Blood Pressure Variability Parameters Prediction Research Of Cardiovascular Risk In Patients With Chronic Kidney Disease

Objective:Chronic kidney disease (CKD) presents obvious rising trend all over the world, has become a global public health problem. Increased risk of death in patients with CKD, the first is the risk of cardiovascular death. Ambulatory blood pressure is a common inspection method, the check noninvasive, accurate, reliable, and there are already a large number of studies presented BPV can predict cardiovascular risk. The Framingham heart study, known as the model of medical research. Therefore, we study in patients with chronic kidney disease the correlation between BPV and Framingham risk score. Provide a theoretical basis for the prevention and treatment of CKD in patients with cardiovascular disease.Methods:Collected in October 2010 to June 2014 in the First Affiliated Hospital of Kunming Medical University kidney internal medicine in hospital and diagnosed as chronic kidney disease (CKD). Aged between 20years-79years, volunteered to participate in this study. A complete medical history, measured height weight, perfect 24-hour urinary protein quantitative, blood routine, blood glucose, blood lipid, renal function, perform 24 hours of ambulatory blood pressure measurements. A total of 546 CKD patients were enrolled in this study, male 294, female 252, the average age 48.1±15.53. The 24-hour ambulatory blood pressure measurements in patients with BPV-related parameters were calculated (in this study, the choice of SD, CV, wSD, ARV). Framingham risk score is calculated based on the patient’s medical history, laboratory result, etc. Analysis correlation between the BPV related parameters, traditional cardiovascular risk factors (such as age, BMI, GFR, 24hours urinary protein quantitative, hemoglobin, uric acid) and Framingham risk score. Multiple regression analysis was used to identify BPV can be used as predictors of cardiovascular risk.Results:In 546 CKD patients, correlation analysis showed:the variables have correlation with Framingham risk score included:age, GFR, BMI, Defined daily dose, 24hours urinary protein quantitative, SD (systolic blood pressure), systolic blood pressure Average real variability, diastolic blood pressure Average real variability, wSD (systolic blood pressure). In these variables, age (r=0.795, P< 0.01), BMI(r=0.156, P<0.01), Defined daily dose (r=0.221, P<0.01),24hours urinary protein quantitative (r=0.172, P<0.01), SD (systolic blood pressure) (r=0.227, P< 0.01), systolic blood pressure Average real variability (r=0.262, P<0.01), diastolic blood pressure Average real variability (r=0.100, P<0.05), wSD (systolic blood pressure) (r=0.247, P<0.01) is positive correlated with Framingham risk score, while GFR (r=-0.197, P<0.01) was negative correlated with Framingham risk score. Multivariate regression analysis showed:the predictors of cardiovascular risk including:traditional cardiovascular risk factors (such as history of diabetes, smoking, BMI, GFR), also including:SD (systolic blood pressure) (P<0.01), systolic blood pressure Average real variability (P<0.01), wSD (systolic blood pressure) (P<0.01).Conclusion:In chronic kidney disease (CKD) patients, blood pressure variability (BPV) correlated with cardiovascular risk, systolic blood pressure variability (SBPV) can be used as a predictor of cardiovascular risk in patients with chronic kidney disease. Systolic blood pressure Average real variability highest correlation with cardiovascular risk, in patients with chronic kidney disease.