title: Noninvasive Central Systolic Blood Pressure Is More Strongly Related to Kidney Function Decline Than Peripheral Systolic Blood Pressure in a Chinese Community-Based Population.
abstract: This study aimed to investigate the association of noninvasive central aortic blood pressure with kidney function decline in a Chinese community-based population with normal kidney function at baseline. A total of 3153 Chinese participants from an atherosclerosis cohort were included in our analysis. The primary outcome was renal function decline defined as a drop in estimated glomerular filtration rate (eGFR) category accompanied by a ≥25% drop in eGFR from baseline; or a sustained decline in eGFR of >5 mL/min per 1.73 m(2)/y. The secondary outcomes were rapid eGFR decline (a decline in eGFR of >3 mL/min per 1.73 m(2)/y) and new incidence of chronic kidney disease. Participants were 56.6±8.5 years old, 36.0% were males, and 48.8% had hypertension. Mean (SD) baseline eGFR was 101.2±10.6 mL/min per 1.73 m(2) After a mean 2.35-year follow-up, the incidence of renal function decline, rapid eGFR decline and chronic kidney disease were 7.3%, 19.7%, and 0.7%, respectively. In multivariate logistic-regression analyses, central and peripheral systolic blood pressure (SBP) were both independently associated with all outcomes after adjustment for various confounders. When peripheral SBP was forced into the model with central SBP simultaneously, its significant association with the 3 outcomes all disappeared; however, central SBP was still significantly related with all outcomes even after further adjusting peripheral SBP. In conclusion, central SBP is a stronger predictor compared with peripheral SBP for early kidney function decline in a Chinese community-based population with normal kidney function at baseline.
authors.affiliation: From the Departments of Cardiology (F.F., L.Q., J.J., Y.Y., J.L., Y.Z., Y.H.) and Clinical Laboratory (H.L.), Peking University First Hospital, Beijing, China; State Key Laboratory for Organ Failure Research, Renal Division, National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.X., X.Q.); and Department of Emergency, Tsinghua University, YuQuan Hospital, Beijing, China (Y.L.).
authors.forename: Fangfang
authors.initials: F
authors.lastname: Fan
authors.affiliation: From the Departments of Cardiology (F.F., L.Q., J.J., Y.Y., J.L., Y.Z., Y.H.) and Clinical Laboratory (H.L.), Peking University First Hospital, Beijing, China; State Key Laboratory for Organ Failure Research, Renal Division, National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.X., X.Q.); and Department of Emergency, Tsinghua University, YuQuan Hospital, Beijing, China (Y.L.).
authors.forename: Litong
authors.initials: L
authors.lastname: Qi
authors.affiliation: From the Departments of Cardiology (F.F., L.Q., J.J., Y.Y., J.L., Y.Z., Y.H.) and Clinical Laboratory (H.L.), Peking University First Hospital, Beijing, China; State Key Laboratory for Organ Failure Research, Renal Division, National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.X., X.Q.); and Department of Emergency, Tsinghua University, YuQuan Hospital, Beijing, China (Y.L.).
authors.forename: Jia
authors.initials: J
authors.lastname: Jia
authors.affiliation: From the Departments of Cardiology (F.F., L.Q., J.J., Y.Y., J.L., Y.Z., Y.H.) and Clinical Laboratory (H.L.), Peking University First Hospital, Beijing, China; State Key Laboratory for Organ Failure Research, Renal Division, National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.X., X.Q.); and Department of Emergency, Tsinghua University, YuQuan Hospital, Beijing, China (Y.L.).
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.affiliation: From the Departments of Cardiology (F.F., L.Q., J.J., Y.Y., J.L., Y.Z., Y.H.) and Clinical Laboratory (H.L.), Peking University First Hospital, Beijing, China; State Key Laboratory for Organ Failure Research, Renal Division, National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.X., X.Q.); and Department of Emergency, Tsinghua University, YuQuan Hospital, Beijing, China (Y.L.).
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: From the Departments of Cardiology (F.F., L.Q., J.J., Y.Y., J.L., Y.Z., Y.H.) and Clinical Laboratory (H.L.), Peking University First Hospital, Beijing, China; State Key Laboratory for Organ Failure Research, Renal Division, National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.X., X.Q.); and Department of Emergency, Tsinghua University, YuQuan Hospital, Beijing, China (Y.L.).
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.affiliation: From the Departments of Cardiology (F.F., L.Q., J.J., Y.Y., J.L., Y.Z., Y.H.) and Clinical Laboratory (H.L.), Peking University First Hospital, Beijing, China; State Key Laboratory for Organ Failure Research, Renal Division, National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.X., X.Q.); and Department of Emergency, Tsinghua University, YuQuan Hospital, Beijing, China (Y.L.).
authors.forename: Xianhui
authors.initials: X
authors.lastname: Qin
authors.affiliation: From the Departments of Cardiology (F.F., L.Q., J.J., Y.Y., J.L., Y.Z., Y.H.) and Clinical Laboratory (H.L.), Peking University First Hospital, Beijing, China; State Key Laboratory for Organ Failure Research, Renal Division, National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.X., X.Q.); and Department of Emergency, Tsinghua University, YuQuan Hospital, Beijing, China (Y.L.).
authors.forename: Jianping
authors.initials: J
authors.lastname: Li
authors.affiliation: From the Departments of Cardiology (F.F., L.Q., J.J., Y.Y., J.L., Y.Z., Y.H.) and Clinical Laboratory (H.L.), Peking University First Hospital, Beijing, China; State Key Laboratory for Organ Failure Research, Renal Division, National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.X., X.Q.); and Department of Emergency, Tsinghua University, YuQuan Hospital, Beijing, China (Y.L.).
authors.forename: Haixia
authors.initials: H
authors.lastname: Li
authors.affiliation: From the Departments of Cardiology (F.F., L.Q., J.J., Y.Y., J.L., Y.Z., Y.H.) and Clinical Laboratory (H.L.), Peking University First Hospital, Beijing, China; State Key Laboratory for Organ Failure Research, Renal Division, National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.X., X.Q.); and Department of Emergency, Tsinghua University, YuQuan Hospital, Beijing, China (Y.L.). huoyong@263.net.cn drzhy1108@163.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: From the Departments of Cardiology (F.F., L.Q., J.J., Y.Y., J.L., Y.Z., Y.H.) and Clinical Laboratory (H.L.), Peking University First Hospital, Beijing, China; State Key Laboratory for Organ Failure Research, Renal Division, National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.X., X.Q.); and Department of Emergency, Tsinghua University, YuQuan Hospital, Beijing, China (Y.L.). huoyong@263.net.cn drzhy1108@163.com.
authors.forename: Yong
authors.initials: Y
authors.lastname: Huo
mesh_terms: D000328:Adult; D017677:Age Distribution; D000704:Analysis of Variance; D044466:Asian People / Q000706:statistics & numerical data; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination; D002681:China; D015897:Comorbidity; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000503:physiopathology*; D018570:Risk Assessment; D017678:Sex Distribution; D015996:Survival Rate; D013599:Systole / Q000502:physiology*
keywords: atherosclerosis; blood pressure; glomerular filtration rate; hypertension incidence