Cumulative blood pressure load and hypertensive nephropathy in Han Chinese hypertensive patients

The study aims to assess the relationship between cumulative blood pressure load (cBPL) and the risk of renal function decline in hypertensive patients and determine the blood pressure (BP) threshold required to prevent hypertensive nephropathy. A single‐center prospective cohort study was conducted...

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Bibliographic Details
Published in:The journal of clinical hypertension (Greenwich, Conn.) Conn.), 2024-02, Vol.26 (2), p.207-216
Main Authors: Liu, Kuan‐I, Hung, Ming‐Hui, Huang, Chin‐Chou, Chen, Jaw‐Wen
Format: Article
Language:English
Subjects:
Antihypertensives
Blood pressure
Body mass index
Cardiovascular disease
cumulative blood pressure load
Diabetes
Glucose
Hypertension
Kidney diseases
Medical history
nephropathy
Statistical analysis
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Summary:The study aims to assess the relationship between cumulative blood pressure load (cBPL) and the risk of renal function decline in hypertensive patients and determine the blood pressure (BP) threshold required to prevent hypertensive nephropathy. A single‐center prospective cohort study was conducted on hypertensive patients. The cBPL was defined as the proportion of area beyond variable BP cutoffs under ambulatory BP monitoring. Renal events were defined as > 25% (minor) or > 50% (major) decline of baseline estimated glomerular filtration rate (eGFR). Cox regression analysis was conducted between cBPL, other ambulatory BP parameters, and renal events. The results revealed a total of 436 Han Chinese hypertensive patients were eligible for enrollment. During an average follow‐up period of 5.1 ± 3.3 years, a decline of > 25% and > 50% in eGFR was observed in 77 and eight participants, respectively. Cox regression analysis revealed that cSBPL140 (hazard ratio [HR], 1.102; 95% confidence interval [CI], 1.017–1.193; p = .017), cSBPL130 (HR, 1.076; 95% CI, 1.019–1.137; p = .008), and cSBPL120 (HR, 1.054; 95% CI, 1.010–1.099; p = .015) were independently associated with minor renal events. Similarly, cSBPL140 (HR, 1.228; 95% CI, 1.037–1.455; p = .017), cSBPL130 (HR, 1.189; 95% CI, 1.045–1.354; p = .009), and cSBPL120 (HR, 1.155; 95% CI, 1.039–1.285; p = .008) were independently associated with major renal events. In conclusion, cBPL is associated with renal function decline in hypertensive patients. Minimizing cBPL120 may decrease the risk of hypertensive nephropathy.
ISSN:1524-6175
1751-7176
DOI:10.1111/jch.14776