Wang, Y. et al. (2022) Associations of long-term visit-to-visit blood pressure variability with subclinical kidney damage and albuminuria in adulthood: a 30-year prospective cohort study. Hypertension, 79(6), pp. 1247-1256. (doi: 10.1161/HYPERTENSIONAHA.121.18658) (PMID:35360932) (PMCID:PMC9093226)
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Abstract
Background: Recent evidence indicates that long-term visit-to-visit blood pressure variability (BPV) may be associated with risk of cardiovascular disease. We, therefore, aimed to determine the potential associations of long-term BPV from childhood to middle age with subclinical kidney damage (SKD) and albuminuria in adulthood. Methods: Using data from the ongoing cohort of Hanzhong Adolescent Hypertension study, which recruited children and adolescents aged 6 to 18 years at baseline, we assessed BPV by SD and average real variability (ARV) for 30 years (6 visits). Presence of SKD was defined as estimated glomerular filtration rate between 30 and 60 mL/min per 1.73 m2 or elevated urinary albumin-to creatinine ratio at least 30 mg/g. Albuminuria was defined as urinary albumin-to creatinine ratio ≥30 mg/g. Results: During 30 years of follow-up, of the 1771 participants, 204 SKD events occurred. After adjustment for demographic, clinical characteristics, and mean BP during 30 years, higher SDSBP, ARVSBP, SDDBP, ARVDBP, SDMAP, ARVMAP, and ARVPP were significantly associated with higher risk of SKD. When we used cumulative exposure to BP from childhood to adulthood instead of mean BP as adjustment factors, results were similar. In addition, greater long-term BPV was also associated with the risk of albuminuria. Long-term BPV from childhood to middle age was associated with higher risk of SKD and albuminuria in adulthood, independent of mean BP or cumulative exposure to BP during follow-up. Conclusions: Identifying long-term BPV from early age may assist in predicting kidney disease and cardiovascular disease in later life.
| Item Type: | Articles |
|---|---|
| Keywords: | Cardiovascular diseases, albuminuria, kidney, blood pressure, cohort studies. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Delles, Professor Christian |
| Authors: | Wang, Y., Zhao, P., Chu, C., Du, M.-F., Zhang, X.-Y., Zou, T., Hu, G.-L., Zhou, H.-W., Jia, H., Liao, Y.-Y., Chen, C., Ma, Q., Wang, D., Yan, Y., Sun, Y., Wang, K.-K., Niu, Z.-J., Zhang, X., Man, Z.-Y., Wu, Y.-X., Wang, L., Li, H.-X., Zhang, J., Li, C.-H., Gao, W.-H., Gao, K., Lu, W.-H., Desir, G. V., Delles, C., Chen, F.-Y., and Mu, J.-J. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
| Journal Name: | Hypertension |
| Publisher: | American Heart Association |
| ISSN: | 0194-911X |
| ISSN (Online): | 1524-4563 |
| Published Online: | 01 April 2022 |
| Copyright Holders: | Copyright © 2022 The Authors |
| First Published: | First published in Hypertension 79(6): 1247-1256 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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