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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

Systolic blood pressure and mortality among older community-dwelling adults with CKD

Jessica W Weiss1, Eric S Johnson, Amanda Petrik

  • 1Department of Medicine, Division of Nephrology and Hypertension, Oregon Health and Sciences University, Portland, USA. weinstje@ohsu.edu

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|October 22, 2010
PubMed

Insights

Lower baseline systolic blood pressure (SBP) may predict poorer outcomes in older adults with chronic kidney disease (CKD). Higher SBP may increase cardiovascular hospitalization risk but not mortality.

Area of Science:

  • Nephrology
  • Geriatrics
  • Cardiology

Background:

  • Chronic kidney disease (CKD) is prevalent in older adults.
  • CKD outcomes differ in older versus younger patients.
  • Current guidelines recommend a blood pressure target <130/80 mm Hg for all CKD patients.

Purpose of the Study:

  • To investigate the association between baseline systolic blood pressure (SBP) and outcomes in older adults with CKD.
  • To determine if SBP <130 mm Hg or >160 mm Hg affects mortality and cardiovascular disease (CVD) hospitalizations.

Main Methods:

  • Retrospective cohort study of patients aged ≥ 75 years with CKD.
  • Analysis of baseline SBP categorized as <130 mm Hg, 130-160 mm Hg (reference), and >160 mm Hg.
  • Follow-up for 5 years to assess mortality and CVD hospitalizations.

Main Results:

  • Participants with SBP <130 mm Hg had a 22% higher risk of mortality (adjusted HR, 1.22) and a 10% higher risk of CVD hospitalization (adjusted HR, 1.10).
  • Participants with SBP >160 mm Hg had a 26% higher risk of CVD hospitalization (adjusted HR, 1.26) but no significantly increased risk of mortality (adjusted HR, 1.06).
  • A total of 46.4% died and 35.8% were hospitalized during the follow-up period.

Conclusions:

  • Lower baseline SBP (≤130 mm Hg) may be associated with poorer outcomes, including mortality and CVD hospitalizations, in older adults with CKD.
  • Higher baseline SBP (>160 mm Hg) may increase CVD hospitalization risk but not mortality.
  • Further randomized controlled trials are needed to confirm these findings and guide clinical practice.
Abstract

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