Blood Pressure Shifts a Mortality Risk for African-Americans With Kidney Disease
(HealthDay News) – Higher systolic blood pressure visit-to-visit variability (SBV) is independently associated with overall and cardiovascular mortality in African-Americans with chronic kidney disease (CKD), according to a study published online March 14 in the Clinical Journal of the American Society of Nephrology.
Ciaran J. McMullan, from Brigham and Women's Hospital in Boston, and colleagues prospectively observed 908 participants during the trial phase of the African American Study of Kidney Disease. Patients had at least one year of blood pressure measurements and were followed for three to 6.4 years. The standard deviations of the systolic pressure from five visits occurring three to 12 months after randomization were used to calculate SBV.
The researchers found that greater SBV was associated with higher overall mortality. Comparing the highest with lowest tertile of SBV, the adjusted hazard ratio (HR) was 2.82. Greater SBV was also associated with cardiovascular mortality (adjusted HR for the highest and lowest tertile, 4.91). In unadjusted analyses, SBV was associated with both a composite of fatal and non-fatal cardiovascular events and a composite of renal events but was not significant in adjusted analyses.
"In African-Americans with CKD, SBV is strongly and independently associated with overall and cardiovascular mortality," the authors write.