Associations of proteinuria and the estimated glomerular filtration rate with incident hypertension in young to middle-aged Japanese males

Prev Med. 2014 Mar:60:48-54. doi: 10.1016/j.ypmed.2013.12.009. Epub 2013 Dec 14.

Abstract

Objective: To investigate the independent associations of proteinuria and the estimated glomerular filtration rate (eGFR) with incident hypertension.

Methods: We investigated 29,181 Japanese males 18-59years old without hypertension in 2000 and examined whether proteinuria and the eGFR predicted incident hypertension independently over 10years. Incident hypertension was defined as a newly detected blood pressure of ≥140/90mmHg and/or the initiation of antihypertensive drugs. Proteinuria and the eGFR were categorized as dipstick negative (reference), trace or ≥1+ and ≥60 (reference), 50-59.9 or <50ml/min/1.73m(2), respectively. Cox proportional hazards models were used to estimate the hazard ratios (HRs) of incident hypertension.

Results: At baseline, 236 (0.8%) and 477 (1.6%) participants had trace and ≥1+ dipstick proteinuria, while 1416 (4.9%) and 129 (0.4%) participants had an eGFR of 50-59.9 and <50ml/min/1.73m(2), respectively. The adjusted HRs were significant for proteinuria ≥1+ (HRs 1.20, 95% CI: 1.06-1.35) and an eGFR of <50ml/min/1.73m(2) (1.29, 1.03-1.61). When two non-referent categories were combined (dipstick≥trace vs. negative and eGFR<60 vs. ≥60ml/min/1.73m(2)), the association was more significant for proteinuria (1.15, 1.04-1.27) than for eGFR (0.99, 0.92-1.07).

Conclusions: Proteinuria and a reduced eGFR are independently associated with future hypertension in young to middle-aged Japanese males.

Keywords: Dipstick proteinuria; Hypertension; Japanese males; Prospective cohort; eGFR.

MeSH terms

  • Adolescent
  • Adult
  • Antihypertensive Agents / therapeutic use
  • Body Mass Index
  • Cardiovascular Diseases / epidemiology
  • Cohort Studies
  • Follow-Up Studies
  • Glomerular Filtration Rate*
  • Humans
  • Hypertension / drug therapy
  • Hypertension / epidemiology*
  • Japan / epidemiology
  • Kaplan-Meier Estimate
  • Kidney Diseases / diagnosis
  • Kidney Diseases / urine
  • Male
  • Middle Aged
  • Occupational Health Services / statistics & numerical data
  • Physical Examination
  • Proportional Hazards Models
  • Prospective Studies
  • Proteinuria / diagnosis
  • Proteinuria / epidemiology*
  • Proteinuria / urine
  • Reagent Strips
  • Smoking / epidemiology
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Antihypertensive Agents
  • Reagent Strips