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Blood Pressure Levels, Cardiovascular Events, and Renal Outcomes in Chronic Kidney Disease Without Antihypertensive Therapy: A Nationwide Population-Based Cohort Study

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Pubmed体系：

收录情况： ◇ SCIE

作者：
Wu Shujing[1,2] * ; Li Mian[1,2] * ; Lu Jieli[1,2] * ; Tang Xulei[3] * ; Wang Guixia[4] * ; Zheng Ruizhi[1,2] ; Niu Jingya[1,2,5] ; Chen Li[6] ; Huo Yanan[7] ; Xu Min[1,2] ; Wang Tiange[1,2] ; Zhao Zhiyun[1,2] ; Wang Shuangyuan[1,2] ; Lin Hong[1,2] ; Qin Guijun[8] ; Yan Li[9] ; Wan Qin[10] ; Chen Lulu[11] ; Shi Lixin[12] ; Hu Ruying[13] ; Su Qing[14] ; Yu Xuefeng[15] ; Qin Yingfen[16] ; Chen Gang[17] ; Gao Zhengnan[18] ; Shen Feixia[19] ; Luo Zuojie[16] ; Chen Yuhong[1,2] ; Zhang Yinfei[20] ; Liu Chao[21] ; Wang Youmin[22] ; Wu Shengli[23] ; Yang Tao[24] ; Li Qiang[25] ; Mu Yiming[26] ; Zhao Jiajun[27] ; Ning Guang[1,2] ; Bi Yufang[1,2,*1] ; Wang Weiqing[1,2] ; Xu Yu[1,2,*1] ; for the China Cardiometabolic Disease and Cancer Cohort[4C] ;
单位： [1]Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China [2]Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China [3]The First Hospital of Lanzhou University, China [4]The First Hospital of Jilin University, Changchun, China [5]Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, China [6]Qilu Hospital of Shandong University, Jinan, China [7]Jiangxi People's Hospital, Nanchang, China [8]The First Affiliated Hospital of Zhengzhou University, China [9]Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China [10]The Affiliated Hospital of Southwest Medical University, Luzhou, China [11]Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China [12]Affiliated Hospital of Guiyang Medical College, China [13]Zhejiang Provincial Center for Disease Control and Prevention, China [14]Xinhua Hospital Affiliated to Shanghai Jiao-Tong University School of Medicine, China [15]Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China [16]The First Affiliated Hospital of Guangxi Medical University, Nanning, China [17]Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China [18]Dalian Municipal Central Hospital, China [19]The First Affiliated Hospital of Wenzhou Medical University, China [20]Central Hospital of Shanghai Jiading District, China [21]Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China [22]The First Affiliated Hospital of Anhui Medical University, Hefei, China [23]Karamay Municipal People's Hospital, Xinjiang, China [24]The First Affiliated Hospital of Nanjing Medical University, China [25]The Second Affiliated Hospital of Harbin Medical University, Harbin, China [26]Chinese People's Liberation Army General Hospital, Beijing, China [27]Shandong Provincial Hospital affiliated to Shandong University, Jinan, China
出处：
DOI： 10.1161/HYPERTENSIONAHA.122.19902
ISSN：

关键词： blood pressure ◼ cardiovascular disease ◼ chronic kidney disease ◼ end-stage renal disease ◼ hypertension

摘要：
High blood pressure (BP) is highly prevalent in patients with chronic kidney disease. However, the thresholds to initiate BP-lowering treatment in this population are unclear. We aimed to examine the associations between BP levels and clinical outcomes and provide evidence on potential thresholds to initiate BP-lowering therapy in people with chronic kidney disease.This nationwide, multicenter, prospective cohort study included 12 523 chronic kidney disease participants without antihypertensive therapy in mainland China. Participants were followed up during 2011 to 2016 for cardiovascular events (nonfatal myocardial infarction, nonfatal stroke, hospitalized or treated heart failure, and cardiovascular death) and renal events (≥20% decline in the estimated glomerular filtration rate, end-stage kidney disease, and renal death).Overall, 652 cardiovascular events and 1268 renal events occurred during 43 970 person-years of follow-up. We observed a positive and linear relationship between systolic BP and risks of cardiovascular and renal events down to 90 mm Hg, as well as between diastolic BP and risks of renal events down to 50 mm Hg. A J-shaped trend was noted between diastolic BP and risks of cardiovascular events, but a linear relationship was revealed in participants <60 years (P for interaction <0.001). A significant increase in the risk of cardiovascular and renal outcomes was observed at systolic BP ≥130 mm Hg (versus 90-119 mm Hg) and at diastolic BP ≥90 mm Hg (versus 50-69 mm Hg).In people with chronic kidney disease, a higher systolic BP/diastolic BP level (≥130/90 mm Hg) is significantly associated with a greater risk of cardiovascular and renal events, indicating potential thresholds to initiate BP-lowering treatment.

基金：
National Natural Science Foundation of China, 81770842, 81870560, 81941017, 81970691, 81970706, 82022011, 82070880, 82088102, the Shanghai Shenkang Hospital Development Center (SHDC12019101, SHDC2020CR1001A, SHDC2020CR3064B), Shanghai Jiaotong University School of Medicine (DLY201801), the Ruijin Hospital (2018CR002), and the Innovative Research Team of High-Level Local Universities in Shanghai.
语种：
外文
被引次数：
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2022]版：
大类 | 1 区 医学
小类 | 1 区 外周血管病
最新[2025]版：
大类 | 1 区 医学
小类 | 1 区 外周血管病
JCR分区：
出版当年[2021]版：
Q1 PERIPHERAL VASCULAR DISEASE
最新[2023]版：
Q1 PERIPHERAL VASCULAR DISEASE

影响因子： 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

第一作者：
第一作者单位： [1]Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China [2]Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China
共同第一作者：
通讯作者：
通讯机构： [1]Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China [2]Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China [*1]Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai 200025, China
推荐引用方式(GB/T 7714)：
Wu Shujing,Li Mian,Lu Jieli,et al.Blood Pressure Levels, Cardiovascular Events, and Renal Outcomes in Chronic Kidney Disease Without Antihypertensive Therapy: A Nationwide Population-Based Cohort Study[J].HYPERTENSION.2023,80(3):640-649.doi:10.1161/HYPERTENSIONAHA.122.19902.
APA：
Wu Shujing,Li Mian,Lu Jieli,Tang Xulei,Wang Guixia...&for the China Cardiometabolic Disease and Cancer Cohort.(2023).Blood Pressure Levels, Cardiovascular Events, and Renal Outcomes in Chronic Kidney Disease Without Antihypertensive Therapy: A Nationwide Population-Based Cohort Study.HYPERTENSION,80,(3)
MLA：
Wu Shujing,et al."Blood Pressure Levels, Cardiovascular Events, and Renal Outcomes in Chronic Kidney Disease Without Antihypertensive Therapy: A Nationwide Population-Based Cohort Study".HYPERTENSION 80..3(2023):640-649

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