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Relationship between arterial stiffness and chronic kidney disease in patients with primary hypertension

Journal of Human Hypertension volume 34, pages 577–585 (2020)Cite this article

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Abstract

To investigate the association of noninvasive indices of arterial stiffness with chronic kidney disease (CKD) in patients with primary hypertension, 547 (mean age 60 years, 63% males) hypertensive hospital inpatients were recruited, comprising 337 hypertensives without CKD and 210 hypertensives with CKD. Noninvasive arterial stiffness indices were obtained, including central arterial haemodynamics derived from the radial artery waveform using SphygmoCor V8.0 system, carotid-femoral pulse wave velocity (cfPWV), large and small artery elasticity indices (C1, C2 respectively). Intima-media thickness (IMT) was evaluated by ultrasonography. The diagnosis of CKD was assessed by the estimated glomerular filtration rate (eGFR) or urinary albumin creatinine ratio (ACR). Compared with hypertension without CKD, hypertensive patients with CKD were older, had higher central systolic blood pressure, cfPWV, and IMT (all P < 0.01). With decreasing eGFR, cfPWV and augmentation index adjusted to heart rate of 75 bpm increased progressively whereas C2 decreased (P < 0.05) in subjects with CKD. In the overall population, cfPWV showed a significant trend of a negative association with eGFR (P = 0.04) after adjusting for age, gender, and brachial systolic blood pressure. Multiple logistic analysis showed that 1 SD (3 m/s) increase in cfPWV entailed a 1.35 (95% Cl: 1.018–1.790) times higher likelihood of the presence of CKD even after adjustment for confounding factors. The association of arterial stiffness and CKD suggests that cfPWV may be a potential hemodynamic index to evaluate cardiovascular risk in CKD patients with primary hypertension.

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Acknowledgements

We gratefully acknowledge the invaluable assistance of the physicians of the Department of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine. The study would not have been possible without their support.

Funding

Project supported by the National Natural Science Foundation of China (Grant no. 81500190), Shanghai Municipal Commission of Health and Family Planning (Grant no. 201740128), and Shanghai Jiading Science and Technology Committee (JDKW-2017-W12).

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  1. These authors contributed equally: Junli Zuo, Yueliang Hu

Authors and Affiliations

  1. Department of Hypertension, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Junli Zuo, Guili Chang & Shao-li Chu

  2. Department of Geriatrics, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Junli Zuo & Yueliang Hu

  3. Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia

    Junli Zuo, Isabella Tan, Mark Butlin & Alberto Avolio

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  1. Junli Zuo
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Correspondence to Junli Zuo.

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Zuo, J., Hu, Y., Chang, G. et al. Relationship between arterial stiffness and chronic kidney disease in patients with primary hypertension. J Hum Hypertens 34, 577–585 (2020). https://doi.org/10.1038/s41371-019-0275-y

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