Rapid eGFR decline (≥7 ml/min/1.73 m2/year) was associated with a higher risk of cardiovascular events compared to stable eGFR in adults with hypertension (HR 1.63; 95% CI 1.10-2.40).
Cohort (n=1,814)
Does rapid eGFR decline increase the risk of cardiovascular events, kidney events, and mortality in Japanese adults with hypertension?
Short-term rapid eGFR decline is a strong prognostic marker for cardiovascular, kidney, and mortality outcomes in hypertensive patients, supporting its use in clinical risk stratification.
Effect estimate: HR 1.63 (95% CI 1.10-2.40)
OBJECTIVE: : Evidence on the prognostic value of estimated glomerular filtration rate (eGFR) slope in Asian individuals with hypertension is limited. We examined associations of eGFR slope with cardiovascular events, kidney events, and all-cause mortality in a Japanese cohort. METHODS: : We studied 1814 adults with hypertension from the Fukushima Cohort Study. eGFR slope over 1-2 years was classified as <3 (stable), 3-<7 (moderate decline), or ≥7 (rapid decline) ml/min/1.73 m2/year. The primary outcome was cardiovascular events; secondary outcomes were kidney events and all-cause death. Associations were evaluated using multivariable Cox models, restricted cubic splines, and time-dependent Cox models. Missing data and confounding were addressed using multiple imputation and inverse probability weighting. RESULTS: : Over a median follow-up of 5.5 years, 193 cardiovascular events, 77 kidney events, and 118 deaths occurred. Compared with the stable group, the rapid-decline group had higher risks of cardiovascular events hazard ratio (HR) 1.63, 95% confidence interval (CI) 1.10-2.40, kidney events (HR 6.54, 95% CI 3.39-12.63), and all-cause death (HR 2.05, 95% CI 1.28-3.28). Spline analyses suggested U-shaped associations for cardiovascular events and mortality. Findings were consistent after imputation and weighting, and time-dependent analyses showed progressively increasing cardiovascular risk. CONCLUSION: : Short-term eGFR slope was strongly associated with cardiovascular, kidney, and mortality outcomes in Japanese individuals with hypertension, supporting its use for clinical risk stratification.
Oda et al. (Wed,) conducted a cohort in Hypertension (n=1,814). Rapid eGFR decline (≥7 ml/min/1.73 m2/year) vs. Stable eGFR (<3 ml/min/1.73 m2/year) was evaluated on Cardiovascular events (HR 1.63, 95% CI 1.10-2.40). Rapid eGFR decline (≥7 ml/min/1.73 m2/year) was associated with a higher risk of cardiovascular events compared to stable eGFR in adults with hypertension (HR 1.63; 95% CI 1.10-2.40).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: