title: Midlife Blood Pressure and Late-Life GFR and Albuminuria: An Elderly General Population Cohort.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is common in the elderly, but the cause is often not identifiable. Some posit that age-related reductions in glomerular filtration rate (GFR) and increases in albuminuria are normal, whereas others suggest that they are a consequence of vascular disease.
  
  
  METHODS
  Cross-sectional analysis of a substudy of a prospective cohort.
  
  
  METHODS
  AGES (Age, Gene/Environment Susceptibility)-Reykjavik Study.
  
  
  METHODS
  Exposure to higher blood pressure in midlife.
  
  
  METHODS
  Measured GFR using plasma clearance of iohexol and urine albumin-creatinine ratio.
  
  
  RESULTS
  GFR was measured in 805 participants with mean age in midlife and late life of 51.0±5.8 and 80.8±4.0 (SD) years, respectively. Mean measured GFR was 62.4±16.5 mL/min/1.73 m(2) and median albuminuria was 8.0 (IQR, 5.4-16.5) mg/g. Higher midlife systolic and diastolic blood pressures were associated with lower later-life GFRs. Associations persisted after adjustment. Higher midlife systolic and diastolic blood pressures were also associated with higher albumin-creatinine ratios, and associations remained significant even after adjustment.
  
  
  CONCLUSIONS
  This is a study of survivors, and people who agreed to participate in this study were healthier than those who refused. Blood pressure may encompass effects of the other risk factors. Results may not be generalizable to populations of other races. We were not able to adjust for measured GFR or albuminuria at the midlife visit.
  
  
  CONCLUSIONS
  Factors other than advanced age may account for the high prevalence of CKD in the elderly. Midlife factors are potential contributing factors to late-life kidney disease. Further studies are needed to identify and treat midlife modifiable factors to prevent the development of CKD.
authors.affiliation: Tufts Medical Center, Boston, MA. Electronic address: linker@tuftsmedicalcenter.org.
authors.forename: Lesley A
authors.initials: LA
authors.lastname: Inker
authors.affiliation: Tufts Medical Center, Boston, MA.
authors.forename: Aghogho
authors.initials: A
authors.lastname: Okparavero
authors.affiliation: The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA.
authors.forename: Hocine
authors.initials: H
authors.lastname: Tighiouart
authors.affiliation: Icelandic Heart Association, Kopavogur, Iceland; University of Iceland, Reykjavik, Iceland.
authors.forename: Thor
authors.initials: T
authors.lastname: Aspelund
authors.affiliation: Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
authors.forename: Margret B
authors.initials: MB
authors.lastname: Andresdottir
authors.affiliation: Icelandic Heart Association, Kopavogur, Iceland.
authors.forename: Gudny
authors.initials: G
authors.lastname: Eiriksdottir
authors.affiliation: National Institute on Aging, Bethesda, MD.
authors.forename: Tamara
authors.initials: T
authors.lastname: Harris
authors.affiliation: National Institute on Aging, Bethesda, MD.
authors.forename: Lenore
authors.initials: L
authors.lastname: Launer
authors.affiliation: Icelandic Heart Association, Kopavogur, Iceland.
authors.forename: Hjalmfridur
authors.initials: H
authors.lastname: Nikulasdottir
authors.affiliation: Icelandic Heart Association, Kopavogur, Iceland.
authors.forename: Johanna Eyrun
authors.initials: JE
authors.lastname: Sverrisdottir
authors.affiliation: Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
authors.forename: Hrefna
authors.initials: H
authors.lastname: Gudmundsdottir
authors.affiliation: The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA.
authors.forename: Farzad
authors.initials: F
authors.lastname: Noubary
authors.affiliation: Cardiovascular Engineering Inc, Norwood, MA.
authors.forename: Gary
authors.initials: G
authors.lastname: Mitchell
authors.affiliation: University of Iceland, Reykjavik, Iceland; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
authors.forename: Runolfur
authors.initials: R
authors.lastname: Palsson
authors.affiliation: Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
authors.forename: Olafur S
authors.initials: OS
authors.lastname: Indridason
authors.affiliation: Icelandic Heart Association, Kopavogur, Iceland; University of Iceland, Reykjavik, Iceland.
authors.forename: Vilmundur
authors.initials: V
authors.lastname: Gudnason
authors.affiliation: Tufts Medical Center, Boston, MA.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Levey
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000419:Albuminuria / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D003287:Contrast Media; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007472:Iohexol; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors
chemical_list: D003287:Contrast Media; D007472:Iohexol; D003404:Creatinine
keywords: Chronic kidney disease (CKD); aging; albumin-creatinine ratio (ACR); albuminuria; blood pressure; elderly; hypertension; iohexol clearance; measured glomerular filtration rate (mGFR); mid-life; modifiable risk factor; renal function