Age Modifies Link Between Blood Pressure and Cardiovascular, Renal Outcomes in CKD

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Age affects the association between blood pressure and cardiovascular and renal outcomes in CKD.
Age affects the association between blood pressure and cardiovascular and renal outcomes in CKD.

(HealthDay News) — Age modifies the association between blood pressure and adverse cardiovascular (CV) and renal outcomes in elderly patients with chronic kidney disease (CKD), according to research published in the Clinical Journal of the American Society of Nephrology.

Csaba P. Kovesdy, MD, of the University of Tennessee Health Science Center in Memphis, and colleagues analyzed data for 300 424 veterans with incident CKD to examine the associations of blood pressure with mortality and adverse outcomes.

The researchers found that both systolic and diastolic blood pressure had a U-shaped association with all-cause mortality. Systolic blood pressure showed a linear association, whereas diastolic blood pressure showed no consistent association, with coronary heart disease (CHD), stroke, and end-stage renal disease (ESRD). 

For systolic blood pressure of 170 mm Hg or greater compared with 130 mm Hg to 139 mm Hg, hazard ratios for mortality were attenuated with increasing age as follows: younger than 50 years, 1.95; 50 to 59 years, 2.01; 60 to 69 years, 1.68; 70 to 79 years, 1.39; and ≥0 years or older, 1.30.

The risk for incident CHD, stroke, and ESRD was increased incrementally with increasing systolic blood pressure in patients younger than 80 years, but no consistent association was observed for those 80 years of age and older (P<.05 for interaction for all outcomes).

"In veterans with incident CKD, systolic blood pressure shows different associations in older vs younger patients," the researchers wrote. "The association of higher systolic blood pressure with adverse outcomes is present, but markedly reduced in older individuals, especially in those ≥80 years old."

Reference

  1. Kovesdy CP, Alrifai A, Gosmanova EO, et al. Age and Outcomes Associated with BP in Patients with Incident CKD. Clin J Am Soc Nephrol. 2016. doi:10.2215/​CJN.08660815.
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