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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Blood pressure and decline in kidney function: findings from the Systolic Hypertension in the Elderly Program (SHEP)

J Hunter Young1, Michael J Klag, Paul Muntner

  • 1Department of Medicine, The Johns Hopkins University School of Medicine and The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. jhyoung@jhmi.edu

Journal of the American Society of Nephrology : JASN
|October 25, 2002
PubMed

Insights

High blood pressure (BP) is linked to worsening kidney function in older adults. Systolic blood pressure is the primary driver of this decline, independent of other factors.

Area of Science:

  • Nephrology
  • Geriatrics
  • Cardiovascular Medicine

Background:

  • The relationship between blood pressure (BP) and kidney function decline in the elderly is not fully understood.
  • Identifying the specific BP component responsible for kidney disease is crucial for targeted interventions.

Purpose of the Study:

  • To investigate the association between baseline BP and incident kidney function decline in older adults.
  • To determine which BP component poses the highest risk for kidney disease progression.

Main Methods:

  • Analysis of 2181 participants from the Systolic Hypertension in the Elderly Program (SHEP) placebo arm.
  • Kidney function decline defined as a serum creatinine increase ≥ 0.4 mg/dl over 5 years.
  • Statistical models adjusted for age, gender, ethnicity, smoking, diabetes, and cardiovascular disease history.

Main Results:

  • Higher levels of all BP components (systolic, diastolic, pulse, mean arterial pressure) were associated with an increased risk of kidney function decline.
  • Systolic blood pressure demonstrated the strongest independent association with kidney function decline.
  • The relative risk for the highest vs. lowest quartile of systolic BP was 2.44 (1.67–3.56).

Conclusions:

  • Systolic blood pressure is a significant and independent predictor of kidney function decline in older individuals.
  • Elevated systolic BP poses a substantial risk for developing kidney disease in the elderly population.
  • Interventions targeting systolic BP may be key in preventing kidney disease progression in this demographic.

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