Observational studyClinical journal of the American Society of Nephrology : CJASN2016
Visit-to-Visit Variability of BP and CKD Outcomes: Results from the ALLHAT.
Observational study in Clinical journal of the American Society of Nephrology : CJASN, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Blood Pressure Variability and the Progression of Chronic Kidney Disease: a Systematic Review and Meta-Analysis.Journal of general internal medicine · 2023Pooled it
- Pharmacological interventions for heart failure in people with chronic kidney disease.The Cochrane database of systematic reviews · 2020Pooled it
- Visit-to-visit blood pressure variability and risk of chronic kidney disease: A systematic review and meta-analyses.PloS one · 2020Pooled it
- Long-Term Blood Pressure Variability and Kidney Function in Participants of the ASPREE Trial.American journal of hypertension · 2022Trial
- Blood pressure variability is related to faster cognitive decline in ischemic stroke patients: PICASSO subanalysis.Scientific reports · 2021Trial
- The impact of blood pressure variability and African Caribbean ethnicity on the progression of diabetic kidney disease in type 1 diabetes.Diabetologia · 2026Article
- Associations of Long-Term Blood Pressure Burden and Variability With Kidney Function Decline.Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- Visit-to-Visit Systolic Blood Pressure Variability Independently Predicts Cardiovascular Events in a Kidney Transplant Recipients' Cohort.Journal of the American Heart Association · 2024Observational
- Blood pressure changes impact corticospinal integrity and downstream gait and balance control.Neurobiology of aging · 2022Article
- Accelerated Peripapillary Retinal Nerve Fiber Layer Degeneration in Patients With Chronic Kidney Disease: A 2-Year Longitudinal Study.Translational vision science & technology · 2022Article
- Visit-to-visit variability in blood pressure and kidney disease progression in IgA nephropathy.Clinical kidney journal · 2022Article
- Observational
- Comparing statistical methods in assessing the prognostic effect of biomarker variability on time-to-event clinical outcomes.BMC medical research methodology · 2022Article
- Association Between Systolic Blood Pressure Variability and Major Adverse Cardiovascular Events in Korean Patients With Chronic Kidney Disease: Findings From KNOW-CKD.Journal of the American Heart Association · 2022Article
- Associations of Long-Term Visit-to-Visit Blood Pressure Variability With Subclinical Kidney Damage and Albuminuria in Adulthood: a 30-Year Prospective Cohort Study.Hypertension (Dallas, Tex. : 1979) · 2022Article
- Association of Circulating Osteoprotegerin Level with Blood Pressure Variability in Patients with Chronic Kidney Disease.Journal of clinical medicine · 2021Article
- Article
- Cumulative hypertension burden and risk of end-stage renal disease.Hypertension research : official journal of the Japanese Society of Hypertension · 2021Article
- Impact of home telemonitoring and management support on blood pressure control in non-dialysis CKD: a systematic review protocol.BMJ open · 2021Article
- Establishment of a novel nomogram for the clinically diagnostic prediction of minimal change disease, -a common cause of nephrotic syndrome.BMC nephrology · 2020Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
BACKGROUND AND
objectivesIncreased visit-to-visit variability of BP is associated with cardiovascular disease risk. We examined the association of visit-to-visit variability of BP with renal outcomes among 21,245 participants in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We measured mean BP and visit-to-visit variability of BP, defined as SD, across five to seven visits occurring 6-28 months after participants were randomized to chlorthalidone, amlodipine, or lisinopril. The composite outcome included incident ESRD after assessment of SD of systolic BP or ≥50% decline in eGFR between 24 months and 48 or 72 months after randomization. We repeated the analyses using average real variability and peak value of systolic BP and for visit-to-visit variability of diastolic BP.
resultsOver a mean follow-up of 3.5 years, 297 outcomes occurred. After multivariable adjustment, including baseline eGFR and mean systolic BP, the hazard ratios for the composite end point were 1.29 (95% confidence interval [95% CI], 0.75 to 2.22), 1.76 (95% CI, 1.06 to 2.91), 1.46 (95% CI, 0.88 to 2.45), and 2.05 (95% CI, 1.25 to 3.36) for the second through fifth (SD of systolic BP =6.63-8.82, 8.83-11.14, 11.15-14.56, and >14.56 mmHg, respectively) versus the first (SD of systolic BP <6.63 mmHg) quintile of SD of systolic BP, respectively (P trend =0.004). The association was similar when ESRD and a 50% decline in eGFR were analyzed separately, for other measures of visit-to-visit variability of systolic BP, and for visit-to-visit variability of diastolic BP.
conclusionsHigher visit-to-visit variability of BP is associated with higher risk of renal outcomes independent of mean BP.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.