Stricter systolic blood pressure control is associated with higher all-cause mortality in patients with chronic kidney disease.
Stricter systolic blood pressure control is associated with higher all-cause mortality in patients with chronic kidney disease.
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DOI：
10.1136/ebmed-2014-110111
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发表时间：
2015-04
期刊：
影响因子：
--
通讯作者：
Bansal N
中科院分区：
文献类型：
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作者：
Bansal N
方法：这是一项回顾性队列研究，研究对象为患有慢性肾脏病且收缩期高血压未得到控制的美国退伍军人。未控制的收缩期高血压定义为SBP≥ 130 mm Hg和/或使用降压药物。所有血压测量值均来自临床实践。随访患者直至主要结局为全因死亡或研究期结束。中位随访时间为6.0年。为了模拟改善血压控制的治疗干预，根据随访期间记录的SBP对患者进行分类，在至少50%的随访中达到SBP< 120或120-139 mm Hg。为了解释基线临床特征差异相对于后续SBP可能导致的偏倚，生成SBP< 120 vs 120-139 mm Hg可能性的倾向评分。
MethodsThis was a retrospective cohort study of US veterans with CKD with uncontrolled systolic hypertension. Uncontrolled systolic hypertension was defined as SBP≥ 130 mm Hg and/or use of antihypertensive medications. All blood pressure measurements were obtained from clinical practice. Patients were followed until the primary outcome of all-cause mortality or end of study period. Median follow-up time was 6.0 years. To model therapeutic interventions resulting in improved blood pressure control, patients were categorised on the basis of SBP recorded during their follow-up visits, either achieving SBP< 120 or 120–139 mm Hg on at least 50% of all follow-up visits. To account for possible bias caused by differences in baseline clinical characteristics in reference to subsequent SBP, propensity scores for the likelihood of SBP< 120 vs 120–139 mm Hg were generated.