1. CHAPTER 8: BLOOD PRESSURE CONTROL AND DYSLIPIDAEMIA S. Prasad Menon Hooi Lai Seong Lee Wan Tin Sunita Bavanandan Source: 20 th MDTR Report 2012, NRR

2. Table 8.1.1: Distribution of pre dialysis systolic blood pressure, HD patients 1997-2012 Year Number of patients MeanSDMedianLQUQ % Patients pre dialysis systolic blood pressure (mmHg) <120120-<140140-<160160-<180≥180 19971659144.520.8144.2130.8158.1113035194 1998210814620.5146.7133.2159.2102739195 19992965148.720.8148.5135.3162.282538236 2000430814820.6147.8134.7161.792538236 20015147148.820.9148.8134.9162.682537237 20025911149.220.6149135.8163.382438246 20036834149.720.2149.8136.4162.972439237 20047937149.720150136.6163.172339256 20059221149.919.4149.6137162.862440246 200611526151.419.3151.1138.816452241257 200712830152.119.1151.9139.3164.752140277 200815314152.119152139.4164.642140277 20091787115119150.6138.2163.552341257 201019432150.818.9150.4138.3163.352341256 201122685151.518.8151.4139163.942241266 201225812151.518.9151.3139.1163.852241257 Source: 20 th MDTR Report 2012, NRR

3. Figure 8.1.1(a): Cumulative distribution of pre dialysis systolic blood pressure, HD patients 1997-2012 Source: 20 th MDTR Report 2012, NRR

4. Figure 8.1.1(b): Mean of pre dialysis systolic blood pressure, HD patients 1997-2012 Source: 20 th MDTR Report 2012, NRR

5. Table 8.1.2: Distribution of pre dialysis systolic blood pressure, PD patients 1997-2012 Year Number of patients MeanSDMedianLQUQ % Patients pre dialysis systolic blood pressure (mmHg) <120120-<140140-<160160-<180≥180 1997468142.720.3142.9128.3156.3133137173 199851914121.2140126.4157.5163429183 199957614119.8140127.2156143534152 2000638137.220.4136.1123.3150183929132 200173913920.2137.5125.8151.7163830133 2002843139.820.5140127.1151.8143634124 20031154140.520.1140126.7154.1153532153 2004125914119.8140.9127.4154.5133436143 20051351140.420.2139.3127.3153.2133832143 20061523139.319.3138.4126.7151.6144032112 20071753139.919.2139.4127152.8153733132 20082049139.418.7139.5126.7151.4153635122 20092177140.718.7140.5128.1153.41335 142 2010232714017.8140128.3151.4123738112 20112578139.718140127.9151.5133638112 20122796140.818.3141.1128.5152.8133438142 Source: 20 th MDTR Report 2012, NRR

6. Figure 8.1.2 (a): Distribution of pre dialysis systolic blood pressure, PD patients 1997-2012 Source: 20 th MDTR Report 2012, NRR

7. Figure 8.1.2(b): Mean of pre dialysis systolic blood pressure, PD patients 1997-2012 Source: 20 th MDTR Report 2012, NRR

8. Table 8.1.3: Distribution of pre dialysis diastolic blood pressure, HD patients 1997-2012 Year Number of patients MeanSDMedianLQUQ % Patients pre dialysis diastolic blood pressure (mmHg) <7070-<8080-<9090-<100≥100 1997166083.710.984.27790.7102338226 1998210883.510.783.976.990.6102438235 1999296583.510.583.577.190102440216 2000430782.210.482.375.789112839184 2001514681.610.481.77588.3123037174 2002590781.210.481.374.588.1133037163 2003683280.610.280.873.987.2143237143 2004793580.310.280.373.686.9153336143 2005922180.310.680.473.587153236143 20061152580.411.180.473.387.1163235143 20071283080.411.180.273.187163234144 20081531279.811.179.672.486.71833 133 20091787079.71279.27286.4193331124 20101943079.411.87971.886.2203431124 20112268479.311.978.971.786.2203431124 20122580978.911.878.671.285.8213430114 Source: 20 th MDTR Report 2012, NRR

