program
| Interaction with race (P-interaction < 0.001) | ||||
|---|---|---|---|---|
| Parameters/Models | Whites with No ATRH (n = 86, 959) | Whites with ATRH (n = 11, 621) | Blacks with No ATRH (n = 26, 362) | Blacks with ATRH (n = 4588) |
| Incident ESKD cases | 1049 | 309 | 864 | 251 |
| Person-Years (PY) | 958, 674 | 87, 690 | 289, 066 | 33, 689 |
| Incidence rate*/1000PY (95 % CI) | 0.63 (0.58–0.68) | 1.90 (1.69–2.14) | 2.53 (2.35–2.72) | 5.69 (5.01–6.47) |
| Incidence rate ratio* (95% CI) | 1.00 (ref) | 3.02 (2.66–3.43) | 4.02 (3.67–4.40) | 9.05 (7.88–10.38) |
| Hazard ratios (95% CI) | ||||
| Model 1 | 1.00 (ref) | 2.56 (2.25–2.91) | 2.65 (2.42–2.91) | 5.17 (4.49–5.94) |
| Model 2 | 1.00 (ref) | 2.27 (2.00–2.58) | 2.77 (2.52–3.04) | 5.31 (4.26–6.11) |
| Model 3 | 1.00 (ref) | 1.98 (1.72–2.28) | 2.64 (2.37–2.94) | 4.68 (4.01–5.46) |
| Interaction with eGFR (P-interaction < 0.001) | ||||
| Parameters/Models | Patients with eGFR ≥ 60 and No ATRH (n = 102, 526) | Patients with eGFR ≥ 60 and ATRH (n = 14, 507) | Patients with eGFR < 60 but No ATRH (n = 19, 638) | Patients with eGFR < 60 and ATRH (n = 3014) |
| Incident ESKD cases | 1004 | 325 | 1134 | 288 |
| Person-Years (PY) | 1, 128, 157 | 107, 304 | 215, 177 | 23, 906 |
| Incidence rate/1000PY (95 % CI) | 0.89 (0.84–0.95) | 3.03 (2.72–3.38) | 5.27(4.97–5.59) | 12.05 (10.73–13.52) |
| Incidence rate ratio (95% CI) | 1.00 (ref) | 3.40 (3.00–3.86) | 5.92 (5.43 (6.45) | 13.54 (11.87–15.4) |
| Hazard ratios (95% CI) | ||||
| Model 1 | 1.00 (ref) | 2.55 (2.25–2.89) | 10.20 (9.31–11.57) | 17.22 (15.04–19.70) |
| Model 2 | 1.00 (ref) | 2.54 (2.24–2.88) | 10.22 (9.33–11.19) | 17.23 (15.06–19.72) |
| Model 3 | 1.00 (ref) | 2.33 (2.03–2.68) | 9.99 (9.03–11.05) | 14.63 (12.60–16.98) |
Model 1: adjusted for age, sex and race (omitted when testing the interaction with race but included for models testing eGFR interaction). Model 2: adjusted for age (restricted cubic splines with 4 knots), sex, race, calendar year of cohort entry and baseline eGFR (omitted when testing the interaction with eGFR but included for models testing interaction with race). Model 3: Model 2 + smoking + BMI (restricted cubic splines with 4 knots) + serum lipids (total cholesterol, triglycerides, LDL cholesterol and HDL cholesterol) + history of Cancer, COPD, diabetes, CAD, PAD and stroke.
Abbreviations: ATRH, apparent treatment resistant hypertension; BMI, body mass index; CAD, coronary artery disease; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; PAD, peripheral artery disease.
Incidence rates are adjusted for baseline eGFR (adjusted to the mean baseline eGFR: 80.4mL/min/1.73m2).
Overall Incidence rates of ESKD among a) patients with eGFR ≥60 = 1.08 (1.02–1.13) per 1000PY; b) patients with eGFR < 60 = 5.95 (5.64–6.27) per 1000PY.