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Updated: May 13, 2026

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

Association of BP variability with mortality among African Americans with CKD

Ciaran J McMullan1, George L Bakris, Robert A Phillips

  • 1Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. cmcmullan1@partners.org

Clinical Journal of the American Society of Nephrology : CJASN
|March 16, 2013
PubMed

Insights

Systolic blood pressure visit-to-visit variability (SBV) is linked to increased mortality in African Americans with chronic kidney disease (CKD). Higher SBV independently predicts greater overall and cardiovascular mortality in this population.

Area of Science:

  • Nephrology
  • Cardiology
  • Public Health

Background:

  • Systolic blood pressure visit-to-visit variability (SBV) is a potential risk factor for adverse outcomes.
  • Limited research exists on SBV associations in patients with chronic kidney disease (CKD).
  • The relationship between SBV and CKD progression or end-stage renal disease (ESRD) remains unclear.

Purpose of the Study:

  • To investigate the association between SBV and mortality in patients with CKD.
  • To examine the link between SBV and cardiovascular events.
  • To assess the relationship of SBV with renal events in the African American Study of Kidney Disease (AASK) trial.

Main Methods:

  • Prospective observational study of 908 participants in the AASK trial.
  • Systolic blood pressure variability (SBV) calculated as the standard deviation of systolic pressure from five visits post-randomization.
  • Proportional hazards regression used to assess associations with mortality and composite endpoints, adjusting for confounders.

Main Results:

  • Increased SBV was significantly associated with higher overall mortality (adjusted HR, 2.82; 1.14-6.95).
  • Greater SBV also correlated with increased cardiovascular mortality (adjusted HR, 4.91; 1.12-21.50).
  • SBV showed associations with composite cardiovascular and renal endpoints in unadjusted analyses, but not after adjustment.

Conclusions:

  • In African Americans with CKD, SBV is a strong predictor of overall mortality.
  • SBV is independently associated with cardiovascular mortality in this patient group.
  • These findings highlight the clinical importance of monitoring SBV in CKD patients.
Abstract

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