Visit-to-visit blood pressure variability and risk of chronic kidney disease: A systematic review and meta-analyses

Li, Huihui; Xue, Jing; Dai, Wenjie; Chen, Yusa; Zhou, Qiaoling; Chen, Wenhang

doi:10.1371/journal.pone.0233233

Cited by 13 publications

(18 citation statements)

References 56 publications

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“…Several longitudinal studies have reported that higher BPV was significantly associated with the risk of developing CKD or progression to end‐stage kidney disease, but most of these assessments were made using visit‐to‐visit BPV based on office blood pressure. 8 , 9 , 10 , 11 , 12 A longitudinal study by Okada et al 23 did not reveal a significant association between BPV based on home blood pressure and incidence of end‐stage kidney disease over 3 years in 135 patients with CKD. Discrepancies between these studies and our present results may be attributable to differences in the study subjects (ie, a general population versus patients with CKD), sample size (ie, 2432 versus 135), and outcomes (ie, incident CKD versus incident end‐stage kidney disease).…”

Section: Discussionmentioning

confidence: 96%

“… 5 , 6 , 7 Several epidemiological and clinical studies have reported that elevated visit‐to‐visit BPV assessed by office blood pressure at each visit was associated with increased risk of the incidence or progression of CKD. 8 , 9 , 10 , 11 , 12 Alternatively, the assessment of BPV based on home blood pressure, which is reproducible and has no white coat effect, might provide reliable information on BPV, and could lead to optimization of blood pressure management. 3 , 13 , 14 , 15 Home blood pressure measurements can be performed under standardized conditions, allowing home blood pressure values to be used to monitor blood pressure variability over several days.…”

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confidence: 99%

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Day‐to‐Day Blood Pressure Variability and Risk of Incident Chronic Kidney Disease in a General Japanese Population

Sasaki

Sakata

Oishi

et al. 2022

JAHA

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Background Several longitudinal studies have reported that higher visit‐to‐visit blood pressure variability is associated with greater risk for developing chronic kidney disease. However, no population‐based studies have investigated the association between day‐to‐day home blood pressure variability and incident chronic kidney disease. Methods and Results A total of 2342 Japanese community‐dwelling residents aged ≥40 years without chronic kidney disease at baseline were followed up by annual health examinations for 10 years. Home blood pressure was measured 3 times every morning for 28 days. Day‐to‐day coefficients of variation of home systolic blood pressure levels were categorized into quintiles. Chronic kidney disease was defined as an estimated glomerular filtration rate <60 mL/min per 1.73 m 2 or the presence of proteinuria. The hazard ratios for developing chronic kidney disease were estimated with a Cox proportional hazards model. During the follow‐up period, 772 participants developed chronic kidney disease. Increased coefficients of variation of home systolic blood pressure were associated significantly with higher risk of chronic kidney disease after adjusting for confounders ( P for trend <0.001): Individuals in the highest quintile of coefficients of variation had a 1.50‐fold (95% CI, 1.17–1.94) greater risk of developing chronic kidney disease than those in the lowest quintile. The combination of higher coefficients of variation and higher mean value of home systolic blood pressure was associated with the multivariable‐adjusted risk of developing chronic kidney disease. Conclusions These findings suggest that increased day‐to‐day blood pressure variability is a significant risk factor for developing chronic kidney disease in a general Japanese population.

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Section: Discussionmentioning

confidence: 96%

mentioning

confidence: 99%

Day‐to‐Day Blood Pressure Variability and Risk of Incident Chronic Kidney Disease in a General Japanese Population

Sasaki

Sakata

Oishi

et al. 2022

JAHA

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“…Chen et al demonstrated that even after adjusting for mean childhood BP levels, adult hypertension was associated with increased BPV in terms of SD of serial BP measurements obtained during childhood [ 44 ]. It was reported that both high BP-SD and BP-CV might increase the risk of chronic kidney disease, but the former association was more significant [ 45 ]. One meta-analysis provided evidence that great SBP-SD may indicate an increased risk of stroke (RR 1.20, 95% CI 1.07–1.35); however, when CV was considered, the hazard for stroke was not stable (RR 1.12, 95% CI 1.00–1.26) [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

School-based surveillance on visit-to-visit blood pressure variability and high blood pressure in children and adolescents

