Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Hypertension and Circulatory Control
Comparison of Prognostic Values of Daytime and Night-Time Systolic Blood Pressures on Renal Outcomes in Patients With Chronic Kidney Disease
Eisuke KatafuchiMasaru NakayamaShigeru TanakaTeppei SakohRyota YoshitomiAkiko FukuiMakiko SekiYusuke NakamataMitsuhiro TominagaKazuhiko TsuruyaTakanari Kitazono
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Supplementary material

2017 Volume 81 Issue 10 Pages 1454-1462

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Abstract

Background:Differences in the predictive value of daytime systolic blood pressure (SBP) and night-time SBP by ambulatory blood pressure monitoring on renal outcomes have not been fully investigated in chronic kidney disease (CKD) patients. This study compared the prognostic value between daytime and night-time SBP on renal outcomes in CKD.

Methods and Results:This prospective observational study included 421 patients. The composite renal endpoint was endstage renal disease (ESRD) or death. Cox models were used to determine associations of daytime and night-time SBP with renal outcomes. There were 150 renal events (ESRD, 130; death, 20). Multivariable Cox analyses demonstrated that hazard ratios (HRs) [95% confidence interval (CI)] for composite renal outcomes of every 10-mmHg increase in daytime and night-time SBP levels were 1.13 (1.02–1.26) (P=0.02) and 1.15 (1.05–1.27) (P<0.01), respectively. In addition, compared with the 1st daytime or night-time SBP quartile, HRs (95% CI) for outcomes in the 2nd, 3rd, and 4th quartiles were: daytime SBP, 1.25 (0.70–2.25), 1.09 (0.61–1.94), and 1.58 (0.88–2.85; P=0.13) (P for trend=0.16); night-time SBP, 1.09 (0.61–1.96), 1.31 (0.76–2.28), and 1.82 (1.00–3.30; P=0.049) (P for trend=0.03), respectively.

Conclusions:Night-time SBP appeared superior to daytime SBP for predicting renal outcomes in this population of patients.

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© 2017 THE JAPANESE CIRCULATION SOCIETY
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