Division of Cardiovascular and Rare Diseases, Center for Biomedical Science, National Institute of Health, Chungbuk, South Korea.
BMC Public Health. 2012 Nov 9;12:960. doi: 10.1186/1471-2458-12-960.
Elevated blood pressure (BP) is a major risk factor for the progression of chronic kidney disease (CKD). However, little is known about the influence of prehypertension on CKD. In this study, we investigated the relationship between prehypertension and CKD in a middle-aged Korean population. Furthermore, we prospectively evaluated the effect of active BP control on deterioration of kidney function during the two-year follow-up.
The Korean Genome and Epidemiology Study is a community-based prospective cohort study started in 2001, with a follow-up survey conducted every two years. A total of 9509 participants aged 40-69 years were included in a baseline study. BP was classified according to the Seventh Report of the Joint National Committee on High BP (JNC-7) categories and CKD was defined as the presence of proteinuria or eGFR< 60mL/min/1.73m(2). A multivariable logistic regression model was used to identify associations between BP and CKD.
The overall prevalence of CKD was 13.2%, and significantly increased with BP level. The multivariable-adjusted odds ratio of CKD was 1.59 for prehypertension and 2.27 for hypertension, compared with a normal BP. At the two-year follow-up, among the participants with prehypertension, subjects whose BP was poorly controlled had a significantly higher risk of eGFR drop (OR, 1.37; 95% CI, 1.13-1.67), as compared to controls. The prevalence of eGFR drop was 57.8% in the controlled BP group and 66.0% in the poorly-controlled BP group.
Prehypertension, as well as hypertension, is significantly associated with CKD among middle-aged Koreans. Our results indicate that active control of the blood-pressure of prehypertensive individuals is needed to prevent deterioration of kidney function.
高血压是慢性肾脏病（CKD）进展的主要危险因素。然而，对于轻度高血压对 CKD 的影响知之甚少。在这项研究中，我们调查了中年韩国人群中轻度高血压与 CKD 之间的关系。此外，我们前瞻性评估了在两年随访期间积极控制血压对肾功能恶化的影响。
韩国基因与流行病学研究是一项基于社区的前瞻性队列研究，于 2001 年启动，每两年进行一次随访调查。共有 9509 名年龄在 40-69 岁的参与者参加了基线研究。根据第七次联合国家委员会高血压报告（JNC-7）分类标准对血压进行分类，将 CKD 定义为蛋白尿或 eGFR<60mL/min/1.73m(2)。使用多变量逻辑回归模型来确定血压与 CKD 之间的关联。
CKD 的总体患病率为 13.2%，且随血压水平显著升高。与正常血压相比，轻度高血压和高血压患者的 CKD 多变量调整比值比分别为 1.59 和 2.27。在两年随访期间，在轻度高血压患者中，血压控制不佳的患者 eGFR 下降的风险显著更高（OR，1.37；95%CI，1.13-1.67），与对照组相比。血压控制良好组的 eGFR 下降率为 57.8%，血压控制不佳组为 66.0%。
轻度高血压以及高血压与中年韩国人群的 CKD 显著相关。我们的研究结果表明，需要积极控制轻度高血压患者的血压，以防止肾功能恶化。
