Key result
High blood pressure variability linked to ~46% greater risk of incident ESRD.
Why the study?
Does high systolic and diastolic blood pressure variability increase the risk of end-stage renal disease?
Cohort (n=8,199,089)
Does high systolic and diastolic blood pressure variability increase the risk of end-stage renal disease?
Effect estimate: HR 1.46 (95% CI 1.40-1.53)
Absolute Event Rate: 0.35% vs 0.23%
p-value: p=<0.0001
High variability in both systolic and diastolic blood pressure is independently associated with an increased risk of developing end-stage renal disease, particularly in patients with uncontrolled hypertension.
BP variability was associated with ESRD risk; hypothesis-generating and should not yet change practice.
test, and log-rank test were used in the statistical analysis. There were 16 567 cases of ESRD during a median follow-up of 7.89±0.88 years. The highest quartile of systolic or diastolic BP showed a higher incident rate of ESRD compared with the other 3 quartiles. It was augmented in patients with the highest quartile of both systolic and diastolic BP variabilities. Among patients with the highest quartile of systolic and diastolic BP variabilities, the uncontrolled hypertension group (>140/90 mm Hg) taking antihypertensive medication showed the highest incidence rate of ESRD. These results were consistent when modeling variability of BP using coefficient of variation, SD, and variability independent of the mean and in various sensitivity analyses. Systolic and diastolic BP variabilities were independently associated with an increased incidence of ESRD, and it was augmented when both variabilities were present together.
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Bae et al. (2019) conducted a cohort in End-Stage Renal Disease (ESRD) (n=8,199,089). Highest quartile of systolic and diastolic blood pressure variability vs. Lower three quartiles of systolic and diastolic blood pressure variability was evaluated on Incident end-stage renal disease (ESRD) (HR 1.46, 95% CI 1.40-1.53, p=<0.0001). The highest quartile of both systolic and diastolic blood pressure variability was independently associated with an increased risk of incident end-stage renal disease (HR 1.46) compared to the lower three quartiles.
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