Hyperbaric area index calculated from ABPM elucidates the condition of CKD patients: the CKD-JAC study

Satoshi Iimuro, Enyu Imai, Tsuyoshi Watanabe, Kosaku Nitta, Tadao Akizawa, Seiichi Matsuo, Hirofumi Makino, Yasuo Ohashi, Akira Hishida

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: High prevalence of masked hypertension as well as persistent hypertension was observed in the Chronic Kidney Disease Japan Cohort (CKD-JAC) study. We proposed a novel indicator of blood pressure (BP) load, hyperbaric area index (HBI), calculated from ambulatory blood pressure monitoring (ABPM) data. The characteristic of this index and its relationship with kidney function were also evaluated. Methods: The CKD-JAC study, enrolled 2,977 patients, is a prospective observational study started in September 2007. ABPM was conducted in a sub-group from September 2007 to April 2010 and baseline ABPM data of 1,075 subjects (63.4 % male, 60.7 years old) were analyzed. Results: Mean systolic HBI of male and female patients were 242.3 and 176.5 mmHg×h, respectively. HBI sensitively reflected sex (54.7 mmHg×h higher in males than in females), seasonal effects (51.6 mmHg×h higher in winter than in summer), and advancing CKD stage [(16.5 mmHg×h higher) per −10 mL/min/1.73 m2 in eGFR]. The HBI was a significant factor to associate with reduced kidney function, after adjusting with nocturnal BP change (NBPC), sex, and other variables (p value <0.001). Conclusions: Our findings suggested that HBI might be a novel sensitive indicator for the reduction of kidney function, independent of patterns of NBPC.

Original languageEnglish
Pages (from-to)114-124
Number of pages11
JournalClinical and Experimental Nephrology
Issue number1
Publication statusPublished - Feb 2015


  • Ambulatory blood pressure monitoring (ABPM)
  • Blood pressure load
  • Chronic kidney disease
  • Hyperbaric area index
  • Hypertension

ASJC Scopus subject areas

  • Physiology
  • Nephrology
  • Physiology (medical)


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