Association between pulse pressure and cardiovascular disease in renal transplant patients.
Elevated pulse pressure in general population has been shown to be associated with cardiovascular disease, which is the main cause of death in renal transplant patients. We investigated the effect that a wider pulse pressure range may have on cardiovascular disease after renal transplantation in 532 transplant patients with functioning graft for more than 1 year. Patients were classified into two groups depending on 1-year pulse pressure (< or >/=65 mmHg) and we analyzed patient and graft survival, post-transplant cardiovascular disease and main causes of death. Higher pulse pressure was associated with older recipient age (40.8 +/- 10.8 vs. 50 +/- 11.3), higher systolic blood pressure (132.7 +/- 16.1 vs. 164.5 +/- 16), lower blood diastolic pressure (84.5 +/- 11.6 vs. 84.4 +/- 11.2), higher prevalence of diabetes (12% vs. 23%) and total cardiovascular disease (20.9% vs. 33.6%). Five- and 10-year patient survivals were lower in the group with higher pulse pressure, being vascular disease the main cause of death in both groups. In a Cox regression model increased pulse pressure was associated with higher cardiovascular disease (RR = 1.73, 95% CI: 1.13-2.32 p < 0.01). In conclusion, pulse pressure was an independent risk factor for increased cardiovascular morbidity and mortality in renal transplant patients.
Fernández-Fresnedo
Gema
G
Nephrology Service, University Hospital Marqués de Valdecilla, Santander, Spain. nefffg@humv.es
Escallada
Rafael
R
Martin de Francisco
Angel Luis
AL
Ruiz
Juan Carlos
JC
Rodrigo
Emilio
E
Sanz de Castro
Saturnino
S
González Cotorruelo
Julio
J
Arias
Manuel
M
D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged