Key result
Pre-hypertension was significantly associated with an increased risk of incident chronic kidney disease compared to normotension (HR 1.49, P<0.003).
Why the study?
Does pre-hypertension increase the risk of incident chronic kidney disease in a general population?
Cohort (n=2,150)
Does pre-hypertension increase the risk of incident chronic kidney disease in a general population?
Hazard Ratio: 1.49
p-value: p=< 0.003
Pre-hypertension is a significant predictor of incident chronic kidney disease in the general population, accounting for a substantial population-attributable fraction.
Pre-hypertension was associated with higher CKD incidence; leaves open whether BP lowering prevents onset in at-risk populations.
BACKGROUND: Hypertension is associated with an increased risk of development of chronic kidney disease (CKD). However, it is unclear whether pre-hypertension is related to the incidence of CKD. METHODS: The incidence of CKD defined as positive proteinuria or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m(2) was examined in 2150 inhabitants without pre-existing CKD from the general Japanese population. The association of blood pressure and CKD incidence was examined using a Cox regression model adjusted for age, sex, habitual smoking and drinking, obesity, history of cardiovascular disease, diabetes mellitus or hypercholesterolemia, eGFR at baseline, number of follow-up examinations and year of baseline examination. Participants were categorized according to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. RESULTS: Participants were categorized into normotension (n = 586, 27.3 % ), pre-hypertension (n = 815, 37.9 % ), Stage 1 hypertension (n = 386, 18.0 % ) and Stage 2 hypertension (n = 363, 16.9 % ). During a mean follow-up of 6.5 years (14 023 person-years), 461 incidences of CKD were recorded. Compared to normotension, adjusted hazard ratios of CKD were significantly higher for pre-hypertension (1.49, P < 0.003), Stage 1 (1.83, P < 0.001) and Stage 2 (2.55, P < 0.001) hypertension. The population-attributable fraction of pre-hypertension (12.1 % ) was considered to be compatible to that of Stage 1 (8.6 % ) and Stage 2 (14.9 % ) hypertension. CONCLUSION: This was the first study to demonstrate that pre-hypertension was significantly associated with an increased risk of CKD and was one of the considerable causes of CKD in the general population.
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Kanno et al. (2012) conducted a cohort in Chronic kidney disease (n=2,150). Pre-hypertension vs. Normotension was evaluated on Incidence of CKD defined as positive proteinuria or eGFR < 60 mL/min/1.73 m2 (HR 1.49, p=< 0.003). Pre-hypertension was significantly associated with an increased risk of incident chronic kidney disease compared to normotension (HR 1.49, P<0.003).