Blood pressure and progression of chronic kidney disease: importance of systolic, diastolic, or diurnal variation

Curr Hypertens Rep. 2004 Oct;6(5):400-4. doi: 10.1007/s11906-004-0060-2.

Abstract

Several studies show that systolic blood pressure is an important predictor of renal disease progression, just as it is linked with cardiovascular consequences in hypertension. In contrast, particularly in older patients, diastolic blood pressure was not independently associated with risk of kidney disease progression in the same studies. Pulse pressure has been shown to be equivalent in predicting renal outcomes, but might not have added value after adjusting for systolic blood pressure. Several cross- sectional studies present a strong correlation of ambulatory blood pressure monitoring values with microalbuminuria, compared with office-based blood pressure measurements. Small, prospective studies have shown an association between loss of nocturnal blood pressure decline and outcomes, including microalbuminuria, accelerated kidney disease progression, and mortality.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure
  • Blood Pressure Determination
  • Circadian Rhythm
  • Clinical Trials as Topic
  • Diastole / physiology
  • Disease Progression
  • Female
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / drug therapy*
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / prevention & control*
  • Male
  • Prognosis
  • Prospective Studies
  • Sensitivity and Specificity
  • Survival Analysis
  • Systole / physiology

Substances

  • Antihypertensive Agents