9. Figure 8.1.3 (a): Cumulative Distribution of pre dialysis diastolic blood pressure, HD patients 1997-2012 Source: 20 th MDTR Report 2012, NRR

10. Figure 8.1.3(b): Mean of pre dialysis diastolic blood pressure, HD patients 1997-2012 Source: 20 th MDTR Report 2012, NRR

11. Table 8.1.4: Distribution of pre dialysis diastolic blood pressure, PD patients 1997-2012 Year Number of patients MeanSDMedianLQUQ % Patients pre dialysis diastolic blood pressure (mmHg) <7070-<8080-<9090-<100≥100 199746785.310.685.879.891.461941268 199851984.311.38577.190.182436248 19995768410.984.277.99092044207 200063882.91183.376.689.6102441205 200173983.110.982.776.489.692938186 200284382.810.883.476.190112441215 2003115682.210.982.375.689.4122638194 2004125882.210.58375.489.2112838184 2005135181.610.982.27588.3122940155 2006152281.310.681.574.888132840153 2007175280.610.780.77486.9143238123 2008204979.710.1807386.3163236132 2009217780.210.380.273.586.9153335143 2010232779.910.48072.986.8173334133 201125788010.280.173.386.7163336132 2012279981.212.180.873.987.8153135154 Source: 20 th MDTR Report 2012, NRR

12. Figure 8.1.4(a): Cumulative Distribution of pre dialysis diastolic blood pressure, PD patients 1997-2012 Source: 20 th MDTR Report 2012, NRR

13. Figure 8.1.4(b): Mean of pre dialysis diastolic blood pressure, PD patients 1997-2012 Source: 20 th MDTR Report 2012, NRR

14. Table 8.1.5(a): Median systolic blood pressure among HD patients, HD centres Year Number of centres Min 5 th Centile LQMedianUQ 95 th Centile Max 199745120.4133.6140.1145.2152158165.7 199848131.7135.9140.8145.8150.7158.6159.2 199973134.2135.8143.9148.8153.5163.8170.5 2000103130.1137.3142.8148153.5162.8167.7 2001126126.9136.9143150155161.9180.5 2002145128.3136.7144.7149.2154162169.7 2003176126.7136.6144.9150156.4163.3173.7 2004217122.1137.5145.8150155.5162.8169.8 2005241121.7137.1143.9151155162.1171.8 2006287130.8138.8146.5151.5156.6163180.3 2007320131.7140.2147.4152.3157164.8174.1 2008378130140.4147.4152.3157164.2174.3 2009424132.9139.7146.7151.1155.7162.4173.2 2010459130.1140146.4150.3155.5163.3175 2011513125.5139.4147.2151.6156.1163.6175.3 2012563125.8140.7147.8151.9156.1163.3171 Source: 20 th MDTR Report 2012, NRR

15. Figure 8.1.5 (a): Variation in median systolic blood pressure among HD patients, HD centres 2012 Source: 20 th MDTR Report 2012, NRR

16. Table 8.1.5 (b): Median diastolic blood pressure among HD patients, HD centres Year Number of centres Min 5 th Centile LQMedianUQ 95 th Centile Max 19974576.4808284.385.587.594.3 19984875.178.68283.686.18990.6 19997375.578.781.583.8868991.3 200010375.176.58082.384.788.494.2 200112673.97679.881.983.787.591.3 200214572.375.979.481.483.687.690.8 200317673.47578.780.483.686.493.3 200421770.27478.380.882.786.888.4 20052416973.178.180.882.786.690.3 20062876874.477.880.583.186.7101 200732070.173.277.880.282.987.2124.5 200837866.873.37779.682.586.892.3 200942468.572.876.679.38286.4134.1 201045968.672.376.579.18286142.2 20115136972.676.378.781.986.3143.1 201256366.371.375.878.581.586.5124.2 Source: 20 th MDTR Report 2012, NRR

