Abstract
Background High prevalence of masked hypertension as well as persistent hypertension was observed in the Chronic Kidney Disease Japan Cohort (CKD-JAC) study. We proposed a novel indicator of blood pressure (BP) load, hyperbaric area index (HBI), calculated from ambulatory blood pressure monitoring (ABPM) data. The characteristic of this index and its relationship with kidney function were also evaluated.MethodsThe CKD-JAC study, enrolled 2,977 patients, is a prospective observational study started in September 2007. ABPM was conducted in a sub-group from September 2007 to April 2010 and baseline ABPM data of 1,075 subjects (63.4 % male, 60.7 years old) were analyzed.ResultsMean systolic HBI of male and female patients were 242.3 and 176.5 mmHg×h, respectively. HBI sensitively reflected sex (54.7 mmHg×h higher in males than in females), seasonal effects (51.6 mmHg×h higher in winter than in summer), and advancing CKD stage [(16.5 mmHg×h higher) per −10 mL/min/1.73 m2 in eGFR]. The HBI was a significant factor to associate with reduced kidney function, after adjusting with nocturnal BP change (NBPC), sex, and other variables (p value <0.001).ConclusionsOur findings suggested that HBI might be a novel sensitive indicator for the reduction of kidney function, independent of patterns of NBPC.
Highlights
Blood pressure (BP) is one of the most important risk factors for cardiovascular diseases (CVDs)
We proposed a novel indicator of blood pressure (BP) load, hyperbaric area index (HBI), calculated from ambulatory blood pressure monitoring (ABPM) data
The HBI was a significant factor to associate with reduced kidney function, after adjusting with nocturnal BP change (NBPC), sex, and other variables (p value \0.001)
Summary
Blood pressure (BP) is one of the most important risk factors for cardiovascular diseases (CVDs). Ambulatory blood pressure monitoring (ABPM) has come to be used as a powerful medical examination device since late 80s, and various indicators calculated from ABPM data have been reported as novel predictive factors for several organ injuries [4,5,6,7]. HBI lacks clear definitions, such as, on which value the boundary line for hypertension is set up In recent years, this index has been examined in a few studies targeting several diseases, such as hypertension [10] and diabetes complication [11]. We proposed a novel indicator of blood pressure (BP) load, hyperbaric area index (HBI), calculated from ambulatory blood pressure monitoring (ABPM) data. The characteristic of this index and its relationship with kidney function were evaluated. 10 % of the subjects had not been prescribed even one antihypertensive drug
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