Association of BP variability with mortality among African Americans with CKD

Research output: Contribution to journalArticle

Ciaran J. McMullan, George L. Bakris, Robert A. Phillips, John P. Forman

Background and objectives Increased systolic BP visit-to-visit variability (SBV) may be associated with higher overall mortality and cardiovascular events. However, few studies have examined these associations in patients with CKD, and the relation of SBV with CKD progression and ESRD has not been shown. This study analyzed the association of SBV with overall mortality, cardiovascular mortality, cardiovascular events, and renal events among individuals enrolled in the African American Study of Kidney Disease (AASK) trial. Design, setting, participants, & measurements This was a prospective observational study of 908 participants during the trial phase of the AASK study, with at least 1 year of BP measurements available and followed for 3-6.4 years. SBV was calculated as the SD of the systolic pressure from five visits occurring 3-12 months after randomization. The association of SBV with risk of overall mortality, cardiovascular mortality, a composite of fatal and nonfatal cardiovascular events, and a composite of renal events was assessed using proportional hazards regression and adjusting for multiple potential confounders. Results Greater SBV was associated with higher overall mortality. The adjusted hazard ratio (95% confidence interval) was 2.82 (1.14-6.95) comparing the highest with lowest tertile of SBV. A similar comparison revealed that greater SBV was also associated with cardiovascular mortality (adjusted hazard ratio, 4.91; 1.12-21.50). SBV was associated with both the cardiovascular renal composite endpoints in unadjusted but not adjusted analyses. Conclusions In African Americans with CKD, SBV is strongly and independently associated with overall and cardiovascular mortality.

Original languageEnglish (US)
Pages (from-to)731-738
Number of pages8
JournalClinical Journal of the American Society of Nephrology
Volume8
Issue number5
DOIs
StatePublished - May 7 2013

PMID: 23493382

PMCID: PMC3641624

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Association of BP variability with mortality among African Americans with CKD. / McMullan, Ciaran J.; Bakris, George L.; Phillips, Robert A.; Forman, John P.

In: Clinical Journal of the American Society of Nephrology, Vol. 8, No. 5, 07.05.2013, p. 731-738.

Research output: Contribution to journalArticle

Harvard

McMullan, CJ, Bakris, GL, Phillips, RA & Forman, JP 2013, 'Association of BP variability with mortality among African Americans with CKD' Clinical Journal of the American Society of Nephrology, vol. 8, no. 5, pp. 731-738. https://doi.org/10.2215/CJN.10131012

APA

McMullan, C. J., Bakris, G. L., Phillips, R. A., & Forman, J. P. (2013). Association of BP variability with mortality among African Americans with CKD. Clinical Journal of the American Society of Nephrology, 8(5), 731-738. https://doi.org/10.2215/CJN.10131012

Vancouver

McMullan CJ, Bakris GL, Phillips RA, Forman JP. Association of BP variability with mortality among African Americans with CKD. Clinical Journal of the American Society of Nephrology. 2013 May 7;8(5):731-738. https://doi.org/10.2215/CJN.10131012

Author

McMullan, Ciaran J. ; Bakris, George L. ; Phillips, Robert A. ; Forman, John P. / Association of BP variability with mortality among African Americans with CKD. In: Clinical Journal of the American Society of Nephrology. 2013 ; Vol. 8, No. 5. pp. 731-738.

BibTeX

@article{df156ef63ab14410b7e4cada1065f89a,
title = "Association of BP variability with mortality among African Americans with CKD",
abstract = "Background and objectives Increased systolic BP visit-to-visit variability (SBV) may be associated with higher overall mortality and cardiovascular events. However, few studies have examined these associations in patients with CKD, and the relation of SBV with CKD progression and ESRD has not been shown. This study analyzed the association of SBV with overall mortality, cardiovascular mortality, cardiovascular events, and renal events among individuals enrolled in the African American Study of Kidney Disease (AASK) trial. Design, setting, participants, & measurements This was a prospective observational study of 908 participants during the trial phase of the AASK study, with at least 1 year of BP measurements available and followed for 3-6.4 years. SBV was calculated as the SD of the systolic pressure from five visits occurring 3-12 months after randomization. The association of SBV with risk of overall mortality, cardiovascular mortality, a composite of fatal and nonfatal cardiovascular events, and a composite of renal events was assessed using proportional hazards regression and adjusting for multiple potential confounders. Results Greater SBV was associated with higher overall mortality. The adjusted hazard ratio (95{\%} confidence interval) was 2.82 (1.14-6.95) comparing the highest with lowest tertile of SBV. A similar comparison revealed that greater SBV was also associated with cardiovascular mortality (adjusted hazard ratio, 4.91; 1.12-21.50). SBV was associated with both the cardiovascular renal composite endpoints in unadjusted but not adjusted analyses. Conclusions In African Americans with CKD, SBV is strongly and independently associated with overall and cardiovascular mortality.",
author = "McMullan, {Ciaran J.} and Bakris, {George L.} and Phillips, {Robert A.} and Forman, {John P.}",
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issn = "1555-9041",
publisher = "American Society of Nephrology",
number = "5",

