Author + information
- Wasawat Vutthikraivita,b,
- Pattara Rattanawonga,b,
- Possawat Vutthikraivita,b,
- Prabhakorn Kitbhokaa,b,
- Nattachai Suwachittanonta,b and
- Tepsiri Chongkrairatanakula,b
Background: Previous studies showed that pulse pressure is an important mortality predictor in hemodialysis patients as well as a stronger independent parameter compared to the other blood pressure (BP) parameters. However, the association between pulse pressure and progression of chronic kidney disease (CKD) in African American population has not been well studied.
Methods: Pulse pressures and basic characteristics among African American population between 2011-2012 were retrieved from electronic medical record in Carolina Diabetes and Kidney Center, Sumter, SC. Patients with estimated glomerular filtration rate (eGFR) < 15 ml/min per 1.73m2 and loss-to-follow up were excluded. Three years follow up of patients with eGFR lower than their baseline was considered as “Worsened GFR”. Three years follow up of patients with equal or greater eGFR than baseline was considered as “Stable GFR”. The association between baseline CV risk factors, pulse pressure, and 3-year change of eGFR were analyzed by using linear binary regression analysis.
Results: A total of 314 African American (mean age 67.2±12.2 years, 35% male) were finally included in the study. Prevalence of hypertension, diabetes, and dyslipidemia were 39.2%, 64.0%, and 27.4%, respectively. Mean baseline GFR was 38.0±12.5 ml/min per 1.73m2. After 3-year follow up, patients with pulse pressure above 60 mmHg had worse eGFR reduction compared to patients with pulse pressure equal or below 60 mmHg (-8.1±10.2 vs -2.4±10.4 ml/min per 1.73m2, respectively, p<0.001) Declining renal function as assessed by eGFR was inversely related to baseline pulse pressure (r=-0.26; p<0.001), diastolic blood pressure (r=-0.16; p 0.004), and systolic blood pressure (r=-0.31; p<0.001). After adjusted for all CV risk factors in CKD populations, pulse pressure is the only independent risk factor for worsened eGFR (RR 1.03, 95%CI 1.01 – 1.05, p 0.009).
Conclusions: This is the first study to show the relationship between pulse pressure and progression of renal function in African American population. Besides other BP parameters, pulse pressure is another reliable predictor of worsening renal function in CKD population.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Toward Precision Medicine in the Treatment of Elevated Blood Pressure
Abstract Category: 33. Prevention: Hypertension
Presentation Number: 1186-044
- 2017 American College of Cardiology Foundation