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February 11, 2015American Journal of HypertensionOpen Access

Compared with the lowest SBP sixtile (≤118 mm Hg), eGFR declined significantly at SBPs ≥ 134 mm Hg in subjects with proteinuria, and at SBPs ≥ 141 mm Hg in those without proteinuria.

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Why the study?

Do higher systolic blood pressure and proteinuria accelerate renal function decline in a general community-based population?

Population

141,514 subjects aged 29-74 years from a nationwide database in Japan who participated in the annual…

Comparison

Higher systolic blood pressure levels and… vs Lowest systolic blood pressure sixtile and…

Design

Cohort

Follow-up

2 years

Authors

AHAtsushi HirayamaTKTsuneo KontaKKKeita Kamei

Discussion

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Overview

Proteinuria may lower SBP threshold for eGFR decline; leaves open optimal BP targets in community cohorts.

Structured PICO

Do higher systolic blood pressure and proteinuria accelerate renal function decline in a general community-based population?

P
Population
141,514 subjects aged 29-74 years (40% men) from a nationwide database in Japan who participated in the annual 'Specific Health Check and Guidance in Japan' checkup in 2008 and 2010.
I
Intervention
Higher systolic blood pressure levels and presence of proteinuria at baseline
C
Comparator
Lowest systolic blood pressure sixtile (≤118 mm Hg) and absence of proteinuria
O
Outcome
2-year change in estimated glomerular filtration rate (eGFR)surrogate

Higher systolic blood pressure is independently associated with rapid eGFR decline, with a lower threshold for harm in patients with baseline proteinuria.

Cite This Study

Hirayama et al. (2015) studied this question.

synapsesocial.com/papers/6a721d5075498292b70b58ddhttps://doi.org/10.1093/ajh/hpv003
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Blood Pressure Control, Proteinuria, and the Progression of Renal Disease1995 · 1,354 citations
  2. 2The Effect of a Lower Target Blood Pressure on the Progression of Kidney Disease: Long-Term Follow-up of the Modification of Diet in Renal Disease Study2005 · 523 citations
  3. 3Effect of Blood Pressure Lowering and Antihypertensive Drug Class on Progression of Hypertensive Kidney Disease Results From the AASK Trial2002 · 2,049 citations
  4. 42014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults2013 · 8,073 citations
  5. 5Risk of Developing Low Glomerular Filtration Rate or Elevated Serum Creatinine in a Screened Cohort in Okinawa, Japan2007 · 25 citations