17. Figure 8.1.5 (b): Variation in median diastolic blood pressure among HD patients, HD centres 2012 Source: 20 th MDTR Report 2012, NRR

18. Table 8.1.5 (c): Proportion of HD patients with pre dialysis blood pressure < 140/90 mmHg, HD centres Year Number of centres Min 5 th Centile LQMedianUQ 95 th Centile Max 19974511152936456386 199848914273541.55472 199973382331415567 20001030122132436073 20011260122031425873 20021450102129395970 20031763920.527395881 2004217082029385682 20052415112028395695 2006287091724355280 20073200817263347.580 2008378081724334873 20094240101827355280 2010459071826355087 2011513071724335094 2012563081724334780 Source: 20 th MDTR Report 2012, NRR

19. Figure 8.1.5 (c): Variation in proportion of HD patients with pre dialysis blood pressure < 140/90 mmHg, HD centres 2012 Source: 20 th MDTR Report 2012, NRR

20. Table 8.1.6(a): Median systolic blood pressure among PD patients, PD centres Year Number of centres Min 5 th Centile LQMedianUQ 95 th Centile Max 19977124 139.4142.5150151.6 19989111.6 135138.6140.8147.5 19999117 133.7137.8140152.8 200011116.2 132.4134.9137.7149.1 200111119.6 130.7137.5138.8149 200215123.9 134.5140144.5148.2 200318123.8 132.4142.4144.3151.8 200418122.9 134.5139.8143.3149.7 200519121.9 134.8136.6142.2158 200622112.7118.3130.2136.3140.4146154.9 200722115.9116.3135.2138.2141.8148153.5 200823115.6118.1136138.9141.6147.7147.9 200924113.5116.3135.8138.3143.9150161.5 201026114.3115.6130.4138.6143.3146.3147.9 201128112.5114.2129139.8141.6146.5147.5 201228113114.2132.7140.6143.7149.8156.7 Source: 20 th MDTR Report 2012, NRR

21. Figure 8.1.6 (a): Variation in median systolic blood pressure among PD patients, PD centres 2012 Source: 20 th MDTR Report 2012, NRR

22. Table 8.1.6 (b): Median diastolic blood pressure among PD patients, PD centres Year Number of centre Min 5 th Centile LQMedianUQ 95 th Centile Max 1997 782.5 85.386 88.7 1998 973.2 85.185.88687 1999 976.8 82.384.385.886.8 2000 1173.1 80.58384.488 2001 1178 80.983.484.888 2002 1576.8 81.883.385.789.5 2003 1877.5 81.282.98488 2004 1877.5 80.883.284.287 2005 1974.4 80.382.984.286.3 2006 2271.67478.981.282.486.788.4 2007 2268.877.378.98082.383.286.9 2008 2373.47678.3808285.586.6 2009 2472.973.378.679.482.684.387.9 2010 267474.777.379.582.486.587.4 2011 2874.174.578.379.681.985.186.9 2012 2873.575.778.68083.287.291 Source: 20 th MDTR Report 2012, NRR

23. Figure 8.1.6 (b): Variation in median diastolic blood pressure among PD patients, PD centres 2012 Source: 20 th MDTR Report 2012, NRR

24. Table 8.1.6 (c): Proportion of PD patients with pre dialysis blood pressure < 140/90 mmHg, PD centres Year Number of centre Min 5 th Centile LQMedianUQ 95 th Centile Max 1997726 35414659 1998936 444749100 1999930 425257100 20001124 52586395 20011136 46526487 20021519 33475691 20031828 3846.56574 20041830 38475673 20051923 43556292 2006221836435968100 20072227 44546891 200823272943535885100 2009241029405057.59296 201026303438516488100 2011282931434670.597100 201228526394563.59096 Source: 20 th MDTR Report 2012, NRR

