Seasonal antihypertensive treatment adjustments were linked to eGFR loss, a 2-fold risk of dialysis with increased treatment, and a 2.5-fold risk of death with reduced treatment in the warm season.
Cohort (n=398)
Yes
Does seasonal blood pressure variation and subsequent treatment adjustment impact renal outcomes and mortality in hypertensive patients with and without CKD?
Seasonal blood pressure variation in a Mediterranean climate necessitates frequent treatment adjustments, which are associated with adverse renal outcomes and increased mortality.
Effect estimate: 2.5-fold risk
BACKGROUND: This study aims to assess seasonal blood pressure (BP) variation in chronic kidney disease (CKD) and non-CKD patients living in a Mediterranean climate, and to find out if this variation entails significant adjustment of treatment and if it impacts renal outcomes and mortality. METHODS: This retrospective study included all hypertensive patients seen between February 2006 and April 2020 in two Lebanese clinics. Regression analyses were used to assess the association of seasonal BP variability and treatment adjustment with eGFR change from baseline, dialysis initiation and death. RESULTS: A total of 398 patients of 64.2 ±13.9 years were followed for 51.1 ±44.3 months, 67% had eGFR< 60 mL/min. Mean systolic and diastolic BP was 137.7 ±14.7 and 76.5 ±9.5 mmHg respectively. Systolic and diastolic BP were significantly lower in the warm season in CKD and non-CKD patients (P<0.001). The majority (91.4%) needed seasonal treatment modifications. After adjustment to age, sex, baseline eGFR, BP and number of antihypertensive drugs, we found a significant loss of eGFR with treatment modifications in both seasons, double risk of dialysis with the increase of antihypertensive treatment in both seasons and a 2.5 more risk of death with reduced treatment in the warm season. CONCLUSION: This study confirmed the seasonal BP variability in CKD and non-CKD patients from a Mediterranean climate. All types of treatment adjustment were associated with eGFR loss. Low BP in the warm season was highly associated with death.
Charbel et al. (Thu,) conducted a cohort in Hypertension with or without chronic kidney disease (n=398). Seasonal antihypertensive treatment adjustment was evaluated on eGFR change from baseline, dialysis initiation, and death (2.5-fold risk). Seasonal antihypertensive treatment adjustments were linked to eGFR loss, a 2-fold risk of dialysis with increased treatment, and a 2.5-fold risk of death with reduced treatment in the warm season.