Reservoir Pressure Integral Is Independently Associated With the Reduction in Renal Function in Older Adults

TY - JOUR

T1 - Reservoir Pressure Integral Is Independently Associated With the Reduction in Renal Function in Older Adults

AU - Aizawa, Kunihiko

AU - Hughes, Alun D.

AU - Casanova, Francesco

AU - Gates, Phillip E.

AU - Mawson, David M.

AU - Gooding, Kim M.

AU - Gilchrist, Mark

AU - Goncalves, Isabel

AU - Nilsson, Jan

AU - Khan, Faisel

AU - Colhoun, Helen M.

AU - Palombo, Carlo

AU - Parker, Kim H.

AU - Shore, Angela C.

N1 - Funding Information: This study was supported by the European Union’s Seventh Framework Programme (FP7/2007-2013) for the Innovative Medicine Initiative under grant agreement number IMI/115006 (the Surrogate Markers for Micro- and Macrovascular Hard Endpoints for Innovative Diabetes Tools [SUMMIT] consortium) and, in part, by the National Institute of Health Research (NIHR) Exeter Clinical Research Facility. The views expressed are those of the authors and not necessarily those of the UK National Health Service, the NIHR or the UK Department of Health and Social Care. A.D. Hughes receives support from the British Heart Foundation, the Economic and Social Research Council (ESRC), the Horizon 2020 Framework Programme of the European Union, the National Institute on Aging, the National Institute for Health Research University College London Hospitals Biomedical Research Centre, the UK Medical Research Council and works in a unit that receives support from the UK Medical Research Council.

PY - 2022/10

Y1 - 2022/10

N2 - Background: Arterial hemodynamic parameters derived from reservoir-excess pressure analysis exhibit prognostic utility. Reservoir-excess pressure analysis may provide useful information about an influence of altered hemodynamics on target organ such as the kidneys. We determined whether the parameters derived from the reservoir-excess pressure analysis were associated with the reduction in estimated glomerular filtration rate in 542 older adults (69.4±7.9 years, 194 females) at baseline and after 3 years.Methods: Reservoir-excess pressure parameters, including reservoir pressure integral, excess pressure integral, systolic, and diastolic rate constants, were obtained by radial artery tonometry.Results: After 3 years, and in a group of 94 individuals (72.4±7.6 years, 26 females), there was an estimated glomerular filtration rate reduction of >5% per year (median reduction of 20.5% over 3 years). A multivariable logistic regression analysis revealed that higher baseline reservoir pressure integral was independently associated with a smaller reduction in estimated glomerular filtration rate after accounting for conventional cardiovascular risk factors and study centers (odds ratio: 0.660 [95% CIs, 0.494-0.883]; P=0.005). The association remained unchanged after further adjustments for potential confounders and baseline renal function (odds ratio: 0.528 [95% CIs, 0.351-0.794]; P=0.002). No other reservoir-excess pressure parameters exhibited associations with the reduction in renal function.Conclusions: This study demonstrates that baseline reservoir pressure integral was associated with the decline in renal function in older adults at 3-year follow-up, independently of conventional cardiovascular risk factors. This suggests that reservoir pressure integral may play a role in the functional decline of the kidneys.

AB - Background: Arterial hemodynamic parameters derived from reservoir-excess pressure analysis exhibit prognostic utility. Reservoir-excess pressure analysis may provide useful information about an influence of altered hemodynamics on target organ such as the kidneys. We determined whether the parameters derived from the reservoir-excess pressure analysis were associated with the reduction in estimated glomerular filtration rate in 542 older adults (69.4±7.9 years, 194 females) at baseline and after 3 years.Methods: Reservoir-excess pressure parameters, including reservoir pressure integral, excess pressure integral, systolic, and diastolic rate constants, were obtained by radial artery tonometry.Results: After 3 years, and in a group of 94 individuals (72.4±7.6 years, 26 females), there was an estimated glomerular filtration rate reduction of >5% per year (median reduction of 20.5% over 3 years). A multivariable logistic regression analysis revealed that higher baseline reservoir pressure integral was independently associated with a smaller reduction in estimated glomerular filtration rate after accounting for conventional cardiovascular risk factors and study centers (odds ratio: 0.660 [95% CIs, 0.494-0.883]; P=0.005). The association remained unchanged after further adjustments for potential confounders and baseline renal function (odds ratio: 0.528 [95% CIs, 0.351-0.794]; P=0.002). No other reservoir-excess pressure parameters exhibited associations with the reduction in renal function.Conclusions: This study demonstrates that baseline reservoir pressure integral was associated with the decline in renal function in older adults at 3-year follow-up, independently of conventional cardiovascular risk factors. This suggests that reservoir pressure integral may play a role in the functional decline of the kidneys.

KW - Aged

KW - Blood Pressure

KW - Female

KW - Glomerular Filtration Rate

KW - Humans

KW - Hypertension

KW - Kidney/physiology

KW - Radial Artery

KW - Kidney

KW - Risk factors

KW - Aging

KW - Blood pressure

KW - Hemodynamics

UR - https://www.scopus.com/pages/publications/85137765720

U2 - 10.1161/HYPERTENSIONAHA.122.19483

DO - 10.1161/HYPERTENSIONAHA.122.19483

M3 - Article

C2 - 35993228

SN - 0194-911X

VL - 79

SP - 2364

EP - 2372

JO - Hypertension

JF - Hypertension

IS - 10

ER -