The association of blood pressure variability with adverse outcomes in a primary care chronic kidney disease cohort
| Autor: | Laura J. Gray, David Shepherd, Lucy Chambers, James F Medcalf, Susil Pallikadavath, Mahak Sukhnani, Nigel J. Brunskill, Rupert W. Major |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Physiology Adverse outcomes Population Blood Pressure Primary care Cohort Studies Risk Factors Internal medicine Internal Medicine Humans Medicine Renal Insufficiency Chronic Adverse effect education education.field_of_study Primary Health Care business.industry Retrospective cohort study medicine.disease Blood pressure Cardiovascular Diseases Hypertension Cohort Cardiology and Cardiovascular Medicine business Kidney disease |
| Zdroj: | Journal of Hypertension. 39:2067-2074 |
| ISSN: | 1473-5598 0263-6352 |
| DOI: | 10.1097/hjh.0000000000002893 |
| Popis: | Background Hypertension is common in individuals with chronic kidney disease and both conditions are associated with adverse outcomes including cardiovascular morbidity. Therefore, it is clinically important to identify methods of risk prediction in individuals with chronic kidney disease. Blood pressure variability has recently emerged as a predictor of cardiovascular events and mortality in the general population, with growing evidence indicating that it may play a similar role in individuals with chronic kidney disease. However, there have been no large studies assessing blood pressure variability in individuals with chronic kidney disease in primary care, where the majority of these patients are managed. Method Using a retrospective observational study design, we analyzed routinely collected blood pressure readings from 16 999 individuals in The Leicester and County Chronic Kidney Disease cohort. Standard deviation, coefficient of variation and average real variability of SBP were used to calculate blood pressure variability. Results During a median follow-up of 5.0 (IQR 3.3--5.0) years, 2053 (12.1%) patients had cardiovascular events, death occurred in 5021 (29.6%) individuals and 156 (0.9%) individuals had endstage kidney disease events. In adjusted models, standard deviation and coefficient of variation were associated with cardiovascular events, all-cause mortality and endstage kidney disease. Average real variability was associated with all-cause mortality and cardiovascular events, but not endstage kidney disease. Conclusion Blood pressure variability may be an accessible, routinely collected, noninvasive measure for stratifying the risk of adverse events in individuals with chronic kidney disease in a primary care setting. |
| Databáze: | OpenAIRE |
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