title: High-normal blood pressure and impaired renal function. A prospective study in a population-based cohort.
abstract: OBJECTIVE
  The association between high-normal blood pressure and the impairment of renal function is highly controversial. We analysed the contribution of high-normal blood pressure on incident impaired renal function.
  
  
  METHODS
  The study was performed in a population-based cohort of 1307 subjects free of diabetes, cardiovascular and renal disease at baseline, who attended both at baseline and after 6-year follow-up a metabolic screening. The outcome was incident impaired renal function, defined as a glomerular filtration rate <60 mL/min/1.73 m2.
  
  
  RESULTS
  Incidence of impaired renal function was 2.5%, 4.5%, 8.7% and 10.8% in optimal, normal, high-normal blood pressure and hypertension, respectively. Adjusted relative odds ratio (OR) of impaired renal function were modelled using logistic regression analyses including multiple confounders. The adjusted OR were 1.6 (95% CI 0.5-5.0) for normal blood pressure, 3.4 (1.2-10.3) for high-normal blood pressure and 3.7 (1.3-10.7) for hypertension. Results were similar after excluding overweight or obese patients.
  
  
  CONCLUSIONS
  High-normal blood pressure is an independent predictor of impaired renal function. Trials are warranted to test if therapeutic intervention on blood pressure is justified also in subjects with high-normal blood pressure to preserve renal function.
authors.affiliation: Department of Medical Science University of Turin, Turin, Italy - marilena.durazzo@unito.it.
authors.forename: S
authors.initials: S
authors.lastname: Bo
authors.forename: G
authors.initials: G
authors.lastname: Gruden
authors.forename: E
authors.initials: E
authors.lastname: Charbonnier
authors.forename: M
authors.initials: M
authors.lastname: Martorana
authors.forename: R
authors.initials: R
authors.lastname: Gambino
authors.forename: M
authors.initials: M
authors.lastname: Cassader
authors.forename: L
authors.initials: L
authors.lastname: Gentile
authors.forename: P
authors.initials: P
authors.lastname: Cavallo-Perin
authors.forename: M
authors.initials: M
authors.lastname: Durazzo
mesh_terms: D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D058246:Prehypertension / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D012107:Research Design; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D003404:Creatinine