Blood pressure components and the risk for proteinuria in Japanese men: The Kansai Healthcare Study

• Published in: Journal of epidemiology Vol. 27; no. 11; pp. 505 - 510
• Main Authors: Shibata, Mikiko, Sato, Kyoko Kogawa, Uehara, Shinichiro, Koh, Hideo, Kinuhata, Shigeki, Oue, Keiko, Kambe, Hiroshi, Morimoto, Michio, Hayashi, Tomoshige
• Format: Journal Article
• Language: English
• Published: Japan Elsevier B.V 01.11.2017; Japan Epidemiological Association; Elsevier
• Subjects: Adult; Antihypertensives; Blood pressure; Blood Pressure - physiology; Blood pressure components; Chronic kidney disease; Cohort analysis; Confidence intervals; Diabetes mellitus; Epidemiology; Glomerular filtration rate; Hazards; Health care; Health risk assessment; Humans; Japan - epidemiology; Male; Men; Middle age; Middle Aged; Original; Proportional Hazards Models; Prospective cohort study; Prospective Studies; Proteinuria; Proteinuria - epidemiology; Risk; Risk Factors; Statistical models; Chronic kidney disease; Blood pressure components; Epidemiology; Prospective cohort study; Proteinuria
• ISSN: 0917-5040; 1349-9092
• DOI: 10.1016/j.je.2016.10.010

We examined prospectively which of the four blood pressure (BP) components (systolic BP [SBP], diastolic BP [DBP], pulse pressure [PP], and mean arterial pressure [MAP]) was best in predicting the risk of proteinuria. This prospective study included 9341 non-diabetic Japanese middle-aged men who had no proteinuria and an estimated glomerular filtration rate ≥60 mL/min/1.73 m2 and were not taking antihypertensive medications at entry. Persistent proteinuria was defined if proteinuria was detected two or more times consecutively and persistently at the annual examination until the end of follow-up. We calculated the difference in values of Akaike's information criterion (ΔAIC) in comparison of the BP components-added model to the model without them in a Cox proportional hazards model. During the 84,587 person-years follow-up period, we confirmed 151 cases of persistent proteinuria. In multiple-adjusted models that included a single BP component, the hazard ratios for persistent proteinuria for the highest quartile of SBP, PP, and MAP were 3.11 (95% confidence interval [CI], 1.79–5.39), 1.87 (95% CI, 1.18–2.94), and 2.21 (95% CI, 1.33–3.69) compared with the lowest quartile of SBP, PP, and MAP, respectively. The hazard ratio for the highest quartile of DBP was 2.69 (95% CI, 1.65–4.38) compared with the second quartile of DBP. Of all models that included a single BP component, those that included SBP alone or DBP alone had the highest values of ΔAIC (14.0 and 13.1, respectively) in predicting the risk of persistent proteinuria. Of all BP components, SBP and DBP were best in predicting the risk of persistent proteinuria in middle-aged Japanese men. •We examined which blood pressure (BP) components increased risk of proteinuria.•We used systolic BP, diastolic BP, pulse pressure, and mean arterial pressure.•Systolic and diastolic BP were the best predictors of persistent proteinuria.