Relationship between blood pressure variability and different renal function impairment stages in elderly hypertension patients / 中华老年医学杂志

ABSTRACT

Objective To observe the change of blood pressure variability (BPV)in elderly hypertension patients,and to analysis the correlation between BPV and stages of renal function damage.Methods 127 elderly primary hypertensive patients with chronic kidney disease(CKD) were divided into three groupsstage 2 CKD group (aged 60-90 years,n=50),stage 3 CKD group (aged 62-93 years,n=40) and stage 4 CKD group (aged 64-94 years,n=37),according to National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (K/DOQI) guide.24 h ambulatory blood pressure monitoring (24 hABPM) was used to measure 24 h mean systolic blood pressure (24 hSBP),24 hSBP standard deviation (24 hSBPSD),and to calculate 24 hSBP coefficient of variation (24 hSBPCV).Differences in above indicators among groups were analyzed by ANOVA.The relationship between above indicators and estimated glomerular filtration rate (eGFR),urinary albumin excretion rates(UAER) were assessed by Spearman rank correlation coefficient.Logistic regression analysis was employed to assess the relationship between BPV and the degrees of impaired renal function.Results 24 h SBPSD and 24h SBPCV were lower in stage 2 CKD group than in stage 3 CKD and stage 4 CKD groups [(11.91±2.56) vs.(13.98±2.89),(14.25±3.16);(9.79±2.01)vs.(11.28± 1.70),(11.53±2.65) ;all P＜0.05].24 h SBPSD,24 h DBPCV and 24 h diastolic blood pressure (24 hdBP) CV were negatively correlated with eGFR (all P＜0.01) and were positively correlated with UAER (all P＜0.01).Logistic regression analysis showed that 24 h DBPSD and 24h SBPCV were related to impaired renal function (both P＜0.05).Conclusions Blood pressure variability is increasing along with impairing renal function in elderly hypertensive patients.Blood pressure variability is associated with renal function damage.