title: Systolic blood pressure values might further risk-stratify the adverse outcomes of LVH in older patients with chronic kidney disease.
abstract: BACKGROUND
  LVH is highly prevalent in patients with CKD and is independently associated with subsequent cardiovascular events. We hypothesized that adding systolic blood pressure values to LVH might differentiate different subgroups of patients at higher risk of cardiovascular events (CVE) and other adverse outcomes.
  
  
  METHODS
  Retrospective cohort study of 243 patients older than 60 years with stages 1-5 pre-dialysis CKD. LVH was assessed by electrocardiogram or echocardiogram.
  
  
  RESULTS
  Cardiovascular events occurred in 7 patients (10.3%) among those with SBP <130 and no LVH, 8 patients (10.5%) among those with SBP ≥130 and no LVH, 7 patients (21.2%) among those with SBP <130 and LVH and 25 patients (37.9%) among those with SBP ≥ 130 and LVH. On multivariate analyses, comparing to SBP < 130 and no LVH, the HR for CVE in those with SBP ≥ 130 and LVH was 4 (1.75, 10.3),p= 0.0007; 2.13 (0.71, 6.32)p= 0.16 in those with SBP <130 and LVH and 1.20 (0.42, 3.51)p= 0.72 in those with SBP ≥130 and no LVH. No significant differences were noted in changes in renal function and mortality rates among the groups.
  
  
  CONCLUSIONS
  The combination of higher systolic blood pressure and LVH might identify older patients with CKD at higher risk of cardiovascular outcomes.
authors.affiliation: Nephrology Department, Affiliated Community Medical Centers, Rice Memorial Hospital, 101 Willmar 274 Ave SW., Willmar, MN 56201 USA.
authors.forename: Carlos R
authors.initials: CR
authors.lastname: Franco Palacios
authors.affiliation: Hospital Medicine Department, Affiliated Community Medical Centers. Rice Memorial Hospital, Willmar, MN USA.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Goyal
authors.affiliation: Pharmacy Department, Rice Memorial Hospital, Willmar, MN USA.
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Thompson
authors.affiliation: University of Oklahoma, Cardiac Catheterization Laboratory, Oklahoma, USA.
authors.forename: Brent
authors.initials: B
authors.lastname: Deschaine
keywords: Cardiovascular disease; Chronic kidney disease; Elderly; Hypertension; LVH; Outcomes