Optimal blood pressure for patients with chronic kidney disease: a nationwide population-based cohort study

• Published in: Scientific reports Vol. 11; no. 1; p. 1538
• Main Authors: Lee, You-Bin, Lee, Ji Sung, Hong, So-Hyeon, Kim, Jung A, Roh, Eun, Yoo, Hye Jin, Baik, Sei Hyun, Choi, Kyung Mook
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 15.01.2021; Nature Publishing Group UK; Nature Portfolio
• Subjects: Aged; Antihypertensive Agents - therapeutic use; Antihypertensives; Blood pressure; Blood Pressure - drug effects; Blood Pressure - physiology; Cardiovascular diseases; Cardiovascular Diseases - mortality; Cohort analysis; Cohort Studies; Diastole - drug effects; End-stage renal disease; Female; Glomerular Filtration Rate; Health hazards; Humans; Hypertension; Hypertension - physiopathology; Kidney diseases; Kidney Failure, Chronic - complications; Kidneys; Male; Medical screening; Middle Aged; Population studies; Population-based studies; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - mortality; Renal Insufficiency, Chronic - physiopathology; Republic of Korea - epidemiology; Risk Factors; Systole - drug effects; Republic of Korea
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-81328-y

The effect of blood pressure (BP) on the incident cardiovascular events, progression to end-stage renal disease (ESRD) and mortality were evaluated among chronic kidney disease (CKD) patients with and without antihypertensive treatment. This nationwide study used the Korean National Health Insurance Service-Health Screening Cohort data. The hazards of outcomes were analysed according to the systolic BP (SBP) or diastolic BP (DBP) among adults (aged ≥ 40 years) with CKD and without previous cardiovascular disease or ESRD (n = 22,278). The SBP and DBP were ≥ 130 mmHg and ≥ 80 mmHg in 10,809 (48.52%) and 11,583 (51.99%) participants, respectively. During a median 6.2 years, 1271 cardiovascular events, 201 ESRD incidents, and 1061 deaths were noted. Individuals with SBP ≥ 130 mmHg and DBP ≥ 80 mmHg had higher hazards of hypertension-related adverse outcomes compared to the references (SBP 120-129 mmHg and DBP 70-79 mmHg). SBP < 100 mmHg was associated with hazards of all-cause death, and composite of ESRD and all-cause death during follow-up only among the antihypertensive medication users suggesting that the BP should be < 130/80 mmHg and the SBP should not be < 100 mmHg with antihypertensive agents to prevent the adverse outcome risk of insufficient and excessive antihypertensive treatment in CKD patients.