Kidney Disease, Hypertension Treatment, and Cerebral Perfusion and Structure.
Hypertension
albuminuria
blood pressure (BP)
cerebral perfusion
chronic kidney disease (CKD)
intensive BP control
magnetic resonance imaging (MRI)
neuroimaging
white matter injury
white matter lesions
Journal
American journal of kidney diseases : the official journal of the National Kidney Foundation
ISSN: 1523-6838
Titre abrégé: Am J Kidney Dis
Pays: United States
ID NLM: 8110075
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
received:
02
03
2021
accepted:
28
07
2021
pubmed:
21
9
2021
medline:
27
4
2022
entrez:
20
9
2021
Statut:
ppublish
Résumé
The safety of intensive blood pressure (BP) targets is controversial for persons with chronic kidney disease (CKD). We studied the effects of hypertension treatment on cerebral perfusion and structure in individuals with and without CKD. Neuroimaging substudy of a randomized trial. A subset of participants in the Systolic Blood Pressure Intervention Trial (SPRINT) who underwent brain magnetic resonance imaging studies. Presence of baseline CKD was assessed by estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (UACR). Participants were randomly assigned to intensive (systolic BP <120 mm Hg) versus standard (systolic BP <140 mm Hg) BP lowering. The magnetic resonance imaging outcome measures were the 4-year change in global cerebral blood flow (CBF), white matter lesion (WML) volume, and total brain volume (TBV). A total of 716 randomized participants with a mean age of 68 years were enrolled; follow-up imaging occurred after a median 3.9 years. Among participants with eGFR <60 mL/min/1.73 m Measurement variability due to multisite design. Among adults with hypertension who have primarily early kidney disease, intensive versus standard BP treatment did not appear to have a detrimental effect on brain perfusion or structure. The findings support the safety of intensive BP treatment targets on brain health in persons with early kidney disease. SPRINT was funded by the National Institutes of Health (including the National Heart, Lung, and Blood Institute; the National Institute of Diabetes and Digestive and Kidney Diseases; the National Institute on Aging; and the National Institute of Neurological Disorders and Stroke), and this substudy was funded by the National Institutes of Diabetes and Digestive and Kidney Diseases. SPRINT was registered at ClinicalTrials.gov with study number NCT01206062.
Identifiants
pubmed: 34543687
pii: S0272-6386(21)00877-5
doi: 10.1053/j.ajkd.2021.07.024
pmc: PMC8926938
mid: NIHMS1766773
pii:
doi:
Substances chimiques
Antihypertensive Agents
0
Banques de données
ClinicalTrials.gov
['NCT01206062']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
677-687.e1Subventions
Organisme : NIA NIH HHS
ID : R03 AG063213
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002548
Pays : United States
Organisme : NIDDK NIH HHS
ID : U24 DK060990
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK092241
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG072947
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR003142
Pays : United States
Investigateurs
Paul Whelton
(P)
Karen C Johnson
(KC)
Joni Snyder
(J)
Diane Bild
(D)
Denise Bonds
(D)
Nakela Cook
(N)
Jeffrey Cutler
(J)
Lawrence Fine
(L)
Peter Kaufmann
(P)
Paul Kimmel
(P)
Lenore Launer
(L)
Claudia Moy
(C)
William Riley
(W)
Laurie Ryan
(L)
Joni Snyder
(J)
Eser Tolunay
(E)
Song Yang
(S)
David Reboussin
(D)
Jeff Williamson
(J)
Walter T Ambrosius
(WT)
William Applegate
(W)
Greg Evans
(G)
Capri Foy
(C)
Barry I Freedman
(BI)
Dalane Kitzman
(D)
Mary Lyles
(M)
Nick Pajewski
(N)
Steve Rapp
(S)
Scott Rushing
(S)
Neel Shah
(N)
Kaycee M Sink
(KM)
Mara Vitolins
(M)
Lynne Wagenknecht
(L)
Valerie Wilson
(V)
Letitia Perdue
(L)
Nancy Woolard
(N)
Tim Craven
(T)
Katelyn Garcia
(K)
Sarah Gaussoin
(S)
Laura Lovato
(L)
Jill Newman
(J)
James Lovato
(J)
Lingyi Lu
(L)
Chris McLouth
(C)
Greg Russell
(G)
Bobby Amoroso
(B)
Patty Davis
(P)
Jason Griffin
(J)
Darrin Harris
(D)
Mark King
(M)
Kathy Lane
(K)
Wes Roberson
(W)
Debbie Steinberg
(D)
Donna Ashford
(D)
Phyllis Babcock
(P)
Dana Chamberlain
(D)
Vickie Christensen
(V)
Loretta Cloud
(L)
Christy Collins
(C)
Delilah Cook
(D)
Katherine Currie
(K)
Debbie Felton
(D)
Stacy Harpe
(S)
Marjorie Howard
(M)
Michelle Lewis
(M)
Pamela Nance
(P)
Nicole Puccinelli-Ortega
(N)
Laurie Russell
(L)
Jennifer Walker
(J)
Brenda Craven
(B)
Candace Goode
(C)
Margie Troxler
(M)
Janet Davis
(J)
Sarah Hutchens
(S)
Anthony A Killeen
(AA)
Anna M Lukkari
(AM)
Robert Ringer
(R)
Brandi Dillard
(B)
Norbert Archibeque
(N)
Stuart Warren
(S)
Mike Sather
(M)
James Pontzer
(J)
Zach Taylor
(Z)
Elsayed Z Soliman
(EZ)
Zhu-Ming Zhang
(ZM)
Yabing Li
(Y)
Chuck Campbell
(C)
Susan Hensley
(S)
Julie Hu
(J)
Lisa Keasler
(L)
Mary Barr
(M)
Tonya Taylor
(T)
R Nick Bryan
(RN)
Christos Davatzikos
(C)
Ilya Nasarallah
(I)
Lisa Desiderio
(L)
Mark Elliott
(M)
