In:
Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 66, No. 1 ( 2015-07), p. 30-36
Abstract:
Whether long-term blood pressure (BP) variability among individuals without diabetes mellitus is associated with new-onset chronic kidney disease (CKD) risk, independently of other BP parameters (eg, mean BP, cumulative exposure to BP) and metabolic profile changes during follow-up, remains uncertain. We used data from a nationwide study of 48 587 Japanese adults aged 40 to 74 years (mean age, 61.7 years; 39% men) without diabetes mellitus or CKD (estimated glomerular filtration rate 〈 60 mL/min per 1.73 m2 or proteinuria by dipstick). BP was measured at baseline and during 3 annual follow-up visits (4 visits). BP variability was defined as standard deviation (SD) and average real variability during the 4 visits. At the year 3 follow-up visit, 6.3% of the population had developed CKD. In multivariable-adjusted logistic regression models, 1 SD increases in SD SBP (per 5 mmHg), SD DBP (per 3 mmHg), average real variability SBP (per 6 mmHg), and average real variability DBP (per 4 mmHg) were associated with new-onset CKD (odds ratios [ORs] and 95% confidence intervals, 1.15 [1.11–1.20] , 1.08 [1.04–1.12], 1.13 [1.09–1.17] , 1.06 [1.02–1.10], respectively; all P 〈 0.01) after adjustment for clinical characteristics, and with mean BP from year 0 to year 3. The associations of SD BP and average real variability BP with CKD remained significant after additional adjustments for metabolic parameter changes during follow-up (ORs, 1.06–1.15; all P 〈 0.01). Sensitivity analyses by sex, antihypertensive medication use, and the presence of hypertension showed similar conclusions. Among those in the middle-aged and elderly general population without diabetes mellitus, long-term BP variability during 3 years was associated with new-onset CKD risk, independently of mean or cumulative exposure to BP and metabolic profile changes during follow-up.
Type of Medium:
Online Resource
ISSN:
0194-911X
,
1524-4563
DOI:
10.1161/HYPERTENSIONAHA.115.05472
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2015
detail.hit.zdb_id:
2094210-2
Permalink