Blood Pressure Predicts Risk of Developing End‐Stage Renal Disease in Men and Women

Abstract— Blood pressure as a risk factor for development of end‐stage renal disease has not been fully studied, particularly in women. We studied the development of end‐stage renal disease from 1983 through 2000 in 98 759 subjects, 46 881 men and 51 878 women, 20 to 98 years of age, who were screened in 1983 in Okinawa, Japan. Data for all dialysis patients registered from 1983 to 2000 in Okinawa were used to identify the screened subjects in whom end‐stage renal disease developed. In follow‐up, 400 subjects, 231 men and 169 women, had end‐stage renal disease. Age, body mass index, and adjusted relative risk for systolic and diastolic blood pressure for both men and women were measured. When these results were compared with an optimal blood pressure, the relative risk of development of end‐stage renal disease for those with high‐normal blood pressure and hypertension were significant in both men and women. Hypertension is a significant risk factor for development of end‐stage renal disease not only in men but also in women. Control of blood pressure within normal levels should be stressed as a strategy to prevent end‐stage renal disease in both men and women.

[1]  J. Miller,et al.  Early predictors of 15-year end-stage renal disease in hypertensive patients. , 1995, Hypertension.

[2]  K. Iseki,et al.  Demographic trends in the Okinawa Dialysis Study (OKIDS) registry (1971-2000). , 2002, Kidney international.

[3]  Guidelines for the management of hypertension for general practitioners. , 2001, Hypertension research : official journal of the Japanese Society of Hypertension.

[4]  P. Metcalf,et al.  Albuminuria in people at least 40 years old: effect of alcohol consumption, regular exercise, and cigarette smoking. , 1993, Clinical chemistry.

[5]  M Ishii,et al.  [The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, and 1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension]. , 2000, Nihon rinsho. Japanese journal of clinical medicine.

[6]  S. Rosansky,et al.  The association of blood pressure levels and change in renal function in hypertensive and nonhypertensive subjects. , 1990, Archives of internal medicine.

[7]  P. Metcalf,et al.  Albuminuria in people at least 40 years old: effect of obesity, hypertension, and hyperlipidemia. , 1992, Clinical chemistry.

[8]  Detection.  The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) , 1997 .

[9]  Tom Greene,et al.  Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. , 2002, JAMA.

[10]  K. Iseki,et al.  Blood pressure and risk of end-stage renal disease in a screened cohort. , 1996, Kidney international. Supplement.

[11]  C. Iseki,et al.  Multiple risk factor clustering of hypertension in a screened cohort , 2000, Journal of hypertension.

[12]  M. Moser.  A critique of the world health organization-international society of hypertension guidelines for the management of hypertension , 1999 .

[13]  B. Kasiske,et al.  Renal disease in patients with massive obesity. , 1986, Archives of internal medicine.

[14]  D. Marcelli,et al.  Proteinuria and blood pressure as causal components of progression to end-stage renal failure. Northern Italian Cooperative Study Group. , 1996, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[15]  K. Iseki,et al.  Influence of smoking and obesity on the development of proteinuria. , 2002, Kidney international.

[16]  K. Iseki,et al.  Analysis of drug prescription in chronic haemodialysis patients. , 2002, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[17]  K. Iseki,et al.  Risk of developing end-stage renal disease in a cohort of mass screening. , 1996, Kidney international.

[18]  K. Iseki,et al.  Predictors of end-stage renal disease and body mass index in a screened cohort. , 1997, Kidney international. Supplement.

[19]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, JAMA.

[20]  P. Whelton,et al.  Blood pressure and end-stage renal disease in men. , 1996, The New England journal of medicine.

[21]  K. Iseki,et al.  Pulse pressure and risk of total mortality and cardiovascular events in patients on chronic hemodialysis. , 2002, Kidney international.

[22]  S. Bigler,et al.  Functional and structural changes in the kidney in the early stages of obesity. , 2001, Journal of the American Society of Nephrology : JASN.

[23]  K. Iseki,et al.  Comparison of the effect of blood pressure on the development of stroke, acute myocardial infarction, and end-stage renal disease. , 2000, Hypertension research : official journal of the Japanese Society of Hypertension.