Night-time blood pressure is associated with the development of chronic kidney disease in a general population: The Ohasama Study

Atsuhiro Kanno, Masahiro Kikuya, Kei Asayama, Michihiro Satoh, Ryusuke Inoue, Miki Hosaka, Hirohito Metoki, Taku Obara, Haruhisa Hoshi, Kazuhito Totsune, Toshinobu Sato, Yoshio Taguma, Hiroshi Sato, Yutaka Imai, Takayoshi Ohkubo

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)

Abstract

OBJECTIVE:: Ambulatory blood pressure (BP) is reportedly associated with target organ damage. However, whether ambulatory BP carries prognostic significance for the development of chronic kidney disease (CKD) has not been confirmed. METHOD:: We measured ambulatory BP in 843 participants without CKD at baseline from a general Japanese population and examined the incidence of CKD defined as positive proteinuria or an estimated glomerular filtration rate (eGFR) less than 60âŠml/min per 1.73 m at health checks. The association between baseline ambulatory BP and CKD incidence was examined using the Cox proportional hazard regression model adjusted for sex, age, BMI, habitual smoking, habitual alcohol consumption, diabetes mellitus, hypercholesterolemia, a history of cardiovascular disease, antihypertensive medication, eGFR at baseline, the number of follow-up examinations, and the year of the baseline examination. RESULTS:: The mean age of the participants averaged 62.9⊱â̌8.1 years, 71.3% were women and 23.7% were under antihypertensive medication. During a median follow-up of 8.3 years, 220 participants developed CKD events. The adjusted hazard ratios for CKD in a 1-standard deviation increase in daytime and night-time SBP were 1.13 [95% confidence interval (CI) 0.97-1.30] and 1.21 (95% CI 1.04-1.39), respectively. When night-time and daytime BP was mutually adjusted into the same model, only night-time BP persisted as an independent predictor of CKD. CONCLUSION:: Night-time BP is a better predictor of CKD development than daytime BP in the general population. Ambulatory BP measurement is considered useful for evaluating the risk of progression to CKD.

Original languageEnglish
Pages (from-to)2410-2417
Number of pages8
JournalJournal of hypertension
Volume31
Issue number12
DOIs
Publication statusPublished - 2013 Dec

Keywords

  • ambulatory blood pressure measurement
  • chronic kidney disease
  • dipping status
  • hypertension
  • nighttime blood pressure

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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