Journal article
Long-Term Blood Pressure Variability and Kidney Function in Participants of the ASPREE Trial
American journal of hypertension, Vol.35(2), pp.173-181
02/01/2022
DOI: 10.1093/ajh/hpab143
PMCID: PMC8807162
PMID: 34519331
Abstract
Abstract
Background
Whether long-term blood pressure variability (BPV) predicts kidney function decline in generally healthy older adults is unknown. We investigated this association in ASPirin in Reducing Events in the Elderly (ASPREE) trial participants.
Methods
Between 2010 and 2014, Australian and US individuals aged ≥70 years (≥65 if US minority) were recruited and followed with annual study visits for a median of 4.7 years. Time-to-event analyses and linear mixed effects models were used to examine associations between incident chronic kidney disease (CKD), and trajectories of estimated glomerular filtration rate (eGFR) and log albumin–creatinine ratio (log ACR) with systolic BPV as a continuous measure, and, by tertile of SD of systolic blood pressure (BP). BPV was estimated using systolic BP measures from baseline through the second annual visit, and kidney outcomes were assessed following this period.
Results
Incident CKD occurred in 1,829 of 6,759 participants (27.2%), and more commonly in BPV tertiles 2 (27.4%) and 3 (28.3%) than tertile 1 (25.5%); however, the risk was not significantly increased after covariate adjustment (tertile 3 hazard ratio = 1.02; 95% confidence interval: 0.91–1.14). Analysis of eGFR (n = 16,193) and log ACR trajectories (n = 15,213) showed individuals in the highest BPV tertile having the lowest eGFR and highest log ACR, cross-sectionally. However, the trajectories of eGFR and log ACR did not differ across BPV tertiles.
Conclusions
CKD and markers of reduced kidney function occur more commonly in individuals with higher BPV; however, BPV does not influence trajectory of decline in kidney function over time in older adults who are in generally good health.
Clinical trials registration
Trial Number NCT01038583 and ISRCTN83772183.
Graphical Abstract
Graphical Abstract
Details
- Title: Subtitle
- Long-Term Blood Pressure Variability and Kidney Function in Participants of the ASPREE Trial
- Creators
- Michael E Ernst - University of IowaMichelle A Fravel - University of IowaKatherine L Webb - Monash UniversityJames B Wetmore - Hennepin Healthcare Research InstituteRory Wolfe - Monash UniversityEnayet Chowdhury - Curtin UniversityChristopher M Reid - Monash UniversityRobyn L Woods - Monash UniversityLawrence Beilin - Royal Perth HospitalKaren L Margolis - HealthPartnersAnne M Murray - Berman Center for Outcomes and Clinical ResearchKevan R Polkinghorne - Monash UniversityASPirin in Reducing Events in the Elderly (ASPREE) Investigator Group
- Resource Type
- Journal article
- Publication Details
- American journal of hypertension, Vol.35(2), pp.173-181
- DOI
- 10.1093/ajh/hpab143
- PMID
- 34519331
- PMCID
- PMC8807162
- NLM abbreviation
- Am J Hypertens
- ISSN
- 0895-7061
- eISSN
- 1879-1905
- Publisher
- Oxford University Press
- Grant note
- DOI: 10.13039/100000049, name: National Institute on Aging, award: U01AG029824, U19AG062682; DOI: 10.13039/100000054, name: National Cancer Institute; DOI: 10.13039/100000002, name: National Institutes of Health, award: 334047, 1127060; name: National Health and Medical Research Council of Australia; DOI: 10.13039/501100001779, name: Monash University; DOI: 10.13039/100008018, name: Victorian Cancer Agency
- Language
- English
- Date published
- 02/01/2022
- Academic Unit
- Family and Community Medicine; Pharmacy Practice and Science
- Record Identifier
- 9984297336502771
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