Usefulness of assessing masked and white-coat hypertension by ambulatory blood pressure monitoring for determining prevalent risk of chronic kidney disease: The Ohasama study

Atsuhiro Kanno, Hirohito Metoki, Masahiro Kikuya, Hiroyuki Terawaki, Azusa Hara, Takanao Hashimoto, Kei Asayama, Ryusuke Inoue, Yoh Shishido, Masaaki Nakayama, Kazuhito Totsune, Takayoshi Ohkubo, Yutaka Imai

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Abstract

Masked hypertension (MHT) is considered to be associated with organ damage, whereas the association of white-coat hypertension (WCHT) with organ damage remains controversial. Using home blood pressure measurements, we have previously reported that MHT is associated with a risk of chronic kidney disease (CKD) compared with sustained normal blood pressure (SNBP), although WCHT was not significantly related to CKD in a general Japanese population. The objective of this study was to examine CKD risk associated with WCHT and MHT as determined by ambulatory blood pressure (ABP) monitoring. Among 1023 residents in the general Japanese population of Ohasama, ABP and casual blood pressure (CBP) levels were recorded and blood and urine samples were collected. CKD was defined as a positive proteinuria and/or estimated glomerular filtration rate 60 ml min-1 per 1.73 m2. Participants were categorized into four groups using daytime ABP of 140/85 mm Hg and CBP of 140/90 mm Hg as cutoff points: SNBP, 60.0%; WCHT, 15.4%; MHT, 15.0%; and sustained hypertension (SHT), 9.6%. Odds ratios (ORs) for prevalence of CKD were calculated using a multiple logistic regression model. Compared with SNBP, risk of CKD was significantly higher in SHT (OR, 2.81; 95% confidence interval (CI), 1.66-4.75; P<0.0001), MHT (OR, 2.29; 95% CI, 1.45-3.63; P<0.0004) and WCHT (OR, 1.67; 95% CI, 1.03-2.71; P<0.0368). CKD was significantly associated with MHT and WCHT on the basis of ABP monitoring compared with SNBP in the general Japanese population.

Original languageEnglish
Pages (from-to)1192-1198
Number of pages7
JournalHypertension Research
Volume33
Issue number11
DOIs
Publication statusPublished - 2010 Nov 1
Externally publishedYes

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Keywords

  • ambulatory blood pressure
  • chronic kidney disease
  • masked hypertension
  • white-coat hypertension

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Kanno, A., Metoki, H., Kikuya, M., Terawaki, H., Hara, A., Hashimoto, T., Asayama, K., Inoue, R., Shishido, Y., Nakayama, M., Totsune, K., Ohkubo, T., & Imai, Y. (2010). Usefulness of assessing masked and white-coat hypertension by ambulatory blood pressure monitoring for determining prevalent risk of chronic kidney disease: The Ohasama study. Hypertension Research, 33(11), 1192-1198. https://doi.org/10.1038/hr.2010.139