Background and objective Elevated blood pressure is a major risk factor for the progression of chronic kidney disease(CKD). Studies have reported that hypertension is strongly associated with kidney disease, little is known about the influence of prehypertension on CKD. In the present study, we aimed to investigate the effect of prehypertension on deterioration in kidney function using estimated glomerular filtration rate(eGFR) in middle-aged Korean population.
Subjects and Methods The Korean Genome and Epidemiology Study is a community-based prospective cohort study started in 2001 and the follow-up survey was conducted every two year. 9,568 participants aged 40-69 years old were included in a baseline study. Blood pressure was classified according to the Seventh Report of the Joint National Committee on High Blood Pressure(JNC-7) categories and glomerular filtration rate(GFR) was estimated with the Modification of Diet for Renal Disease(MDRD) equation.
Results The overall prevalence of eGFR<60mL/min/1.73m² was 11.4% and the prevalence of CKD was increased across the categories of blood pressure. The multivariable-adjusted odds ratio of eGFR<60mL/min/1.73m², adjusted for age, sex, body mass index, fasting plasma glucose, total cholesterol, high-density lipoproteincholesterol, low-density lipoproteincholesterol, waist circumference, was 1.441 for prehypertension and 1.884 for hypertension compared with normal blood pressure. At the 2-year follow-up, among the participants with prehypertension, decreased GFR was observed in 4.5% of subjects with controlled blood pressure and 6.6% of subjects with poorly controlled blood pressure, and the multivariable-adjusted odds ratio of chronic kidney disease event was 1.53 for poorly controlled group when controlled group was used as a reference.
Conclusion Prehypertension, as well as hypertension, is significantly associated with low eGFR among middle-aged Korean. Our results indicate that from prehypertension, active blood-pressure control is needed to prevent the deterioration of kidney function.
Keywords blood pressure, chronic kidney disease, prehypertension, estimated glomerular filtration rate
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