title: New-onset hypertension and risk for chronic kidney disease in the Japanese general population.
abstract: OBJECTIVE
  Our aims were to assess the progression rate of normotension and prehypertension to hypertension in Japan, and the effect of the new-onset hypertension on chronic kidney disease (CKD).
  
  
  METHODS
  This was a nationwide study of 45 378 Japanese aged 40-74 years (mean age 60 years, 37% men) without hypertension or cardiovascular disease at baseline. At baseline and 3-year follow-up, blood pressure (BP) and kidney function were assessed. CKD was defined as an estimated glomerular filtration rate (eGFR) below 60 ml/min per 1.73 m² or the presence of proteinuria (≥1+ by a dipstick).
  
  
  RESULTS
  At 3-year follow-up, the incidence rates of hypertension among participants with optimal BP (<120/80 mmHg, n = 18,724), normal BP (120-129/80-84 mmHg, n = 15,017) and high-normal BP (130-139/85-89 mmHg, n = 11,637) were 8, 23, and 39% in men, and 6, 20, and 37% in women, respectively. Among those without CKD at baseline (n = 42,625), 2142 participants (5%) had developed CKD during follow-up. Irrespective of the baseline BP classifications, participants with new-onset hypertension had a higher risk for proteinuria [odds ratio (95% confidence interval) 1.7 (1.3-2.3) in men and 1.6 (1.2-2.2) in women], but not for eGFR below 60 ml/min per 1.73 m², compared with those who maintained optimal BP during follow-up. Men who remained in the high-normal BP range during follow-up showed higher risk for proteinuria [odds ratio (95% confidence interval) 1.6 (1.1-2.3)], but not for eGFR below 60 ml/min per 1.73 m².
  
  
  CONCLUSIONS
  This nationwide longitudinal study suggests that, over 3 years of follow-up, women and men with new-onset hypertension and men with high-normal BP were at higher risk of newly developing proteinuria.
authors.affiliation: aDivision of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi bDepartment of Hemovascular Medicine and Artificial Organs, Faculty of Medicine, University of Miyazaki cDialysis Division, University of Miyazaki Hospital, Miyazaki dDepartment of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata eDialysis Unit, University Hospital of the Ryukyus, Okinawa f1Health Care Center, Osaka University, Osaka gDepartment of Nephrology, Faculty of Medicine, University of Tsukuba, Ibaraki hDepartment of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka iDivision of Clinical Nephrology and Rheumatology, Niigata University Medical School, Nigata jDepartment of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, Ibaraki kDivision of Nephrology and Hypertension, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa lDepartment of Nephrology, Hypertension, Diabetology, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University, Fukushima mDepartment of Medical Informatics and Economics, School of Medicine nDepartment of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, 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
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authors.lastname: Konta
authors.forename: Kunitoshi
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authors.lastname: Iseki
authors.forename: Chiho
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authors.lastname: Iseki
authors.forename: Toshiki
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authors.lastname: Moriyama
authors.forename: Kunihiro
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authors.lastname: Yamagata
authors.forename: Kazuhiko
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authors.lastname: Tsuruya
authors.forename: Ichiei
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authors.lastname: Narita
authors.forename: Masahide
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authors.lastname: Kondo
authors.forename: Kenjiro
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authors.lastname: Kimura
authors.forename: Koichi
authors.initials: K
authors.lastname: Asahi
authors.forename: Issei
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authors.lastname: Kurahashi
authors.forename: Yasuo
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authors.lastname: Ohashi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D044466:Asian People / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology*; D007564:Japan / Q000453:epidemiology; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology*; D012307:Risk Factors