Prognostic Effect of Isolated Nocturnal Hypertension in Chinese Patients With Nondialysis Chronic Kidney Disease.
BACKGROUND
Isolated nocturnal hypertension (INH) has been studied among the general population and hypertensive patients. However, little insight is available on the prognostic effect of INH in patients with chronic kidney disease (CKD). This study investigated the prognostic effect of INH in a cohort of Chinese patients with nondialysis CKD.


METHODS AND RESULTS
A total of 588 Chinese CKD patients who were admitted to the Third Affiliated Hospital of Sun Yat-Sen University were enrolled in this study. We monitored blood pressure (BP) throughout the day and followed health outcomes in the 588 CKD patients admitted to our hospital division. We recorded time to total mortality, cardiovascular mortality, renal events, and cardiovascular events. A total of 370 (62.92%) individuals had nocturnal hypertension, which included 136 (23.13%) patients with INH. Multivariable Cox regression analyses showed that nocturnal BP was a significant risk factor for renal events and cardiovascular events in CKD patients, even when adjusted for clinic BP, 24-hour BP, or daytime BP. Patients with nocturnal hypertension showed a worse prognosis compared with patients with nocturnal normotension (P<0.05), and nocturnal hypertension (versus nocturnal normotension) was associated with an increased risk for renal events (hazard ratio [HR], 3.81; 95% CI, 1.74-8.36) and cardiovascular events (HR, 8.34; 95% CI, 1.98-35.07). In addition, patients with INH had a worse prognosis than patients with normotension (P<0.017), whereas INH (versus normotension) was associated with a higher risk of renal events (HR, 2.78; 95% CI, 1.16-6.65) and cardiovascular events (HR, 6.82; 95% CI, 1.52-30.63).


CONCLUSIONS
INH was associated with a poor prognosis in Chinese nondialysis CKD patients.
['Wang|Cheng|C|', 'Li|Yan|Y|', 'Zhang|Jun|J|', 'Ye|Zengchun|Z|', 'Zhang|Qunzi|Q|', 'Ma|Xinxin|X|', 'Peng|Hui|H|', 'Lou|Tanqi|T|']
D000328:Adult D001157:Arterial Occlusive Diseases D018660:Blood Pressure Monitoring, Ambulatory D002318:Cardiovascular Diseases D002423:Cause of Death D002681:China D002940:Circadian Rhythm D003404:Creatinine D018450:Disease Progression D005260:Female D006333:Heart Failure D006801:Humans D006973:Hypertension D007676:Kidney Failure, Chronic D035002:Lower Extremity D008297:Male D008875:Middle Aged D009026:Mortality D015999:Multivariate Analysis D009203:Myocardial Infarction D009204:Myocardial Revascularization D058729:Peripheral Arterial Disease D011379:Prognosis D016016:Proportional Hazards Models D051436:Renal Insufficiency, Chronic D015356:Retinal Artery Occlusion D020521:Stroke D055815:Young Adult
isolated nocturnal hypertension hypertension chronic kidney disease kidney prognosis ambulatory blood pressure monitoring kidney (diabetes)