title: The clinical association of the blood pressure variability with the target organ damage in hypertensive patients with chronic kidney disease.
abstract: It is known that blood pressure variability (BPV) can independently affect target organ damage (TOD), even with normal blood pressure. There have been few studieson chronic kidney disease (CKD) patients. We evaluated the relationship between BPV and TOD in a cross-sectional, multicenter study on hypertensive CKD patients. We evaluated 1,173 patients using 24-hr ambulatory blood pressure monitoring. BPV was defined as the average real variability, with a mean value of the absolute differences between consecutive readings of systolic blood pressure. TOD was defined as left ventricular hypertrophy (LVH) (by the Romhilt-Estes score ≥4 in electrocardiography) and kidney injury (as determined from an estimated glomerular filtration rate [eGFR]<30 mL/min/1.73 m(2) and proteinuria).The mean BPV of the subjects was 15.9±4.63 mmHg. BPV displayed a positive relationship with LVH in a univariate analysis and after adjustment for multi-variables (odds ratio per 1 mmHg increase in BPV: 1.053, P=0.006). In contrast, BPV had no relationship with kidney injury. These data suggest that BPV may be positively associated with LVH in hypertensive CKD patients.
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jiwon
authors.identifier: 0000-0003-0251-7858
authors.initials: J
authors.lastname: Ryu
authors.affiliation: Department of Internal Medicine, National Medical Center, Seoul, Korea.
authors.forename: Ran-Hui
authors.identifier: 0000-0003-2783-2600
authors.initials: RH
authors.lastname: Cha
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Dong Ki
authors.identifier: 0000-0002-5195-7852
authors.initials: DK
authors.lastname: Kim
authors.affiliation: Medical Research Collaborating Center of Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Ju Hyun
authors.identifier: 0000-0001-5743-6751
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, The Catholic University of Korea College of Medicine, Uijeongbu, Korea.
authors.forename: Sun Ae
authors.identifier: 0000-0003-1175-8098
authors.initials: SA
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.
authors.forename: Dong Ryeol
authors.identifier: 0000-0002-5309-7606
authors.initials: DR
authors.lastname: Ryu
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Ji Eun
authors.identifier: 0000-0001-9429-9602
authors.initials: JE
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Sejoong
authors.identifier: 0000-0002-7238-9962
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Inje University College of Medicine, Ilsan, Korea.
authors.forename: Sang-Youb
authors.identifier: 0000-0003-3312-0597
authors.initials: SY
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Cheonan, Korea.
authors.forename: Eun Young
authors.identifier: 0000-0002-4513-9888
authors.initials: EY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Yon Su
authors.identifier: 0000-0003-3091-2388
authors.initials: YS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis*; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology*; D007668:Kidney / Q000293:injuries; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011507:Proteinuria / Q000150:complications; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000175:diagnosis*
keywords: Blood Pressure Variability; Hypertension; Hypertrophy, Left Ventricular; Kidney Failure, Chronic; Target Organ Damage