title: Interarm systolic blood pressure as a predictor of cardiovascular events in patients with chronic kidney disease.
abstract: BACKGROUND
  Increased interarm systolic blood pressure difference (IASBPD) is associated with mortality and cardiovascular (CV) events both in the general population and in patients at high CV risk. The aim of the present study was to assess the value of IASBPD ≥ 10 mmHg for predicting CV events in patients with chronic kidney disease (CKD).
  
  
  METHODS
  The study sample comprised 652 patients with CKD (age 67 ± 15 years, 58.1% men). Follow-up was 19 ± 5 months. We recorded increased IASBPD and related factors and assessed the predictive value of this variable for CV events.
  
  
  RESULTS
  We recorded diabetes mellitus in 136 patients (20.8%), history of CV disease in 213 (32.6%) and dyslipidaemia in 327 (50.1%). The mean glomerular filtration rate was 45.9 ± 18.9 mL/min/1.73 m(2), and the median albumin/creatinine ratio was 26(0-151) mg/g. IASBPD was ≥10 mmHg in 184 patients (28.1%). The factors associated with IASBPD ≥10 mmHg were age, systolic blood pressure levels, history of congestive heart failure, lower levels of high-density lipid cholesterol and higher use of hypertensive drugs. Fifty-eight patients (8.5%) developed a CV event during the follow-up. IASBPD ≥10 mmHg [HR, 1.802, 95%CI (1.054-3.079); P = 0.031] was an independent predictor of CV events.
  
  
  CONCLUSIONS
  Increased IASBPD is an independent predictor of CV events in CKD patients.
authors.affiliation: Nephrology Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Borja
authors.initials: B
authors.lastname: Quiroga
authors.affiliation: Nephrology Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Galán
authors.affiliation: Nephrology Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Soledad
authors.initials: S
authors.lastname: García de Vinuesa
authors.affiliation: Nephrology Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Marian
authors.initials: M
authors.lastname: Goicoechea
authors.affiliation: Nephrology Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Úrsula
authors.initials: Ú
authors.lastname: Verdalles
authors.affiliation: Nephrology Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Luño
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000737:chemistry; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D002318:Cardiovascular Diseases / Q000150:complications* / Q000175:diagnosis*; D008076:Cholesterol, HDL / Q000097:blood; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D013599:Systole / Q000502:physiology*
chemical_list: D000959:Antihypertensive Agents; D008076:Cholesterol, HDL
keywords: blood pressure; cardiovascular events; cardiovascular risk; chronic kidney disease; increased interarm systolic blood pressure difference