Association of morning blood pressure surge with chronic kidney disease progression in patients with chronic kidney disease and hypertension
Abstract Blood pressure (BP) usually rise from being asleep to awake, which is named the morning blood pressure surge (MBPS). Researches have reported that elevated MBPS was related with CV events, incident CKD in hypertensive patients. However, there have been no studies that have investigated the...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-10-01
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| Series: | The Journal of Clinical Hypertension |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jch.14366 |
| _version_ | 1797645251111813120 |
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| author | Xiang Liu Ting Zhang Aiya Qin Fangming Li Zhiyao Zheng Huan Zhou Yi Tang Wei Qin |
| author_facet | Xiang Liu Ting Zhang Aiya Qin Fangming Li Zhiyao Zheng Huan Zhou Yi Tang Wei Qin |
| author_sort | Xiang Liu |
| collection | DOAJ |
| description | Abstract Blood pressure (BP) usually rise from being asleep to awake, which is named the morning blood pressure surge (MBPS). Researches have reported that elevated MBPS was related with CV events, incident CKD in hypertensive patients. However, there have been no studies that have investigated the association between MBPS and renal or heart outcomes in patients with CKD and hypertension, in these patients, the MBPS is much lower because of high prevalence of night hypertension and reduced BP dipping. In this prospective two‐center observational study, we enrolled patients with CKD and hypertension and the 24 h ambulatory blood pressure monitoring (ABPM) was conducted in all patients. Time to total mortality, CKD progression and CV events was recorded; Finally, a total of 304 patients were enrolled and 94 (30.9%) of them had elevated MBPS. After a follow‐up for median 30 months, 23 (7.6%), 34 (11.2%), and 95 (31.3%) patients occurred death, CKD progression and new‐onset CV events, respectively. The Cox regression analysis suggested the elevated MBPS was a strong predictor of CKD progression (HR 2.35, 95%CI 1.2 ‐4.63, p = .013), independent of morning BP, while no associations were found between elevated MBPS and CV events (HR 1.02, 95%CI 0.66 ‐1.57), as well as death (HR 1.08, 95%CI 0.46 ‐2.55). In conclusion, we provided the first evidence that elevated MBPS was an important risk factor of CKD progression in patients with CKD and hypertension. Appropriate evaluation and management of MBPS may be helpful to postpone CKD progression. |
| first_indexed | 2024-03-11T14:43:39Z |
| format | Article |
| id | doaj.art-af0b84108f544904ae6d3e8e6a7d5e08 |
| institution | Directory Open Access Journal |
| issn | 1524-6175 1751-7176 |
| language | English |
| last_indexed | 2024-03-11T14:43:39Z |
| publishDate | 2021-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Journal of Clinical Hypertension |
| spelling | doaj.art-af0b84108f544904ae6d3e8e6a7d5e082023-10-30T13:26:15ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762021-10-0123101879188610.1111/jch.14366Association of morning blood pressure surge with chronic kidney disease progression in patients with chronic kidney disease and hypertensionXiang Liu0Ting Zhang1Aiya Qin2Fangming Li3Zhiyao Zheng4Huan Zhou5Yi Tang6Wei Qin7Division of Nephrology Department of Medicine West China Hospital Sichuan University Chengdu Sichuan ChinaWest China School of Medicine Sichuan University Chengdu Sichuan ChinaDivision of Nephrology Department of Medicine West China Hospital Sichuan University Chengdu Sichuan ChinaDivision of Nephrology Department of Medicine West China Hospital Sichuan University Chengdu Sichuan ChinaWest China School of Medicine Sichuan University Chengdu Sichuan ChinaWest China School of Medicine Sichuan University Chengdu Sichuan ChinaDivision of Nephrology Department of Medicine West China Hospital Sichuan University Chengdu Sichuan ChinaDivision of Nephrology Department of Medicine West China Hospital Sichuan University Chengdu Sichuan ChinaAbstract Blood pressure (BP) usually rise from being asleep to awake, which is named the morning blood pressure surge (MBPS). Researches have reported that elevated MBPS was related with CV events, incident CKD in hypertensive patients. However, there have been no studies that have investigated the association between MBPS and renal or heart outcomes in patients with CKD and hypertension, in these patients, the MBPS is much lower because of high prevalence of night hypertension and reduced BP dipping. In this prospective two‐center observational study, we enrolled patients with CKD and hypertension and the 24 h ambulatory blood pressure monitoring (ABPM) was conducted in all patients. Time to total mortality, CKD progression and CV events was recorded; Finally, a total of 304 patients were enrolled and 94 (30.9%) of them had elevated MBPS. After a follow‐up for median 30 months, 23 (7.6%), 34 (11.2%), and 95 (31.3%) patients occurred death, CKD progression and new‐onset CV events, respectively. The Cox regression analysis suggested the elevated MBPS was a strong predictor of CKD progression (HR 2.35, 95%CI 1.2 ‐4.63, p = .013), independent of morning BP, while no associations were found between elevated MBPS and CV events (HR 1.02, 95%CI 0.66 ‐1.57), as well as death (HR 1.08, 95%CI 0.46 ‐2.55). In conclusion, we provided the first evidence that elevated MBPS was an important risk factor of CKD progression in patients with CKD and hypertension. Appropriate evaluation and management of MBPS may be helpful to postpone CKD progression.https://doi.org/10.1111/jch.14366ambulatory blood pressure monitoringcardiovascular eventschronic kidney diseaseCKD progressionMBPS |
| spellingShingle | Xiang Liu Ting Zhang Aiya Qin Fangming Li Zhiyao Zheng Huan Zhou Yi Tang Wei Qin Association of morning blood pressure surge with chronic kidney disease progression in patients with chronic kidney disease and hypertension The Journal of Clinical Hypertension ambulatory blood pressure monitoring cardiovascular events chronic kidney disease CKD progression MBPS |
| title | Association of morning blood pressure surge with chronic kidney disease progression in patients with chronic kidney disease and hypertension |
| title_full | Association of morning blood pressure surge with chronic kidney disease progression in patients with chronic kidney disease and hypertension |
| title_fullStr | Association of morning blood pressure surge with chronic kidney disease progression in patients with chronic kidney disease and hypertension |
| title_full_unstemmed | Association of morning blood pressure surge with chronic kidney disease progression in patients with chronic kidney disease and hypertension |
| title_short | Association of morning blood pressure surge with chronic kidney disease progression in patients with chronic kidney disease and hypertension |
| title_sort | association of morning blood pressure surge with chronic kidney disease progression in patients with chronic kidney disease and hypertension |
| topic | ambulatory blood pressure monitoring cardiovascular events chronic kidney disease CKD progression MBPS |
| url | https://doi.org/10.1111/jch.14366 |
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