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Pulse pressure modifies the association between diastolic blood pressure and decrease in kidney function: the Japan Specific Health Checkups Study.
Tamaki, Hiroyuki; Eriguchi, Masahiro; Yoshida, Hisako; Uemura, Takayuki; Tasaki, Hikari; Nishimoto, Masatoshi; Kosugi, Takaaki; Samejima, Ken-Ichi; Iseki, Kunitoshi; Fujimoto, Shouichi; Konta, Tsuneo; Moriyama, Toshiki; Yamagata, Kunihiro; Narita, Ichiei; Kasahara, Masato; Shibagaki, Yugo; Kondo, Masahide; Asahi, Koichi; Watanabe, Tsuyoshi; Tsuruya, Kazuhiko.
Afiliación
  • Tamaki H; Department of Nephrology, Nara Medical University, Kashihara, Nara, Japan.
  • Eriguchi M; Department of Nephrology, Nara Medical University, Kashihara, Nara, Japan.
  • Yoshida H; Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Osaka, Japan.
  • Uemura T; Department of Nephrology, Nara Medical University, Kashihara, Nara, Japan.
  • Tasaki H; Department of Nephrology, Nara Medical University, Kashihara, Nara, Japan.
  • Nishimoto M; Department of Nephrology, Nara Medical University, Kashihara, Nara, Japan.
  • Kosugi T; Department of Nephrology, Nara Medical University, Kashihara, Nara, Japan.
  • Samejima KI; Department of Nephrology, Nara Medical University, Kashihara, Nara, Japan.
  • Iseki K; Steering Committee of The Japan Specific Health Checkups (JSHC) Study, Fukushima, Japan.
  • Fujimoto S; Steering Committee of The Japan Specific Health Checkups (JSHC) Study, Fukushima, Japan.
  • Konta T; Steering Committee of The Japan Specific Health Checkups (JSHC) Study, Fukushima, Japan.
  • Moriyama T; Steering Committee of The Japan Specific Health Checkups (JSHC) Study, Fukushima, Japan.
  • Yamagata K; Steering Committee of The Japan Specific Health Checkups (JSHC) Study, Fukushima, Japan.
  • Narita I; Steering Committee of The Japan Specific Health Checkups (JSHC) Study, Fukushima, Japan.
  • Kasahara M; Steering Committee of The Japan Specific Health Checkups (JSHC) Study, Fukushima, Japan.
  • Shibagaki Y; Steering Committee of The Japan Specific Health Checkups (JSHC) Study, Fukushima, Japan.
  • Kondo M; Steering Committee of The Japan Specific Health Checkups (JSHC) Study, Fukushima, Japan.
  • Asahi K; Steering Committee of The Japan Specific Health Checkups (JSHC) Study, Fukushima, Japan.
  • Watanabe T; Steering Committee of The Japan Specific Health Checkups (JSHC) Study, Fukushima, Japan.
  • Tsuruya K; Department of Nephrology, Nara Medical University, Kashihara, Nara, Japan.
Clin Kidney J ; 17(6): sfae152, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38846104
ABSTRACT

Background:

Unlike systolic blood pressure (SBP), the prognostic value of diastolic blood pressure (DBP) in kidney function has not been established. We hypothesized that pulse pressure (PP), which is associated with arteriosclerosis, would affect the prognostic value of DBP.

Methods:

This longitudinal study used data from the Japan Specific Health Checkups Study was conducted between 2008 and 2014. The participants were stratified into three PP subgroups (low PP ≤39, normal PP 40-59 and high PP ≥60 mmHg). The exposures of interest were SBP and DBP, and the association between SBP/DBP and kidney outcomes (30% decline in the estimated glomerular filtration rate from baseline) was examined in each PP subgroup using a Cox proportional hazards model.

Results:

Among 725 022 participants, 20 414 (2.8%) developed kidney outcomes during a median follow-up period of 34.6 months. Higher SBP was consistently associated with a higher incidence of kidney outcome in all PP subgroups. Although DBP had a positive linear association with the incidence of kidney outcome in low- and normal-PP subgroups, both lower (≤60 mmHg) and higher (≥101 mmHg) DBP were associated with a higher incidence of kidney outcome in the high-PP subgroup, with a U-shaped curve. Hazard ratios (95% confidence intervals) of ≤60 mmHg (reference 61-80 mmHg in normal-PP subgroup) and ≥101 mmHg were 1.26 (1.15-1.38) and 1.86 (1.62-2.14), respectively.

Conclusions:

In this large population-based cohort, DBP was differently associated with kidney outcome by PP level; lower DBP was significantly associated with a higher incidence of kidney outcome in the high-PP subgroup but not in the low- and normal-PP subgroups.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Kidney J Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Kidney J Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido