title: Serum cystatin C, creatinine-based estimated glomerular filtration rate, and the risk of incident hypertension in middle-aged men.
abstract: BACKGROUND
  The aim of this study was to examine the predictive value of serum cystatin C (CysC) and that of creatinine-based estimated glomerular filtration rate (eGFRCreat) for the risk of incident hypertension in a middle-aged male population.
  
  
  METHODS
  Serum CysC levels were measured in 904 nonhypertensive, Japanese male subjects (mean age = 44±6 years) who received an annual general health examination in a company. Serum creatinine levels were simultaneously measured, and eGFRCreat was calculated. Subjects were followed-up for a maximum period of 4 years, and annual blood pressure measurements were recorded.
  
  
  RESULTS
  During the follow-up period, 124 subjects developed hypertension, defined as systolic/diastolic blood pressure ≥140/90 mmHg or use of antihypertensive medications. In the Kaplan-Meier analysis, both the third quintile of CysC and that of eGFRCreat showed the lowest 4-year cumulative incident rate of hypertension. The multiadjusted hazard ratio for incident hypertension was significantly increased in the highest quintile of CysC compared with the third quintile (2.60; 95% confidence interval (CI) = 1.41-4.77; P = 0.002), as well as compared with the lowest 4 quintiles combined (1.89; 95% CI = 1.26-2.84; P = 0.002). However, eGFRCreat did not show significant hazard ratios for incident hypertension in any of the adjusted models.
  
  
  CONCLUSIONS
  Elevated serum CysC levels could predict the risk of incident hypertension in this study population with a maximum follow-up period of 4 years. In contrast, eGFRCreat did not show predictive value for the risk of incident hypertension.
authors.affiliation: Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Otsuka
authors.forename: Katsuhito
authors.initials: K
authors.lastname: Kato
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kachi
authors.forename: Chikao
authors.initials: C
authors.lastname: Ibuki
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Seino
authors.forename: Eitaro
authors.initials: E
authors.lastname: Kodani
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kawada
mesh_terms: D000328:Adult; D044466:Asian People; D003404:Creatinine / Q000097:blood*; D055316:Cystatin C / Q000097:blood*; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012306:Risk
chemical_list: D055316:Cystatin C; D003404:Creatinine
keywords: blood pressure; creatinine; cystatin C; hypertension; kidney function; risk factors.