Blood pressure components and incident cardiovascular disease and mortality events among Iranian adults with chronic kidney disease during over a decade long follow-up: a prospective cohort study

Abstract

[14] identified a strong association between higher PP and CVD events, they could not establish such a relationship between either SBP or DBP with mortality among patients with advanced CKD. Since the studies mentioned above have mainly been conducted on Western populations, their results may not be applicable to other ethnicities such as Middle Eastern populations which have high incidence of CKD and its related risk factors such as hypertension and type 2 diabetes [15–18]. [...]patients with underlying chronic disease such as neoplasms, chronic infection, malnutrition and heart failure have lower DBP, indicating preexisting poor health status and residual confounding, lead to higher CVD and mortality events among the low DBP group, a phenomena called “reverse causality” [27, 28]. [...]some studies showed unintentionally reducing eGFR by tight blood pressure regimens, is itself an independent risk factor for CVD [27, 29]. According to our findings, maintaining SBP at levels < 140 mmHg, DBP between 80 and 85 mmHg and PP < 64 mmHg were associated with lowest risk for CV and all-cause mortality events.