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Abstract: PO1782

Small Changes in eGFR Are Associated with Different Patterns of 24-Hour Ambulatory Blood Pressure Monitoring in the General Population

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Han, Sang Youb, Inje University Ilsan Paik Hospital, Goyang, Korea (the Republic of)
  • Yoon, Sanggon, Inje University Ilsan Paik Hospital, Goyang, Korea (the Republic of)
  • Lee, Seung Ku, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Korea (the Republic of)
  • Shin, Chol, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Korea (the Republic of)
Background

Alteration of circadian blood pressure (BP) rhythm such as non-dipper and reverse-dipper pattern is associated with cardiovascular diseases and chronic kidney disease (CKD). However, most studies did not control for kidney function even though kidney function is an important risk factor. In this study, we tried to show 24-h ambulatory blood pressure monitoring (ABPM) patterns based on an eGFR in patients without CKD.

Methods

This study was a cross-sectional study from the data of the Korean Genome and Epidemiology Study, which is ongoing prospective cohort study. A total of 1733 participants (60.0±7.00 years, 938 women) who had an eGFR > 60 ml/min/1.73m2 were included. Dipping status was stratified as reverse dipper (<0%), non-dipper (0% to <10%), and dipper (≥10%) based on the night to day ratio of mean BP. They were divided into 4 groups based on quartile of an eGFR (Q4, 128.6-101.6; Q3, 101.5-95.7; Q2, 95.6-87.4; Q1, 87.3-60.5).

Results

The proportion of dipper was progressively decreased from the highest to the lowest eGFR whereas that of reverse dipper and non-dipper significantly increased. (P<0.001). We analyzed the data using logistic regression model in relation to dipper, non-dipper, reverse dipper, and non-dipper plus reverse dipper according to the quartile groups of an eGFR. The highest quartile group (Q4) was fixed as the reference.
In univariate analyses, Q1 and Q2 groups were significantly associated with increasing odds ratio (OR) with non-dipper, reverse dipper, and non-dipper plus reverse dipper. After full-adjustment with age, sex, hypertension, diabetes, body mass index, smoking status, exercise, and alcohol consumption, the lowest eGFR group was significantly associated with reverse dippers and non-dipper plus reverse dippers compared to the highest eGFR group (OR=1.689, 95% CI, 1.005-2.840; OR=1.427, 95% CI, 1.027-1.985, respectively). The significant linear trend of non-dipper plus reverse dipper with a decrease in eGFR was confirmed with the test for trend (P=0.024).

Conclusion

Small changes in eGFR are associated with different pattern of 24-h ABPM in general population. ABPM could be useful tool to detect patients with non-dipper in these population.