Why the study?
No population-based studies had evaluated the association between day-to-day home blood pressure variability and incident chronic kidney disease, despite known links with visit-to-visit variability.
Does higher day-to-day home blood pressure variability increase the risk of incident chronic kidney disease in adults without baseline kidney disease?
Does higher day-to-day home blood pressure variability increase the risk of incident chronic kidney disease in adults without baseline kidney disease?
Increased day-to-day home blood pressure variability is a significant, independent risk factor for the development of incident chronic kidney disease in the general population.
Answers are grounded in this paper and cite their sources.
Day-to-day home BP variability was associated with incident CKD; extends visit-to-visit data but remains hypothesis-generating.
Background Several longitudinal studies have reported that higher visit‐to‐visit blood pressure variability is associated with greater risk for developing chronic kidney disease. However, no population‐based studies have investigated the association between day‐to‐day home blood pressure variability and incident chronic kidney disease. Methods and Results A total of 2342 Japanese community‐dwelling residents aged ≥40 years without chronic kidney disease at baseline were followed up by annual health examinations for 10 years. Home blood pressure was measured 3 times every morning for 28 days. Day‐to‐day coefficients of variation of home systolic blood pressure levels were categorized into quintiles. Chronic kidney disease was defined as an estimated glomerular filtration rate <60 mL/min per 1.73 m 2 or the presence of proteinuria. The hazard ratios for developing chronic kidney disease were estimated with a Cox proportional hazards model. During the follow‐up period, 772 participants developed chronic kidney disease. Increased coefficients of variation of home systolic blood pressure were associated significantly with higher risk of chronic kidney disease after adjusting for confounders ( P for trend <0.001): Individuals in the highest quintile of coefficients of variation had a 1.50‐fold (95% CI, 1.17–1.94) greater risk of developing chronic kidney disease than those in the lowest quintile. The combination of higher coefficients of variation and higher mean value of home systolic blood pressure was associated with the multivariable‐adjusted risk of developing chronic kidney disease. Conclusions These findings suggest that increased day‐to‐day blood pressure variability is a significant risk factor for developing chronic kidney disease in a general Japanese population.
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Sasaki et al. (2022) studied this question.
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