Open AccessPrognostic Effect of Isolated Nocturnal Hypertension in Chinese Patients With Nondialysis Chronic Kidney Disease
Author(s) -
Wang Cheng,
Li Yan,
Zhang Jun,
Ye Zengchun,
Zhang Qunzi,
Ma Xinxin,
Peng Hui,
Lou Tanqi
Publication year - 2016
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.116.004198
Subject(s) - medicine , hazard ratio , kidney disease , proportional hazards model , blood pressure , nocturnal , cohort , population , cardiology , confidence interval , environmental health
Background Isolated nocturnal hypertension ( INH ) has been studied among the general population and hypertensive patients. However, little insight is available on the prognostic effect of INH in patients with chronic kidney disease ( CKD ). This study investigated the prognostic effect of INH in a cohort of Chinese patients with nondialysis CKD . Methods and Results A total of 588 Chinese CKD patients who were admitted to the Third Affiliated Hospital of Sun Yat‐Sen University were enrolled in this study. We monitored blood pressure ( BP ) throughout the day and followed health outcomes in the 588 CKD patients admitted to our hospital division. We recorded time to total mortality, cardiovascular mortality, renal events, and cardiovascular events. A total of 370 (62.92%) individuals had nocturnal hypertension, which included 136 (23.13%) patients with INH . Multivariable Cox regression analyses showed that nocturnal BP was a significant risk factor for renal events and cardiovascular events in CKD patients, even when adjusted for clinic BP , 24‐hour BP , or daytime BP . Patients with nocturnal hypertension showed a worse prognosis compared with patients with nocturnal normotension ( P <0.05), and nocturnal hypertension (versus nocturnal normotension) was associated with an increased risk for renal events (hazard ratio [ HR ], 3.81; 95% CI , 1.74–8.36) and cardiovascular events ( HR , 8.34; 95% CI , 1.98–35.07). In addition, patients with INH had a worse prognosis than patients with normotension ( P <0.017), whereas INH (versus normotension) was associated with a higher risk of renal events ( HR , 2.78; 95% CI , 1.16–6.65) and cardiovascular events ( HR , 6.82; 95% CI , 1.52–30.63). Conclusions INH was associated with a poor prognosis in Chinese nondialysis CKD patients.