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Kidney Function and Systolic Blood Pressure New Insights From Cystatin C: Data from the Heart and Soul Study

Control of hypertension is paramount in treating chronic kidney disease. The relationship between kidney function and blood pressure (BP) components has been studied in persons with diagnosed CKD, diabetes, or hypertension. Whether kidney function in the normal range is associated with systolic BP (... Full description

Journal Title: American journal of hypertension 2006, Vol.19 (9), p.939-946
Main Author: Peralta, Carmen A
Other Authors: Whooley, Mary A , Ix, Joachim H , Shlipak, Michael G
Format: Electronic Article Electronic Article
Language: English
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Quelle: Alma/SFX Local Collection
Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0895-7061
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2771570
title: Kidney Function and Systolic Blood Pressure New Insights From Cystatin C: Data from the Heart and Soul Study
format: Article
creator:
  • Peralta, Carmen A
  • Whooley, Mary A
  • Ix, Joachim H
  • Shlipak, Michael G
subjects:
  • Aged
  • Analysis of Variance
  • Arterial hypertension. Arterial hypotension
  • Article
  • Biological and medical sciences
  • Biomarkers - blood
  • Biomarkers - urine
  • Blood and lymphatic vessels
  • Blood Pressure
  • Cardiology. Vascular system
  • Clinical manifestations. Epidemiology. Investigative techniques. Etiology
  • Creatinine - urine
  • Cross-Sectional Studies
  • Cystatin C
  • Cystatins - blood
  • Diabetes
  • Female
  • Fundamental and applied biological sciences. Psychology
  • Glomerular Filtration Rate
  • Hemodynamics. Rheology
  • Humans
  • Hypertension
  • Kidney
  • Kidney diseases
  • Kidney Failure, Chronic - blood
  • Kidney Failure, Chronic - metabolism
  • Kidney Failure, Chronic - physiopathology
  • Kidney Failure, Chronic - urine
  • Kidney Function Tests
  • Linear Models
  • Male
  • Medical sciences
  • Middle Aged
  • Plasticizers
  • Predictive Value of Tests
  • Prospective Studies
  • San Francisco
  • systolic blood pressure
  • Universities and colleges
  • Vertebrates: cardiovascular system
ispartof: American journal of hypertension, 2006, Vol.19 (9), p.939-946
description: Control of hypertension is paramount in treating chronic kidney disease. The relationship between kidney function and blood pressure (BP) components has been studied in persons with diagnosed CKD, diabetes, or hypertension. Whether kidney function in the normal range is associated with systolic BP (SBP), diastolic BP (DBP), and pulse pressure is unclear. We evaluated the association between kidney function and each BP component using cystatin C and 24-h creatinine clearance (CrCl) among 906 participants in the Heart and Soul Study. We observed that SBP was linearly associated with cystatin C concentrations (1.19 ± 0.55 mm Hg increase per 0.4 mg/L cystatin C, P = .03) across the range of kidney functions. In contrast, using CrCl, SBP was significantly associated with kidney function only in subjects with CrCl 60 mL/min (0.36 ± 0.77 mm Hg per 28 mL/min, P = .64). Slopes differed significantly (for spline term P = .001). We found that DBP was not associated with cystatin C (0.34 ± 0.40 mm Hg per 0.4 mg/L cystatin, P = .39) or CrCl (0.62 ± 0.44 mm Hg per 28 mL/min clearance, P = .16). Pulse pressure was linearly associated with cystatin C (1.28 ± 0.55 mm Hg per 0.4 mg/L cystatin, P = .02) and with CrCl
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0895-7061
fulltext: fulltext
issn:
  • 0895-7061
  • 1941-7225
  • 1879-1905
url: Link


