title: Associations of proteinuria and the estimated glomerular filtration rate with incident hypertension in young to middle-aged Japanese males.
abstract: OBJECTIVE
  To investigate the independent associations of proteinuria and the estimated glomerular filtration rate (eGFR) with incident hypertension.
  
  
  METHODS
  We investigated 29,181 Japanese males 18-59years old without hypertension in 2000 and examined whether proteinuria and the eGFR predicted incident hypertension independently over 10years. Incident hypertension was defined as a newly detected blood pressure of ≥140/90mmHg and/or the initiation of antihypertensive drugs. Proteinuria and the eGFR were categorized as dipstick negative (reference), trace or ≥1+ and ≥60 (reference), 50-59.9 or <50ml/min/1.73m(2), respectively. Cox proportional hazards models were used to estimate the hazard ratios (HRs) of incident hypertension.
  
  
  RESULTS
  At baseline, 236 (0.8%) and 477 (1.6%) participants had trace and ≥1+ dipstick proteinuria, while 1416 (4.9%) and 129 (0.4%) participants had an eGFR of 50-59.9 and <50ml/min/1.73m(2), respectively. The adjusted HRs were significant for proteinuria ≥1+ (HRs 1.20, 95% CI: 1.06-1.35) and an eGFR of <50ml/min/1.73m(2) (1.29, 1.03-1.61). When two non-referent categories were combined (dipstick≥trace vs. negative and eGFR<60 vs. ≥60ml/min/1.73m(2)), the association was more significant for proteinuria (1.15, 1.04-1.27) than for eGFR (0.99, 0.92-1.07).
  
  
  CONCLUSIONS
  Proteinuria and a reduced eGFR are independently associated with future hypertension in young to middle-aged Japanese males.
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Okumura
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: takahisa@med.nagoya-u.ac.jp.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Kondo
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, USA.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Matsushita
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Osugi
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Shimokata
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Matsudaira
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Maeda
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D000293:Adolescent; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015331:Cohort Studies; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007674:Kidney Diseases / Q000175:diagnosis / Q000652:urine; D008297:Male; D008875:Middle Aged; D009786:Occupational Health Services / Q000706:statistics & numerical data; D010808:Physical Examination; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011507:Proteinuria / Q000175:diagnosis / Q000453:epidemiology* / Q000652:urine; D011934:Reagent Strips; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D011934:Reagent Strips
keywords: Dipstick proteinuria; Hypertension; Japanese males; Prospective cohort; eGFR