Higher systolic blood pressure is associated with progression of carotid intima–media thickness in patients with chronic kidney disease

To examine the relationship between systolic blood pressure and progression of carotid intima-media thickness in patients with chronic kidney disease (CKD), we studied 3364 patients from a community-based cohort of elderly individuals of whom 724 had CKD defined as creatinine clearances of stage 3 or less. The contribution of systolic blood pressure was evaluated in four ranges (<120, 120-129, 130-139, and > or = 140 mm Hg). All multiple linear regression analyses were adjusted for traditional and nontraditional cardiovascular risk factors. The higher ranges of systolic blood pressure at baseline were associated with a greater carotid intima-media thickness at the initiation of the study in patients with or without CKD. Covariate-adjusted averages of carotid intima-media thickness at the initiation of the study in patients with CKD significantly increased across the four strata of systolic blood pressure. Higher systolic blood pressure at baseline was associated with a significantly greater yearly change in covariate-adjusted mean carotid intima-media thickness and vascular events in patients with CKD over a 4-year follow-up period.