Lower Diastolic Blood Pressure was Associated with Higher Incidence of Chronic Kidney Disease in the General Population Only in those Using Antihypertensive Medications
Lower Diastolic Blood Pressure was Associated with Higher Incidence of Chronic Kidney Disease in the General Population Only in those Using Antihypertensive Medications
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DOI：
10.1159/000501828
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发表时间：
2019-10-01
影响因子：
2.8
通讯作者：
Shibagaki, Yugo
中科院分区：
文献类型：
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作者：
Uchida, Daisuke;Kido, Ryo;Shibagaki, Yugo
背景/目标：在一般人群中，舒张压（DBP）与慢性肾脏病（CKD）发病率的相关性尚未得到很好的研究。研究方法：使用2008年至2011年日本39-74岁普通人群的国民健康检查数据库，我们在127，954名无CKD的参与者中评估了DBP与2年后CKD发病率之间的相关性。DBP从最低值（100 mm Hg）开始每5 mm Hg分类，并进一步分层为使用和不使用降压药物（BP药物）。我们使用logistic回归模型计算估计CKD事件调整风险的OR。结果如下：参与者中62%为女性，25.9%使用BP药物，平均年龄为76岁，估计肾小球滤过率为78.2 +/- 13.4，DBP为76 +/- 11 mm Hg。两年后，12，379人（9.7%）发展为CKD。与DBP 60-64 mm Hg（未使用BP药物）作为参考相比，多变量分析显示，在任何DBP类别下，未使用BP药物的患者的CKD风险无差异。然而，在使用BP药物的患者中，风险随着DBP从95 mmHg降至60 mmHg而增加（趋势p <0.05），DBP的OR为1.51（95% CI 1.14-1.99
Background/Aims: The association of diastolic blood pressure (DBP) with incidence of chronic kidney disease (CKD) in the general population is not well examined. Methods: Using national health check-up database from 2008 to 2011 in the general Japanese population aged 39-74 years, we evaluated the association between DBP and incidence of CKD 2 years later in 127,954 participants without CKD. DBP was categorized by every 5 mm Hg from the lowest (100 mm Hg) and was further stratified into those with and without antihypertensive medications (BP meds). We calculated the OR for estimating adjusted risk of incident CKD using logistic regression model. Results: Participants were 62% female and 25.9% with BP meds, mean age of 76 years with estimated glomerular filtration rate of 78.2 +/- 13.4 and DBP of 76 +/- 11 mm Hg. Two years later, 12,379 (9.7%) developed CKD. Compared to DBP 60-64 mm Hg without BP meds as reference, multivariate analysis showed no difference in CKD risk at any DBP category among those without BP meds. However, in those with BP meds, risk increased according to lower DBP from 95 to 60 mm Hg (p for trend 0.05) with OR 1.51 (95% CI 1.14-1.99) in DBP