Visit‐to‐Visit Systolic Blood Pressure Variability Independently Predicts Cardiovascular Events in a Kidney Transplant Recipients' Cohort
Background The predictive role of blood pressure variability for all‐cause mortality and fatal and nonfatal cardiovascular events has been described in the general population and in patients with diabetes, independently of mean BP. Although systolic blood pressure variability has been proposed as an...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-08-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.034108 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850147533395853312 |
|---|---|
| author | Elisabetta Bussalino Daniela Picciotto Lucia Macciò Angelica Parodi Maria Teresa Gandolfo Francesca Viazzi |
| author_facet | Elisabetta Bussalino Daniela Picciotto Lucia Macciò Angelica Parodi Maria Teresa Gandolfo Francesca Viazzi |
| author_sort | Elisabetta Bussalino |
| collection | DOAJ |
| description | Background The predictive role of blood pressure variability for all‐cause mortality and fatal and nonfatal cardiovascular events has been described in the general population and in patients with diabetes, independently of mean BP. Although systolic blood pressure variability has been proposed as an informative measure for predicting clinical outcomes in patients with chronic kidney disease, its role in kidney transplant recipients is still debatable. Methods and Results We performed a retrospective, observational, monocentric analysis of all kidney transplant recipients in follow‐up at the outpatient Nephrology Clinic of San Martino Hospital from January 1, 2016 to December 31, 2016, who underwent kidney transplantation >12 months. The primary outcome was a fatal or nonfatal cardiovascular event (myocardial infarction, unstable angina, stroke, and hospitalization for heart failure). Visit‐to‐visit systolic blood pressure variability was expressed as the SD of systolic blood pressure values recorded at baseline and 3 months up to 18 months. Among the 272 patients (mean age, 64±13; 63% men) included in the present analyses, for each increase of 2.7 mm Hg in systolic blood pressure SD, the risk for events increased 3‐fold (hazard ratio [HR], 3.1 [95% CI, 1.19–7.88]; P=0.02), and patients in the highest tertile of systolic blood pressure SD showed a 4‐fold increased risk (HR, 4.1 [95% CI, 1.34–12.43]; P=0.01). This relationship was maintained even after incremental adjustment for time‐averaged pulse pressure, age, diabetes, and prior cardiovascular event (HR, 3.2 [95% CI, 1.1–10.0]; P=0.04). Conclusions Long‐term blood pressure variability represents a risk factor for cardiovascular events in kidney transplant recipients, even independently by several confounding factors including blood pressure load. |
| format | Article |
| id | doaj-art-c1e8957e2ef24d0ead3a68f2fed94f34 |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-c1e8957e2ef24d0ead3a68f2fed94f342025-08-20T02:27:32ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-08-01131510.1161/JAHA.124.034108Visit‐to‐Visit Systolic Blood Pressure Variability Independently Predicts Cardiovascular Events in a Kidney Transplant Recipients' CohortElisabetta Bussalino0Daniela Picciotto1Lucia Macciò2Angelica Parodi3Maria Teresa Gandolfo4Francesca Viazzi5Clinic of Nephrology, Dialysis and Transplant IRCCS Ospedale Policlinico San Martino Genoa ItalyClinic of Nephrology, Dialysis and Transplant IRCCS Ospedale Policlinico San Martino Genoa ItalyClinic of Nephrology, Dialysis and Transplant IRCCS Ospedale Policlinico San Martino Genoa ItalyClinic of Nephrology, Dialysis and Transplant IRCCS Ospedale Policlinico San Martino Genoa ItalyClinic of Nephrology, Dialysis and Transplant IRCCS Ospedale Policlinico San Martino Genoa ItalyClinic of Nephrology, Dialysis and Transplant IRCCS Ospedale Policlinico San Martino Genoa ItalyBackground The predictive role of blood pressure variability for all‐cause mortality and fatal and nonfatal cardiovascular events has been described in the general population and in patients with diabetes, independently of mean BP. Although