Time in Target Range of Systolic Blood Pressure and Cardiovascular Disease in Patients with Chronic Kidney Disease: A Korean Nationwide Cohort Study.

IF 4.3 3区医学 Q1 UROLOGY & NEPHROLOGY

American Journal of Nephrology Pub Date : 2025-05-19 DOI:10.1159/000546380

Soo-Young Yoon, Su Jin Jeong, Jin Sug Kim, Hyeon Seok Hwang, Kyunghwan Jeong

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引用次数: 0

Abstract

Introduction: Time in target range of systolic blood pressure (SBP-TTR) is the percentage of time that the SBP remains within 110-130 mm Hg. The association between the SBP-TTR and clinical outcomes in patients with chronic kidney disease (CKD) remains unclear. We evaluated the risks of cardiovascular disease (CVD), all-cause mortality, and renal events across the SBP-TTR groups.

Methods: Overall, 193,289 patients with CKD who underwent at least two health checkups between 2012 and 2015 were selected from the Korean National Health Insurance Database. The patients were categorized into three categories based on their SBP-TTR levels: 76-100%, 26-75%, and 0-25%. The primary outcome was CVD risk and the secondary outcomes were all-cause mortality and progression to end-stage kidney disease (ESKD) according to SBP-TTR using Cox regression analysis.

Results: Compared with patients with SBP-TTR of 76-100%, the adjusted hazard ratios (HRs) for CVD were 1.07 (95% confidence interval [CI], 1.03-1.10) and 1.09 (95% CI: 1.06-1.13) for patients with SBP-TTR of 26-75%, and 0-25%, respectively. The adjusted HR for all-cause mortality was 1.04 (95% CI: 1.003-1.07) and 1.37 (95% CI: 1.28-1.46) for patients with SBP-TTR of 26-75% and 0-25%, respectively. The adjusted HRs for ESKD progression increased gradually: 1.14-fold (95% CI: 1.07-1.21) for the SBP-TTR 26-75% group and 1.37-fold (95% CI: 1.28-1.46) for the SBP-TTR 0-25% group. For patients not taking antihypertensive medications, a lower SBP-TTR was associated with a higher risk of CVD events and ESKD progression than in those taking antihypertensive medications.

Conclusion: Among patients with CKD, those with a lower SBP-TTR had a higher risk of cardiovascular events, mortality, and progression to ESKD.

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慢性肾病患者收缩压目标范围内时间与心血管疾病：一项韩国全国性队列研究

收缩压目标范围内的时间（SBP- ttr）是指收缩压保持在110-130 mmHg范围内的时间百分比。SBP-TTR与慢性肾脏疾病（CKD）患者临床预后之间的关系尚不清楚。我们评估了SBP-TTR组的心血管疾病（CVD）、全因死亡率和肾脏事件的风险。方法：总体而言，从韩国国民健康保险数据库中选择了在2012年至2015年期间接受至少两次健康检查的193289例CKD患者。根据SBP-TTR水平将患者分为76-100%、26-75%和0-25%三类。根据SBP-TTR使用Cox回归分析，主要结局是CVD风险，次要结局是全因死亡率和进展到终末期肾脏疾病（ESKD）。结果：与SBP-TTR为76-100%的患者相比，SBP-TTR为26-75%和0-25%的CVD校正风险比（hr）分别为1.07（95%置信区间[CI]， 1.03-1.10）和1.09 （95% CI, 1.06-1.13）。对于SBP-TTR为26-75%和0-25%的患者，调整后的全因死亡率HR分别为1.04 （95% CI, 1.003-1.07）和1.37 （95% CI, 1.28-1.46）。ESKD进展的调整hr逐渐增加：SBP-TTR 26-75%组为1.14倍（95% CI, 1.07-1.21）， SBP-TTR 0-25%组为1.37倍（95% CI, 1.28-1.46）。对于未服用抗高血压药物的患者，较低的SBP-TTR与CVD事件和ESKD进展的风险高于服用抗高血压药物的患者。结论：在CKD患者中，SBP-TTR较低的患者心血管事件、死亡率和进展为ESKD的风险较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Nephrology 医学-泌尿学与肾脏学

CiteScore

7.50

自引率

2.40%

发文量

审稿时长

4-8 weeks

期刊介绍： The ''American Journal of Nephrology'' is a peer-reviewed journal that focuses on timely topics in both basic science and clinical research. Papers are divided into several sections, including: