Journal article
Blood Pressure Variability Predicts Adverse Events and Cardiovascular Outcomes in Chronic Kidney Disease: A Post-Hoc Analysis of the SPRINT Trial
American journal of hypertension, v 31(1)
01 Jan 2018
PMID: 28985328
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Visit-to-visit blood pressure variability has been associated with adverse cardiovascular outcomes. Using the SPRINT trial data set, we explored the relationship between blood pressure variability, cardiovascular outcomes, and hypoperfusion-related adverse events of antihypertensive therapy in patients with chronic kidney disease (CKD) enrolled in the study.
The analyses included patients with CKD randomized in SPRINT who reached the target systolic blood pressure for their respective groups (intensive < 120 mm Hg; standard < 140 mm Hg). Coefficients of variation (CV) for diastolic blood pressure (DBP) for each subject characterized variability. Cox proportional hazards regression was used to identify independent predictors of the SPRINT primary outcome (including acute coronary syndrome, stroke, acute heart failure, and death from cardiovascular causes) and the 3 major side effects of therapy-hypotension, syncope, and acute kidney injury (AKI). P < 0.15 on univariate analysis was required to enter the model, and P < 0.05 to remain in it.
Overall, 2,488 subjects (1,273 standard; 1,124 intensive) met inclusion criteria. DBP CV predicted a greater hazard for primary outcome (hazard ratio [HR] 1.126, P < 0.0001) in the overall model as well as in separate analyses by treatment arms (standard group HR 1.107, P < 0.0001; intensive group HR 1.100, P = 0.0004). DBP CV also independently predicted a greater hazard for AKI (HR 1.117), syncope (HR 1.111), and hypotensive events (HR 1.104).
Visit-to-visit DBP variability independently predicts worse cardiovascular outcomes and hypoperfusion-related adverse events in patients with CKD enrolled in SPRINT.
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Details
- Title
- Blood Pressure Variability Predicts Adverse Events and Cardiovascular Outcomes in Chronic Kidney Disease: A Post-Hoc Analysis of the SPRINT Trial
- Creators
- Kenechukwu Mezue - Einstein Medical Center PhiladelphiaAbhinav Goyal - Einstein Medical Center PhiladelphiaGregg S. Pressman - Einstein Medical Center PhiladelphiaJay C. Horrow - Drexel UniversityJanani Rangaswami - Thomas Jefferson University
- Publication Details
- American journal of hypertension, v 31(1)
- Publisher
- Oxford Univ Press
- Number of pages
- 5
- Grant note
- Department of Medicine, Einstein Medical Center
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Anesthesiology and Perioperative Medicine
- Web of Science ID
- WOS:000417715700009
- Scopus ID
- 2-s2.0-85039416341
- Other Identifier
- 991019168172204721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Peripheral Vascular Disease