血压与高龄高血压中国人群肾功能快速下降相关。
Blood Pressure is Associated with Rapid Kidney Function Decline in a Very Elderly Hypertensive Chinese Population.
机构信息
Department of Endoscopy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, People's Republic of China.
Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China.
出版信息
Clin Interv Aging. 2020 Aug 10;15:1317-1323. doi: 10.2147/CIA.S255640. eCollection 2020.
PURPOSE
In prior analyses, blood pressure (BP) was related to rapid kidney function decline (RKFD). However, studies of this relationship in populations of advanced age are lacking. In the present study, we therefore examined the relationship between BP and RKFD in a population of 284 hypertensive Chinese individuals over the age of 80.
PATIENTS AND METHODS
All study participants were diagnosed with hypertension (systolic BP [SBP] 160-200 mmHg; diastolic BP [DBP] <110 mmHg). RKFD was defined based upon a decline in estimated glomerular filtration rate (eGFR) >5mL/min per 1.73 m per year during follow-up. The Cox regression models (competing risk models) were used for calculating hazard ratios (HRs) to examine the relationship between SBP, DBP, pulse pressure (PP) and RKFD.
RESULTS
Over a 3.3-year median follow-up period, 68 study participants (23.9%) were diagnosed with RKFD, while 35 (12.3%) died. After adjusting for confounding variables, we determined that each 10 mmHg rise in SBP and PP was associated with a 34% and 110% increase, respectively, in RKFD risk (adjusted HR: 1.34, 95% confidence interval [CI]: 1.05-1.71 for SBP, =0.02; HR: 2.10, 95% CI: 0.87-5.08 for PP, =0.10). In addition, we determined that each 10 mmHg increase in DBP was linked to a 10% reduction in RKFD risk (adjusted HR: 0.90, 95% CI: 0.70-1.14, =0.37).
CONCLUSION
Our results indicate that SBP, but not DBP or PP, is positively correlated with RKFD risk in a very elderly hypertensive Chinese population.
目的
在先前的分析中，血压（BP）与肾功能快速下降（RKFD）有关。然而，在老年人群中缺乏对此关系的研究。因此，在本研究中，我们检查了 284 名 80 岁以上的高血压中国人群中 BP 与 RKFD 之间的关系。
患者和方法
所有研究参与者均被诊断为高血压（收缩压 [SBP] 160-200mmHg；舒张压 [DBP] <110mmHg）。RKFD 根据随访期间估算肾小球滤过率（eGFR）下降> 5mL/min/1.73m 每年定义。Cox 回归模型（竞争风险模型）用于计算风险比（HR）以检查 SBP、DBP、脉压（PP）与 RKFD 之间的关系。
结果
在 3.3 年的中位随访期间，68 名研究参与者（23.9%）被诊断为 RKFD，35 名（12.3%）死亡。调整混杂变量后，我们确定 SBP 和 PP 每升高 10mmHg，分别与 RKFD 风险增加 34%和 110%相关（调整后的 HR：SBP 为 1.34，95%置信区间 [CI]：1.05-1.71，=0.02；PP 为 2.10，95%CI：0.87-5.08，=0.10）。此外，我们还发现 DBP 每升高 10mmHg，与 RKFD 风险降低 10%相关（调整后的 HR：0.90，95% CI：0.70-1.14，=0.37）。
结论
我们的结果表明，在非常高龄的高血压中国人群中，SBP 与 RKFD 风险呈正相关，而 DBP 或 PP 则无此相关性。
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