25. Figure 8.1.6 (c): Variation in proportion of PD patients with pre dialysis blood pressure ≤140/90 mmHg, PD centres 2012 Source: 20 th MDTR Report 2012, NRR

26. Table 8.2.1: Distribution of serum cholesterol, HD patients 1997-2012 Year Number of patients MeanSDMedianLQUQ % Patients serum cholesterol (mmol/L) <3.53.5-<5.35.3-<6.2≥6.2 199711585.11.45.14.25.98472619 199811665.11.354.25.87512417 1999187151.34.94.15.710532215 2000295451.24.94.25.88522416 200138985.11.34.94.25.88512516 2002475151.24.94.25.79532513 200358064.81.14.84.15.59582211 200467104.71.14.745.41159228 200579064.71.14.645.31260208 2006101394.61.14.63.95.31461187 2007113474.61.14.53.85.21462186 2008138204.51.14.43.85.21562176 2009159044.61.14.53.85.21462176 2010176534.61.14.53.85.21462187 2011206724.51.14.43.85.11663156 2012234704.51.14.43.85.11663155 Source: 20 th MDTR Report 2012, NRR

27. Figure 8.2.1: Cumulative distribution of cholesterol, HD patients 1997- 2012 Source: 20 th MDTR Report 2012, NRR

28. Table 8.2.2: Distribution of serum cholesterol, PD patients 1997-2012 Year Number of patients MeanSDMedianLQUQ % Patients serum cholesterol (mmol/L) <3.53.5-<5.35.3-<6.2≥6.2 19974206.11.465.16.92253043 199834861.45.956.83292841 19994345.71.45.64.96.43363031 20005265.91.65.74.96.73313036 20015815.81.45.74.86.62352835 20027665.61.45.54.66.44363029 200311045.41.45.34.46.15442823 200412305.31.45.24.46.15472721 200512425.21.354.35.95532418 200613955.21.45.14.35.96502618 200716295.11.35.14.25.98482618 200819025.21.454.35.97502418 200920165.31.55.14.366482620 201021865.21.45.14.367482520 201123505.11.354.25.88502517 201226845.11.44.94.25.87522417 Source: 20 th MDTR Report 2012, NRR

29. Figure 8.2.2: Cumulative distribution of cholesterol (mmol/L), PD patients 1997-2012 Source: 20 th MDTR Report 2012, NRR

30. Table 8.2.3: Distribution of serum triglyceride, HD patients 1997-2012 Year Number of patients MeanSD Media n LQUQ % Patients serum triglyceride (mmol/L) <1.71.7-<2.32.3-<3.5≥3.5 199710742.11.41.81.32.545241812 199810892.21.51.81.32.642262012 199916332.11.31.71.22.549211811 200023912.11.41.71.32.648221912 200131622.11.41.71.22.548221713 200238612.11.41.81.22.547221812 2003471021.31.71.22.548231811 2004560721.21.71.22.451231710 2005695021.31.71.22.450221810 2006952221.31.61.22.35421169 2007108821.91.21.61.12.35521168 2008129271.91.21.61.12.35620158 2009151831.91.31.61.12.35421169 2010169701.91.31.61.12.35421169 2011197241.91.21.61.12.35521168 2012227801.91.21.61.12.35521169 Source: 20 th MDTR Report 2012, NRR

31. Figure 8.2.3: Cumulative distribution of serum triglyceride, HD patients 1997-2012 Source: 20 th MDTR Report 2012, NRR

32. Table 8.2.4: Distribution of serum triglyceride, PD patients 1997-2012 Year Number of patients MeanSD Media n LQUQ % Patients serum triglyceride (mmol/L) <1.71.7-<2.32.3-<3.5≥3.5 19974132.61.92.21.4336222518 19983442.41.8 1.3342221719 19994212.41.621.4338251819 20005202.72.22.11.5333242321 20015762.61.821.433622 20 20027672.51.721.4339212218 200311002.31.61.81.22.845202114 200412232.21.61.81.32.647231713 200512412.21.51.81.32.743241814 200613912.21.61.71.22.647211813 200716252.11.41.81.32.645241912 200819072.21.51.81.32.745212014 200920172.21.61.81.32.746212014 201021772.11.41.81.32.547231811 2011236521.31.71.22.35123179 2012266721.31.71.22.548231910 Source: 20 th MDTR Report 2012, NRR

