Effect of blood pressure index on clinical outcomes in patients with heart failure and chronic kidney disease

Abstract Aims This study aimed to assess the effect of blood pressure (BP) index, in terms of level and variability, on the progression of cardiovascular and renal diseases in patients with both heart failure (HF) and chronic kidney disease (CKD). Methods and results The study involved patients with HF and CKD from the database of the Chronic Renal Insufficiency Cohort (CRIC) study. The study endpoint includes the following: (i) primary endpoint, including cardiovascular disease (CVD) events, renal events, and all‐cause death; (ii) CVD events; (iii) renal events; and (iv) all‐cause death. Among 3939 participants in the CRIC study, a total of 382 patients were included. The duration of the follow‐up was 6.3 ± 2.7 years, the age was 60.2 ± 8.9 years, and 57.6% were male. BP index included 20 indicators in relation to BP level and variability, 4 of which were analysed including baseline systolic BP (SBP), standard deviation of SBP, coefficient of variation of diastolic BP (DBP CV), and average real variability of pulse pressure. In the Cox regression analysis after adjustment, baseline SBP was significant for the risk of primary endpoint [hazard ratio (HR) 1.22, 95% confidence interval (CI) 1.03–1.44, P = 0.02] and renal events (HR 1.54, 95% CI 1.22–1.95, P