Blood pressure ≥160/95 mm Hg was associated with a 5.21-fold greater risk of early kidney function decline compared to <140/90 mm Hg in hypertensive men (95% CI 2.06-13.21; P<0.001).
Cohort (n=722)
Does higher treated blood pressure increase the risk of early kidney function decline in treated hypertensive men without chronic kidney disease?
Higher levels of treated blood pressure are significantly associated with an early decline in kidney function among hypertensive men without chronic kidney disease.
Effect estimate: RR 5.21 (95% CI 2.06 to 13.21)
p-value: p=<0.001
Few cohort studies have examined the longitudinal association between change in blood pressure and decline in kidney function among treated hypertensive patients without chronic kidney disease. We conducted a nonconcurrent cohort study to examine the effects of blood pressure on estimated glomerular filtration rate and early kidney function decline (rise in serum creatinine > or =0.6 mg/dL during follow-up) among 504 African-American and 218 white hypertensive patients. Our results showed that each standard deviation higher treated systolic (18 mm Hg) and diastolic (10 mm Hg) blood pressure was associated with an average annual decline (95% confidence interval CI) in estimated glomerular filtration rate of -0.92 (-1.49 to -0.36 P=0.001) and -0.83 (-1.38 to -0.28 P=0.003) mL x min(-1) x 1.73 m(-2), respectively, after adjustment for race, age, education, income, use of antihypertensive drugs, body mass index, and history of diabetes and dyslipidemia. Likewise, each standard deviation higher systolic and diastolic blood pressure was associated with relative risks (95% CIs) of 1.81 (1.29 to 2.55 P or =160/95 mm Hg had a -2.67 (-4.01 to -1.32 P<0.001) mL x min(-1) x 1.73 m(-2) greater annual decline in estimated glomerular filtration rate and a 5.21-fold (2.06 to 13.21 P<0.001) greater risk of early kidney function decline. Our study found that higher levels of treated blood pressure were positively and significantly related to early decline in kidney function among hypertensive men. These results indicate that better blood pressure control might prevent the onset of chronic kidney disease among hypertensives.
Vupputuri et al. (Tue,) conducted a cohort in Hypertension without chronic kidney disease (n=722). Blood pressure ≥160/95 mm Hg vs. Blood pressure <140/90 mm Hg was evaluated on Early kidney function decline (rise in serum creatinine ≥0.6 mg/dL) (RR 5.21, 95% CI 2.06 to 13.21, p=<0.001). Blood pressure ≥160/95 mm Hg was associated with a 5.21-fold greater risk of early kidney function decline compared to <140/90 mm Hg in hypertensive men (95% CI 2.06-13.21; P<0.001).