33. Figure 8.2.4: Cumulative distribution of serum triglyceride, PD patients 1997-2012 Source: 20 th MDTR Report 2012, NRR

34. Table 8.2.5 (a): Median serum cholesterol level among HD patients, HD centres Year Number of centres Min 5 th Centile LQMedianUQ 95 th Centile Max 1997344.14.24.655.35.75.8 1998314.24.44.855.35.55.6 1999453.54.34.64.85.15.65.8 20007644.24.74.95.25.55.7 2001974.14.44.755.15.96.3 20021224.34.54.74.95.15.66.4 20031524.14.34.64.855.35.6 20041873.84.24.54.74.95.46.1 20052113.84.14.44.64.85.25.6 20062683.33.94.34.64.85.25.9 20072923.644.34.54.85.15.4 20083463.23.84.24.54.75.16.3 20093843.544.34.54.85.25.6 20104233.544.34.54.85.15.7 20114883.53.94.24.44.64.95.7 20125453.53.94.24.44.64.95.9 Source: 20 th MDTR Report 2012, NRR

35. Figure 8.2.5 (a): Variation in median serum cholesterol level among HD patients, HD centres 2012 Source: 20 th MDTR Report 2012, NRR

36. Table 8.2.5(b): Proportion of HD patients with serum cholesterol < 5.3mmol/L, HD centres Year Number of centre Min 5 th Centile LQMedianUQ 95 th Centile Max 19973432354655.5677991 199831203049586886100 19994532365663758386 200076364051.561.569.58694 20019714315360698083 200212222405563707793 2003152384458.567768392 200418725446169778997 2005211345065738191100 200626829526774.58292100 2007292365768.5758492100 2008346305669778492100 2009384355268768493100 2010423275568768492100 2011488365872808695100 2012545316273808693100 Source: 20 th MDTR Report 2012, NRR

37. Figure 8.2.5 (b): Variation in proportion of patients with serum cholesterol < 5.3mmol/L, HD centres 2012 Source: 20 th MDTR Report 2012, NRR

38. Table 8.2.5 (c): Median serum triglyceride level among HD patients, HD centres Year Number of centres Min 5 th Centile LQMedianUQ 95 th Centile Max 1997331.3 1.61.81.92.52.9 1998281.4 1.61.822.12.3 1999391.21.31.51.71.92.42.5 20005911.31.51.81.92.62.8 20018511.41.51.71.92.43.8 2002971.11.41.61.822.33.2 20031271.21.31.51.71.92.22.5 200416111.31.51.71.82.23 20051930.91.31.51.61.82.22.6 200625511.31.51.61.82.34 20072790.81.21.41.61.82.12.9 200832011.21.41.61.722.5 200936511.21.41.61.82.12.4 20104010.91.21.51.61.82.22.9 201147011.21.41.61.82.16.3 20125280.81.21.51.61.82.12.8 Source: 20 th MDTR Report 2012, NRR

39. Figure 8.2.5 (c): Variation in median serum triglyceride level among HD patients, HD centers 2012 Source: 20 th MDTR Report 2012, NRR

40. Table 8.2.5(d): Proportion of HD patients with serum triglyceride < 2.1mmol/L, HD centres Year Number of centres Min 5 th Centile LQMedianUQ 95 th Centile Max 19973323355965758894 199828445056.562.571.58083 19993941476068738892 20005923385865738486 20018527455968778691 20029727455567718393 2003127274458697590100 200416119475970808897 200519329456067748493 2006255144664707789100 2007279365263717989100 200832036546471.58088100 2009365385063717889100 2010401275063707788100 201147005064717989100 20125282850637078.58894 Source: 20 th MDTR Report 2012, NRR

41. Figure 8.2.5 (d): Variation in proportion of patients with serum triglyceride < 2.1mmol/L, HD centers 2012 Source: 20 th MDTR Report 2012, NRR

42. Table 8.2.6 (a): Median serum cholesterol level among PD patients, PD centres Year Number of centres Min 5 th Centile LQMedianUQ 95 th Centile Max 199765.8 5.9 6.1 199864.8 5.65.86.16.2 199985.1 5.45.75.866 2000105.2 5.45.65.96.4 200110555.65.96.2 2002154.9 5.45.55.76.2 2003184.5 55.35.75.9 2004184.6 4.95.35.56.1 2005194.4 4.755.45.9 2006214.44.64.85.15.36.16.2 2007214.5 4.95.25.45.56.1 2008224.34.54.85.15.45.55.8 2009234.7 4.85.15.45.96.7 2010254.64.74.95.15.467.3 2011274.34.44.95.15.35.97.2 2012274.34.44.84.95.367.8 Source: 20 th MDTR Report 2012, NRR

43. Figure 8.2.6 (a): Variation in median serum cholesterol level among PD patients, PD centres 2012 Source: 20 th MDTR Report 2012, NRR

44. Table 8.2.6 (b): Proportion of PD patients with serum cholesterol < 5.3mmol/L, PD centres Year Number of centres Min 5 th Centile LQMedianUQ 95 th Centile Max 1997624 25263033 1998624 27323753 1999810 3639.54556 20001011 18314354 20011022 3033.54459 20021513 29384480 20031823 3847.55983 20041826 4249.56069 20051927 46576974 20062120254757637279 20072129404553657486 20082230414655687374 2009239314452667277 2010259274351607172 2011270234553667388 20122711204859687881 Source: 20 th MDTR Report 2012, NRR

45. Figure 8.2.6 (b): Variation in proportion of patients with serum cholesterol < 5.3mmol/L, PD centres 2012 Source: 20 th MDTR Report 2012, NRR

46. Table 8.2.6 (c): Median serum triglyceride level among PD patients, PD centres Year Number of centres Min 5 th Centile LQMedianUQ 95 th Centile Max 199761.7 1.92.12.22.4 199861.2 1.51.71.92.1 199981.6 1.922.12.6 2000101.8 22.32.52.6 2001101.5 1.922.133 2002151.5 1.81.922.4 2003181.2 1.71.81.92.3 2004181.3 1.71.8 2.2 2005191.4 1.61.922.2 2006211.11.41.61.81.92.12.6 2007211.21.51.71.81.92.12.7 2008221.31.51.71.822.22.3 2009231.41.51.71.81.92.22.5 2010241.41.51.61.81.92.1 2011271.21.41.6 1.82.12.2 2012271.4 1.61.71.92.42.7 Source: 20 th MDTR Report 2012, NRR

47. Figure 8.2.6 (c): Variation in median serum triglyceride level among PD patients, PD centres 2012 Source: 20 th MDTR Report 2012, NRR

48. Table 8.2.6 (d): Proportion of PD patients with serum triglyceride < 2.1mmol/L, PD centres Year Number of centres Min 5 th Centile LQMedianUQ 95 th Centile Max 1997640 46525661 1998651 55617085 1999837 53.55660.564 20001018 42495462 20011027 50535868 20021538 52565776 20031849 54596292 20041847 6062.56488 20051940 53606891 20062133525461657882 20072140526064668081 20082248 5660658284 20092327485460677071 201024495059.56268.57477 20112741536166738093 20122742445964718186 Source: 20 th MDTR Report 2012, NRR

49. Figure 8.2.6 (d): Variation in proportion of patients with serum triglyceride < 2.1mmol/L, PD centres 2012 Source: 20 th MDTR Report 2012, NRR