Optimal blood pressure for patients with end-stage renal disease following coronary interventions

Ya Ling Yang, Su Chan Chen, Cheng Hsueh Wu, Shao Sung Huang, Wan Leong Chan, Shing Jong Lin, Chia Yu Chou, Jaw Wen Chen, Pan Ju-Pin, Min Ji Charng, Ying Hwa Chen, Tao Cheng Wu, Tse Min Lu, Pai Feng Hsu, Po Hsun Huang, Hao Min Cheng, Chin Chou Huang, Shih Hsien Sung, Yenn Jiang Lin, Hsin Bang Leu

Research output: Contribution to journalArticlepeer-review

Abstract

Hypertension is a frequent manifestation of chronic kidney disease but the ideal blood pressure (BP) target in patients with coronary artery disease (CAD) with end-stage renal disease (ESRD) (eGFR < 15 ml/min/1.73m2) still unclear. The authors aimed to investigate the ideal achieved BP in ESRD patients with CAD after coronary intervention. Five hundred and seventy-five ESRD patients who had undergone percutaneous coronary interventions (PCIs) were enrolled and their clinical outcomes were analyzed according to the category of systolic BP (SBP) and diastolic BP (DBP) achieved. The clinical outcomes included major cardiovascular events (MACE) and MACE plus hospitalization for congestive heart failure (total cardiovascular (CV) event).The mean systolic BP was 135.0 ± 24.7 mm Hg and the mean diastolic BP was 70.7 ± 13.1 mm Hg. Systolic BP 140–149 mm Hg and diastolic BP 80–89 mm Hg had the lowest MACE (11.0%; 13.2%) and total CV event (23.3%; 21.1%). Patients with systolic BP < 120 mm Hg had a higher risk of MACE (HR: 2.01; 95% CI: 1.17–3.46, p =.008) than those with systolic BP 140–149 mm Hg. Patients with systolic BP ≥ 160 mm Hg (HR: 1.84; 95% CI, 3.27–1.04, p =.04) and diastolic blood BP ≥ 90 mm Hg (HR: 2.19; 95% CI: 1.15–4.16, p =.02) had a higher risk of total CV event rate when compared to those with systolic BP 140–149 mm Hg and diastolic BP 80–89 mm Hg. A J-shaped association between systolic (140–149 mm Hg) and diastolic (80–89 mm Hg) BP and decreased cardiovascular events for CAD was found in patients with ESRD after undergoing PCI in non-Western population.

Original languageEnglish
Pages (from-to)1622-1630
Number of pages9
JournalJournal of Clinical Hypertension
Volume23
Issue number8
DOIs
Publication statusPublished - Aug 2021
Externally publishedYes

Keywords

  • blood pressure
  • coronary artery disease
  • end-stage renal disease
  • percutaneous coronary intervention

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

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