Cargando…
The Relation of Clinic and Ambulatory BP with the Risk of Cardiovascular Events and All-Cause Mortality among Patients on Peritoneal Dialysis
Large observational studies showed a U-shaped association of clinic blood pressure (BP) with mortality among patients undergoing peritoneal dialysis (PD). Whether ambulatory BP provides a more direct risk signal in this population remains unknown. In a prospective cohort of 108 PD patients, standard...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196741/ https://www.ncbi.nlm.nih.gov/pubmed/34063995 http://dx.doi.org/10.3390/jcm10112232 |
_version_ | 1783706756413652992 |
---|---|
author | Georgianos, Panagiotis I. Vaios, Vasilios Zebekakis, Pantelis E. Liakopoulos, Vassilios |
author_facet | Georgianos, Panagiotis I. Vaios, Vasilios Zebekakis, Pantelis E. Liakopoulos, Vassilios |
author_sort | Georgianos, Panagiotis I. |
collection | PubMed |
description | Large observational studies showed a U-shaped association of clinic blood pressure (BP) with mortality among patients undergoing peritoneal dialysis (PD). Whether ambulatory BP provides a more direct risk signal in this population remains unknown. In a prospective cohort of 108 PD patients, standardized clinic BP was recorded at baseline with the validated device HEM-705 (Omron, Healthcare, Bannockburn, IL, USA) and 24-h ambulatory BP monitoring was performed using the Mobil-O-Graph monitor (IEM, Stolberg, Germany). Over a median follow-up of 16 months (interquartile range: 19 months), 47.2% of the overall population reached the composite outcome of non-fatal myocardial infarction, non-fatal stroke, or all-cause death. In Cox-regression analysis, systolic but not diastolic BP was prognostically informative. Compared with the reference quartile 1 of 24-h systolic BP (SBP), the multivariate-adjusted hazard ratio for the composite outcome was 1.098 (95% confidence interval (CI): 0.434–2.777) in quartile 2, 1.004 (95% CI: 0.382–2.235) in quartile 3 and 2.449 (95% CI: 1.156–5.190) in quartile 4. In contrast, no such association was observed between increasing quartiles of clinic SBP and composite outcome. The present study shows that among PD patients, increasing ambulatory SBP is independently associated with higher risk of adverse cardiovascular events and mortality, providing superior prognostic information than standardized clinic SBP. |
format | Online Article Text |
id | pubmed-8196741 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-81967412021-06-13 The Relation of Clinic and Ambulatory BP with the Risk of Cardiovascular Events and All-Cause Mortality among Patients on Peritoneal Dialysis Georgianos, Panagiotis I. Vaios, Vasilios Zebekakis, Pantelis E. Liakopoulos, Vassilios J Clin Med Article Large observational studies showed a U-shaped association of clinic blood pressure (BP) with mortality among patients undergoing peritoneal dialysis (PD). Whether ambulatory BP provides a more direct risk signal in this population remains unknown. In a prospective cohort of 108 PD patients, standardized clinic BP was recorded at baseline with the validated device HEM-705 (Omron, Healthcare, Bannockburn, IL, USA) and 24-h ambulatory BP monitoring was performed using the Mobil-O-Graph monitor (IEM, Stolberg, Germany). Over a median follow-up of 16 months (interquartile range: 19 months), 47.2% of the overall population reached the composite outcome of non-fatal myocardial infarction, non-fatal stroke, or all-cause death. In Cox-regression analysis, systolic but not diastolic BP was prognostically informative. Compared with the reference quartile 1 of 24-h systolic BP (SBP), the multivariate-adjusted hazard ratio for the composite outcome was 1.098 (95% confidence interval (CI): 0.434–2.777) in quartile 2, 1.004 (95% CI: 0.382–2.235) in quartile 3 and 2.449 (95% CI: 1.156–5.190) in quartile 4. In contrast, no such association was observed between increasing quartiles of clinic SBP and composite outcome. The present study shows that among PD patients, increasing ambulatory SBP is independently associated with higher risk of adverse cardiovascular events and mortality, providing superior prognostic information than standardized clinic SBP. MDPI 2021-05-21 /pmc/articles/PMC8196741/ /pubmed/34063995 http://dx.doi.org/10.3390/jcm10112232 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Georgianos, Panagiotis I. Vaios, Vasilios Zebekakis, Pantelis E. Liakopoulos, Vassilios The Relation of Clinic and Ambulatory BP with the Risk of Cardiovascular Events and All-Cause Mortality among Patients on Peritoneal Dialysis |
title | The Relation of Clinic and Ambulatory BP with the Risk of Cardiovascular Events and All-Cause Mortality among Patients on Peritoneal Dialysis |
title_full | The Relation of Clinic and Ambulatory BP with the Risk of Cardiovascular Events and All-Cause Mortality among Patients on Peritoneal Dialysis |
title_fullStr | The Relation of Clinic and Ambulatory BP with the Risk of Cardiovascular Events and All-Cause Mortality among Patients on Peritoneal Dialysis |
title_full_unstemmed | The Relation of Clinic and Ambulatory BP with the Risk of Cardiovascular Events and All-Cause Mortality among Patients on Peritoneal Dialysis |
title_short | The Relation of Clinic and Ambulatory BP with the Risk of Cardiovascular Events and All-Cause Mortality among Patients on Peritoneal Dialysis |
title_sort | relation of clinic and ambulatory bp with the risk of cardiovascular events and all-cause mortality among patients on peritoneal dialysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196741/ https://www.ncbi.nlm.nih.gov/pubmed/34063995 http://dx.doi.org/10.3390/jcm10112232 |
work_keys_str_mv | AT georgianospanagiotisi therelationofclinicandambulatorybpwiththeriskofcardiovasculareventsandallcausemortalityamongpatientsonperitonealdialysis AT vaiosvasilios therelationofclinicandambulatorybpwiththeriskofcardiovasculareventsandallcausemortalityamongpatientsonperitonealdialysis AT zebekakispantelise therelationofclinicandambulatorybpwiththeriskofcardiovasculareventsandallcausemortalityamongpatientsonperitonealdialysis AT liakopoulosvassilios therelationofclinicandambulatorybpwiththeriskofcardiovasculareventsandallcausemortalityamongpatientsonperitonealdialysis AT georgianospanagiotisi relationofclinicandambulatorybpwiththeriskofcardiovasculareventsandallcausemortalityamongpatientsonperitonealdialysis AT vaiosvasilios relationofclinicandambulatorybpwiththeriskofcardiovasculareventsandallcausemortalityamongpatientsonperitonealdialysis AT zebekakispantelise relationofclinicandambulatorybpwiththeriskofcardiovasculareventsandallcausemortalityamongpatientsonperitonealdialysis AT liakopoulosvassilios relationofclinicandambulatorybpwiththeriskofcardiovasculareventsandallcausemortalityamongpatientsonperitonealdialysis |