Abstract MP70: The Association of Kidney Function and Damage with Incident Hypertension: The Atherosclerosis Risk in Communities (ARIC) Study
Introduction: Several studies have found that albuminuria, a marker of kidney damage, predicts incident hypertension. In contrast, conflicting results have been observed for measures of kidney function such as estimated glomerular filtration rate (eGFR). Of note, only a few studies have simultaneously investigated these two kidney measures in this context, leaving further uncertainties regarding respective contribution of kidney function and damage in the development of hypertension.
Methods: We studied 4,927 ARIC Study participants without hypertension (blood pressure ≥140/90 mmHg or use of antihypertensive medications) and history of cardiac disease at baseline (1996-98). Incident hypertension was defined as self-reported medication use for hypertension via annual follow-up phone calls. We primarily assessed GFR estimated by the best available equation published in 2012 using serum creatinine and cystatin C (CKD-EPI eGFRcre+cys) and albuminuria quantified by urine albumin:creatinine ratio (UACR). We also investigated two novel kidney function markers, β-trace protein (BTP) and β2-microglobulin (B2M), to evaluate the robustness of our findings. Cox proportional hazards models were used to estimate hazard ratios (HRs) of incident hypertension by quintiles of these kidney measures.
Results: A total of 2,455 cases of incident hypertension developed during a median follow-up of 10.5 years (incidence rate 56/1,000 person-years). A significantly elevated HR of incident hypertension was observed for the top quintile compared to the bottom quintile for UACR (≥7.0 mg/g) but not for eGFRcre+cys, BTP, or B2M (Table). Similar results were observed even when the top quintile of kidney function measures was subdivided into three groups.
Conclusion: Elevated albuminuria, but not kidney function measures, was significantly associated with incident hypertension, suggesting that kidney damage is more involved in the development of hypertension than reduced overall filtration function.
- © 2013 by American Heart Association, Inc.