Knight Eric L, Kramer Holly M, Curhan Gary C
Renal Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Am J Kidney Dis. 2003 Mar;41(3):588-95. doi: 10.1053/ajkd.2003.50120.
High-normal blood pressure (BP) is associated with increased cardiovascular risk compared with optimal BP, but no study has specifically examined the association between high-normal BP and microalbuminuria, an established predictor of future cardiovascular events.
This was a cross-sectional study of normotensive (systolic BP [SBP] < 140 mm Hg, diastolic BP [DBP] < 90 mm Hg) individuals without diabetes with no hypertension history enrolled in the Third National Health and Nutrition Examination Survey. BP was categorized as high normal (SBP, 130 to 139 mm Hg or DBP, 85 to 89 mm Hg), normal (SBP, 120 to 129 mm Hg or DBP, 80 to 84 mm Hg), and optimal (SBP < 120 mm Hg and DBP < 80 mm Hg). We also separately examined SBP, DBP, mean arterial pressure (MAP), and pulse pressure. Microalbuminuria was defined using sex-specific cutoff values (urine albumin-creatinine ratio > or = 17 and < or = 250 microg/mg [> or =1.0 and < or =28 mg/mmol] for men and > or = 25 and < or = 355 microg/mg for women [> or =3 and < or =40 mg/mmol]). We used multivariate logistic regression to analyze the association between different BP measurements and microalbuminuria.
Compared with optimal BP, high-normal BP was significantly associated with increased odds of microalbuminuria (odds ratio [OR], 2.13; 95% confidence interval [CI], 1.51 to 3.01). Similarly, MAP (OR, 1.41; 95% CI, 1.15 to 1.74 per 10-mm Hg increment), SBP (OR, 1.27; 95% CI, 1.09 to 1.48 per 10-mm Hg increment), and DBP (OR, 1.29; 95% CI, 1.06 to 1.57 per 10-mm Hg increment) were significantly associated with microalbuminuria.
High-normal BP is significantly associated with microalbuminuria compared with optimal BP and may be a biomarker of the increased cardiovascular risk observed in this population.
与最佳血压相比，血压正常高值与心血管风险增加相关，但尚无研究专门探讨血压正常高值与微量白蛋白尿之间的关联，而微量白蛋白尿是未来心血管事件的既定预测指标。
这是一项对参加第三次全国健康与营养检查调查的无糖尿病且无高血压病史的血压正常（收缩压[SBP]<140 mmHg，舒张压[DBP]<90 mmHg）个体进行的横断面研究。血压分为正常高值（SBP 130至139 mmHg或DBP 85至89 mmHg）、正常（SBP 120至129 mmHg或DBP 80至84 mmHg）和最佳（SBP<120 mmHg且DBP<80 mmHg）。我们还分别检查了SBP、DBP、平均动脉压（MAP）和脉压。微量白蛋白尿采用性别特异性临界值定义（男性尿白蛋白肌酐比值≥17且≤250 μg/mg[≥1.0且≤28 mg/mmol]，女性≥25且≤355 μg/mg[≥3且≤40 mg/mmol]）。我们使用多因素逻辑回归分析不同血压测量值与微量白蛋白尿之间的关联。
与最佳血压相比，血压正常高值与微量白蛋白尿几率增加显著相关（比值比[OR]为2.13；95%置信区间[CI]为1.51至3.01）。同样，MAP（每增加10 mmHg，OR为1.41；95%CI为1.15至1.74）、SBP（每增加10 mmHg，OR为1.27；95%CI为1.09至1.48）和DBP（每增加10 mmHg，OR为1.29；95%CI为1.06至1.57）与微量白蛋白尿显著相关。
与最佳血压相比，血压正常高值与微量白蛋白尿显著相关，可能是该人群心血管风险增加的生物标志物。
