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논문분류	춘계학술대회 초록집
제목	Isolated Hypertension and Hypotension and Kidney Outcome: Results from UK Biobank Data
저자	Jong Hyun Jhee
출판정보	2025; 2025(1):
키워드	Chronic kidney disease, isolated systolic hypertension, diabetes, blood pressure
초록	Isolated effects of blood pressure (BP) patterns and their effect on kidney function remain underexplored. This study aimed to evaluate the independent contributions of isolated BP patterns to kidney outcome. Using data from the UK Biobank, we analyzed 383,950 individuals with an initial SBP ≥ 90 mmHg and eGFR of ≥ 60 mL/min/1.73 m2. Participants were categorized into BP groups based on their BP patterns: combined hypertension (Both HTN, SBP ≥ 140 mmHg and DBP ≥ 90 mmHg), isolated systolic hypertension (ISH, SBP ≥ 140 mmHg and DBP < 90 mmHg), isolated diastolic hypertension (IDH, SBP < 140 mmHg and DBP ≥ 90 mmHg), normotension (SBP < 140 mmHg and 60 ≤ DBP < 90 mmHg), and isolated diastolic hypotension (IDHypo, SBP < 140 mmHg and DBP < 60 mmHg). Kidney outcome was incident CKD and ESKD defined by ICD-10 diagnosis (N18) and OPAC-based surgery codes. The median age of the participants was 57 years and 57.5% were women. During a median follow-up of 13.6 (12.9-14.3) years, a total of 8,624 events of kidney outcome occurred. In multivariable Cox models, ISH was significantly associated with an increased risk of kidney outcome (aHR 1.21, 95% CI 1.13–1.28), as was both HTN (aHR 1.15, 95% CI 1.07–1.23). In contrast, IDH (aHR 0.95, 95% CI 0.80–1.13) and IDHypo (aHR 1.10, 95% CI 0.80–1.51) were not significantly associated with kidney outcome in the overall population. However, among participants with diabetes, ISH remained a significant risk factor (aHR 1.14, 95% CI 1.00–1.29), and IDHypo was also associated with an increased risk of kidney outcome (aHR 1.68, 95% CI 1.02–2.78). These findings highlight the significant impact of ISH on kidney outcome, whereas IDH appears to have minimal influence in the general population. In patients with diabetes, cautious monitoring of isolated DBP reduction is warranted.
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