title: Masked hypertension determined by self-measured blood pressure at home and chronic kidney disease in the Japanese general population: the Ohasama study.
abstract: Both chronic kidney disease (CKD) and masked hypertension (MHT) are known to be linked with an increased risk of cardiovascular disease (CVD), but their relationship has remained unclear. The present study aimed to evaluate the CKD incidence in individuals with MHT in the general Japanese population. We recorded self-measured blood pressure at home (HBP) and casual blood pressure (CBP) in 1,365 individuals (mean 63.0 years old; males, 32.5%; mean creatinine clearance [CCr], 60.9 mL/min; positive proteinuria, 6.7%) and classified the subjects into four groups: sustained normal blood pressure (SNBP, 60.3%), white-coat hypertension (WCHT, 14.9%), MHT (12.8%), and sustained hypertension (SHT, 12.0%). Kidney parameter results for the respective groups (SNBP, WCHT, MHT, and SHT) were as follows: 61.7 mL/min, 61.8 mL/min, 59.6 mL/min, and 57.3 mL/min for CCr, 4.2%, 8.9%, 10.3%, and 12.8% for the prevalence of positive proteinuria, and 2.3%, 3.0%, 6.3%, and 9.8% for the proportion with CCr<60 mL/min with proteinuria. Compared with the SNBP group, the MHT and SHT groups exhibited significant differences in these parameters (p<0.05, for each). The adjusted odds ratios for CCr<60 mL/min with proteinuria were significantly higher in the MHT (2.56) and SHT (3.60) groups compared with the SNBP group (reference). MHT, like SHT, is closely related to CKD, and HBP measurement could be a useful screening strategy to detect CKD in the general population.
authors.affiliation: Research Division of Dialysis and Chronic Kidney Disease, Tohoku University Graduate School of Medicine and Pharmaceutical Sciences, Sendai, Japan. terawaki@jikei.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Terawaki
authors.forename: Hirohito
authors.initials: H
authors.lastname: Metoki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Nakayama
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuya
authors.forename: Kei
authors.initials: K
authors.lastname: Asayama
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Inoue
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Hoshi
authors.forename: Sadayoshi
authors.initials: S
authors.lastname: Ito
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology*; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007674:Kidney Diseases / Q000453:epidemiology* / Q000208:ethnology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D016017:Odds Ratio