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Prognostic Effect of Masked Morning Hypertension in Chinese Inpatients With Non-dialysis Chronic Kidney Disease: A

Lin Lin1, Xinying Jiang1, Lingling Liu1

  • 1Division of Nephrology, Department of Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, 52 Meihua East Road, Zhuhai 519000, Guangdong, China.

American Journal of Hypertension
|April 16, 2024
PubMed

Insights

Masked morning hypertension (MMH) significantly increases mortality and cardiovascular risks in non-dialysis-dependent chronic kidney disease (NDD-CKD) patients. Early detection and management of MMH are crucial for improving outcomes in NDD-CKD.

Area of Science:

  • Nephrology
  • Cardiology
  • Hypertension Research

Background:

  • Non-dialysis-dependent chronic kidney disease (NDD-CKD) affects a significant patient population.
  • Understanding prognostic factors in NDD-CKD is crucial for patient management.
  • Morning hypertension (MH) and masked morning hypertension (MMH) are specific hypertension phenotypes.

Purpose of the Study:

  • To investigate the prognostic significance of masked morning hypertension (MMH) in patients with non-dialysis-dependent chronic kidney disease (NDD-CKD).
  • To determine the association between MMH and adverse clinical outcomes, including mortality and cardiovascular events.

Main Methods:

  • A cohort of 2,130 NDD-CKD patients was classified into four blood pressure groups.
  • Analysis correlated blood pressure phenotypes with primary (all-cause mortality) and secondary endpoints (cardio-cerebrovascular disease [CVD], end-stage kidney disease [ESKD]).

Main Results:

  • The prevalence of morning hypertension (MH) and masked morning hypertension (MMH) was 47.4% and 14.98%, respectively.
  • MMH independently elevated the risk of all-cause mortality (HR=4.22) and CVD events (HR=5.14).
  • No significant association was found between MMH and end-stage kidney disease (ESKD) progression.

Conclusions:

  • Masked morning hypertension (MMH) is a significant independent risk factor for mortality and cardiovascular events in NDD-CKD patients.
  • These findings underscore the prognostic importance of MMH in this population.
  • Comprehensive management strategies for MH are recommended for NDD-CKD patients.
Abstract

Keywords:
all-cause mortalityblood pressurecardio-cerebrovascular diseasechronic kidney diseaseend-stage kidney diseasehypertensionmasked morning hypertension

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