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. 2017 Sep;19(9):890-898.
doi: 10.1111/jch.13017. Epub 2017 May 7.

Prognostic value of nighttime blood pressure load in Chinese patients with nondialysis chronic kidney disease

Yan Li  1   2 , Qiongxia Deng  1 , Huiqun Li  1 , Xinxin Ma  1 , Jun Zhang  1 , Hui Peng  1 , Cheng Wang  1 , Tanqi Lou  1
Affiliations

Prognostic value of nighttime blood pressure load in Chinese patients with nondialysis chronic kidney disease

Yan Li et al. J Clin Hypertens (Greenwich). 2017 Sep.

Abstract

The prognostic value of nighttime blood pressure (BP) load in patients with chronic kidney disease (CKD) remains unknown. The prognostic value of nighttime BP load in a cohort of Chinese patients with nondialysis CKD was investigated. The authors monitored ambulatory BP and followed health outcomes in 588 Chinese CKD patients. Multivariable-adjusted Cox regression analyses indicated that nighttime BP load was a significant risk factor for all clinical outcomes in CKD patients, even when adjusted for clinic BP. Tertile 3 of systolic BP load (vs tertile 1) was associated with an increased risk of renal events (hazard ratio [HR], 2.21; 95% confidence interval [CI], 1.12-4.38) and cardiovascular events (HR, 5.34; 95% CI, 1.58-18.04); tertile 3 of diastolic BP load (vs tertile 1) was associated with an increased risk of all-cause mortality (HR, 6.73; 95% CI, 1.79-25.20), cardiovascular mortality (HR, 7.18; 95% CI, 1.47-35.03), renal events (HR, 2.40; 95% CI, 1.17-4.92), and cardiovascular events (HR, 5.87; 95% CI, 1.97-17.52). Higher nighttime BP load, especially nighttime diastolic BP load, was associated with a poorer prognosis in Chinese nondialysis CKD patients.

Keywords: cardiovascular events; chronic kidney disease; mortality; nighttime blood pressure load; prognosis.

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Conflict of interest statement

No conflicts of interest, financial or otherwise, are declared by the authors.

Figures

Figure 1
Figure 1
Patient selection. ABPM indicates ambulatory blood pressure monitoring; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate
Figure 2
Figure 2
Kaplan‐Meier survival curves as a function of patients with different levels of nighttime systolic blood pressure (SBP) load. (a) Cumulative survival curves for all‐cause mortality in patients with different levels of nighttime SBP load. (b) Cumulative survival curves for cardiovascular mortality in patients with different levels of nighttime SBP load. (c) Cumulative survival curves for renal events in patients with different levels of nighttime SBP load. (d) Cumulative survival curves for cardiovascular events in patients with different levels of nighttime SBP load. P<.001 indicated a comparison between tertiles of nighttime SBP load
Figure 3
Figure 3
Kaplan‐Meier survival curves as a function of patients with different levels of nighttime diastolic blood pressure (DBP) load. (a) Cumulative survival curves for all‐cause mortality in patients with different levels of nighttime DBP load. (b) Cumulative survival curves for cardiovascular mortality in patients with different levels of nighttime DBP load. (c) Cumulative survival curves for renal events in patients with different levels of nighttime DBP load. (d) Cumulative survival curves for cardiovascular events in patients with different levels of nighttime DBP load. P<.001 indicated a comparison between tertiles of nighttime DBP load
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