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Stricter blood pressure control is associated with lower left ventricular mass in children after kidney transplantation: a longitudinal analysis of the 4C-T study

BACKGROUND: - - We assessed the effect of blood pressure (BP) control on left ventricular mass index (LVMI) and left ventricular hypertrophy (LVH). - - METHODS: - - Ninety-six patients (64 males) ≥9 months post-kidney transplantation from the 4C-T (Cardiovascular Comorbidity in Children with Chro...

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Main Authors: Sugianto, Rizky (Author) , Grabitz, Carl (Author) , Bayazit, Aysun (Author) , Duzova, Ali (Author) , Thurn-Valsassina, Daniela (Author) , Memaran, Nima (Author) , Doyon, Anke (Author) , Canpolat, Nur (Author) , Kaplan Bulut, Ipek (Author) , Azukaitis, Karolis (Author) , Obrycki, Łukasz (Author) , Anarat, Ali (Author) , Büscher, Rainer (Author) , Caliskan, Salim (Author) , Harambat, Jérôme (Author) , Lugani, Francesca (Author) , Ozcakar, Zeynep B. (Author) , Paripović, Dušan (Author) , Ranchin, Bruno (Author) , Querfeld, Uwe (Author) , Schaefer, Franz (Author) , Schmidt, Bernhard M.W. (Author) , Melk, Anette (Author)
Format: Article (Journal)
Language:English
Published: September 2023
In: Hypertension
Year: 2023, Volume: 80, Issue: 9, Pages: 1900-1908
ISSN:1524-4563
DOI:10.1161/HYPERTENSIONAHA.123.21187
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1161/HYPERTENSIONAHA.123.21187
Verlag, kostenfrei, Volltext: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.123.21187
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Author Notes:Rizky I. Sugianto, Carl Grabitz, Aysun Bayazit, Ali Duzova, Daniela Thurn-Valsassina, Nima Memaran, Anke Doyon, Nur Canpolat, Ipek Kaplan Bulut, Karolis Azukaitis, Łukasz Obrycki, Ali Anarat, Rainer Büscher, Salim Caliskan, Jérôme Harambat, Francesca Lugani, Zeynep B. Ozcakar, Dušan Paripović, Bruno Ranchin, Uwe Querfeld, Franz Schaefer, Bernhard M.W. Schmidt, Anette Melk
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Summary:BACKGROUND: - - We assessed the effect of blood pressure (BP) control on left ventricular mass index (LVMI) and left ventricular hypertrophy (LVH). - - METHODS: - - Ninety-six patients (64 males) ≥9 months post-kidney transplantation from the 4C-T (Cardiovascular Comorbidity in Children with Chronic Kidney Disease and Transplantation) study were analyzed longitudinally (mean follow-up, 2.6±1.3 years). Cumulative systolic blood pressure (SBP)/diastolic BP exposure was calculated as a time-averaged area under the curve and categorized: ≤50th, 50th to ≤75th, 75th to ≤90th, and >90th percentile (pct). We performed adjusted linear and logistic mixed models for LVMI and LVH, respectively. - - RESULTS: - - At baseline, LVMI was 49.7±12.7g/m2.16 with 64% (n=61) kidney transplantation recipients displaying LVH. Compared with patients with cumulative SBP exposure >90th pct, patients with cumulative SBP of 50th to ≤75th showed a significant LVMI reduction of −5.24g/m2.16 (P=0.007). A similar tendency was seen for cumulative SBP≤50th (β=−3.70 g/m2.16; P=0.067), but patients with cumulative SBP of 75th to ≤90th pct showed no reduction. A post hoc analysis in patients with cumulative SBP≤75th revealed that median SBP exposure was at 57.5th pct. For cumulative diastolic BP, a significant LVMI reduction was seen in all 3 categories ≤90th pct compared with patients >90th pct. Patients with cumulative SBP of ≤50th or 50th to ≤75th pct showed 79% or 83% lower odds of developing LVH, respectively. Patients with cumulative diastolic BP ≤50th showed a tendency of 82% lower odds for LVH (95% CI, 0.03-1.07). - - CONCLUSIONS: - - Stricter BP control led to regression of LVMI and LVH. Our data suggest a BP target below the 60th pct, which needs to be substantiated in a randomized controlled trial.
Item Description:Online veröffentlicht: 18. Juli 2023
Gesehen am 08.12.2023
Physical Description:Online Resource
ISSN:1524-4563
DOI:10.1161/HYPERTENSIONAHA.123.21187

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