Cumulative hypertension burden and risk of end-stage renal disease

Hypertension is the leading risk factor for end-stage renal disease (ESRD). However, the association between sustained exposure to increased blood pressure (BP) and ESRD is not well established. This study investigated whether the cumulative hypertension burden is a substantial risk factor for ESRD....

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Bibliographic Details
Published in:Hypertension research 2021-12, Vol.44 (12), p.1652-1661
Main Authors: Kim, Chang Seong, Kim, Bongseong, Choi, Hong Sang, Bae, Eun Hui, Ma, Seong Kwon, Han, Kyung-Do, Kim, Soo Wan
Format: Article
Language:English
Subjects:
Blood Pressure
Epidemiology
Health risks
Humans
Hypertension
Hypertension - epidemiology
Incidence
Kidney diseases
Kidney Failure, Chronic - epidemiology
Pathogenesis
Risk Factors
Systole
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Summary:Hypertension is the leading risk factor for end-stage renal disease (ESRD). However, the association between sustained exposure to increased blood pressure (BP) and ESRD is not well established. This study investigated whether the cumulative hypertension burden is a substantial risk factor for ESRD. The incidence of ESRD among 2,144,801 participants identified from the Korean National Health Insurance Service database who had documented BP assessment data in their annual health check-up data from between 2006 and 2010, was determined. Over a median follow-up of 7.2 years, ESRD was identified in 1758 participants. Hypertension burden was defined as the cumulative exposure to hypertension (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) during four consecutive follow-up periods and ranged from 0 to 4. The hypertension burden was as follows: 0 (n = 1,164,488), 77.6%; 1 (n = 292,377), 13.6%; 2 (n = 114,397), 5.3%; 3 (n = 52,671), 2.5%; and 4 (n = 20,886), 1.0%. Compared to the hypertension burden of 0, the adjusted hazard ratio for ESRD was 1.35, 1.54, 1.51, and 2.28 for hypertension burdens of 1, 2, 3, and 4, respectively. A positive dose-dependent relationship between hypertension burden and ESRD was found (P for interaction 
ISSN:0916-9636
1348-4214
DOI:10.1038/s41440-021-00723-0