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  • Boggia, Jose (author)

Risk Stratification by 24-Hour Ambulatory Blood Pressure and Estimated Glomerular Filtration Rate in 5322 Subjects From 11 Populations

  • Article/chapterEnglish2013

Publisher, publication year, extent ...

  • 2013
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-192439
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-192439URI
  • https://doi.org/10.1161/HYPERTENSIONAHA.112.197376DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • No previous study addressed whether in the general population estimated glomerular filtration rate (eGFR [Chronic Kidney Disease Epidemiology Collaboration formula]) adds to the prediction of cardiovascular outcome over and beyond ambulatory blood pressure. We recorded health outcomes in 5322 subjects (median age, 51.8 years; 43.1% women) randomly recruited from 11 populations, who had baseline measurements of 24-hour ambulatory blood pressure (ABP(24)) and eGFR. We computed hazard ratios using multivariable-adjusted Cox regression. Median follow-up was 9.3 years. In fully adjusted models, which included both ABP(24) and eGFR, ABP(24) predicted (P <= 0.008) both total (513 deaths) and cardiovascular (206) mortality; eGFR only predicted cardiovascular mortality (P=0.012). Furthermore, ABP(24) predicted (P <= 0.0056) fatal combined with nonfatal events as a result of all cardiovascular causes (555 events), cardiac disease (335 events), or stroke (218 events), whereas eGFR only predicted the composite cardiovascular end point and stroke (P <= 0.035). The interaction terms between ABP(24) and eGFR were all nonsignificant (P >= 0.082). For cardiovascular mortality, the composite cardiovascular end point, and stroke, ABP(24) added 0.35%, 1.17%, and 1.00% to the risk already explained by cohort, sex, age, body mass index, smoking and drinking, previous cardiovascular disease, diabetes mellitus, and antihypertensive drug treatment. Adding eGFR explained an additional 0.13%, 0.09%, and 0.14%, respectively. Sensitivity analyses stratified for ethnicity, sex, and the presence of hypertension or chronic kidney disease (eGFR <60mL/min per 1.73 m(2)) were confirmatory. In conclusion, in the general population, eGFR predicts fewer end points than ABP(24). Relative to ABP(24), eGFR is as an additive, not a multiplicative, risk factor and refines risk stratification 2-to14-fold less.

Subject headings and genre

  • ambulatory blood pressure
  • population science
  • renal function
  • cardiovascular risk factors
  • epidemiology

Added entries (persons, corporate bodies, meetings, titles ...)

  • Thijs, Lutgarde (author)
  • Li, Yan (author)
  • Hansen, Tine W. (author)
  • Kikuya, Masahiro (author)
  • Bjorklund-Bodegard, KristinaUppsala universitet,Geriatrik(Swepub:uu)krisbjor (author)
  • Ohkubo, Takayoshi (author)
  • Jeppesen, Jorgen (author)
  • Torp-Pedersen, Christian (author)
  • Dolan, Eamon (author)
  • Kuznetsova, Tatiana (author)
  • Stolarz-Skrzypek, Katarzyna (author)
  • Tikhonoff, Valerie (author)
  • Malyutina, Sofia (author)
  • Casiglia, Edoardo (author)
  • Nikitin, Yuri (author)
  • Lind, LarsUppsala universitet,Kardiovaskulär epidemiologi(Swepub:uu)larslind (author)
  • Schwedt, Emma (author)
  • Sandoya, Edgardo (author)
  • Kawecka-Jaszcz, Kalina (author)
  • Filipovsky, Jan (author)
  • Imai, Yutaka (author)
  • Wang, Jiguang (author)
  • Ibsen, Hans (author)
  • O'Brien, Eoin (author)
  • Staessen, Jan A. (author)
  • Uppsala universitetGeriatrik (creator_code:org_t)

Related titles

  • In:Hypertension61:1, s. 18-+0194-911X1524-4563

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