systolic blood pressure variability has been proposed as an informative measure for predicting clinical outcomes in patients with chronic kidney disease, its role in kidney transplant recipients is still debatable. Methods and Results We performed a retrospective, observational, monocentric analysis of all kidney transplant recipients in follow‐up at the outpatient Nephrology Clinic of San Martino Hospital from January 1, 2016 to December 31, 2016, who underwent kidney transplantation >12 months. The primary outcome was a fatal or nonfatal cardiovascular event (myocardial infarction, unstable angina, stroke, and hospitalization for heart failure). Visit‐to‐visit systolic blood pressure variability was expressed as the SD of systolic blood pressure values recorded at baseline and 3 months up to 18 months. Among the 272 patients (mean age, 64±13; 63% men) included in the present analyses, for each increase of 2.7 mm Hg in systolic blood pressure SD, the risk for events increased 3‐fold (hazard ratio [HR], 3.1 [95% CI, 1.19–7.88]; P=0.02), and patients in the highest tertile of systolic blood pressure SD showed a 4‐fold increased risk (HR, 4.1 [95% CI, 1.34–12.43]; P=0.01). This relationship was maintained even after incremental adjustment for time‐averaged pulse pressure, age, diabetes, and prior cardiovascular event (HR, 3.2 [95% CI, 1.1–10.0]; P=0.04). Conclusions Long‐term blood pressure variability represents a risk factor for cardiovascular events in kidney transplant recipients, even independently by several confounding factors including blood pressure load.https://www.ahajournals.org/doi/10.1161/JAHA.124.034108blood pressure variabilitycardiovascular outcomecardiovascular riskkidney transplantation |
| spellingShingle | Elisabetta Bussalino Daniela Picciotto Lucia Macciò Angelica Parodi Maria Teresa Gandolfo Francesca Viazzi Visit‐to‐Visit Systolic Blood Pressure Variability Independently Predicts Cardiovascular Events in a Kidney Transplant Recipients' Cohort Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease blood pressure variability cardiovascular outcome cardiovascular risk kidney transplantation |
| title | Visit‐to‐Visit Systolic Blood Pressure Variability Independently Predicts Cardiovascular Events in a Kidney Transplant Recipients' Cohort |
| title_full | Visit‐to‐Visit Systolic Blood Pressure Variability Independently Predicts Cardiovascular Events in a Kidney Transplant Recipients' Cohort |
| title_fullStr | Visit‐to‐Visit Systolic Blood Pressure Variability Independently Predicts Cardiovascular Events in a Kidney Transplant Recipients' Cohort |
| title_full_unstemmed | Visit‐to‐Visit Systolic Blood Pressure Variability Independently Predicts Cardiovascular Events in a Kidney Transplant Recipients' Cohort |
| title_short | Visit‐to‐Visit Systolic Blood Pressure Variability Independently Predicts Cardiovascular Events in a Kidney Transplant Recipients' Cohort |
| title_sort | visit to visit systolic blood pressure variability independently predicts cardiovascular events in a kidney transplant recipients cohort |
| topic | blood pressure variability cardiovascular outcome cardiovascular risk kidney transplantation |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.034108 |
| work_keys_str_mv | AT elisabettabussalino visittovisitsystolicbloodpressurevariabilityindependentlypredictscardiovasculareventsinakidneytransplantrecipientscohort AT danielapicciotto visittovisitsystolicbloodpressurevariabilityindependentlypredictscardiovasculareventsinakidneytransplantrecipientscohort AT luciamaccio visittovisitsystolicbloodpressurevariabilityindependentlypredictscardiovasculareventsinakidneytransplantrecipientscohort AT angelicaparodi visittovisitsystolicbloodpressurevariabilityindependentlypredictscardiovasculareventsinakidneytransplantrecipientscohort AT mariateresagandolfo visittovisitsystolicbloodpressurevariabilityindependentlypredictscardiovasculareventsinakidneytransplantrecipientscohort AT francescaviazzi visittovisitsystolicbloodpressurevariabilityindependentlypredictscardiovasculareventsinakidneytransplantrecipientscohort |