ASSOCIATION BETWEEN SYSTOLIC BLOOD PRESSURE AND CHANGE IN EGFR OVER TIME IN A MULTI-ETHNIC COHORT: THE HELIUS STUDY

Abstract

Objective: The assess the extent to which blood pressure relates to progression of CKD, among different ethnicities with disparate cardiorenal risk. We assessed the relationship between baseline systolic blood pressure (SBP) and change in renal function over time in a multi-ethnic population. Design and method: This analysis used baseline and follow-up data from 9 828 participants in the prospective Healthy Life in an Urban Setting (HELIUS) cohort study, a population-based study, including individuals of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan descent. Linear regression and interaction analysis were used to assess the association between baseline SBP and change in eGFR over time. Results: Overall eGFR decreased by -0.30 ml/min/1.73m2 (95%CI[-0.42, -0.19], p<0.001) per 10 mmHg increase in baseline SBP after 6.3 (SD 1.1) years of follow-up. This curve steepened from a SBP of 120 mmHg onwards to -0.44 ml/min/1.73m2 (95%CI[-0.61, -0.27], p<0.001) for every 10 mmHg increase in SBP. The association was significantly influenced by ethnicity (p<0.001), diabetes (p = 0.003) and albuminuria (p = 0.002), but not by age or sex. Individuals with albuminuria or diabetes had a more than 3 times larger SBP related eGFR decline compared to those without diabetes or albuminuria. Dutch, African Surinamese and Moroccan participants had a slightly steeper eGFR decline, but the direction of effect was consistent across all subgroups. Conclusions: Our findings confirm the relation between SBP and eGFR over time in different ethnic groups, steepening from a SBP of 120 mmHg onwards and may help to further guide strategies for preventing hypertension related CKD.