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Blood Pressure Phenotypes and Cardio-Kidney Outcomes: Findings From UK Biobank Data
Yongin Cho1, Hye-Sun Park2, Jong Ho Jhee3
1Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Republic of Korea (Y.C.).
Circulation. Population Health and Outcomes
|July 7, 2026
Summary
Different blood pressure (BP) patterns, not just high BP, increase cardio-kidney outcome (CKO) risks. Understanding these distinct BP phenotypes is crucial for managing CKO and preventing cardiovascular and kidney diseases.
Area of Science:
- Cardiology
- Nephrology
- Public Health
Background:
- Hypertension is a primary driver of cardio-kidney outcomes (CKO).
- Specific blood pressure (BP) phenotypes and their impact on CKO require further investigation.
- This study addresses the need to understand the independent contributions of various BP phenotypes to CKO.
Purpose of the Study:
- To evaluate the independent contributions of distinct blood pressure (BP) phenotypes to cardio-kidney outcomes (CKO).
- To analyze the association between different BP classifications and the risk of CKO in a large population cohort.
Main Methods:
- A prospective, population-based study utilizing UK Biobank data from 2006-2010.
- Classification of participants into five BP phenotypes: normotension, systolic-diastolic hypertension, isolated systolic hypertension, isolated diastolic hypertension, and isolated low diastolic BP.
- Primary outcome (CKO) defined as a composite of incident chronic kidney disease, major cardiovascular events, and all-cause mortality, analyzed using multivariable Cox proportional hazards models.
Main Results:
- Analysis included 322,328 participants with a median follow-up of 13.6 years, during which 32,440 CKO events occurred.
- All identified BP phenotypes demonstrated an increased risk of CKO compared to normotension.
- Specific findings include elevated CKO risks for isolated systolic hypertension (HR, 1.22), systolic-diastolic hypertension (HR, 1.21), isolated diastolic hypertension (HR, 1.11), and isolated low diastolic BP (HR, 1.10).
Conclusions:
- Distinct blood pressure (BP) phenotypes, beyond absolute thresholds, are associated with differential risks for cardio-kidney outcomes (CKO).
- Further interventional studies are warranted to explore strategies targeting combined systolic-diastolic BP phenotypes to mitigate CKO risk.
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