Association of central arterial blood pressure and left ventricular hypertrophy in patients with chronic kidney disease. Issue 1 (31st August 2021)

• Record Type: Journal Article
• Authors: Cai, Ruyi; Shao, Lina; Zhu, Yifan; Liu, Yueming; Zhang, Jinshi; He, Qiang
• Is Part Of: Nephrology. Volume 27:Issue 1(2022)
• Page Start: 57
• Page End: 65
• Publication Date: 2021-08-31
• Subjects: blood pressure -- brachial artery blood pressure -- central aortic pressure -- chronic kidney disease -- left ventricular hypertrophy; Nephrology -- Periodicals; Kidneys -- Diseases -- Periodicals; Nephrologists -- Periodicals; 616.61; 616.61
• DOI: 10.1111/nep.13967
• Languages: English
• ISSNs: 1320-5358

Abstract

Abstract: Aims: In the general population, central arterial blood pressure has proved to be more closely related to left ventricular hypertrophy (LVH) than brachial arterial blood pressure. We aimed to investigate whether this relationship was true in patients with chronic kidney disease (CKD). Methods: In this retrospective study, we reviewed the medical records of 289 adult patients with CKD from the Zhejiang Provincial People's Hospital in Zhejiang, China. Demographic, echocardiographic and brachial and central blood pressure parameters were retrieved from medical records. Central blood pressure was measured using the SphygmoCor® CvMS (AtCor, Australia) device and its corresponding software. Multivariate logistic regression analyses were performed to identify independent predictors of LVH. Receiver operating characteristic curves were used to determine the ability of central and brachial blood pressure to predict LVH. Results: The left ventricular mass index was positively associated with both central and brachial blood pressures. However, multiple logistic regression analysis demonstrated that a central pulse pressure (CPP) ≥ 58 mm Hg was an independent risk factor for LVH (OR = 5.597, 95%CI 2.363–13.259, p < .001). Brachial pulse pressure is not superior to CPP in predicting LVH (area under the curve [AUC] = 0.695, 95%CI 0.634–0.756, p < .001 vs. AUC = 0.687, 95%CI: 0.626–0.748, p < .001, respectively; p = .4824). Conclusion: Our results suggested that, similarly to the general population, CPP is a better parameter for predicting the occurrence of LVH in patients with CKD. SUMMARY AT A GLANCE: Increased central pulse pressure (CPP, estimated using a special device and software) and phosphate levels, and decreased haemoglobin levels are independent risk factors for left ventricular hypertrophy (LVH) in CKD patients. CPP is a better clinical parameter than brachial pulse pressure in predicting the occurrence of LVH in patients with CKD.