Blood Pressure, Proteinuria, and Renal Function Decline: Associations in a Large Community-Based Population

Atsushi Hirayama, Tsuneo Konta, Keita Kamei, Kazuko Suzuki, Kazunobu Ichikawa, Shouichi Fujimoto, Kunitoshi Iseki, Toshiki Moriyama, Kunihiro Yamagata, Kazuhiko Tsuruya, Kenjiro Kimura, Ichiei Narita, Masahide Kondo, Koichi Asahi, Issei Kurahashi, Yasuo Ohashi, Tsuyoshi Watanabe

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Abstract

Background: Hypertension and proteinuria are risk factors for adverse renal outcomes in patients with chronic kidney disease. This study investigated the associations of blood pressure and proteinuria on renal function in a community-based population. Methods: We analyzed data from a nationwide database of 141,514 subjects who participated in the annual "Specific Health Check and Guidance in Japan" checkup in 2008 and 2010. The study subjects were aged between 29 and 74 years, and the cohort comprised 40% men. We examined relationships between blood pressure levels, proteinuria at baseline, and the 2-year change in the estimated glomerular filtration rate (eGFR), which was determined using the Japanese equation. Results: After adjusting for possible confounders, the change in the eGFR was inversely correlated with systolic blood pressure (SBP), but not diastolic blood pressure (DBP), at baseline, irrespective of the presence of proteinuria. Compared with the lowest SBP sixtile (≤118mm Hg), eGFRs declined significantly at SBPs ≥ 134mm Hg in subjects with proteinuria, while eGFRs declined significantly at SBPs ≥ 141mm Hg in those without proteinuria. At the same SBPs, renal function decline was faster and the risk for incident renal insufficiency was higher in subjects with proteinuria compared with those without proteinuria. Conclusions: This study showed that a difference in SBP, but not DBP, is independently associated with a rapid eGFR decline in the general Japanese population, and that the association of SBP on the decline of renal function was greater in subjects with proteinuria compared with those without proteinuria.

Original languageEnglish
Pages (from-to)1150-1156
Number of pages7
JournalAmerican journal of hypertension
Volume28
Issue number9
DOIs
Publication statusPublished - 2015 Jun 17

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Keywords

  • blood pressure
  • cohort study
  • hypertension
  • renal function

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Hirayama, A., Konta, T., Kamei, K., Suzuki, K., Ichikawa, K., Fujimoto, S., Iseki, K., Moriyama, T., Yamagata, K., Tsuruya, K., Kimura, K., Narita, I., Kondo, M., Asahi, K., Kurahashi, I., Ohashi, Y., & Watanabe, T. (2015). Blood Pressure, Proteinuria, and Renal Function Decline: Associations in a Large Community-Based Population. American journal of hypertension, 28(9), 1150-1156. https://doi.org/10.1093/ajh/hpv003