Ethnic differences in the association between blood pressure components and chronic kidney disease in middle aged and older Asian adults

Abstract

BackgroundChronic kidney disease (CKD) is an emerging public health problem worldwide. Previous studies have shown an association between blood pressure (BP) and CKD. However, it is not clear if there are ethnic differences in this association. We examined the association between BP and CKD in a multi-ethnic Asian population in Singapore.MethodsWe analysed data from three large population-based studies conducted between 2004–2011, (n=3,167 Chinese, 3,082 Malays and 3,228 Indians) aged 40–80 years. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73m2 from serum creatinine. Hypertension was defined as a self-reported current use of antihypertensive medication or systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg. We also analysed the association of CKD with individual BP components.ResultsThe prevalence of both hypertension and CKD was higher among Malays (68.6, 21%) compared to Chinese (57.9, 5.9%) and Indians (56.0, 7.4%), but treatment for hypertension was lower among Malays (53.4%) compared to Chinese (89.8%) and Indians (83.1%). Hypertension was associated with CKD in all three ethnic groups (OR [95% CI] = 2.71 [1.59-4.63], 2.08 [1.62-2.68], 2.43 [1.66-3.57] in Chinese, Malays and Indians). Among the BP components, both systolic and diastolic BP were associated with CKD in Malays whereas, systolic BP was not significantly associated with CKD, and diastolic BP showed an inverse association which was explained by anti-hypertensive medication use in Chinese and Indians.ConclusionsHypertension was associated with CKD in Chinese, Malays and Indians. However, the BP components were associated with CKD only in Malays.

Retinal Vascular Imaging Markers and Incident Chronic Kidney Disease: A Prospective Cohort Study

“…Glomerular filtration rate was estimated from serum creatinine using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation 46 . Serum creatinine was measured using an enzymatic method calibrated to the National Institute of Standards and Technology (NIST) Liquid Chromatography Isotope Dilution Mass Spectrometry (LC-IDMS) method recommended by the National Kidney Disease Education Program and traceable to NIST SRM967 47 .…”

Hypertension, blood pressure control and diabetic retinopathy in a large population-based study

“…BP was measured with digital automatic BP monitor (Dinamap model Pro Series DP110X-RW, 100V2; GE Medical Systems Information Technologies, Inc., Milwaukee, WI) applied to the right arm of a seated participant after five-minute rest. Two BP measurements were taken 5 minutes apart, and if the two BP measurements differed by more than 10 mm systolic and 5 mm diastolic, a third measurement was taken and the average of two closest readings were taken as the BP value [22]. PP was calculated as the difference between SBP and DBP (SBP-DBP).…”

Impact of pharmacist‐led education sessions on the knowledge and practice of calcium carbonate administration among Malaysian chronic kidney disease patients

“…In regards to ethnicity, we found a higher prevalence of CKD in Malays, followed by Chinese and Indians. The pattern of distribution followed a Singaporean cohort study reporting a higher prevalence of CKD in Malays versus other ethnicities . The reasons for this finding are due to a higher prevalence of hypertension, overweight/obesity, smoking and lower levels of glomerular filtration rate among Malay CKD patients .…”

“…The pattern of distribution followed a Singaporean cohort study reporting a higher prevalence of CKD in Malays versus other ethnicities. 22 The reasons for this finding are due to a higher prevalence of hypertension, overweight/obesity, smoking and lower levels of glomerular filtration rate among Malay CKD patients. 22 Another study examining the effect of education and prevalence of CKD in the United States and Netherlands found a strong association between a lower education level and a higher prevalence of CKD.…”

“…22 The reasons for this finding are due to a higher prevalence of hypertension, overweight/obesity, smoking and lower levels of glomerular filtration rate among Malay CKD patients. 22 Another study examining the effect of education and prevalence of CKD in the United States and Netherlands found a strong association between a lower education level and a higher prevalence of CKD. 23 Our study results also showed almost 91% of our CKD patients have only either primary or secondary education.…”