Predictive significance of blood pressure values for the incidence of cardiovascular events in chronic hemodialysis patients.
We conducted a prospective study investigating the relationship between blood pressure values and the risk of cardiovascular disease in patients with end-stage renal diseases. Five hundred fifty-three patients on chronic hemodialysis were followed for 5 years, and the relationship between systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP) and pulse pressure (PP) and the incidence of death and cardiovascular events were evaluated. There were 85 cardiovascular and 88 non-cardiovascular deaths during the 5 years. Fatal and nonfatal cardiovascular events occurred in 205 patients. Factors such as old age, diabetes and electrocardiographic findings of left ventricular hypertrophy and arrhythmia were associated with a high incidence of cardiovascular events as well as the incidence of death. With regard to blood pressure values, only PP was significantly associated with the risk of death (p=0.003). Both SBP and PP showed a significant association with the incidence of cardiovascular events (p=0.004 and p<0.001). In other words, an increase in PP by 10 mmHg corresponded to a 22% increase in cardiovascular events, and a 10 mmHg SBP increase corresponded to a 10% increase in cardiovascular events. In conclusion, PP is a better predictor of death and cardiovascular events than other blood pressure values in chronic hemodialysis patients.
Ishimitsu
Toshihiko
T
Department of Hypertension and Cardiorenal Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan. isimitu@dokkyomed.ac.jp
Nakano
Nobuyuki
N
Sudo
Yasuyo
Y
Akashiba
Akira
A
Takahashi
Toshiaki
T
Ohta
Satoshi
S
Minami
Junichi
J
Matsuoka
Hiroaki
H
D000368:Aged; D001794:Blood Pressure; D005260:Female; D006331:Heart Diseases / Q000401:mortality*; D006801:Humans; D006973:Hypertension / Q000401:mortality*; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000401:mortality* / Q000706:statistics & numerical data; D012307:Risk Factors; D020521:Stroke / Q000401:mortality*