title: Influence of Kidney Function on Blood Pressure Response to Lifestyle Modifications: Secondary Analysis From the Exercise and Nutritional Interventions for Cardiovascular Health (ENCORE) Trial.
abstract: The kidney is an important regulator of blood pressure (BP). To determine whether BP response to lifestyle modification varies across normal ranges of kidney function, the authors examined the moderating role of estimated glomerular filtration rate (eGFR) on clinic and ambulatory systolic BP (SBP) response in overweight and obese adults with unmedicated high BP. Among 144 participants of the Exercise and Nutritional Interventions for Cardiovascular Health (ENCORE) trial, mean age was 52.0±9.6 years and median eGFR was 89.1 (53-146) mL/min/1.73m2. After multivariable regression, the interaction between eGFR and weight loss was significant for clinic (P=.023) and ambulatory SBP (P=.041). Similarly, the interaction between eGFR and improved fitness was significant for clinic (P=.041) and ambulatory SBP (P=.044). The relationship between reduced dietary sodium and SBP was not moderated by eGFR. SBP findings were inconsistent for adherence to the Dietary Approaches to Stop Hypertension (DASH) diet. These findings suggest that the effects of lifestyle modifications on SBP may be influenced by eGFR, even when kidney function is preserved.
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, NC.
authors.forename: Crystal C
authors.initials: CC
authors.lastname: Tyson
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Smith
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
authors.forename: Andrew
authors.initials: A
authors.lastname: Sherwood
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Mabe
authors.affiliation: Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Alan L
authors.initials: AL
authors.lastname: Hinderliter
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
authors.forename: James A
authors.initials: JA
authors.lastname: Blumenthal
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D004039:Diet, Sodium-Restricted / Q000379:methods*; D005260:Female; D005919:Glomerular Filtration Rate; D000070497:Healthy Lifestyle; D006801:Humans; D007668:Kidney / Q000502:physiology*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D050177:Overweight / Q000628:therapy*; D064797:Physical Conditioning, Human / Q000379:methods*; D061217:Weight Reduction Programs