Blood pressure components and incident cardiovascular disease and mortality events among Iranian adults with chronic kidney disease during over a decade long follow-up: a prospective cohort study
Abstract Background To explore the association between systolic and diastolic blood pressure (SBP and DBP respectively) and pulse pressure (PP) with cardiovascular disease (CVD) and mortality events among Iranian patients with prevalent CKD. Methods Patients [n = 1448, mean age: 60.9 (9.9) years] de...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-08-01
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| Series: | Journal of Translational Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12967-018-1603-7 |
| _version_ | 1819105639533641728 |
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| author | Ashkan Hashemi Sormeh Nourbakhsh Samaneh Asgari Mohammadhassan Mirbolouk Fereidoun Azizi Farzad Hadaegh |
| author_facet | Ashkan Hashemi Sormeh Nourbakhsh Samaneh Asgari Mohammadhassan Mirbolouk Fereidoun Azizi Farzad Hadaegh |
| author_sort | Ashkan Hashemi |
| collection | DOAJ |
| description | Abstract Background To explore the association between systolic and diastolic blood pressure (SBP and DBP respectively) and pulse pressure (PP) with cardiovascular disease (CVD) and mortality events among Iranian patients with prevalent CKD. Methods Patients [n = 1448, mean age: 60.9 (9.9) years] defined as those with estimated glomerular filtration rate < 60 ml/min/1.73 m2, were followed from 31 January 1999 to 20 March 2014. Multivariable Cox proportional hazard models were applied to examine the associations between different components of BP with outcomes. Results During a median follow-up of 13.9 years, 305 all-cause mortality and 317 (100 fatal) CVD events (among those free from CVD, n = 1232) occurred. For CVD and CV-mortality, SBP and PP showed a linear relationship, while a U-shaped relationship for DBP was observed with all outcomes. Considering 120 ≤ SBP < 130 as reference, SBP ≥ 140 mmHg was associated with the highest hazard ratio (HR) for CVD [1.68 (1.2–2.34)], all-cause [1.72 (1.19–2.48)], and CV-mortality events [2.21 (1.16–4.22)]. Regarding DBP, compared with 80 ≤ DBP < 85 as reference, the level of ≥ 85 mmHg increased risk of CVD and all-cause mortality events; furthermore, DBP < 80 mmHg was associated with significant HR for CVD events [1.55 (1.08–2.24)], all-cause [1.68 (1.13–2.5)] and CV-mortality events [3.0 (1.17–7.7)]. Considering PP, the highest HR was seen in participants in the 4th quartile for all outcomes of interest; HRs for CVD events [1.92 (1.33–2.78)], all-cause [1.71 (1.11–2.63)] and CV-mortality events [2.22 (1.06–4.64)]. Conclusions Among patients with CKD, the lowest risk of all-cause and CV-mortality as well as incident CVD was observed in those with SBP < 140, 80 ≤ DBP < 85 and PP < 64 mmHg. |
| first_indexed | 2024-12-22T02:25:27Z |
| format | Article |
| id | doaj.art-6ffdff39b5d44932a7e60bf1a719e4f3 |
| institution | Directory Open Access Journal |
| issn | 1479-5876 |
| language | English |
| last_indexed | 2024-12-22T02:25:27Z |
| publishDate | 2018-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Translational Medicine |
| spelling | doaj.art-6ffdff39b5d44932a7e60bf1a719e4f32022-12-21T18:42:01ZengBMCJournal of Translational Medicine1479-58762018-08-0116111410.1186/s12967-018-1603-7Blood pressure components and incident cardiovascular disease and mortality events among Iranian adults with chronic kidney disease during over a decade long follow-up: a prospective cohort studyAshkan Hashemi0Sormeh Nourbakhsh1Samaneh Asgari2Mohammadhassan Mirbolouk3Fereidoun Azizi4Farzad Hadaegh5Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesPrevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesPrevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesJohns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins HospitalEndocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesPrevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesAbstract