Lu Xi, Chen Dawei, Kang Long, Sun Linsu, Xie Xinlan, Tan Xinyi, Meng Yuanyuan, Lei Fang, Sun Tao, Chen Junxin
State Key Laboratory of New Drug Discovery and Development for Major Diseases, Gannan Medical University, Ganzhou, China.
Department of Cardiology, Qichun Central Hospital, Huanggang, China.
Kidney360. 2025 Aug 8. doi: 10.34067/KID.0000000872.
The onset age of hypertension has decreased significantly due to lifestyle changes over the years. However, the link between hypertension onset age and subsequent incidence of chronic kidney disease (CKD) remains unclear.
Individual-level data were obtained from the UK Biobank. Information on the diagnosis of hypertension and CKD was collected at baseline and follow-up. The propensity score matching method and Cox proportional hazards models were used to evaluate the relationship between different hypertension morbidity ages and the incidence of CKD.
A total of 485,101 participants without CKD at baseline were included in this analysis (women, 265,343 [54.70%]). Among the 186,880 participants with hypertension, the multivariable-adjusted hazard ratio (HR) for developing CKD was 1.117 (95% CI: 1.102-1.132) for each 10-year decrease in age at the onset of hypertension. After applying propensity score matching, the risk of CKD in hypertensive patients was significantly higher compared to those without hypertension across all age groups. Additionally, the hazard ratios tended to increase with a decrease in age at the onset of hypertension. Subgroup analysis showed that participants with cardiovascular disease (CVD) at baseline increased the adverse effect of hypertension on CKD in younger participants.
Our research indicated that the younger the age at hypertension diagnosis, the greater the risk of developing CKD. Individuals who experience the onset of hypertension before the age of 45 may constitute a high-risk CKD subpopulation, highlighting the need for vigilant monitoring and early intervention.
由于多年来生活方式的改变，高血压的发病年龄已显著降低。然而，高血压发病年龄与随后慢性肾脏病（CKD）发病率之间的联系仍不清楚。
从英国生物银行获取个体水平的数据。在基线和随访时收集高血压和CKD的诊断信息。采用倾向评分匹配法和Cox比例风险模型评估不同高血压发病年龄与CKD发病率之间的关系。
本分析纳入了485101名基线时无CKD的参与者（女性265343名[54.70%]）。在186880名高血压参与者中，高血压发病年龄每降低10岁，发生CKD的多变量调整风险比（HR）为1.117（95%CI：1.102-1.132）。应用倾向评分匹配后，各年龄组高血压患者发生CKD的风险均显著高于非高血压患者。此外，风险比往往随着高血压发病年龄的降低而增加。亚组分析显示，基线时有心血管疾病（CVD）的参与者增加了高血压对年轻参与者CKD的不良影响。
我们的研究表明，高血压诊断时年龄越小，发生CKD的风险越高。45岁之前发生高血压的个体可能构成CKD的高危亚人群，这突出了进行密切监测和早期干预的必要性。
