Effect of age and isolated systolic or diastolic hypertension on target organ damage in non-dialysis patients with chronic kidney disease.
Effect of age and isolated systolic or diastolic hypertension on target organ damage in non-dialysis patients with chronic kidney disease.
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DOI：
10.18632/aging.202609
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发表时间：
2021-02-22
期刊：
影响因子：
--
通讯作者：
Wang C
中科院分区：
文献类型：
--
作者：
Hao Y;Li X;Zhu Y;Ke J;Lou T;Li M;Wang C
本研究的目的是探讨年龄依赖性的单纯收缩期/舒张期高血压（ISH/IDH）与慢性肾脏病（CKD）靶器官损害之间的关系。在2，459例CKD患者中进行了一项横断面研究，并进行了动态血压监测。血压分为四组：正常血压，ISH，IDH和收缩-舒张期高血压。结果测量为左心室质量指数（LVMI），估计肾小球滤过率（eGFR）和尿白蛋白肌酐比值（ACR）。老年患者（≥60岁）ISH患病率高于年轻患者（<60岁），IDH患病率低于年轻患者。在多变量分析中，与血压正常组相比，年轻的ISH患者与较高的LVMI（+14.4 g/m2）、较低的eGFR（-0.2 log单位）和较高的ACR（+0.5 log单位）相关;但年轻的IDH患者仅与较低的eGFR（-0.2 log单位）和较高的ACR（+0.4 log单位）相关。在老年患者中，ISH与较高的LVMI（+8.8 g/m2）、较低的eGFR（-0.2 log单位）和较高的ACR（+1.0 log单位）相关，而IDH与这些肾脏/心血管参数无关。总之，ISH与靶器官损伤的相对高风险相关，与年龄无关，而IDH仅与年轻CKD患者的肾损伤相关。
The aim of this study was to investigate associations between age-dependent variations in isolated systolic/diastolic hypertension (ISH/IDH) with target organ damage in chronic kidney disease (CKD). A cross-sectional study was conducted among 2,459 CKD patients with ambulatory blood pressure monitoring. Blood pressure was categorized into four groups: normotension, ISH, IDH, and systolic-diastolic hypertension. The outcome measurements were left ventricular mass index (LVMI), estimated glomerular filtration rate(eGFR), and urinary albumin creatinine ratio (ACR). Older patients (≥60-years-old) had a higher prevalence of ISH and a lower prevalence of IDH than younger patients (<60-years-old). In multivariate analysis, compared with the normotension group, younger patients with ISH were associated with higher LVMI (+14.4 g/m2), lower eGFR (−0.2 log units), and higher ACR (+0.5 log units); but younger patients with IDH were only associated with lower eGFR (−0.2 log units) and higher ACR (+0.4 log units). Among older patients, ISH was correlated with higher LVMI (+8.8 g/m2), lower eGFR (−0.2 log units), and higher ACR (+1.0 log units), whereas IDH was not associated with these renal/cardiovascular parameters. In conclusion, ISH was associated with a relatively high risk of target organ damage irrespective of age, whereas IDH was only correlated with renal injury in younger CKD patients.
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