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Blood pressure variability increases with advancing chronic kidney disease stage: a cross-sectional analysis of 16 546 hypertensive patients

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dc.contributor.author Sarafidis, Pantelis A.
dc.contributor.author Ruilope Urioste, Luis Miguel
dc.contributor.author Loutradis, Charalampos
dc.contributor.author Gorostidi, Manuel
dc.contributor.author Sierra, Alejandro de la
dc.contributor.author Cruz, Juan J. de la
dc.contributor.author Vinyoles, Ernest
dc.contributor.author Divisón Garrote, Juan Antonio
dc.contributor.author Segura, Julián
dc.contributor.author Banegas, José R.
dc.date.accessioned 2018-05-10T14:23:18Z
dc.date.available 2018-05-10T14:23:18Z
dc.date.issued 2018
dc.identifier.citation Sarafidis, P. A., Ruilope, L. M., Loutradis, C., Gorostidi, M., Sierra, A., Cruz, J., ... & Banegas, J. R. (2018). Blood pressure variability increases with advancing chronic kidney disease stage: a cross-sectional analysis of 16 546 hypertensive patients. Journal of Hypertension, 36(5), 1076-1085. https://doi.org/10.1097/HJH.0000000000001670 spa
dc.identifier.issn 0263-6352
dc.identifier.issn 1473-5598
dc.identifier.uri http://hdl.handle.net/11268/7248
dc.description.abstract Objective: Increased BP-variability predicts cardiovascular morbidity and mortality in hypertensives. This study aimed to examine short-term BP-variability according to renal function stage. Methods: We included 16 546 patients [10 270 (62.1%) without/6276 (38.9%) with CKD Stage 1–5] from the Spanish Ambulatory-Blood-Pressure Monitoring (ABPM) Registry. Stages of CKD were defined according to K/DIGO criteria, based on estimated glomerular filtration rate calculated with the CKD-EPI equation and albumin-to-creatine ratio. BP-variability was assessed with standard deviation (SD), weighted SD (wSD), coefficient of variation (CV), and average real variability (ARV). Results: Compared with those without CKD, a lower proportion of CKD patients were dippers (51.9 versus 39.6%; P < 0.001). Across CKD stages, a progressive decrease in dipper (from 39.1 to 20.4%; P < 0.001) and increase in riser proportion (from 12.3 to 36.7%; P < 0.001) were noted. Patients with CKD had significantly higher SBP SD, wSD, CV and ARV and lower DBP SD compared with those without CKD (P < 0.001). Within CKD Stages, an increasing trend from Stage 1 towards Stage 5 was observed for SBP SD (from 13.8 ± 3.7 to 15.6 ± 5.4 mmHg), wSD (from 12.0 ± 3.2 to 13.9 ± 5.1 mmHg), CV (from 10.4 ± 2.7 to 11.5 ± 4.1%), ARV (from 9.9 ± 2.3 to 11.4 ± 3.2 mmHg); P < 0.001 for all comparisons. DBP SD (P < 0.001), wSD and ARV (P = 0.002) were slightly decreasing, whereas DBP CV increased from Stage 1 to Stage 4 (P < 0.001). In multivariate analysis, male gender, older age, abdominal obesity, diabetes, number of antihypertensive medications, and clinic SBP were independent factors for higher SBP 24-h ARV in CKD. Conclusion: An increase in short-term SBP-variability was present with advancing CKD stages in a large cohort. This increased SBP-variability may be involved in the sharp elevation of cardiovascular risk with worsening renal function. spa
dc.description.sponsorship SIN FINANCIACIÓN spa
dc.language.iso eng spa
dc.title Blood pressure variability increases with advancing chronic kidney disease stage: a cross-sectional analysis of 16 546 hypertensive patients spa
dc.type article spa
dc.description.impact 4.209 JCR (2018) Q1, 13/65 Peripheral Vascular Disease spa
dc.identifier.doi 10.1097/HJH.0000000000001670
dc.rights.accessRights closedAccess spa
dc.subject.uem Cardiopatía coronaria spa
dc.subject.uem Hipertensión spa
dc.subject.uem Obesidad spa
dc.subject.unesco Enfermedad cardiovascular spa
dc.description.filiation UEM spa
dc.peerreviewed Si spa


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