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titleKidney Function and Systolic Blood Pressure New Insights From Cystatin C: Data from the Heart and Soul Study
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descriptionControl of hypertension is paramount in treating chronic kidney disease. The relationship between kidney function and blood pressure (BP) components has been studied in persons with diagnosed CKD, diabetes, or hypertension. Whether kidney function in the normal range is associated with systolic BP (SBP), diastolic BP (DBP), and pulse pressure is unclear. We evaluated the association between kidney function and each BP component using cystatin C and 24-h creatinine clearance (CrCl) among 906 participants in the Heart and Soul Study. We observed that SBP was linearly associated with cystatin C concentrations (1.19 ± 0.55 mm Hg increase per 0.4 mg/L cystatin C, P = .03) across the range of kidney functions. In contrast, using CrCl, SBP was significantly associated with kidney function only in subjects with CrCl <60 mL/min (6.4 ± 2.13 mm Hg increase per 28 mL/min, P = .003) but not >60 mL/min (0.36 ± 0.77 mm Hg per 28 mL/min, P = .64). Slopes differed significantly (for spline term P = .001). We found that DBP was not associated with cystatin C (0.34 ± 0.40 mm Hg per 0.4 mg/L cystatin, P = .39) or CrCl (0.62 ± 0.44 mm Hg per 28 mL/min clearance, P = .16). Pulse pressure was linearly associated with cystatin C (1.28 ± 0.55 mm Hg per 0.4 mg/L cystatin, P = .02) and with CrCl <60 mL/min (7.27 ± 2.16 mm Hg per 28 mL/min, P = .001). Both SBP and pulse pressure were significantly associated with kidney function across a wide range of cystatin C concentrations, even in subjects with presumably normal kidney function, by creatinine-based measures. Cystatin C may provide new insights into the association of CKD and hypertension, a relationship that may be an underappreciated barrier to hypertension control.
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subjectAged ; Analysis of Variance ; Arterial hypertension. Arterial hypotension ; Article ; Biological and medical sciences ; Biomarkers - blood ; Biomarkers - urine ; Blood and lymphatic vessels ; Blood Pressure ; Cardiology. Vascular system ; Clinical manifestations. Epidemiology. Investigative techniques. Etiology ; Creatinine - urine ; Cross-Sectional Studies ; Cystatin C ; Cystatins - blood ; Diabetes ; Female ; Fundamental and applied biological sciences. Psychology ; Glomerular Filtration Rate ; Hemodynamics. Rheology ; Humans ; Hypertension ; Kidney ; Kidney diseases ; Kidney Failure, Chronic - blood ; Kidney Failure, Chronic - metabolism ; Kidney Failure, Chronic - physiopathology ; Kidney Failure, Chronic - urine ; Kidney Function Tests ; Linear Models ; Male ; Medical sciences ; Middle Aged ; Plasticizers ; Predictive Value of Tests ; Prospective Studies ; San Francisco ; systolic blood pressure ; Universities and colleges ; Vertebrates: cardiovascular system
ispartofAmerican journal of hypertension, 2006, Vol.19 (9), p.939-946
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descriptionControl of hypertension is paramount in treating chronic kidney disease. The relationship between kidney function and blood pressure (BP) components has been studied in persons with diagnosed CKD, diabetes, or hypertension. Whether kidney function in the normal range is associated with systolic BP (SBP), diastolic BP (DBP), and pulse pressure is unclear. We evaluated the association between kidney function and each BP component using cystatin C and 24-h creatinine clearance (CrCl) among 906 participants in the Heart and Soul Study. We observed that SBP was linearly associated with cystatin C concentrations (1.19 ± 0.55 mm Hg increase per 0.4 mg/L cystatin C, P = .03) across the range of kidney functions. In contrast, using CrCl, SBP was significantly associated with kidney function only in subjects with CrCl <60 mL/min (6.4 ± 2.13 mm Hg increase per 28 mL/min, P = .003) but not >60 mL/min (0.36 ± 0.77 mm Hg per 28 mL/min, P = .64). Slopes differed significantly (for spline term P = .001). We found that DBP was not associated with cystatin C (0.34 ± 0.40 mm Hg per 0.4 mg/L cystatin, P = .39) or CrCl (0.62 ± 0.44 mm Hg per 28 mL/min clearance, P = .16). Pulse pressure was linearly associated with cystatin C (1.28 ± 0.55 mm Hg per 0.4 mg/L cystatin, P = .02) and with CrCl <60 mL/min (7.27 ± 2.16 mm Hg per 28 mL/min, P = .001). Both SBP and pulse pressure were significantly associated with kidney function across a wide range of cystatin C concentrations, even in subjects with presumably normal kidney function, by creatinine-based measures. Cystatin C may provide new insights into the association of CKD and hypertension, a relationship that may be an underappreciated barrier to hypertension control.
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notesThe Heart and Soul Study is supported by grants from the Department of Veterans Affairs, the American Federation for Aging Research (Paul Beeson Scholars Program), the Robert Wood Johnson Foundation (Faculty Scholars Program), and the Ischemia Research and Education Foundation. Dr. Peralta was supported by the General Medicine Fellowship at University of California–San Francisco (UCSF). Dr. Ix was supported by the UCSF Academic Senate Individual Investigator Program. Dr. Shlipak was supported by the American Federation for Aging Research and National Institute on Aging (Paul Beeson Scholars Program) and the Robert Wood Johnson Foundation (Generalist Faculty Scholars Program).
abstractControl of hypertension is paramount in treating chronic kidney disease. The relationship between kidney function and blood pressure (BP) components has been studied in persons with diagnosed CKD, diabetes, or hypertension. Whether kidney function in the normal range is associated with systolic BP (SBP), diastolic BP (DBP), and pulse pressure is unclear. We evaluated the association between kidney function and each BP component using cystatin C and 24-h creatinine clearance (CrCl) among 906 participants in the Heart and Soul Study. We observed that SBP was linearly associated with cystatin C concentrations (1.19 ± 0.55 mm Hg increase per 0.4 mg/L cystatin C, P = .03) across the range of kidney functions. In contrast, using CrCl, SBP was significantly associated with kidney function only in subjects with CrCl <60 mL/min (6.4 ± 2.13 mm Hg increase per 28 mL/min, P = .003) but not >60 mL/min (0.36 ± 0.77 mm Hg per 28 mL/min, P = .64). Slopes differed significantly (for spline term P = .001). We found that DBP was not associated with cystatin C (0.34 ± 0.40 mm Hg per 0.4 mg/L cystatin, P = .39) or CrCl (0.62 ± 0.44 mm Hg per 28 mL/min clearance, P = .16). Pulse pressure was linearly associated with cystatin C (1.28 ± 0.55 mm Hg per 0.4 mg/L cystatin, P = .02) and with CrCl <60 mL/min (7.27 ± 2.16 mm Hg per 28 mL/min, P = .001). Both SBP and pulse pressure were significantly associated with kidney function across a wide range of cystatin C concentrations, even in subjects with presumably normal kidney function, by creatinine-based measures. Cystatin C may provide new insights into the association of CKD and hypertension, a relationship that may be an underappreciated barrier to hypertension control.
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