Optimal blood pressure for patients with chronic kidney disease: a nationwide population-based cohort study

You Bin Lee; Ji Sung Lee; So hyeon Hong; Jung A. Kim; Eun Roh; Hye Jin Yoo; Sei Hyun Baik; Kyung Mook Choi

doi:10.1038/s41598-021-81328-y

Optimal blood pressure for patients with chronic kidney disease: a nationwide population-based cohort study

You Bin Lee, Ji Sung Lee, So hyeon Hong, Jung A. Kim, Eun Roh, Hye Jin Yoo, Sei Hyun Baik, Kyung Mook Choi

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

Abstract

The effect of blood pressure (BP) on the incident cardiovascular events, progression to end-stage renal disease (ESRD) and mortality were evaluated among chronic kidney disease (CKD) patients with and without antihypertensive treatment. This nationwide study used the Korean National Health Insurance Service-Health Screening Cohort data. The hazards of outcomes were analysed according to the systolic BP (SBP) or diastolic BP (DBP) among adults (aged ≥ 40 years) with CKD and without previous cardiovascular disease or ESRD (n = 22,278). The SBP and DBP were ≥ 130 mmHg and ≥ 80 mmHg in 10,809 (48.52%) and 11,583 (51.99%) participants, respectively. During a median 6.2 years, 1271 cardiovascular events, 201 ESRD incidents, and 1061 deaths were noted. Individuals with SBP ≥ 130 mmHg and DBP ≥ 80 mmHg had higher hazards of hypertension-related adverse outcomes compared to the references (SBP 120–129 mmHg and DBP 70–79 mmHg). SBP < 100 mmHg was associated with hazards of all-cause death, and composite of ESRD and all-cause death during follow-up only among the antihypertensive medication users suggesting that the BP should be < 130/80 mmHg and the SBP should not be < 100 mmHg with antihypertensive agents to prevent the adverse outcome risk of insufficient and excessive antihypertensive treatment in CKD patients.

Original language	English
Article number	1538
Journal	Scientific reports
Volume	11
Issue number	1
DOIs	https://doi.org/10.1038/s41598-021-81328-y
Publication status	Published - 2021 Dec

Bibliographical note

Funding Information:
This work was supported by a research grant of Korea University [B1901301, A920197507, and K2020461 to K.M.C]. The funding sources had no role in the design, collection, analysis, and interpretation of data; writing of the report; and decision to submit the article for publication. This work was performed using the database from the Korean National Health Insurance Service (KNHIS). The National Health Information Database constructed by the KNHIS (no. NHIS-2019-2-166) was used, and the results do not necessarily represent the opinion of the National Health Insurance Corporation.

Publisher Copyright:
© 2021, The Author(s).

ASJC Scopus subject areas

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UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1038/s41598-021-81328-y

Cite this

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title = "Optimal blood pressure for patients with chronic kidney disease: a nationwide population-based cohort study",

abstract = "The effect of blood pressure (BP) on the incident cardiovascular events, progression to end-stage renal disease (ESRD) and mortality were evaluated among chronic kidney disease (CKD) patients with and without antihypertensive treatment. This nationwide study used the Korean National Health Insurance Service-Health Screening Cohort data. The hazards of outcomes were analysed according to the systolic BP (SBP) or diastolic BP (DBP) among adults (aged ≥ 40 years) with CKD and without previous cardiovascular disease or ESRD (n = 22,278). The SBP and DBP were ≥ 130 mmHg and ≥ 80 mmHg in 10,809 (48.52%) and 11,583 (51.99%) participants, respectively. During a median 6.2 years, 1271 cardiovascular events, 201 ESRD incidents, and 1061 deaths were noted. Individuals with SBP ≥ 130 mmHg and DBP ≥ 80 mmHg had higher hazards of hypertension-related adverse outcomes compared to the references (SBP 120–129 mmHg and DBP 70–79 mmHg). SBP < 100 mmHg was associated with hazards of all-cause death, and composite of ESRD and all-cause death during follow-up only among the antihypertensive medication users suggesting that the BP should be < 130/80 mmHg and the SBP should not be < 100 mmHg with antihypertensive agents to prevent the adverse outcome risk of insufficient and excessive antihypertensive treatment in CKD patients.",

author = "Lee, {You Bin} and Lee, {Ji Sung} and Hong, {So hyeon} and Kim, {Jung A.} and Eun Roh and Yoo, {Hye Jin} and Baik, {Sei Hyun} and Choi, {Kyung Mook}",

note = "Funding Information: This work was supported by a research grant of Korea University [B1901301, A920197507, and K2020461 to K.M.C]. The funding sources had no role in the design, collection, analysis, and interpretation of data; writing of the report; and decision to submit the article for publication. This work was performed using the database from the Korean National Health Insurance Service (KNHIS). The National Health Information Database constructed by the KNHIS (no. NHIS-2019-2-166) was used, and the results do not necessarily represent the opinion of the National Health Insurance Corporation. Publisher Copyright: {\textcopyright} 2021, The Author(s).",

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AU - Roh, Eun

AU - Yoo, Hye Jin

AU - Baik, Sei Hyun

AU - Choi, Kyung Mook

N1 - Funding Information: This work was supported by a research grant of Korea University [B1901301, A920197507, and K2020461 to K.M.C]. The funding sources had no role in the design, collection, analysis, and interpretation of data; writing of the report; and decision to submit the article for publication. This work was performed using the database from the Korean National Health Insurance Service (KNHIS). The National Health Information Database constructed by the KNHIS (no. NHIS-2019-2-166) was used, and the results do not necessarily represent the opinion of the National Health Insurance Corporation. Publisher Copyright: © 2021, The Author(s).

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N2 - The effect of blood pressure (BP) on the incident cardiovascular events, progression to end-stage renal disease (ESRD) and mortality were evaluated among chronic kidney disease (CKD) patients with and without antihypertensive treatment. This nationwide study used the Korean National Health Insurance Service-Health Screening Cohort data. The hazards of outcomes were analysed according to the systolic BP (SBP) or diastolic BP (DBP) among adults (aged ≥ 40 years) with CKD and without previous cardiovascular disease or ESRD (n = 22,278). The SBP and DBP were ≥ 130 mmHg and ≥ 80 mmHg in 10,809 (48.52%) and 11,583 (51.99%) participants, respectively. During a median 6.2 years, 1271 cardiovascular events, 201 ESRD incidents, and 1061 deaths were noted. Individuals with SBP ≥ 130 mmHg and DBP ≥ 80 mmHg had higher hazards of hypertension-related adverse outcomes compared to the references (SBP 120–129 mmHg and DBP 70–79 mmHg). SBP < 100 mmHg was associated with hazards of all-cause death, and composite of ESRD and all-cause death during follow-up only among the antihypertensive medication users suggesting that the BP should be < 130/80 mmHg and the SBP should not be < 100 mmHg with antihypertensive agents to prevent the adverse outcome risk of insufficient and excessive antihypertensive treatment in CKD patients.

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ER -

Optimal blood pressure for patients with chronic kidney disease: a nationwide population-based cohort study

Abstract

Bibliographical note

ASJC Scopus subject areas

UN SDGs

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