Nighttime hospital blood pressure – a predictor of death, ESRD, and decline in GFR

Drawz, Paul; Rosenthal, Noah; Babineau, Denise C.; Rahman, Mahboob

doi:10.3109/0886022x.2010.510615

Cited by 17 publications

(19 citation statements)

References 40 publications

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“…16,19 Persons who do not exhibit a 10% to 20% decrease in blood pressure at night (compared to day) are classified as “nondippersȍ nondipping is associated with an increased risk of chronic kidney disease. 16,32 Nikolaeva and colleagues 33 found that the circadian timing system controls the daily rhythms of sodium and potassium excretion by the kidney, which suggests that dysfunction of these rhythms may have a significant influence on blood pressure. A longitudinal study showed that creatinine clearance declines more rapidly in nondippers than in dippers, and urinary protein excretion is greater in the nondippers than in the dippers.…”

Section: Discussionmentioning

confidence: 99%

Association Between Shiftwork and Glomerular Filtration Rate in Police Officers

Charles

Fekedulegn

et al. 2013

Journal of Occupational &Amp; Environmental Medicine

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Objective To investigate associations between shiftwork and glomerular filtration rate among white/Hispanic (n = 273) and African American (n = 81) police officers. Methods Analysis of variance/analysis of variance was utilized to compare mean values of estimated glomerular filtration rate (eGFR) across shiftwork categories. Results Shiftwork was significantly associated with eGFR among white/Hispanic officers only: day (88.6 ± 2.8), afternoon (90.6 ± 2.9), and night shift (83.1 ± 3.1 mL/min/1.73 m2); afternoon versus night, P = 0.007. Percentage of hours worked on the night shift was inversely associated with mean levels of eGFR, trend P = 0.001. Body mass index modified the association between shiftwork and eGFR (interaction P = 0.038). Among officers with body mass index 25 kg/m2 or higher, those who worked the night shift had the lowest mean eGFR (afternoon vs night, P = 0.012; day vs night, P = 0.029). Conclusions Night-shift work was associated with decreased kidney function among white/Hispanic officers. Longitudinal studies are warranted among all races.

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Section: Discussionmentioning

confidence: 99%

Association Between Shiftwork and Glomerular Filtration Rate in Police Officers

Charles

Fekedulegn

et al. 2013

Journal of Occupational &Amp; Environmental Medicine

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“…Patients who ultimately developed microalbuminuria had a rise in nighttime BP between the baseline and year 2 ambulatory BP; nighttime BP did not change in those who did not develop microalbuminuria. In a novel approach to evaluating nighttime BP, our group looked at hospitalized patients who had BP measured at night; higher nighttime BP was associated with higher risk for subsequent adverse clinical outcomes [40]. In summary, alteration in diurnal variation with elevation in nocturnal BP is common in CKD and is associated with higher risk of renal and cardiovascular outcomes.…”

Section: Altered Diurnal Rhythm In Ckd: Causes and Implicationsmentioning

confidence: 98%

Nocturnal Medications Dosing: Does It Really Make a Difference in Blood Pressure Control Among Patients with Chronic Kidney Disease?

Mallick

Rahman

2012

Curr Hypertens Rep

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Ambulatory blood pressure (BP) monitoring is superior to clinic BP monitoring in predicting long-term consequences of hypertension. This has raised interest in diurnal variation in BP and elevation in nighttime BP as a prognostic and therapeutic target. Several studies have identified prevalence of nocturnal hypertension in patients with accelerated progression of chronic kidney disease and target organ damage. Some studies suggest that nocturnal BP can be lowered by changing administration of antihypertensive medication to bed time; whether that results in retarding kidney disease progression is not very clear. Further research is needed to determine if certain classes of medications or interventions are superior in controlling nocturnal hypertension, and protocols need to be developed to screen patients for monitoring nocturnal BP. Further studies are needed to evaluate long-term renal outcomes of evening dosing in patients with nocturnal hypertension and chronic kidney disease.

