[PP.06.32] VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY AND ITS CORRELATION WITH DECLINE IN KIDNEY FUNCTION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS. (September 2017)

• Record Type: Journal Article
• Authors: Husin, H.; Chia, Y.; Hadi, H.
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000523361.69798.9a
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Blood pressure variability (BPV) is associated with poorer outcomes in patients with diabetes. Research on the characteristics of visit-to-visit BPV and its prognostic implications is limited. This study aimed to determine the value of BPV, associated factors of systolic BPV and its correlation with decline in kidney function in patients with type 2 diabetes mellitus (T2DM). Design and method: This was a 10-year retrospective cohort study of 333 patients with T2DM at a primary care clinic. Blood pressure (BP) at every follow up visit from 2005 to 2014 were captured. BPV was defined as the standard deviation of the BP readings. Decline in kidney function was expressed as the annual rate of decline in estimated glomerular filtration rate (eGFR). Factors associated with visit-to-visit systolic BPV was determined using Pearson's correlation coefficient and independent t-test. Independent association of decline in annual eGFR rate was determined using multivariate linear regression analysis. Results: This study involved 112 male patients (33.6%) and 221 female patients (66.4%). The mean age of patients at baseline was 57.8 ± 9.5 years old. By the end of study period, the mean duration of years of diabetes was 15.9 ± 6.2 years and 298 (89.5%) of patients had co-morbid hypertension. The mean visit-to-visit systolic BPV was 12.7 ± 3.1 mmHg. Higher systolic BPV was found in patients who were older, females, with co-morbid hypertension, more frequent clinic visits, higher mean systolic BP, higher mean total cholesterol and users of antihypertensive medications. The mean annual decline in eGFR rate in this study was −0.78 ± 1.60 ml/min/1.73m 2 . Independent factors associated with decline in kidney function were systolic BPV, longer duration of diabetes and use of diuretics. Conclusions: The visit-to-visit standard deviation of BPV in patients with T2DM is 12.7 mmHg. Systolic BPV is an independent risk factor associated with decline in kidney function. Hence visit-to-visit BPV is an important additional target to reduce decline in kidney function in patients with T2DM.