Time-varying systolic blood pressure of 130-139 mmHg significantly increased the risk of incident chronic kidney disease by 39% compared to 100-119 mmHg in treatment-naïve individuals (HR 1.39).
Cohort (n=7,343)
Does elevated blood pressure (SBP ≥ 130 mmHg or DBP ≥ 90 mmHg) increase the risk of incident chronic kidney disease in treatment-naïve individuals?
In treatment-naïve individuals, blood pressure levels of SBP ≥ 130 mmHg or DBP ≥ 90 mmHg are associated with a significantly increased risk of developing chronic kidney disease, supporting earlier BP-lowering interventions.
Effect estimate: HR 1.39 (95% CI 1.10-1.77)
p-value: p=0.007
BACKGROUND: Although hypertension is a well-known risk factor for chronic kidney disease (CKD), the blood pressure (BP) at which antihypertensive interventions should be initiated remains to be determined. Therefore, we investigated the association between BP and CKD in treatment-naïve individuals. METHODS: This prospective cohort study considered 7,343 individuals in the Korean Genome and Epidemiology Study who were not taking antihypertensive medications. Subjects were categorized into six groups according to their systolic BP (SBP) and five groups according to their diastolic BP (DBP). The primary outcome was incident CKD, which was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m2 or the development of proteinuria. The secondary outcome was incident cardiovascular disease (CVD). RESULTS: In the time-varying Cox models, the hazard ratios (95% confidence interval CI) for CKD were 1.39 (1.10-1.77) with SBP 130-139 mmHg, 1.79 (1.40-2.28) with SBP 140-159 mmHg, and 3.22 (2.35-4.40) with SBP ≥ 160 mmHg, compared with SBP 100-119 mmHg. In addition, the hazard ratios (95% CI) for CKD were 1.88 (1.48-2.37) with DBP 90-99 mmHg and 4.30 (3.20-5.76) with DBP ≥ 100 mmHg, compared with DBP 70-79 mmHg. A significantly increased CVD risk was also observed in subjects with SBP ≥ 130 mmHg or DBP ≥ 90 mmHg. CONCLUSION: Our findings indicate that SBP ≥ 130 mmHg and DBP ≥ 90 mmHg are associated with an increased risk of CKD. Therefore, BP-lowering strategies should be considered starting at those thresholds to prevent CKD development.
Lee et al. (Wed,) conducted a cohort in Hypertension (Treatment-naïve) (n=7,343). Systolic blood pressure 130-139 mmHg vs. Systolic blood pressure 100-119 mmHg was evaluated on Incident chronic kidney disease (eGFR <60 mL/min/1.73 m2 or development of proteinuria) (HR 1.39, 95% CI 1.10-1.77, p=0.007). Time-varying systolic blood pressure of 130-139 mmHg significantly increased the risk of incident chronic kidney disease by 39% compared to 100-119 mmHg in treatment-naïve individuals (HR 1.39).