Key result
Systolic blood pressure, active smoking, serum uric acid, calcium-containing medications, potassium metabolism, and non-use of beta blockers were independently associated with increased arterial stiffness in nephrology outpatients.
Cross-Sectional (n=191)
No
In nephrology outpatients, modifiable risk factors including systolic blood pressure, smoking, serum uric acid, and calcium-containing medications are independently associated with increased arterial stiffness.
Should not yet change practice; leaves open causal inference and prospective validation in nephrology patients.
Arterial stiffness, as measured by pulse wave velocity (PWV), is an independent predictor of cardiovascular events and mortality. Arterial stiffness increases with age. However, modifiable risk factors such as smoking, BP and salt intake also impact on PWV. The finding of modifiable risk factors may lead to the identification of treatable factors, and, thus, is of interest to practicing nephrologist. We have now studied the prevalence and correlates of arterial stiffness, assessed by PWV, in 191 patients from nephrology outpatient clinics in order to identify modifiable risk factors for arterial stiffness that may in the future guide therapeutic decision-making. PWV was above normal levels for age in 85/191 (44.5%) patients. Multivariate analysis showed that advanced age, systolic BP, diabetes mellitus, serum uric acid and calcium polystyrene sulfonate therapy or calcium-containing medication were independent predictors of PWV. A new parameter, Delta above upper limit of normal PWV (Delta PWV) was defined to decrease the weight of age on PWV values. Delta PWV was calculated as (measured PWV) - (upper limit of the age-adjusted PWV values for the general population). Mean±SD Delta PWV was 0.76±1.60 m/sec. In multivariate analysis, systolic blood pressure, active smoking and calcium polystyrene sulfonate therapy remained independent predictors of higher delta PWV, while age, urinary potassium and beta blocker therapy were independent predictors of lower delta PWV. In conclusion, arterial stiffness was frequent in nephrology outpatients. Systolic blood pressure, smoking, serum uric acid, calcium-containing medications, potassium metabolism and non-use of beta blockers are modifiable factors associated with increased arterial stiffness in Nephrology outpatients.
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Elewa et al. (2015) conducted a cross-sectional in Chronic Kidney Disease, Diabetic Nephropathy, and Hypertension (n=191). Modifiable risk factors (systolic blood pressure, smoking, uric acid, calcium-containing medications, potassium metabolism, non-use of beta blockers) vs. Absence of risk factors / lower levels was evaluated on Arterial stiffness assessed by pulse wave velocity (PWV) and Delta PWV. Systolic blood pressure, active smoking, serum uric acid, calcium-containing medications, potassium metabolism, and non-use of beta blockers were independently associated with increased arterial stiffness in nephrology outpatients.
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