Abstract: TH-PO196
Nocturnal Systolic Blood Pressure Dipping and Progression of CKD
Session Information
- Hypertension and CVD: Clinical - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Seo, Jun Hye, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- Ahn, Hyojin, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- Park, Cheol Ho, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- Nam, Boyoung, Yonsei University Institute of Kidney Disease, Seodaemun-gu, Seoul, Korea (the Republic of)
- Ryu, Jaejin, Yonsei University Institute of Kidney Disease, Seodaemun-gu, Seoul, Korea (the Republic of)
- Kim, Gyu Ri, Yonsei University Institute of Kidney Disease, Seodaemun-gu, Seoul, Korea (the Republic of)
- Yoo, Tae-Hyun, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- Kim, Hyung Woo, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- Han, Seung Hyeok, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- Kang, Shin-Wook, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
Background
The relationship between declining nocturnal blood pressure (BP) and adverse cardiovascular outcomes is well-recognized. However, the relationship between diurnal BP profile and the risk of chronic kidney disease (CKD) progression is unclear.
Methods
We analyzed 1,061 participants from Cardiovascular and Metabolic Disease Etiology Research Center-High Risk (CMERC-HI). The main exposure was diurnal systolic BP (SBP) profile and diurnal SBP difference ([nighttime SBP-daytime SBP]×100/daytime SBP). The primary outcome was CKD progression, defined as a composite of ≥ a 50% decline in the estimated glomerular filtration rate from baseline or the initiation of kidney replacement therapy.
Results
During 4,749 person-years of follow-up (median, 4.8 years), the composite outcome occurred in 380 (35.8%) participants. Compared to dippers, the hazard ratios (HRs) for the risk of adverse kidney outcomes were 1.02 (95% confidence interval [CI], 0.64–1.62), 1.30 (95% CI, 1.02–1.66), and 1.40 (95% CI, 1.03–1.90) for extreme dipper, non-dipper, and reverse dipper, respectively. In a continuous modeling, a 10% increase in diurnal SBP difference was associated with a 1.21-fold (95% CI, 1.07–1.37) higher risk of CKD progression.
Conclusion
Decreased nocturnal SBP decline was associated with adverse kidney outcomes in patients with CKD. Particularly, patients with non-dipping and reverse dipping patterns were at higher risk for CKD progression than those with a dipping pattern.