Abstract 13239: The Association of Novel Kidney Filtration Markers With Incident Hypertension: The Atherosclerosis Risk in Communities (ARIC) Study
Introduction: Several studies have reported that albuminuria predicts incidence of hypertension. In contrast, conflicting results have been observed regarding the association of kidney filtration markers, such as serum creatinine and cystatin C, with incident hypertension. Novel kidney filtration markers β-trace protein (BTP) and β2-microglobulin (B2M) reflect kidney dysfunction better than serum creatinine and thus may predict well the incidence of hypertension.
Hypothesis: Elevated levels of BTP and B2M are associated with incident hypertension.
Methods: We studied 4,577 participants of the ARIC Study who did not have hypertension at baseline (1996-98), defined as blood pressure ≥140/90 mmHg or self-reported medications for hypertension, and did not have a history of cardiac disease. Incident hypertension was defined as self-reported medication use for hypertension via annual phone calls. We estimated hazard ratios (HRs) of incident hypertension by quintiles of BTP, B2M and urine albumin:creatinine ratio (UACR).
Results: Participants who were excluded due to prevalent hypertension at baseline had higher serum BTP and B2M levels and higher albuminuria compared with those who were included in this analysis. A total of 1,737 cases of incident hypertension developed during a median follow-up of 9.9 years (incidence rate 45/1,000 person-years). Significantly elevated HRs of incident hypertension were observed in top three quintiles of UACR (≥2.6 mg/g) (Table). In contrast, no categories of BTP or B2M had significantly increased HR. Similarly, quintiles of serum creatinine, cystatin C, or estimated glomerular filtration rate were not associated with incident hypertension.
Conclusion: Elevated albuminuria, but not BTP and B2M, was significantly associated with incident hypertension, suggesting that kidney damage resulting in albuminuria is more involved in the development of hypertension than reduced overall filtration rate.
- © 2011 by American Heart Association, Inc.