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Regional variation in pre-dialysis blood pressure and its association with cardiovascular mortality rates in Japanese patients undergoing dialysis

Hypertension Research volume 47, pages 102–111 (2024)Cite this article

A Comment to this article was published on 07 December 2023

Abstract

Adequate blood pressure (BP) management poses a significant challenge in improving the prognosis of patients undergoing dialysis. We aimed to investigate the relationship between pre-dialysis systolic blood pressure (SBP) and underlying disease in Japanese patients undergoing dialysis, based on prefectural location, and assess the association between pre-dialysis SBP and cardiovascular disease (CVD) mortality rate. We extracted the basic information of 336,182 patients who were undergoing dialysis in 2021 from the Web-based Analysis of Dialysis Data Archives database. Data on average pre-dialysis SBP were analyzed according to sex, prefectural location, and diabetic status, and the CVD mortality rate for each prefecture was calculated. The mean pre-dialysis SBP of the patients (males, 66.3%; mean age, 69.7 ± 12.5 years) was 151.9 ± 24.7 mmHg. Overall, 133,037 patients had underlying diabetic kidney disease (DKD). The patients with DKD were younger, had a shorter dialysis duration, and a higher pre-dialysis SBP than those with non-DKD comorbidities. The prefecture-based mean pre-dialysis SBP values were all higher than 140 mmHg. At the prefectural level, CVD mortality rate was positively correlated with pre-dialysis SBP (r = 0.3127, p = 0.0324) and diastolic blood pressure (r = 0.3378, p = 0.0202) among female patients. At the prefectural level, pre-dialysis SBP is >140 mmHg in Japanese patients undergoing dialysis, especially in those with DKD. The positive association between pre-dialysis SBP and CVD mortality rate suggests that optimal BP management at the prefectural level may reduce CVD mortality rates.

At the prefectural level, pre-dialysis SBP is higher than 140 mmHg in Japanese patients undergoing dialysis, especially higher in those with DKD.

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Acknowledgements

We thank the Committee of the Renal Data Registry of the Japanese Society for Dialysis Therapy (JSDT) for permission to use their registry data. The results of the present study were derived from the analysis of split data from the WADDA system of the JSDT. However, the interpretation and reporting of these data are the responsibilities of the authors and should not be viewed as official policies or interpretations of the JSDT. All the authors have approved the manuscript.

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Authors and Affiliations

  1. Division of Cardiology, Nephrology, Respiratory and Neurology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan

    Hirofumi Sakuma, Minori Ikeda, Shiori Nakao, Reina Suetsugu, Motoki Matsuki, Naoyuki Hasebe & Naoki Nakagawa

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  1. Hirofumi Sakuma
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  2. Minori Ikeda
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Correspondence to Naoki Nakagawa.

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Sakuma, H., Ikeda, M., Nakao, S. et al. Regional variation in pre-dialysis blood pressure and its association with cardiovascular mortality rates in Japanese patients undergoing dialysis. Hypertens Res 47, 102–111 (2024). https://doi.org/10.1038/s41440-023-01415-7

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