High Systolic BP Tied to Declining Renal Function

Posted by: admin on: February 27, 2012

High Systolic Pressure in elderly population should be not be ignored says a new study. Read on to know why.


PHILADELPHIA — A rise in systolic blood pressure is associated with greater odds of a rapid decline in kidney function in the general older population, researchers found.

Among men and women 65 and older, those with the highest systolic blood pressure — 160 mm Hg or greater — had about double the chances of their renal function worsening at a fast clip  according to Dena Rifkin, MD, of the University of California San Diego. The relationship was independent of either diastolic blood pressure or pulse pressure, The findings are consistent with a previous study looking at the placebo arm of the SHEP (Systolic Hypertension in the Elderly Program) trial, which included individuals 60 and older who had systolic hypertension.

She and her colleagues examined data on 4,365 older adults (mean age 72) enrolled in the Cardiovascular Health Study, which recruited men and women from four U.S. communities. Each participant was assessed at baseline, at three years, and at seven years.

The mean estimated glomerular filtration rate at baseline — calculated using cystatin C measurements — was 80 mL/min/1.73 m2. A rapid decline in kidney function was defined as a drop of at least 3 mL/min/1.73 m2 per year. Overall, 25% of the participants met that threshold.

Baseline systolic blood pressure readings ranged from less than 120 mm Hg up to 160 mm Hg and higher.

Moving from the lowest to the highest pressure groups, there was an increase in the odds of having a rapid kidney function decline for systolic, diastolic, and pulse pressure.

However, after putting all three pressure readings together in a single multivariate model, the relationships between the odds of a rapid kidney function decline and both diastolic and pulse pressure disappeared. Only systolic blood pressure remained strongly associated with a greater likelihood of a rapid decline.

The use of antihypertensives did not affect the association.

Although the study did not examine outcomes such as a progression to end-stage renal disease, death, or major adverse cardiovascular events, Rifkin said that a previous analysis by her group showed that a rapid decline in kidney function is associated with an increased risk of poor clinical outcomes.

Ref: http://www.medpagetoday.com/MeetingCoverage/ASN/29628?utm_source=WC&utm_medium=email&utm_campaign=Meeting_Roundup_ASN

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