title: Association between prehypertension and chronic kidney disease in the Japanese general population.
abstract: The increased prevalence of chronic kidney disease (CKD) is a consequence of the accumulation of risk factors, one of which is hypertension. Here we assessed the prevalence of CKD according to blood pressure among 232,025 patients in a Japanese nationwide database with a focus on the prevalence and risk factors of CKD in prehypertension. Patients were stratified by blood pressure and included 75,474 with optimal blood pressure (less than 120/80 mm Hg); 59,194 with prehypertension and a normal blood pressure (120-129/80-84 mm Hg) or 46,547 patients with high-normal blood pressure (130-139/85-89 mm Hg); and 50,810 with hypertension (over 140/90 mm Hg without anti-hypertensive drugs). CKD was defined as an estimated glomerular filtration rate of stage 3 or lower or having proteinuria greater than 1+ by a dipstick method. The prevalence of CKD among patients with optimal blood pressure, prehypertension having normal or high-normal blood pressure, and hypertension was 13.9, 15.6, 18.1, and 20.7% in men, and 10.9, 11.6, 12.9, and 15.0% in women, with a significant difference between genders at each strata of blood pressure. In men, but not in women, whose blood pressure was high-normal, the CKD risk was significantly greater (odds ratio 1.11) than those with optimal blood pressure. Obesity (body mass index over 25) was significantly associated with an increased risk of CKD in both men and women (odds ratio 1.43 and 1.26, respectively), and there was an additive effect of obesity and pre-hypertension on CKD risk in men compared with men with optimal blood pressure. Thus, the prevalence of CKD increased with the severity of blood pressure. Prehypertension with high-normal blood pressure, particularly in conjunction with obesity, was found to be an independent risk factor of CKD in men.
authors.affiliation: Circulatory and Body Fluid Regulation, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yano
authors.forename: Shouichi
authors.initials: S
authors.lastname: Fujimoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sato
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Konta
authors.forename: Kunitoshi
authors.initials: K
authors.lastname: Iseki
authors.forename: Toshiki
authors.initials: T
authors.lastname: Moriyama
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Yamagata
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuruya
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yoshida
authors.forename: Koichi
authors.initials: K
authors.lastname: Asahi
authors.forename: Issei
authors.initials: I
authors.lastname: Kurahashi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D058246:Prehypertension / Q000150:complications*