Ari Borthakur
(A)
Harsha Battapady
(H)
Guray Erus
(G)
Alex Smith
(A)
Ze Wang
(Z)
Jimit Doshi
(J)
Jackson T Wright
(JT)
Mahboob Rahman
(M)
Alan J Lerner
(AJ)
Mahboob Rahman
(M)
Carolyn Still
(C)
Alan Wiggers
(A)
Sara Zamanian
(S)
Alberta Bee
(A)
Renee Dancie
(R)
George Thomas
(G)
Martin Schreiber
(M)
Sankar Dass Navaneethan
(SD)
John Hickner
(J)
Michael Lioudis
(M)
Michelle Lard
(M)
Susan Marczewski
(S)
Jennifer Maraschky
(J)
Martha Colman
(M)
Andrea Aaby
(A)
Stacey Payne
(S)
Melanie Ramos
(M)
Carol Horner
(C)
Mahboob Rahman
(M)
Paul Drawz
(P)
Pratibha P Raghavendra
(PP)
Scott Ober
(S)
Ronda Mourad
(R)
Muralidhar Pallaki
(M)
Peter Russo
(P)
Pratibha Raghavendra
(P)
Pual Fantauzzo
(P)
Lisa Tucker
(L)
Bill Schwing
(B)
John R Sedor
(JR)
Edward J Horwitz
(EJ)
Jeffrey R Schellling
(JR)
John F O'Toole
(JF)
Lisa Humbert
(L)
Wendy Tutolo
(W)
Suzanne White
(S)
Alishea Gay
(A)
Walter Clark
(W)
Robin Hughes
(R)
Mirela Dobre
(M)
Jackson T Wright
(JT)
Carolyn H Still
(CH)
Alberta Bee
(A)
Monique Williams
(M)
Udayan Bhatt
(U)
Lee Hebert
(L)
Anil Agarwal
(A)
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(MB)
Nicole Ford
(N)
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(C)
Jody Baxter
(J)
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(AA)
Alison McKinley Neal Leena Hirmath
(A)
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(O)
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William F Miser
(WF)
Colleen Sagrilla
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Ashley Mintos
(A)
Angel A Howell
(AA)
Kelly Rogers
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Donald Ebersbacher
(D)
Lucy Long
(L)
Beth Bednarchik
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Alan Wiggers
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(L)
Adrian Schnall
(A)
Jonathan Smith
(J)
Lori Peysha
(L)
Lori Peysha
(L)
Beth Bednarchik
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Lisa Leach
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Megan Tribout
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Pinkie Ellington
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(MA)
Pranav Ghody
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(MV)
Raymond Townsend
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Debbie Cohen
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Mark Duckworth
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Virginia Ford
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Sandra Amoroso
(S)
Zoe Pfeffer
(Z)
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(SB)
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Marie Krousel-Wood
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Richard Deichmann
(R)
Patricia Ronney
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Donnalee Trapani
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Michelle Collins
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Charlene Weathers
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Emily Stone
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Andrew McWilliams
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Lindsay Lowe
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Kelly Everett
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(G)
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(RT)
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(J)
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(NL)
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(X)
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(M)
Mohammed Sika
(M)
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(D)
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(JL)
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(DS)
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(S)
Samir Patel
(S)
Manuel Velasquez
(M)
Roshni S Bastian
(RS)
Maria Wing
(M)
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(A)
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(T)
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(G)
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(S)
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(E)
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Siran Sirop
(S)
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(S)
Lauren Wada
(L)
Holly Kramer
(H)
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(V)
Corliss E Taylor
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Mark S Segal
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Amir Kazory
(A)
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Linda Owens
(L)
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(N)
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(M)
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(M)
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Informations de copyright
Published by Elsevier Inc.
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