Evidence map›Paper›PMID 40389635›Full record

ArticleHypertension research : official journal of the Japanese Society of Hypertension2025

Combined pre-dialysis systolic blood pressure and pulse rate assessment for 1-year all-cause and cardiovascular mortality in patients on hemodialysis: a nationwide cohort study.

Nobuhiko Joki, Tatsunori Toida, Kakuya Niihata, Ryohei Inanaga, Kenji Nakata, Masanori Abe, Norio Hanafusa, Noriaki Kurita

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Article in Hypertension research : official journal of the Japanese Society of Hypertension, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Nobuhiko Joki *Division of Nephrology, Toho University Ohashi Medical Center, Tokyo, Japan.
Tatsunori Toida *Division of Nephrology, Toho University Ohashi Medical Center, Tokyo, Japan.
Kakuya Niihata *Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan.
Ryohei InanagaDepartment of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan.
Kenji NakataDivision of Nephrology, Toho University Ohashi Medical Center, Tokyo, Japan.
Masanori AbeThe Committee of Renal Data Registry, the Japanese Society for Dialysis Therapy, Tokyo, Japan.
Norio HanafusaThe Committee of Renal Data Registry, the Japanese Society for Dialysis Therapy, Tokyo, Japan.
Noriaki KuritaDepartment of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan. kuritanoriaki@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The prognostic utility of the combined assessment of pre-hemodialysis systolic blood pressure (SBP) and pulse rate compared to their independent assessment is unclear. In this nationwide cohort study, we aimed to determine whether their combined assessment could enhance the prognostic utility in patients on maintenance hemodialysis using the Japanese Renal Data Registry database. Exposure was defined as a combination of SBP and pulse rate. Forty-eight levels of exposure groups were created: SBP (<100, 100- < 120, 120- < 140, 140- < 160 [reference], 160- < 180, and ≥180 mmHg) and pulse rate (<50, 50- < 60, 60- < 70 [reference], 70- < 80, 80- < 90, 90- < 100, 100- < 110, and ≥110 beats/min). The primary and secondary outcomes were 1-year all-cause and cardiovascular mortalities, respectively. Multivariate Cox proportional hazards models were used, and multiplicative and additive interactions were assessed. The combined model for mortality and cardiac mortality was statistically better than the separate SBP and pulse rate model. Lower SBP was associated with higher risk of all-cause mortality irrespective of pulse rate. Most categories of lower SBP or higher pulse rate vs. the 120- < 140 mmHg and 70- < 80 beats/min category had positive relative excess risk due to interactions, with similar findings observed for cardiac mortality. Combined assessment of pre-dialysis SBP and pulse rate may help the simple stratification of patients with excess risks that cannot be identified by separate SBP and pulse rate assessment.

Indexed as

Blood PressureCardiovascular DiseasesHeart RateKidney Failure, ChronicRenal DialysisAgedCohort StudiesFemaleHumansJapanMaleMiddle AgedPrognosisAdditive interactionHemodialysisMortalityPulse rateSystolic blood pressure

Identifiers

PMID40389635

What OpenQuestion holds

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Registered trials

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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.