Key result
Ambulatory blood pressure variability was univariately associated with renal events but not after adjustment, whereas 24-hour mean systolic blood pressure was independently associated with hypertensive nephropathy (HR 1.105).
Why the study?
The study aimed to investigate whether short-term blood pressure variability was correlated with hypertensive nephropathy in Han Chinese individuals with hypertension.
Is short-term ambulatory blood pressure variability associated with hypertensive nephropathy in Han Chinese patients with hypertension?
Cohort (n=300)
No
Is short-term ambulatory blood pressure variability associated with hypertensive nephropathy in Han Chinese patients with hypertension?
Absolute Event Rate: 6% vs 0.5%
p-value: p=0.007
In Han Chinese patients with hypertension, 24-hour mean blood pressure, but not ambulatory blood pressure variability, is independently associated with the risk of hypertensive nephropathy.
Mean 24-h BP was associated with renal events unlike BPV; leaves open prospective validation before guiding ambulatory monitoring priorities.
Blood pressure (BP) is characterized by spontaneous oscillation over time, which is described as BP variability (BPV). The current study aimed to investigate whether short‐term BPV was correlated with hypertensive nephropathy in Han Chinese individuals with hypertension. A single‐center prospective cohort study of 300 Han Chinese participants with hypertension was conducted in Taiwan. Five different BPV parameters were derived from ambulatory BP monitoring (ABPM), including standard deviation (SD), weighted SD (wSD), coefficient of variation (CoV), successive variation (SV), and average real variability (ARV). Renal event was defined as > 50% reduction in baseline estimated glomerular filtration rate (eGFR). The average age of the participants was 63.5 years. The baseline eGFR was 84.5 mL/min/1.73 m2. The participants were divided into two groups according to the wSD of systolic BP (SBP). Survival was assessed via a Kaplan‐Meier analysis. During the 4.2‐year follow‐up, the participants with the highest SBP wSD tertile had a greater number of renal events (6.0%) than their counterparts (0.5%) (log‐rank test, p = .007). The Cox proportional hazard regression model was used to assess the independent effects of BPV, and results showed that 24‐h SBP (HR = 1.105; 95% CI = 1.020–1.197, p = .015) and 24‐h DBP (HR = 1.162; 95% CI = 1.004–1.344, p = .044) were independently associated with renal events. However, BPV parameters were only associated with renal events univariately, but not after adjusting for baseline characteristics, 24‐h mean BP, and office BP. Therefore, the risk of hypertensive nephropathy was independently associated with 24‐h mean BP, but not with ambulatory BPV, in Han Chinese participants with hypertension.
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Hung et al. (2020) conducted a cohort in Hypertension (n=300). 24-h ambulatory blood pressure variability (highest SBP wSD tertile) vs. Lower tertiles of SBP wSD was evaluated on Renal event (>50% reduction in baseline estimated glomerular filtration rate) (p=0.007). Ambulatory blood pressure variability was univariately associated with renal events but not after adjustment, whereas 24-hour mean systolic blood pressure was independently associated with hypertensive nephropathy (HR 1.105).
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