Stricter Blood Pressure Control Is Associated With Lower Left Ventricular Mass in Children After Kidney Transplantation: A Longitudinal Analysis of the 4C-T Study.


Journal

Hypertension (Dallas, Tex. : 1979)
ISSN: 1524-4563
Titre abrégé: Hypertension
Pays: United States
ID NLM: 7906255

Informations de publication

Date de publication:
09 2023
Historique:
medline: 18 8 2023
pubmed: 18 7 2023
entrez: 18 7 2023
Statut: ppublish

Résumé

We assessed the effect of blood pressure (BP) control on left ventricular mass index (LVMI) and left ventricular hypertrophy (LVH). Ninety-six patients (64 males) ≥9 months post-kidney transplantation from the 4C-T (Cardiovascular Comorbidity in Children with Chronic Kidney Disease and Transplantation) study were analyzed longitudinally (mean follow-up, 2.6±1.3 years). Cumulative systolic blood pressure (SBP)/diastolic BP 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. At baseline, LVMI was 49.7±12.7g/m Stricter BP control led to regression of LVMI and LVH. Our data suggest a BP target below the 60th pct, which needs to be substantiated in a randomized controlled trial.

Sections du résumé

BACKGROUND
We assessed the effect of blood pressure (BP) 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 and Transplantation) study were analyzed longitudinally (mean follow-up, 2.6±1.3 years). Cumulative systolic blood pressure (SBP)/diastolic BP 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/m
CONCLUSIONS
Stricter BP control led to regression of LVMI and LVH. Our data suggest a BP target below the 60th pct, which needs to be substantiated in a randomized controlled trial.

Identifiants

pubmed: 37462031
doi: 10.1161/HYPERTENSIONAHA.123.21187
pmc: PMC10424823
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1900-1908

Auteurs

Rizky I Sugianto (RI)

Department of Pediatric Kidney, Liver and Metabolic Diseases (R.I.S., C.G., D.T.-V., N.M., A.M.), Hannover Medical School, Germany.

Carl Grabitz (C)

Department of Pediatric Kidney, Liver and Metabolic Diseases (R.I.S., C.G., D.T.-V., N.M., A.M.), Hannover Medical School, Germany.

Aysun Bayazit (A)

Department of Pediatric Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey (A.B., A.A.).

Ali Duzova (A)

Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey (A. Duzova).

Daniela Thurn-Valsassina (D)

Department of Pediatric Kidney, Liver and Metabolic Diseases (R.I.S., C.G., D.T.-V., N.M., A.M.), Hannover Medical School, Germany.

Nima Memaran (N)

Department of Pediatric Kidney, Liver and Metabolic Diseases (R.I.S., C.G., D.T.-V., N.M., A.M.), Hannover Medical School, Germany.

Anke Doyon (A)

Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany (A. Doyon, F.S.).

Nur Canpolat (N)

Department of Pediatric Nephrology, Faculty of Medicine, Istanbul University-Cerrahpaşa, Turkey (N.C., S.C.).

Ipek Kaplan Bulut (I)

Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey (I.K.B.).

Karolis Azukaitis (K)

Clinic of Pediatrics, Faculty of Medicine, Vilnius University, Lithuania (K.A.).

Łukasz Obrycki (Ł)

Department of Nephrology, Kidney Transplantation and Arterial Hypertension, the Children's Memorial Health Institute, Warsaw, Poland (L.O.).

Ali Anarat (A)

Department of Pediatric Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey (A.B., A.A.).

Rainer Büscher (R)

University Children's Hospital, Essen, Germany (R.B.).

Salim Caliskan (S)

Department of Pediatric Nephrology, Faculty of Medicine, Istanbul University-Cerrahpaşa, Turkey (N.C., S.C.).

Jérôme Harambat (J)

Pediatrics Department, Centre Hospitalier Universitaire de Bordeaux, France (J.H.).

Francesca Lugani (F)

IRCCS Istituto Giannina Gaslini, Genoa, Italy (F.L.).

Zeynep B Ozcakar (ZB)

Division of Pediatric Nephrology, Department of Pediatrics, Ankara University Medical School, Turkey (Z.B.O.).

Dušan Paripović (D)

Department of Nephrology, University Children's Hospital, School of Medicine, University of Belgrade, Serbia (D.P.).

Bruno Ranchin (B)

Hôpital Femme Mère Enfant, Hospices Civils de Lyon & Université de Lyon, France (B.R.).

Uwe Querfeld (U)

Charité Children's Hospital, Berlin, Germany (U.Q.).

Franz Schaefer (F)

Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany (A. Doyon, F.S.).

Bernhard M W Schmidt (BMW)

Department of Nephrology and Hypertension (B.M.W.S.), Hannover Medical School, Germany.

Anette Melk (A)

Department of Pediatric Kidney, Liver and Metabolic Diseases (R.I.S., C.G., D.T.-V., N.M., A.M.), Hannover Medical School, Germany.

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