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Yang L, Li J, Wei W, Pu Y, Zhang L, Cui T, Ma L, Wang B, Zhao Y, Fu P. Blood Pressure Variability and the Progression of Chronic Kidney Disease: a Systematic Review and Meta-Analysis. J Gen Intern Med 2023; 38:1272-1281. [PMID: 36650323 PMCID: PMC10110830 DOI: 10.1007/s11606-022-08001-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Blood pressure variability (BPV) is a risk factor for poor prognosis including cardiovascular events, chronic kidney disease, and mortality, independent of elevated BP. METHODS We searched PubMed/Medline, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to November 23, 2022. Cohort studies reporting the association between BPV and chronic kidney disease (CKD) progression were selected. Hazard ratios were pooled using a random-effects model. Meta-regression, subgroup analyses, and sensitivity analyses were conducted. RESULTS A total of 23 studies were included in this systematic review and meta-analysis. Increased BPV was associated with progression of CKD (HR: 1.21, 95% CI: 1.09-1.33) and incidence of ESRD (HR: 1.08, 95% CI: 1.08-1.30). Among the different BPV metrics, high variation independent of mean (VIM), coefficient of variation (CV), standard deviation (SD), and average real variability (ARV) were indicated as predictors of CKD progression. DISCUSSION Increased BPV was associated with CKD progression.
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Affiliation(s)
- Letian Yang
- Division of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China
| | - Jian Li
- West China School of Medicine, Sichuan University, Chengdu, 610041, China
| | - Wei Wei
- Division of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China
| | - Yajun Pu
- Division of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China
| | - Ling Zhang
- Division of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China
| | - Tianlei Cui
- Division of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China
| | - Liang Ma
- Division of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China
| | - Bo Wang
- Division of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China
| | - Yuliang Zhao
- Division of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China.
| | - Ping Fu
- Division of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China
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Wang T, Fan F, Gong Y, Gao L, Liu Z, Jia J, Liu M, Jiang Y, Zhang Y, Li J. Comparison of brachial-ankle pulse wave velocity and carotid-femoral pulse wave velocity in association with albuminuria in a community of Beijing: a cross-sectional study. J Hum Hypertens 2022; 37:412-418. [PMID: 35474137 DOI: 10.1038/s41371-022-00697-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 03/15/2022] [Accepted: 04/12/2022] [Indexed: 11/09/2022]
Abstract
This study was performed to investigate and compare the association of albuminuria with the brachial-ankle pulse wave velocity (baPWV) and carotid-femoral pulse wave velocity (cfPWV) in a community-based population in Beijing. Subjects were enrolled from a follow-up survey conducted in 2018 from an atherosclerosis cohort in Shijingshan district, Beijing, China. The baPWV and cfPWV were measured using a BP-203 RPE III arteriosclerosis detection device and PulsePen, respectively. Albuminuria was defined as a urinary albumin-creatinine ratio of ≥30 mg/g. A multivariate logistic regression model was used to evaluate the impacts of different PWV measurements on the prevalence of albuminuria. In total, 5605 subjects were included in the analyses. Their mean age was 62.22 ± 7.55 years, and the prevalence of albuminuria was 8.22%. In the multivariate logistic regression model adjusted for potential covariates, both baPWV (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.03-1.10; P < 0.001) and cfPWV (OR, 1.07; 95% CI, 1.01-1.14; P = 0.018) were significantly associated with albuminuria. Furthermore, when baPWV and cfPWV were entered into the logistic regression model simultaneously, only baPWV was significantly associated with albuminuria using either continuous value (OR, 1.05; 95% CI, 1.01-1.10; P = 0.007) or classified into quartiles (highest vs. lowest value group: OR, 1.55; 95% CI, 1.01-2.37; P for trend = 0.019). Both cfPWV and baPWV were positively associated with albuminuria, while baPWV had a stronger relationship than cfPWV. Thus, baPWV measurement could be considered for the purpose of community health screening.
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Affiliation(s)
- Ting Wang
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Fangfang Fan
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Yanjun Gong
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Lan Gao
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Zhihao Liu
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Jia Jia
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Mengyuan Liu
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Yimeng Jiang
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China. .,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China.
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China. .,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China.
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Sang DS, Zhang Q, Song D, Tao J, Wu SL, Li YJ. Association between brachial‐ankle pulse wave velocity and cardiovascular and cerebrovascular disease in different age groups. Clin Cardiol 2022; 45:315-323. [PMID: 35066888 PMCID: PMC8922528 DOI: 10.1002/clc.23777] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/30/2021] [Accepted: 01/03/2022] [Indexed: 11/05/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Da Sen Sang
- Department of Internal Medicine Hebei Medical University Shijiazhuang Hebei China
| | - Qi Zhang
- Department of Cardiology Baoding No. 1 Central Hospital Baoding Hebei China
| | - Da Song
- Department of Cardiology Baoding No. 1 Central Hospital Baoding Hebei China
| | - Jie Tao
- Department of Cardiology Baoding No. 1 Central Hospital Baoding Hebei China
| | - Shou Ling Wu
- Department of Cardiology Kailuan General Hospital Tangshan Hebei China
| | - Yong Jun Li
- Department of Internal Medicine Hebei Medical University Shijiazhuang Hebei China
- Department of Cardiology The Second Hospital of Hebei Medical University Shijiazhuang Hebei China
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