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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

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Blood Pressure Variability Predicts Adverse Events and Cardiovascular Outcomes in Chronic Kidney Disease: A Post-Hoc

Kenechukwu Mezue1, Abhinav Goyal1, Gregg S Pressman2

  • 1Department of Internal Medicine, Einstein Medical Center, USA.

American Journal of Hypertension
|October 7, 2017
PubMed

Insights

Visit-to-visit diastolic blood pressure variability independently predicts worse cardiovascular outcomes and adverse events in patients with chronic kidney disease. This finding highlights the importance of monitoring blood pressure fluctuations.

Area of Science:

  • Cardiology
  • Nephrology
  • Clinical Trials

Background:

  • Visit-to-visit blood pressure variability is linked to adverse cardiovascular outcomes.
  • The SPRINT trial provides a dataset to explore this relationship in patients with chronic kidney disease (CKD).

Purpose of the Study:

  • To investigate the association between blood pressure variability and cardiovascular outcomes.
  • To examine the link between blood pressure variability and hypoperfusion-related adverse events in CKD patients undergoing antihypertensive therapy.

Main Methods:

  • Analysis of data from the SPRINT trial, including patients with CKD.
  • Characterization of diastolic blood pressure (DBP) variability using coefficients of variation (CV).
  • Cox proportional hazards regression to identify predictors of cardiovascular outcomes and adverse events like hypotension, syncope, and acute kidney injury (AKI).

Main Results:

  • Diastolic blood pressure variability (DBP CV) independently predicted a higher hazard for the primary cardiovascular outcome (HR 1.126, P < 0.0001).
  • DBP CV also independently predicted increased hazards for AKI (HR 1.117), syncope (HR 1.111), and hypotensive events (HR 1.104).
  • These associations were consistent across both standard and intensive blood pressure treatment arms.

Conclusions:

  • Visit-to-visit DBP variability is an independent predictor of adverse cardiovascular outcomes in CKD patients within the SPRINT trial.
  • Increased DBP variability is also associated with a higher risk of hypoperfusion-related adverse events, including AKI, syncope, and hypotension.
  • Monitoring DBP variability may be crucial for risk stratification and management in hypertensive CKD patients.
Abstract

Keywords:
blood pressureblood pressure variabilitychronic kidney diseasehypertension

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