}

RIS

TY - JOUR

T1 - Association of BP variability with mortality among African Americans with CKD

AU - McMullan, Ciaran J.

AU - Bakris, George L.

AU - Phillips, Robert A.

AU - Forman, John P.

PY - 2013/5/7

Y1 - 2013/5/7

N2 - Background and objectives Increased systolic BP visit-to-visit variability (SBV) may be associated with higher overall mortality and cardiovascular events. However, few studies have examined these associations in patients with CKD, and the relation of SBV with CKD progression and ESRD has not been shown. This study analyzed the association of SBV with overall mortality, cardiovascular mortality, cardiovascular events, and renal events among individuals enrolled in the African American Study of Kidney Disease (AASK) trial. Design, setting, participants, & measurements This was a prospective observational study of 908 participants during the trial phase of the AASK study, with at least 1 year of BP measurements available and followed for 3-6.4 years. SBV was calculated as the SD of the systolic pressure from five visits occurring 3-12 months after randomization. The association of SBV with risk of overall mortality, cardiovascular mortality, a composite of fatal and nonfatal cardiovascular events, and a composite of renal events was assessed using proportional hazards regression and adjusting for multiple potential confounders. Results Greater SBV was associated with higher overall mortality. The adjusted hazard ratio (95% confidence interval) was 2.82 (1.14-6.95) comparing the highest with lowest tertile of SBV. A similar comparison revealed that greater SBV was also associated with cardiovascular mortality (adjusted hazard ratio, 4.91; 1.12-21.50). SBV was associated with both the cardiovascular renal composite endpoints in unadjusted but not adjusted analyses. Conclusions In African Americans with CKD, SBV is strongly and independently associated with overall and cardiovascular mortality.

AB - Background and objectives Increased systolic BP visit-to-visit variability (SBV) may be associated with higher overall mortality and cardiovascular events. However, few studies have examined these associations in patients with CKD, and the relation of SBV with CKD progression and ESRD has not been shown. This study analyzed the association of SBV with overall mortality, cardiovascular mortality, cardiovascular events, and renal events among individuals enrolled in the African American Study of Kidney Disease (AASK) trial. Design, setting, participants, & measurements This was a prospective observational study of 908 participants during the trial phase of the AASK study, with at least 1 year of BP measurements available and followed for 3-6.4 years. SBV was calculated as the SD of the systolic pressure from five visits occurring 3-12 months after randomization. The association of SBV with risk of overall mortality, cardiovascular mortality, a composite of fatal and nonfatal cardiovascular events, and a composite of renal events was assessed using proportional hazards regression and adjusting for multiple potential confounders. Results Greater SBV was associated with higher overall mortality. The adjusted hazard ratio (95% confidence interval) was 2.82 (1.14-6.95) comparing the highest with lowest tertile of SBV. A similar comparison revealed that greater SBV was also associated with cardiovascular mortality (adjusted hazard ratio, 4.91; 1.12-21.50). SBV was associated with both the cardiovascular renal composite endpoints in unadjusted but not adjusted analyses. Conclusions In African Americans with CKD, SBV is strongly and independently associated with overall and cardiovascular mortality.

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DO - 10.2215/CJN.10131012

M3 - Article

VL - 8

SP - 731

EP - 738

JO - Clinical Journal of the American Society of Nephrology

T2 - Clinical Journal of the American Society of Nephrology

JF - Clinical Journal of the American Society of Nephrology

SN - 1555-9041

IS - 5

ER -

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