Title Stricter blood pressure control is associated with lower left ventricular mass in children after kidney transplantation: a longitudinal analysis of the 4C-T study /
Authors Sugianto, Rizky Indrameikha ; Grabitz, Carl ; Bayazit, Aysun ; Duzova, Ali ; Thurn-Valsassina, Daniela ; Memaran, Nima ; Doyon, Anke ; Canpolat, Nur ; Kaplan Bulut, Ipek ; Ažukaitis, Karolis ; Obrycki, Lukasz ; Anarat, Ali ; Büscher, Rainer ; Caliskan, Salim ; Harambat, Jerome ; Lugani, Francesca ; Ozcakar, Zeynep B ; Paripovic, Dusan ; Ranchin, Bruno ; Querfeld, Uwe ; Schaefer, Franz ; Schmidt, Bernhard M.W ; Melk, Anette
DOI 10.1161/HYPERTENSIONAHA.123.21187
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Is Part of Hypertension.. Philadelphia : Lippincott Williams & Wilkins. 2023, vol. 80, iss. 9, p. 1900-1908.. ISSN 0194-911X. eISSN 1524-4563
Keywords [eng] cardiovascular morbidity ; hypertension ; left ventricular hypertrophy ; pediatric nephrology ; prospective study
Abstract [eng] BACKGROUND: We assessed the effect of blood pressure control on left ventricular mass index (LVMI) and left ventricular hypertrophy (LVH). METHODS: Ninety-six patients (64 males) ≥9 months post–kidney transplantation from the 4C-T (Cardiovascular Comorbidity in Children with Chronic Kidney Disease—Transplantation) study were analyzed longitudinally (mean follow-up, 2.6±1.3 years). Cumulative systolic blood pressure (SBP)/diastolic blood pressure exposure was calculated as a time-averaged area under the curve and categorized: ≤50th, 50th to ≤75th, 75th to ≤90th, and >90th percentile (pct). We performed adjusted linear and logistic mixed models for LVMI and LVH, respectively. RESULTS: At baseline, LVMI was 49.7±12.7g/m2.16 with 64% (n=61) kidney transplantation recipients displaying LVH. Compared with patients with cumulative SBP exposure >90th pct, patients with cumulative SBP of 50th to ≤75th showed a significant LVMI reduction of −5.24g/m2.16 (P=0.007). A similar tendency was seen for cumulative SBP≤50th (β=−3.70 g/m2.16; P=0.067), but patients with cumulative SBP of 75th to ≤90th pct showed no reduction. A post hoc analysis in patients with cumulative SBP≤75th revealed that median SBP exposure was at 57.5th pct. For cumulative diastolic blood pressure, a significant LVMI reduction was seen in all 3 categories ≤90th pct compared with patients >90th pct. Patients with cumulative SBP of ≤50th or 50th to ≤75th pct showed 79% or 83% lower odds of developing LVH, respectively. Patients with cumulative diastolic blood pressure ≤50th showed a tendency of 82% lower odds for LVH (95% CI, 0.03–1.07). CONCLUSIONS: Continuous exposure to blood pressure below the 60th pct led to regression of LVMI and LVH. Our data suggest stricter blood pressure control, which needs to be substantiated in a randomized controlled trial.
Published Philadelphia : Lippincott Williams & Wilkins
Type Journal article
Language English
Publication date 2023
CC license CC license description