Elevated pulse pressure and risk of chronic kidney disease by hypertension status: A longitudinal study in Japanese adults
Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
Background and Aims
Little is known about the relationship between pulse pressure (PP) and incident chronic kidney disease (CKD) in Asian populations, particularly when analyzed separately by hypertension status. This study aims to assess the association between PP and the subsequent incidence of CKD in Japanese adults.
Methods
This longitudinal study included middle-aged and older Japanese citizens screened by the administrative checkup (1998–2024) conducted by Zentsuji City. The relationship between PP (subtracting diastolic blood pressure [BP] from systolic BP) and incident CKD (estimated filtration rate of <60 mL/min/1.73m 2 ) was evaluated by hypertension status, using the Weibull accelerated failure time model. PP was treated as time-varying, and categorized into <40 (reference), 40–<60, and ≥60 mmHg. In addition to the crude model, two adjusted models were performed, controlling for potential confounders.
Results
Of 15788 participants, 8881 (men: 42.7%) remained in this study. The mean follow-up time was 6.21 years for non-hypertension and 6.27 years for hypertension. The higher the PP, the higher the incidence rate regardless of prevalent hypertension. In non-hypertensive participants with PP ≥60 mmHg, a 10% shorter survival to CKD (95% confidence interval: 3%–16%) was observed, compared to PP <40 mmHg. In hypertensive participants, attenuated results were observed, with all 95% confidence intervals crossing the null value.
Conclusions
Higher PP may serve as a handy indicator for the development of CKD in non-hypertensive Japanese populations. Regular BP monitoring may assist in considering strategies for the public health prevention of CKD, especially for non-hypertensive Asian populations.
