RELATIONSHIP BETWEEN LONG-TERM VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY AND CHRONIC KIDNEY DAMAGE

Abstract

Objective: To assess the age- and sex-specific association between long-term visit-to-visit blood pressure variability (BPV) throughout adulthood and the development of chronic kidney damage (CKD). Design and method: A total of 1277 participants aged over 18 years old enrolled in the China Health and Nutrition Survey from 1991 to 2009 were included in the analysis. Long-term visit-to-visit BPV was evaluated by BP during seven visits. Renal damage was evaluated by estimated glomerular filtration rate. Results: After the eighteen-year follow-up, there were 110 (8.6%) participants with CKD. Adjusted analyses showed that renal function changes differed according to BPV. After full adjustment for the clinical characteristics plus cumulative exposure to BP from visit 1 to visit 7, subjects with higher standard deviation (SD)SBP had a significantly higher risk of renal damage (OR [95% CIs] = 1.05 [1.01–1.09]), average real variability (ARV)SBP (OR[95% CIs] = 1.04 [1.00–1.08]) and maximum and minimum difference (MMD)SBP (OR[95% CIs] = 1.02 [1.00–1.03], all P<0.05). Similar trends existed in the relationship when adjusting for the clinical variables plus mean BP across 7 visits. Subjects in late adulthood with higher SDSBP, DBP, MAP, PP, ARVSBP, DBP, MAP, PP, and MMDSBP, DBP, MAP, PP had significantly higher risks of chronic renal damage ( all P<0.05). Only females with higher SDSBP, DBP, MAP, PP, ARVSBP, DBP, MAP, PP and MMDSBP, DBP, MAP, PP had significantly higher risks of renal damage. Conclusions: This study suggested that long-term visit-to-visit BPV plays a predictive role in the development of renal impairment, especially in females and in subjects in late adulthood. Such evidence may help to direct potential strategies for preventing renal damage.