Reverse Correlation between Body Mass Index and Post‐Transplant Hypertension by a New Diagnostic Criteria

Abstract

IntroductionObesity is associated with hypertension (HTN). Recent new diagnostic criteria for HTN with systolic blood pressure (SBP) and diastolic blood pressure of >130 and >80 mmHg, respectively associated with body mass index (BMI) in kidney transplant recipients is unknown.MethodsSystolic hypertension (SHTN) and diastolic hypertension (DHTN) after 1‐month post‐transplantation is determined by old and new diagnostic criteria. A time‐to‐events of developing post‐transplant SHTN and DHTN associated with pre‐transplant BMI are compared between HTN defined by old and new criteria by using Cox proportional hazard regression analysis.ResultsSeventy kidney transplant recipients are reviewed and followed for 96 months. Mean age was 52.7±1.4 years (mean±SEM) and 59% are males. Half of the study population is White, and 34% and 16% are Black and others, respectively. Mean pre‐transplant BMI is 27.64±0.67 kg/m2. At 1‐month post‐transplant, a mean pre‐transplant SBP and DBP are 130.91±2.14 and 77.71±1.51 mmHg, respectively. With an old diagnostic criterion for HTN, 70% have SHTN but up to 90% have SHTN diagnosed by the new criteria. At 96‐month post‐transplant, obese patients has 15% lower risk for SHTN diagnosed with the old criterion (Hazard ratio (HR) 0.850; 95% CI 0.473 – 1.529; p‐value 0.588); whereas, these patients have 2.3% greater risk for SHTN by new criteria (HR 1.023; 95% CI 0.601 – 1.741; p‐value 0.934) [figure 1]. For DHTN, obese patients have 23.7% decreased risk for DHTN diagnosed with the old criterion (HR 0.763; 95% CI 0.394 – 1.478; p‐value 0.422), and also have 14.9% lower risk for DHTN by new criteria (HR 0.851; 95% CI 0.496 – 1.461; p‐value 0.559) [figure 2].ConclusionThe incidence of SHTN and DHTN are increased with the new diagnostic criterion for HTN. The new criteria appear to have the reverse effect on the association between BMI and SHTN, but not DHTN. Further studies related to SHTN are required to elucidate the outcomes of SHTN after kidney transplantation.Support or Funding InformationNoneThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.