New-onset hypertension and risk for chronic kidney disease in the Japanese general population

Yuichiro Yano, Shouichi Fujimoto, Yuji Sato, Tsuneo Konta, Kunitoshi Iseki, Chiho Iseki, Toshiki Moriyama, Kunihiro Yamagata, Kazuhiko Tsuruya, Ichiei Narita, Masahide Kondo, Kenjiro Kimura, Koichi Asahi, Issei Kurahashi, Yasuo Ohashi, Tsuyoshi Watanabe

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Abstract

Objectives: 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 1.73m2 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 1.73m2, 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 1.73m2. 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.

Original languageEnglish
Pages (from-to)2371-2377
Number of pages7
JournalJournal of hypertension
Volume32
Issue number12
DOIs
Publication statusPublished - Jan 1 2014

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All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Yano, Y., Fujimoto, S., Sato, Y., Konta, T., Iseki, K., Iseki, C., ... Watanabe, T. (2014). New-onset hypertension and risk for chronic kidney disease in the Japanese general population. Journal of hypertension, 32(12), 2371-2377. https://doi.org/10.1097/HJH.0000000000000344