|Urinary albumin excretion, blood pressure changes and hypertension incidence in the community: effect modification by kidney function|
|Xu, Hong1,2,3; Huang, Xiaoyan1,2,4; Riserus, Ulf5; Cederholm, Tommy5; Lindholm, Bengt1,2; Arnlov, Johan6,7; Carrero, Juan Jesus1,2,8,9|
|关键词||Albuminuria Ambulatory Blood Pressure Monitoring Chronic Kidney Disease Hypertension Urinary Albumin Excretion|
|刊名||NEPHROLOGY DIALYSIS TRANSPLANTATION|
|WOS标题词||Science & Technology|
|类目[WOS]||Transplantation ; Urology & Nephrology|
|研究领域[WOS]||Transplantation ; Urology & Nephrology|
|关键词[WOS]||GLOMERULAR-FILTRATION-RATE ; LOW-GRADE ALBUMINURIA ; ALL-CAUSE MORTALITY ; CARDIOVASCULAR-DISEASE ; GENERAL-POPULATION ; SYSTOLIC HYPERTENSION ; VASCULAR DYSFUNCTION ; PROXIMAL TUBULE ; CYSTATIN-C ; MICROALBUMINURIA|
Both increased albuminuria and reduced kidney function may predict blood pressure (BP) progression in the community, while they exacerbate each other′s effects. We investigated associations and interactions between these two risk factors, BP changes and hypertension incidence in community-dwelling elderly men.
Observational study from the Uppsala Longitudinal Study of Adult Men, which included 1051 men (all aged 71 years) with assessments on urinary albumin excretion rate (UAER), 24-hour ambulatory BP monitoring (ABPM) and cystatin-C estimated glomerular filtration rate (eGFR). Of these, 574 men attended re-examination after 6 years, and ABPM measurements were again recorded to assess blood pressure changes and hypertension incidence.
UAER was found to be associated with ABPM measurements both at baseline and longitudinally. In longitudinal analysis, there were significant interactions between UAER and kidney function in its association with the changes of systolic BP, mean arterial pressure and pulse pressure. After stratification for renal function state, UAER independently predicted BP changes only in those who had eGFR < 60 mL/min/1.73 m(2). At re-examination, 71 new cases of hypertension were recorded. In multivariable logistic models, similar interactions were observed on hypertension incidence: UAER was an independent predictor of incident hypertension only in those with reduced renal function. These associations were evident also in the subpopulation of non-diabetics and in participants with normal range UAER (< 20 A mu g/min).
In community-dwelling elderly men, UAER associates with BP progression and hypertension incidence, even within the normal range. Concurrent reduction of renal function modifies and exacerbates these associations.
|作者单位||1.Karolinska Inst, Ctr Gender Med, Stockholm, Sweden|
2.Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden
3.Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden
4.Karolinska Inst, Ctr Mol Med, Stockholm, Sweden
5.Karolinska Inst, Div Renal Med, Dept Clin Sci Intervent & Technol, Stockholm, Sweden
6.Karolinska Inst, Div Baxter Novum, Dept Clin Sci Intervent & Technol, Stockholm, Sweden
7.Chinese Acad Med Sci, Dept Nephrol, Peking Union Med Coll Hosp, Beijing 100730, Peoples R China
8.Peking Univ, Div Nephrol, Shenzhen Hosp, Shenzhen, Peoples R China
9.Uppsala Univ, Sect Geriatr, Dept Publ Hlth & Caring Sci, Uppsala, Sweden
|Xu, Hong,Huang, Xiaoyan,Riserus, Ulf,et al. Urinary albumin excretion, blood pressure changes and hypertension incidence in the community: effect modification by kidney function[J]. NEPHROLOGY DIALYSIS TRANSPLANTATION,2014,29(8):1538-1545.|
|APA||Xu, Hong.,Huang, Xiaoyan.,Riserus, Ulf.,Cederholm, Tommy.,Lindholm, Bengt.,...&Carrero, Juan Jesus.(2014).Urinary albumin excretion, blood pressure changes and hypertension incidence in the community: effect modification by kidney function.NEPHROLOGY DIALYSIS TRANSPLANTATION,29(8),1538-1545.|
|MLA||Xu, Hong,et al."Urinary albumin excretion, blood pressure changes and hypertension incidence in the community: effect modification by kidney function".NEPHROLOGY DIALYSIS TRANSPLANTATION 29.8(2014):1538-1545.|