Wang

Shen²,

Liu

et al. 2021

BMC Cardiovasc Disord

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Background The predictive importance of visit-to-visit blood pressure variability (VVV) for high blood pressure (HBP) in a pediatric population has been largely unsettled. We aimed to evaluate it based on Health Promotion Program for Children and Adolescents (HPPCA), a school-based surveillance conducted from 2012 to 2018 in Suzhou, China. Methods A total of 330,618 participants had BP measurement in 2018 and ≥ 3 BP records during 2012–2017, were recruited from HPPCA. Absolute BP values (in mmHg) were converted into age-, sex- and height- normalized z-scores. VVV was expressed as standard deviation (SD), coefficient of variation (CV) or average real variability (ARV) of BP z-scores during 2012–2017. Logistic regression models were used to assess the associations between VVV and HBP in 2018. Results In 2018, 42,554 (12.87%) subjects were defined as HBP. VVV, except for SBP-CV and DBP-CV, was significantly higher in the HBP group than normotensives group. After adjusting for covariates including mean BP values from 2012 to 2017, SBP-SD, SBP-ARV, DBP-SD and DBP-ARV, increased the risk of HBP by 5.70 [95% confidence interval (95% CI) 5.54–5.87], 4.10 (95% CI 4.01–4.20), 4.70 (95% CI 4.50–4.90) and 3.39 (95% CI 3.28–3.50) times, respectively. Notably, SBP-SD significantly improved risk discrimination of HBP based on other risk variables (c-statistics, net reclassification index and integrated discrimination improvement significantly increased). Conclusions Higher SD or ARV of BP, was independently related with higher probability of HBP in Chinese pediatric population. SBP-SD could be potentially helpful for detecting HBP. Future researches investigating the predictive value of VVV are warrant.

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“…In hemodialysis patients, some studies documented that BPV was related to cardiovascular, cerebrovascular and all-cause death ( 10 , 11 ). However, in CKD patients who do not yet require dialysis, the influence of BPV on renal disease and its value in determining long-term prognosis remains to be elucidated ( 12 ). For patients with stage 1–4 CKD, it is of great importance to protect residual renal function, delay the need for renal replacement therapy, reduce the occurrence of CVD, and improve the prognosis.…”

Section: Introductionmentioning

confidence: 99%

Short-term blood pressure variability and outcomes in non-dialysis chronic kidney disease

Wang

Ma²,

Zhi-lan³

et al. 2022

Front. Med.

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BackgroundBlood pressure variability (BPV) is associated with cardiovascular and all-cause mortality, and has been demonstrated in dialysis patients, but has been poorly studied and remains controversial in non-dialysis chronic kidney disease (CKD) patients. We investigated the effect of short-term BPV on prognosis in this population.MethodsA total of 245 stage 1–4 CKD patients with 24-h ambulatory blood pressure recordings were recruited. BPV was evaluated by standard deviation, coefficient of variation, and variation independent of the mean, respectively. All subjects were followed up to the composite end-point event or until January 15, 2020. Patients were divided into two groups based on 24-h median variation independent of the mean, and demographics, laboratory indicators and echocardiogram results were compared. Logistic regression was used to analyze the risk factors for increased BPV. Multivariate Cox regression and Kaplan-Meier survival analysis were used to explore the relationship between BPV and renal prognosis and major cardiovascular events.ResultsThe mean age was 42.07 ± 12.66 years, with 141 males (57.55%). Multivariate Logistic regression analysis showed that high BMI (OR 1.110, P = 0.017), hyperkalemia (OR 2.227, P = 0.040), increased left ventricular end-diastolic diameter (OR 1.103, P = 0.010) and hypertension (OR 2.525, P = 0.002) were independent risk factors for high BPV. Kaplan-Meier survival analysis showed that renal and cardiovascular outcomes were better in the low BPV group than in the high BPV group (P = 0.006; P = 0.002). After adjusting for age, sex and traditional kidney related risk factors, BPV were not independently associated with renal outcomes. High BPV (HR 4.662, P = 0.017) was the main independent risk factor for major cardiovascular events in CKD.ConclusionsIn non-dialysis CKD, short-term BPV was associated with major cardiovascular disease but not renal progression. BMI, hypertension, potassium balance, and left ventricular end-diastolic diameter influenced short-term BPV.

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Visit-to-visit blood pressure variability and risk of chronic kidney disease: A systematic review and meta-analyses

Cited by 13 publications

References 56 publications

Day‐to‐Day Blood Pressure Variability and Risk of Incident Chronic Kidney Disease in a General Japanese Population

Day‐to‐Day Blood Pressure Variability and Risk of Incident Chronic Kidney Disease in a General Japanese Population

School-based surveillance on visit-to-visit blood pressure variability and high blood pressure in children and adolescents

Short-term blood pressure variability and outcomes in non-dialysis chronic kidney disease

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