title: A population-based, prospective study of blood pressure and risk for end-stage renal disease in China.
abstract: The association between BP and risk for ESRD has not been well characterized in Asian populations. This study examined the relationship between level of BP and incidence of ESRD in a prospective cohort study of 158,365 Chinese men and women who were 40 yr and older. Measurement of BP and covariables were made in 1991 following a standard protocol. Follow-up evaluations were conducted in 1999 to 2000 and included interviewing participants or proxies and obtaining medical records and death certificates for ESRD cases. During 1,236,422 person-years of follow-up, 380 participants initiated renal replacement therapy or died from renal failure (30.7 cases per 100,000 person-years). Compared with those with normal BP, the multivariate adjusted hazard ratios (95% confidence interval) of all-cause ESRD for prehypertension and stage 1 and stage 2 hypertension were 1.30 (0.98 to 1.74), 1.47 (1.06 to 2.06), and 2.60 (1.89 to 3.57), respectively (P < 0.001 for trend). The corresponding hazard ratios (95% confidence interval) of glomerulonephritis-related ESRD were 1.32 (0.82 to 2.11), 1.48 (0.83 to 2.61), and 3.40 (2.02 to 5.74), respectively (P <0.001 for trend). Systolic BP was a stronger predictor of ESRD than diastolic BP or pulse pressure. This study provides novel data on the incidence of ESRD and on the association between BP and glomerulonephritis-related ESRD from a nationally representative sample of adults in China. These results document the importance of high BP as a modifiable risk factor for ESRD in China. Strategies to prevent ESRD should incorporate the prevention, treatment, and control of BP.
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, USA. kristi.reynolds@tulane.edu
authors.forename: Kristi
authors.initials: K
authors.lastname: Reynolds
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Gu
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: John W
authors.initials: JW
authors.lastname: Kusek
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Xigui
authors.initials: X
authors.lastname: Wu
authors.forename: Xiufang
authors.initials: X
authors.lastname: Duan
authors.forename: Chung-Shiuan
authors.initials: CS
authors.lastname: Chen
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Klag
authors.forename: Paul K
authors.initials: PK
authors.lastname: Whelton
authors.forename: Jiang
authors.initials: J
authors.lastname: He
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D001794:Blood Pressure; D002681:China / Q000453:epidemiology; D005260:Female; D006339:Heart Rate; D006801:Humans; D006977:Hypertension, Renal / Q000208:ethnology*; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors