Quiroga Borja, Galán Isabel, García de Vinuesa Soledad, Goicoechea Marian, Verdalles Úrsula, Luño José
Nephrology Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Nephrol Dial Transplant. 2015 May;30(5):801-6. doi: 10.1093/ndt/gfv059. Epub 2015 Mar 9.
Increased interarm systolic blood pressure difference (IASBPD) is associated with mortality and cardiovascular (CV) events both in the general population and in patients at high CV risk. The aim of the present study was to assess the value of IASBPD ≥ 10 mmHg for predicting CV events in patients with chronic kidney disease (CKD).
The study sample comprised 652 patients with CKD (age 67 ± 15 years, 58.1% men). Follow-up was 19 ± 5 months. We recorded increased IASBPD and related factors and assessed the predictive value of this variable for CV events.
We recorded diabetes mellitus in 136 patients (20.8%), history of CV disease in 213 (32.6%) and dyslipidaemia in 327 (50.1%). The mean glomerular filtration rate was 45.9 ± 18.9 mL/min/1.73 m(2), and the median albumin/creatinine ratio was 26(0-151) mg/g. IASBPD was ≥10 mmHg in 184 patients (28.1%). The factors associated with IASBPD ≥10 mmHg were age, systolic blood pressure levels, history of congestive heart failure, lower levels of high-density lipid cholesterol and higher use of hypertensive drugs. Fifty-eight patients (8.5%) developed a CV event during the follow-up. IASBPD ≥10 mmHg [HR, 1.802, 95%CI (1.054-3.079); P = 0.031] was an independent predictor of CV events.
Increased IASBPD is an independent predictor of CV events in CKD patients.
双臂收缩压差值（IASBPD）增大与普通人群及心血管疾病（CV）高风险患者的死亡率和心血管事件相关。本研究的目的是评估IASBPD≥10 mmHg对预测慢性肾脏病（CKD）患者心血管事件的价值。
研究样本包括652例CKD患者（年龄67±15岁，男性占58.1%）。随访时间为19±5个月。我们记录了增大的IASBPD及相关因素，并评估了该变量对心血管事件的预测价值。
我们记录到136例患者（20.8%）患有糖尿病，213例（32.6%）有心血管疾病史，327例（50.1%）有血脂异常。平均肾小球滤过率为45.9±18.9 mL/min/1.73 m²，白蛋白/肌酐比值中位数为26（0 - 151）mg/g。184例患者（28.1%）的IASBPD≥10 mmHg。与IASBPD≥10 mmHg相关的因素有年龄、收缩压水平、充血性心力衰竭病史、高密度脂蛋白胆固醇水平较低以及高血压药物使用较多。58例患者（8.5%）在随访期间发生了心血管事件。IASBPD≥10 mmHg [HR，1.802，95%CI（1.054 - 3.079）；P = 0.031]是心血管事件的独立预测因素。
IASBPD增大是CKD患者心血管事件的独立预测因素。
