Rate of Change in Renal Function and Mortality in Elderly Treated XXXX @entity1 .

@entity1 @entity101 @entity470 @entity1011 @entity165
BACKGROUND AND OBJECTIVES: Evidence relating the rate of change in renal function, measured as @entity470 , after antihypertensive treatment in elderly @entity1 to clinical outcome is sparse. This study characterized the rate of change in @entity470 after commencement of antihypertensive treatment in an elderly population, the factors associated with @entity470 rate change, and the rate's association with all-cause and cardiovascular mortality. DESIGN, SETTING, @entity1 , _ MEASUREMENTS: Data from the Second Australian National Blood Pressure study were used, where 6083 @entity101 @entity1 aged >= 65 years were enrolled during 1995-1997 and followed for a median of 4.1 years (in-trial). Following the Second Australian National Blood Pressure study, @entity1 were followed-up for a further median 6.9 years (post-trial). The annual rate of change in the @entity470 was calculated in 4940 @entity1 using @entity1011 measurements during the in-trial period and classified into quintiles (Q) on the basis of the following @entity470 changes: rapid decline (Q1), decline (Q2), stable (Q3), increase (Q4), and rapid increase (Q5). RESULTS: A rapid decline in @entity470 in comparison with those with stable eGFRs during the in-trial period was associated with older age, living in a rural area, wider pulse pressure at baseline, receiving diuretic-based therapy, taking multiple antihypertensive drugs, and having blood pressure <140/90 mmHg during the study. However, a rapid increase in @entity470 was observed in younger @entity1 and those with a higher @entity165 level. After adjustment for baseline and in-trial covariates, Cox-proportional hazard models showed a significantly greater risk for both all-cause (hazard ratio, 1.28; 95% confidence interval, 1.09 to 1.52; P=0.003) and cardiovascular (hazard ratio, 1.40; 95% confidence interval, 1.11 to 1.76; P=0.004) mortality in the rapid decline group compared with the stable group over a median of 7.2 years after the last @entity470 measure. No significant association with mortality was observed for a rapid increase in @entity470 . CONCLUSIONS: In elderly @entity1 with treated @entity101 , a rapid decline in @entity470 is associated with a higher risk of mortality.