Background To explore the association between systolic and diastolic blood pressure (SBP and DBP respectively) and pulse pressure (PP) with cardiovascular disease (CVD) and mortality events among Iranian patients with prevalent CKD. Methods Patients [n = 1448, mean age: 60.9 (9.9) years] defined as those with estimated glomerular filtration rate < 60 ml/min/1.73 m2, were followed from 31 January 1999 to 20 March 2014. Multivariable Cox proportional hazard models were applied to examine the associations between different components of BP with outcomes. Results During a median follow-up of 13.9 years, 305 all-cause mortality and 317 (100 fatal) CVD events (among those free from CVD, n = 1232) occurred. For CVD and CV-mortality, SBP and PP showed a linear relationship, while a U-shaped relationship for DBP was observed with all outcomes. Considering 120 ≤ SBP < 130 as reference, SBP ≥ 140 mmHg was associated with the highest hazard ratio (HR) for CVD [1.68 (1.2–2.34)], all-cause [1.72 (1.19–2.48)], and CV-mortality events [2.21 (1.16–4.22)]. Regarding DBP, compared with 80 ≤ DBP < 85 as reference, the level of ≥ 85 mmHg increased risk of CVD and all-cause mortality events; furthermore, DBP < 80 mmHg was associated with significant HR for CVD events [1.55 (1.08–2.24)], all-cause [1.68 (1.13–2.5)] and CV-mortality events [3.0 (1.17–7.7)]. Considering PP, the highest HR was seen in participants in the 4th quartile for all outcomes of interest; HRs for CVD events [1.92 (1.33–2.78)], all-cause [1.71 (1.11–2.63)] and CV-mortality events [2.22 (1.06–4.64)]. Conclusions Among patients with CKD, the lowest risk of all-cause and CV-mortality as well as incident CVD was observed in those with SBP < 140, 80 ≤ DBP < 85 and PP < 64 mmHg.http://link.springer.com/article/10.1186/s12967-018-1603-7Blood pressureSystolic blood pressureDiastolic blood pressurePulse pressureChronic kidney diseaseCardiovascular disease |
| spellingShingle | Ashkan Hashemi Sormeh Nourbakhsh Samaneh Asgari Mohammadhassan Mirbolouk Fereidoun Azizi Farzad Hadaegh Blood pressure components and incident cardiovascular disease and mortality events among Iranian adults with chronic kidney disease during over a decade long follow-up: a prospective cohort study Journal of Translational Medicine Blood pressure Systolic blood pressure Diastolic blood pressure Pulse pressure Chronic kidney disease Cardiovascular disease |
| title | Blood pressure components and incident cardiovascular disease and mortality events among Iranian adults with chronic kidney disease during over a decade long follow-up: a prospective cohort study |
| title_full | Blood pressure components and incident cardiovascular disease and mortality events among Iranian adults with chronic kidney disease during over a decade long follow-up: a prospective cohort study |
| title_fullStr | Blood pressure components and incident cardiovascular disease and mortality events among Iranian adults with chronic kidney disease during over a decade long follow-up: a prospective cohort study |
| title_full_unstemmed | Blood pressure components and incident cardiovascular disease and mortality events among Iranian adults with chronic kidney disease during over a decade long follow-up: a prospective cohort study |
| title_short | Blood pressure components and incident cardiovascular disease and mortality events among Iranian adults with chronic kidney disease during over a decade long follow-up: a prospective cohort study |
| title_sort | blood pressure components and incident cardiovascular disease and mortality events among iranian adults with chronic kidney disease during over a decade long follow up a prospective cohort study |
| topic | Blood pressure Systolic blood pressure Diastolic blood pressure Pulse pressure Chronic kidney disease Cardiovascular disease |
| url | http://link.springer.com/article/10.1186/s12967-018-1603-7 |
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