Correlation Analysis Between Different Blood Pressure Levels And Cardiovascular Events In Patients With Maintenance Hemodialysis

Objective:To explore the correlation between blood pressure levels and cardiovascular events in maintenance hemodialysis patients.Methods:The patients who underwent maintenance hemodialysis follow-up for more than2 years and at the hemodialysis center of Linfen Hospital affiliated with Shanxi Medical University from January 2019 to June 2021 were enrolled in this retrospective cohort study.Record the blood pressure of patients with regular dialysis before and after 6 times of dialysis,and take the average value as the consulting room blood pressure.According to the baseline systolic blood pressure,patients were divided into three groups: 110 mm Hg≤SBP<140mm Hg,140 mm Hg≤SBP<155mm Hg,and SBP≥155mm Hg.The selected patients’ baseline data and endpoint events(cardiovascular events)were collected through the electronic medical record system.The Kaplan-Meier survival curve method was used to analyze the cumulative incidence of endpoint events in different blood pressure subgroups.The Cox regression model was used to analyze the risk factors of endpoint events in patients.Results:A total of 144 patients with maintenance hemodialysis were included,including91(63.2%)males,with an average age of 55.92±15.57 years and an average dialysis time of 24.00(12.00,48.00)months.There were 69(47.9%)patients in the110 mm Hg≤SBP<140mm Hg group,37(25.7%)patients in the 140 mm Hg≤SBP<155mm Hg group,and 38(26.4%)patients in the SBP≥155mm Hg group.There were statistically significant differences in the groups in the use of antihypertensive drugs and left ventricular hypertrophy(P<0.05).During the median follow-up of20.89±11.98 months,60(42.0%)patients had endpoint events.The incidence of endpoint events in the three groups was 32.4%(22/69),35.1%(13/37),and 65.8%(25/38),respectively.Kaplan-Meier survival curve showed that the incidence of cardiovascular events in the three groups was statistically significant(Log-Rank testχ2=18.50,P<0.001).Multivariate Cox regression analysis showed that SBP≥155mm Hg was an independent influencing factor for the increased risk of cardiovascular events(with 110 mm Hg≤SBP<140mm Hg as reference,HR=2.307,95%CI 1.185～4.491,P=0.014);Age is also an independent influencing factor for the increase of cardiovascular events risk(HR=1.021,95%CI 1.003～1.039,P=0.021).Conclusions:1.Compared with 110 mm Hg≤SBP<140mm Hg,SBP≥155mm Hg may be an independent risk factor for cardiovascular events in hemodialysis patients.2.Age may also be an independent risk factor for cardiovascular events in hemodialysis patients.Considering that elderly patients have poor physical fitness and more complications,elderly patients should pay more attention to blood pressure management.