Abstract: TH-PO622
Association of Isolated Diastolic Hypertension With Risk of Renal and Cardiovascular Outcomes in CKD: A Report From the Chronic Renal Insufficiency Cohort (CRIC) Study
Session Information
- Hypertension and CVD: Epidemiology, Risk Factors, Prevention
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1502 Hypertension and CVD: Clinical‚ Outcomes‚ and Trials
Authors
- Alsaleh, Saud Abdulelah, University Hospitals, Cleveland, Ohio, United States
- Dobre, Mirela A., University Hospitals, Cleveland, Ohio, United States
- Delozier, Sarah, University Hospitals, Cleveland, Ohio, United States
- Rahman, Mahboob, University Hospitals, Cleveland, Ohio, United States
- Pradhan, Nishigandha, University Hospitals, Cleveland, Ohio, United States
Background
Isolated Diastolic Hypertension (IDH) has drawn increased interest after the new definition of hypertension proposed by the 2017 ACC/AHA guidelines. Our analysis examined the prevalence of IDH, and the association of IDH with adverse renal and CV outcomes in patients with CKD
Methods
Participants in the CRIC Study; a multicenter observational cohort of ethnically diverse patients with CKD aged 21-74 years. IDH was defined as Systolic BP≤ 130 and DBP >80. Outcomes were composite kidney events (50% decline in eGFR or onset of ESKD), composite CV events (MI, CHF, stroke, PAD) and all-cause mortality. Cox proportional hazards models adjusted for demographic and clinical covariates
Results
The cohort included 5621 participants with a mean age of 59 years; 44% were females and 43%were Black. 51% had diabetes. IDH was present in 6.1% fof participants at baseline. After median follow up of 17 years, there was no statistically significant association between IDH and composite kidney outcome (Hazrd ration (HR) 1.17 95% CI 0.93-1.47, p 0.18)The findings were consistent in subgroups by age ≤60 years or >60 years (HR 1.14 95% CI 0.88-1.48, p=0.31and HR 1.55 95% CI 0.84-2.83, p 0.16 respectively) No association was found between presence of IDH and risk of composite CV events (HR 0.91 (95% CI 0.65-1.27, p=0.58) or all-cause mortality (HR 0.82, 95% CI 0.57-1.19, p 0.30)
Conclusion
The Prevalence of IDH in this cohort of participants with CKD patients is 6.1%, similar to that in non-CKD populations. IDH is not associated with risk of adverse kidney and CV events irrespective of age
Association between IDH and clinical outcomes, compared to participants with normal systolic and diastolic BP
| Hazard Ratio (95% CI) | ||
| Composite of MI, Stroke, CHF, PAD | ||
| Unadjusted | Adjusted | |
| Isolated Diastolic hypertension | .55 (.41, .73), p < .001* | .91 (.65, 1.27), p = .576 |
| Isolated Systolic hypertension | 1.71 (1.52, 1.93), p < .001* | 1.20 (1.03, 1.39), p = .022* |
| Systolic Diastolic hypertension | 1.46 (1.26, 1.69), p < .001* | 1.41 (1.17, 1.71), p < .001* |
| All-cause mortality | ||
| Isolated Diastolic hypertension | .42 (.30,.58), p < .001* | .82 (.57, 1.19), p = .304 |
| Isolated Systolic hypertension | 1.58 (1.38, 1.80), p < .001* | 1.11 (.94, 1.30), p = .221 |
| Systolic Diastolic hypertension | 1.23 (1.04, 1.45), p = .017* | 1.42 (1.16, 1.74), p < .001* |