Key result
High systolic blood pressure (>160 mmHg) prior to percutaneous coronary intervention was associated with a significantly increased risk of developing end-stage renal disease (HR 3.69) compared to a reference systolic blood pressure of 110-119 mmHg.
Why the study?
The effect of hypertension prior to PCI on the development of end-stage renal disease was unknown.
Does high blood pressure prior to percutaneous coronary intervention increase the risk of developing end-stage renal disease?
Cohort (n=140,164)
Yes
Does high blood pressure prior to percutaneous coronary intervention increase the risk of developing end-stage renal disease?
Hazard Ratio: 3.69 (95% CI 2.61–5.23)
High systolic or diastolic blood pressure prior to PCI is independently associated with a significantly increased risk of developing end-stage renal disease.
High pre-PCI systolic BP was associated with increased ESRD risk; leaves open whether BP optimization before PCI improves renal outcomes.
BACKGROUND: Hypertension is the most important modifiable risk factor for mortality and morbidity in chronic kidney disease and coronary artery syndrome. The effect of hypertension prior to percutaneous coronary intervention (PCI) on the development of end-stage renal disease (ESRD) is unknown. METHODS: We used nationally representative data from the Korean National Health Insurance System-140,164 subjects were enrolled during 2010-2015; they were free of ESRD at enrolment, underwent PCI, and were followed up until 2017. Blood pressure (BP) was measured within at least 2 years prior to PCI. The primary outcome was the development of ESRD. RESULTS: During a median follow-up of 5.4 years, 2,082 participants (1.5%) developed ESRD. The highest systolic BP group (>160 mmHg) showed a higher hazard ratio (3.69; 95% confidence interval, 2.61-5.23) than the reference group (110-119 mmHg). Similar results were observed in the highest diastolic BP group (>120 mmHg), which showed a higher hazard ratio than the reference group (70-79 mmHg). However, ESRD risk showed a J-shaped relationship with baseline systolic and diastolic BP at 113 and 74 mmHg in diabetes mellitus subgroup, respectively, after adjustment for potential confounders. CONCLUSION: Our study showed that a high systolic or diastolic BP prior to PCI was independently associated with an increased incidence of ESRD.
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Bae et al. (2021) conducted a cohort in Patients undergoing percutaneous coronary intervention (n=140,164). High systolic blood pressure (>160 mmHg) prior to PCI vs. Systolic blood pressure 110-119 mmHg was evaluated on Development of end-stage renal disease (ESRD) (HR 3.69, 95% CI 2.61-5.23). High systolic blood pressure (>160 mmHg) prior to percutaneous coronary intervention was associated with a significantly increased risk of developing end-stage renal disease (HR 3.69) compared to a reference systolic blood pressure of 110-119 mmHg.
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