Correlation between clinic, cumulative, 24h-ambulatory systolic blood pressure, and chronic kidney damage in Chinese elderly

ABSTRACT

The aim of this study was to investigate whether clinic, cumulative, and 24h ambulatory systolic blood pressure (SBP) was associated with chronic kidney damage, defind as estimated glomerular filtration rate (eGFR) <60 ml/(min·1.73 m2) and/or microalbuminuria ≥30 mg/L, and, if so, which measurement of SBP is more associated with chronic kidney damage in Chinese elderly. A total of 1207 participants older than 60 years old were included in the final analysis. Clinical blood pressure, cumulative blood pressure exposure was calculated and ambulatory 24h blood pressure was assessed. Multiple logistic regression analysis showed that the clinic (p < .001), cumulative (p = .033), 24h average (p < .001), daytime (p = .001) and nighttime SBP (p = .001) were respectively associated with lower eGFR, and cumulative (p = .008), 24 average (p < .001), daytime (p < .001), and nighttime SBP (p < .001) were the risk factors of microalbuminuria. The degree of correlation were strongest between 24h average SBP and chronic kidney damage (odds ratio, 1.78; 95% confidence interval, 1.46–2.15; p < .001), clinic SBP and eGFR (odds ratio, 1.57; 95% confidence interval, 1.13–2.17; p = .007), nighttime SBP and microalbuminuria (odds ratio, 1.45; 95% confidence interval, 1.05–2.00; p = .024). The likelihood ratio test demonstrated that the introduction of 24h average SBP will improve the goodness of fit of the clinic SBP model(p < .05), while the introduction of cumulative SBP exposure has no such effect(p > .05). Cumulative SBP exposure seems inferior to other measurement in indentifying chronic kidney damage, including decreased GFR and microalbuminuria.

KEYWORDS:

• Cumulative SBP exposure
• clinic SBP
• 24h average SBP
• chronic kidney damage
• Chinese elderly

Declaration of interest

The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

Funding

This research was supported in part by the Capital University of Medical Sciences Foundation for Basic and Clinical Research − 16JL27, Beijing Health System High Level Health Technology Talent Cultivation Plan − 2015-3-028, open Foundation from Beijing Key Laboratory of Hypertension Research, Sail Plan of Beijing Municipal Administration of Hospital – ZYLX201505.

Additional information

Funding

This research was supported in part by the Capital University of Medical Sciences Foundation for Basic and Clinical Research − 16JL27, Beijing Health System High Level Health Technology Talent Cultivation Plan − 2015-3-028, open Foundation from Beijing Key Laboratory of Hypertension Research, Sail Plan of Beijing Municipal Administration of Hospital – ZYLX201505.

Notes on contributors

Chun-hui Li

Chunhui Li, Hongjie Chi and Xiangyu Shang researched data and wrote the manuscript. Lu Song and Yiming Wang researched data and contributed to the discussion.

Xiangyu Shang

Xiaojiao Chen, Wei Li, Junxing Yu, Haijun Feng researched data. Xinchun Yang and Shouling Wu researched data and reviewed and edited the manuscript.

Shouling Wu

Xinchun Yang and Shouling Wu are the guarantors of this work and, as such, had full access to all study data and takes responsibility for the integrity of the data and the accuracy of the data analysis.