Clinical Interventions in Aging (Aug 2020)

Blood Pressure is Associated with Rapid Kidney Function Decline in a Very Elderly Hypertensive Chinese Population

  • Bai K,
  • Chen R,
  • Lu F,
  • Zhao Y,
  • Pan Y,
  • Wang F,
  • Zhang L

Journal volume & issue
Vol. Volume 15
pp. 1317 – 1323

Abstract

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Kunhao Bai,1,2,* Rui Chen,2,* Fanghong Lu,3 Yingxin Zhao,3 Yujing Pan,4 Fang Wang,2 Luxia Zhang2,5,6 1Department of Endoscopy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, People’s Republic of China; 2Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People’s Republic of China; 3Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China; 4Renal Division, Department of Medicine, Peking University International Hospital, Beijing, China; 5National Institute of Health Data Science at Peking University, Beijing, People’s Republic of China; 6Peking University, Center for Data Science in Health and Medicine, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Luxia Zhang Email [email protected]: In prior analyses, blood pressure (BP) was related to rapid kidney function decline (RKFD). However, studies of this relationship in populations of advanced age are lacking. In the present study, we therefore examined the relationship between BP and RKFD in a population of 284 hypertensive Chinese individuals over the age of 80.Patients and Methods: All study participants were diagnosed with hypertension (systolic BP [SBP] 160– 200 mmHg; diastolic BP [DBP] < 110 mmHg). RKFD was defined based upon a decline in estimated glomerular filtration rate (eGFR) > 5mL/min per 1.73 m2 per year during follow-up. The Cox regression models (competing risk models) were used for calculating hazard ratios (HRs) to examine the relationship between SBP, DBP, pulse pressure (PP) and RKFD.Results: Over a 3.3-year median follow-up period, 68 study participants (23.9%) were diagnosed with RKFD, while 35 (12.3%) died. After adjusting for confounding variables, we determined that each 10 mmHg rise in SBP and PP was associated with a 34% and 110% increase, respectively, in RKFD risk (adjusted HR: 1.34, 95% confidence interval [CI]: 1.05– 1.71 for SBP, p=0.02; HR: 2.10, 95% CI: 0.87– 5.08 for PP, p=0.10). In addition, we determined that each 10 mmHg increase in DBP was linked to a 10% reduction in RKFD risk (adjusted HR: 0.90, 95% CI: 0.70– 1.14, p=0.37).Conclusion: Our results indicate that SBP, but not DBP or PP, is positively correlated with RKFD risk in a very elderly hypertensive Chinese population.Keywords: blood pressure, rapid kidney function decline, very elderly, China

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