Open AccessInfluence of Kidney Function on Blood Pressure Response to Lifestyle Modifications: Secondary Analysis From the Exercise and Nutritional Interventions for Cardiovascular Health (ENCORE) Trial
Author(s) -
Tyson Crystal C.,
Smith Patrick J.,
Sherwood Andrew,
Mabe Stephanie,
Hinderliter Alan L.,
Blumenthal James A.
Publication year - 2016
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12853
Subject(s) - medicine , renal function , blood pressure , overweight , ambulatory , ambulatory blood pressure , dash , physical therapy , obesity , endocrinology , cardiology , computer science , operating system
The kidney is an important regulator of blood pressure ( BP ). To determine whether BP response to lifestyle modification varies across normal ranges of kidney function, the authors examined the moderating role of estimated glomerular filtration rate ( eGFR ) on clinic and ambulatory systolic BP ( SBP ) response in overweight and obese adults with unmedicated high BP . Among 144 participants of the Exercise and Nutritional Interventions for Cardiovascular Health ( ENCORE ) trial, mean age was 52.0±9.6 years and median eGFR was 89.1 (53–146) mL /min/1.73m 2 . After multivariable regression, the interaction between eGFR and weight loss was significant for clinic ( P =.023) and ambulatory SBP ( P =.041). Similarly, the interaction between eGFR and improved fitness was significant for clinic ( P =.041) and ambulatory SBP ( P =.044). The relationship between reduced dietary sodium and SBP was not moderated by eGFR . SBP findings were inconsistent for adherence to the Dietary Approaches to Stop Hypertension ( DASH ) diet. These findings suggest that the effects of lifestyle modifications on SBP may be influenced by eGFR , even when kidney function is preserved.