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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 components and decline in kidney function in community-living older adults: the Cardiovascular Health

Dena E Rifkin1, Ronit Katz, Michel Chonchol

  • 1Divisions of Nephrology and of Family and Preventive Medicine, University of California, San Diego, and Veterans' Affairs Medical Center, San Diego, CA, USA. drifkin@ucsd.edu

American Journal of Hypertension
|May 28, 2013
PubMed

Insights

Elevated systolic blood pressure (SBP) and pulse pressure (PP) significantly accelerate kidney function decline in older adults. Diastolic blood pressure (DBP) showed no significant association with kidney function loss.

Area of Science:

  • Nephrology
  • Geriatrics
  • Cardiovascular Medicine

Background:

  • Hypertension is a known contributor to kidney dysfunction.
  • The specific impact of systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) on kidney function decline in community-dwelling older adults remains unclear.

Purpose of the Study:

  • To investigate the independent and combined associations of SBP, DBP, and PP with kidney function decline in older adults.
  • To determine which blood pressure components are most detrimental to kidney health in this population.

Main Methods:

  • Utilized linear and logistic regression analyses on data from 4,365 older adults in the Cardiovascular Health Study.
  • Estimated glomerular filtration rate (eGFR) using cystatin C over a 7-year follow-up period.
  • Defined rapid kidney function decline as ≥ 3 ml/min/year.

Main Results:

  • Systolic blood pressure (SBP) and pulse pressure (PP), not DBP, were significantly associated with kidney function decline.
  • Each 10-mm Hg increase in SBP and PP correlated with a faster decline of 0.13 and 0.15 ml/min/year, respectively.
  • SBP demonstrated the strongest independent association with rapid kidney function decline, increasing hazard by 14% per 10-mm Hg increment.

Conclusions:

  • Elevated blood pressure, particularly SBP, is a significant factor in the decline of kidney function among older adults.
  • Findings highlight SBP as a critical target for interventions aimed at preserving kidney health in the aging population.
Abstract

Keywords:
blood pressurecystatin Cdiastolic blood pressureelderlyhypertensionkidney functionsystolic blood pressure.

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