Key result
Blood pressure of 130-139/80-89 mmHg was associated with a significantly increased risk of incident chronic kidney disease (RR 1.17) compared to blood pressure <130/80 mmHg in Chinese adults.
Why the study?
Whether the 2017 AHA/ACC definition of hypertension and blood pressure changes are related to increased risk of chronic kidney disease remained debated across different glucose metabolism states.
Does elevated blood pressure according to 2017 ACC/AHA guidelines and long-term BP change increase the risk of incident CKD in older Chinese adults with different glucose metabolism?
Cohort (n=12,951)
No
Does elevated blood pressure according to 2017 ACC/AHA guidelines and long-term BP change increase the risk of incident CKD in older Chinese adults with different glucose metabolism?
Blood pressure of 130-139/80-89 mmHg combined with prediabetes or diabetes, as well as long-term BP increases, are associated with an increased risk of incident CKD and rapid eGFR decline in older adults.
May warrant closer CKD monitoring in older Chinese adults with stage 1 hypertension; extends observational BP-CKD links but leaves targets unresolved.
Whether the definition of hypertension according to 2017 AHA/ACC guidelines and blood pressure (BP) changes was related to the increased risk of chronic kidney disease (CKD) remained debated. This prospective cohort study aimed to investigate the association of BP and long-term BP change with CKD risk with different glucose metabolism according to the new hypertension guidelines. This study examined 12 951 participants and 11 183 participants derived from the older people cohort study, respectively. Participants were divided into three groups based on blood glucose and the risks were assessmented by the logistic regression model. During a 10 years of follow-up period, 2727 individuals developed CKD (21.1%). Compared with those with BP < 130/80 mmHg, individuals with increased BP levels had significantly increased risk of incident CKD. Participants with BP of 130-139/80-89 or ≥140/90 mmHg had 1.51- and 1.89-fold incident risk of CKD in patients with diabetes mellitus (DM). Compared with individuals with stable BP (-5 to 5 mmHg), the risk of CKD was reduced when BP decreased by 5 mmHg or more and increased when BP increased ≥5 mmHg among normoglycemia and prediabetes participants. Similar results were observed for rapid estimated glomerular filtration rate (eGFR) decline. In conclusion, the BP of 130-139/80-89 mmHg combined with prediabetes or DM had an increased risk of incident CKD and rapid eGFR decline in older people. Long-term changes of BP by more than 5 mmHg among normoglycemia or prediabetes were associated with the risk of incident CKD and rapid eGFR decline.
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He et al. (2021) conducted a cohort in Chronic kidney disease risk (n=12,951). Blood pressure 130-139/80-89 mmHg (Stage 1 Hypertension) vs. Blood pressure <130/80 mmHg was evaluated on Incident chronic kidney disease (CKD) (RR 1.17, 95% CI 1.04-1.31, p=<0.001). Blood pressure of 130-139/80-89 mmHg was associated with a significantly increased risk of incident chronic kidney disease (RR 1.17) compared to blood pressure <130/80 mmHg in Chinese adults.
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