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“…In total, 266 subjects died, 22 developed ESRD, 99 had a 50% decline in GFR, and 136 developed MI. Moreover, the results showed that the adjusted hazard ratios associated with a 10 mmHg increase in nighttime systolic BP were 1.04 (95% CI, 0.93 to 1.16) for death, 1.31 (0.95 to 1.80) for ESRD, 1.26 (1.08 to 1.47) for a 50% decline in GFR, 1.07 (0.92 to 1.23) for MI, and 1.12 (1.03 to 1.23) for a composite of death, ESRD, or a 50% decline in GFR [32]. After the follow-up period (median 10.7 years) for 8711 individuals, the results revealed that isolated nocturnal hypertension (normal clinic blood pressure but nocturnal hypertension) was an independent risk factor for all cause mortality and cardiovascular events [41].…”

Section: Discussionmentioning

confidence: 99%

“…Non-dipping status or nocturnal hypertension was associated with target organ damage and increased cardiovascular disease (CVD) risk [4,31,32,33,34,35,36,37,38,39,40]. Nighttime systolic blood pressure ≥125 mmHg may increase the incidence of cardiovascular events (HR = 2.52, 95% CI 1.77-9.02) and end-stage renal disease (HR = 1.87, 95% CI 1.41-4.57) [1].…”

Section: Discussionmentioning

confidence: 99%

Evening -Versus Morning- Dosing Drug Therapy for Chronic Kidney Disease Patients with Hypertension: A Systematic Review

Liu

Huang

et al. 2014

Kidney Blood Press Res

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Background/Aims: There is a strong correlation between non-dipping status and cardiovascular events in chronic kidney disease (CKD) patients. Our study is designed to identify the effect of evening administration of antihypertensive drugs to hypertensive CKD patients. Methods: A comprehensive search of Medline, Embase, the Chinese Biomedical Literature Database, Wanfang Data, Chinese National Knowledge Infrastructure, and the Cochrane Central Register of Controlled Trials was performed in July 2014. Concurrent controlled or crossover trials (including randomized and non-randomized experimental trials) designed to evaluate the effects of evening- versus morning-dosing hypertensive drug regimens on clinical outcomes in CKD patients with hypertension were included. All statistical analyses were performed using the RevMan software, which is available free from the Cochrane Collaboration. Results: Seven trials involving 1277 patients were identified, and the randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) were classified into two groups. Taking at least one blood pressure-lowering medication at bedtime was not shown to reduce total death (P=0.056) or cardiovascular death (P=0.059) but was shown to reduce total events (P<0.001) and major cardiovascular events (P<0.001) in both RCTs and non-RCTs. Compared with a morning dosing regimen, taking antihypertensive drug in the evening significantly lowered nighttime systolic blood pressure (SBP) (P<0.0001) and diastolic blood pressure (P<0.05) in patients in the RCTs but did not affect blood pressure in patients in the non-RCTs (P<0.05). There is limited evidence from one non-RCT that taking an antihypertensive drug (benazepril 10 mg) in the evening did not increase adverse events (P=0.72) or withdrawals due to adverse events (P=0.64). Conclusions: A regimen of antihypertensive drugs in the evening should be considered for CKD patients with hypertension to lower nighttime blood pressure and help prevent total events and cardiovascular mortality. More studies are needed to verify the results of this study. i 2015 S. Karger AG, Basel

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Nighttime hospital blood pressure – a predictor of death, ESRD, and decline in GFR

Cited by 17 publications

References 40 publications

Association Between Shiftwork and Glomerular Filtration Rate in Police Officers

Association Between Shiftwork and Glomerular Filtration Rate in Police Officers

Nocturnal Medications Dosing: Does It Really Make a Difference in Blood Pressure Control Among Patients with Chronic Kidney Disease?

Evening -Versus Morning- Dosing Drug Therapy for Chronic Kidney Disease Patients with Hypertension: A Systematic Review

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