High-normal diastolic blood pressure is a risk for development of microalbuminuria in the general population: The Watari study

Satoshi Konno, Atsushi Hozawa, Yukio Miura, Sadayoshi Ito, Masanori Munakata

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Objective: Although hypertension is a well known risk factor for microalbuminuria, it is unclear whether blood pressure less than 140/90mmHg could be a risk for microalbuminuria. We assessed the relationship between baseline blood pressure and the future onset of microalbuminuria in the general population. Methods: We studied 2603 town inhabitants of Watari, located in the southeastern part of Miyagi prefecture, Japan. Demographic data, medical history, sitting blood pressure, fasting blood chemistry, and urinary albumincreatinine ratio were measured at baseline and were followed annually during the next 3 years. Results: Among 2338 individuals who were normoalbuminuric at baseline (albumin-creatinine ratio <30 mg/g Cr), 161 developed microalbuminuria (albumincreatinine ratio 30-299 mg/g Cr) during a mean follow-up period of 2.4 years. Incident microalbuminuria patients were older (63.7±8.6 vs. 61.4±10.5 years; P<0.01), included fewer men (31.1 vs. 40.1%; P<0.05), had a greater BMI (23.8±3.6 vs. 23.1±3.1 kg/m2; P<0.01), higher blood pressures (133.5±18.1/75. 8±11.9 vs. 127.6±18.1/73.4±11.0mmHg; P<0.01 for both systolic and diastolic), higher triglycerides (median 1.18 vs. 1.02 mmol/l; P<0.01), higher fasting blood glucose (median 5.05 vs. 4.94 mmol/l; P<0.01), higher urinary albumin excretion (median 13.0 vs. 5.9 mg/g Cr; P<0.001), and lower serum creatinine concentrations (59.2±12.8 vs. 61.4±13.2mmol/l; P<0.05) compared to persistent normoalbuminuric individuals. Multivariate Cox proportional hazards analysis including all covariates revealed that only baseline urinary albumin excretion was an independent predictor for future microalbuminuria, whereas high-normal DBP, triglyceride, and fasting blood glucose concentrations were all significant predictors in the model excluding urinary albumin excretion.

Original languageEnglish
Pages (from-to)798-804
Number of pages7
JournalJournal of hypertension
Issue number4
Publication statusPublished - 2013 Apr


  • epidemiology
  • general population
  • high-normal blood pressure
  • microalbuminuria
  • risk factors

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine


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