High-normal blood pressure is associated with microalbuminuria in the general population: the Watari study

Abstract

Microalbuminuria, for which hypertension and diabetes are well-known risk factors, has recently been used to detect individuals at risk for cardiovascular and chronic kidney diseases in the general population. We aimed to determine the thresholds of blood pressure or blood glucose concentration at which the odds ratio of having microalbuminuria begins to increase. An annual public health checkup was conducted on 3166 participants aged 29-84 years (mean, 61 ± 11 years; 40% men) living in Watari town, Japan. We studied their demographic data, medical history of hypertension, diabetes, dyslipidemia, sitting blood pressure and fasting blood samples. Urinary albumin excretion was examined in terms of the albumin/creatinine ratio in spot urine samples. Microalbuminuria was defined as 30-299 mg albumin per gram creatinine. Final analyses included 2133 participants under no anti-hypertensive or anti-diabetic medication. Microalbuminuria was detected in 118 subjects (5.5%). We used the adjusted odds ratios for microalbuminuria in different blood pressure and blood glucose groupings as the reference. The adjusted odds ratio increased linearly with increase in systolic blood pressure. A similar trend, although not as linear, was observed with diastolic blood pressure. The odds ratio increased significantly with high-normal levels of both systolic and diastolic blood pressure. For blood glucose, the adjusted odds ratio increased significantly from the impaired fasting glucose level. Therefore, the odds ratio for microalbuminuria begins to increase from high-normal blood pressure and impaired fasting glucose levels in comparison with the reference. Early intervention in such cases may be useful for reducing cardiovascular and renal risks.

High-normal diastolic blood pressure is a risk for development of microalbuminuria in the general population

“…In a recent cross-sectional study of the general population using the same cohort as used in the present study [13], we reported that compared to optimal blood pressures, high-normal blood pressures are associated with significantly increased odds ratios (ORs) for the prevalence of microalbuminuria. The causal relationship remained uncertain because of the cross-sectional design of that study.…”

“…Fasting blood sugar levels were determined using a Hitachi 7700P apparatus (Hitachi, Tokyo, Japan). The remaining biochemical markers were determined using a standard automatic analyzer (7700DD; Hitachi) [13]. The estimated glomerular filtration ratio (eGFR) was calculated using the formula provided by the Japanese Society of Nephrology [14]: eGFR (ml/min per 1.73 m 2 ) ¼ 194 Â creatinine À1.094 Â age À0.287 Â (0.739 if female).…”

<p>An Observational Registry to Assess Urinary Albumin Evolution in Saudi Hypertensive Patients with the Current Treatment Local algorithm: Results of the RATIONAL Study</p>

“…25 The RATIONAL study tackled hypertension management and diabetes in patients with kidney damage in KSA, given the tight reciprocal influence between these conditions. 25,26 It aimed at identifying patterns of pharmacological management of hypertension and its modulation of microalbuminuria evolution over 1 year, by determining the correlation between the beneficial effect of BP control and ACR levels in hypertensive patients in general and with diabetes in particular. About three-quarters of the study patients were males, matching worldwide hypertension prevalence among the male gender; 27 80% of study patients had diabetes and best represented the overall study population.…”

Skill Underutilization is Associated with Higher Prevalence of Hypertension: The Watari Study

“…This study was conducted as a part of the Watari study, a community-based cohort study aimed at examining the association between qualitative and quantitative job stress and cardiovascular diseases. Detailed descriptions of the study have been provided previously 8,9) . The study protocol was approved by the ethics committee of Tohoku Rosai Hospital, and all the participants provided written informed consent.…”

“…Detailed descriptions of the study have been provided previously 8,9) . The study protocol was approved by the ethics committee of Tohoku Rosai Hospital, and all the participants provided written informed consent.…”