Patients with CKD have higher nocturnal blood pressure compared with those without CKD
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According to a research letter published in Kidney Medicine, kidney function decline correlated with higher nocturnal blood pressure among patients with chronic kidney disease.
“Previous studies have focused on the associations between hypertension and longitudinal change in eGFR. Participants with hypertension or with higher baseline office blood pressure (BP) were found to have faster rates of eGFR decline over follow up in population studies,” Lama Ghazi, MD, PhD, from Yale University School of Medicine, and colleagues wrote in the research letter. “While cross sectional studies have shown an association between masked hypertension and reduced eGFR, no study has evaluated the association between eGFR decline and incident CKD as a predictor of BP profiles assessed by ambulatory BP monitoring. Therefore, the purpose of this cross-sectional study was to examine the association of CKD development with subsequent BP on ambulatory BP monitoring.”
In a post-hoc analysis of the Coronary Artery Risk Development in Young Adults study, researchers collected characteristics to determine risk factors for the development of CKD. Researchers measured the mean ambulatory BP in patients while awake, nocturnal and in a 24-hour period. Similarly, researchers recorded the ambulatory BP phenotypes and dipping patterns.
Using linear and logistic regressions, researchers determined the correlation between CKD development and systolic BP on ambulatory BP “masked as hypertension” and non-dipping systolic BP.
A total of 763 patients with complete ambulatory BP were included in the study. Regardless of antihypertensive medications, CKD did not correlate with mean 24-hour or awake systolic BP and diastolic BP. However, patients who did not receive antihypertensive medications showed higher nocturnal systolic BP and diastolic BP.
Additionally, there was no association between masked hypertension or non-dipping and CKD development.
“We found that overall worsening kidney function was associated with higher nocturnal systolic BP and diastolic BP among adults not receiving antihypertensive medications, but this association was attenuated by demographic factors and comorbidities,” Ghazi and colleagues wrote. “These findings show that compared [with] people without CKD, those with CKD have higher nocturnal BP, particularly if they are not using any antihypertensive medication. Whether nocturnal BP might be a precursor for CKD should be explored further.”
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